HomeMy WebLinkAbout06030037 Application
City of Carmel/Clay Township Permit #: O(d()3()037
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
NAME
PI rI N Ac.1...E COr{<;;tTlII CIION
PHONE
-1\"2....5"2..' .91"'5""
FAX
,1"2.S21-Qn.8
STllEET ADDRESS CITY STATE ZIP
'Z"'2.oE,c 'SC:l\J.1-\ \-\\G\NA'f ~ G.LEHW~o,::r:A . S'1S":d
BUILDER'S EMAIL ADDRESS
Mol'\+ D e.. PI r\ c..or\stV"',c.o^,-
BEST METHOD OF CONTACT:
~o,.l~ on G:dV'lAII..
PROPERTY
OWNER:
PHONE
n .'2.61-11
CITY
I rfDIMAf-l:\US
TYPE OF CONSTR~~:A.SE TYPE OF IMPROVEMENT:
. COMMERClASUbieC( t D FOR CONSNfiti ~CTURE
(p"vatelyownednosplta~ Compliance wht\, AotmWlJ/ON
and med'~oJ!!~es/celile.state l"d I cl71II1t1lN.Q~tm
are commldilltPT OF CO c" .QCal COd~ Porch
o IN~OE: IV1r'1UN~- ~tO:,~~a",neorDeck
o MuriitiJfaIft'\JDIi~MC-L I C 'REMb'ri~ES
o School' "- "~dilNISH
o Church lND1ANAD ACCESSOltV7MfLDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
. SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT G:J:::CELt::rq\V~p:~O'L?:~TE
(or POST & PIER) WALKOLIT: Y N D,"DEI'!.0,LlTi9N!'.; u ." 'I',',:
- - \ I~-.---.__._.-...--_.-- -]11 I \i
Class I structure permits are subject to the Generai ~~strative Rules of the State o'f:fudi~a (See 675 lAC 12) regarding expiration time frames for
11 n~~&N1d compl~g:cons~ctio~.
I, the undersigned, agree that any construction, reconstructia~,~enlarMAtht, re:lotatili'n'~ot alterntiori o~ a structure, or any change in the use of land or structures
requested by this application will comply with, and confci~ t6~ ~ll applicable laws of the State of !~gja'na, and the "Zoning Ordinance of Cannel Indiana - 1993" (?>
289) and amendments, adopted under authority of I.c. 36-iet sefl.,Q~Il~rnl,Assemb1y,afthe Statel of Indi~a, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanit~ry sewer. I further certify that the construc~on will not be used or occupied until a Certificate of
OCC~sst1tiRltPletiOnhas heen i,"uedl"~.: Departm:;lo:~:Yl=~c:~el'Indiana. -.z ( " lot=.
Signature of Owner or Authorized Agent Print ~hJ ~
1~'j/"O~S7)-~l!::r1
NAME
SI MON
nE:'5
LOCATION
8< PROJECT
INFO:
STllEET ADDRESS
IS W .I-fASI'Ur(~TO'" sr.
ADDRESS OF CONSTRUCTION
c..lA
Ac.E (!,OVUCl/b.(l.P
Address of Shell Building (If different than Address of constru~iOn)
/ C"
BUILDING, PROJECT, OR TENANT NAME:
~UA'-:' Q c.LAi
1'6~'
SCOPE(S) OF 0 FDN /I. STR
RELEASE: flJ ELEC 0 SPKLR
STATE COMMERCIAL
DESIGN RELEASE #: 31 ~"'3 l-b
WATER UTILITY
PROVIDER:
rrt~f
SEWER UTILITY C
PROVIDER: t r rz ~
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; ANDIOR
COUNTY WELL ANDIOR SEPTIC PERMIT #'S (If Applicable):
# of Floors:
I
Elevator or Lift: Q YES .. NO
BLDG, CONSTRUCTION lYPE:
FAX
IN .
STATE ZIP
'Ib?04.
sum # (If Appl cable)
. //)0
Lot # and Subdivision (If Applicable
[.
II _ C> OCCUPANCY CLASSIFICATION: M
PROJECT INFORMATION:
Early Release Manufactured
Permit: _Y,~N Trusses: _Y.lN
Lot Split: _Y ~N Sump Pump: _Y '><. N
Does any part of the property lie within a special Flood
designation area: _Y ~N-_ i7 ..e\IJ ~
PLUMBING CONT~CTOR:~~
c
Plumber's Indiana State License #:
OFFICE USE ONLY: ******************************************1(****************************
INSPECTIONS REQUIRED: /1 V'J-( Filing Fees: 'IP_I O~3. ~S
, . P164- .., "" # Charged Re-
UPP~:,Footmg Lower Foot~ Slab ~/Itf.;;, Base Inspections: / q ,.. . ....:>0 Reviews
,- Meter Base ~Site -r,.,.,~Dr Cert. of Occupancy: :3 . () 0
: ~ / /33 8 q~ Additional Fees
o (f)1Q O~2/' /'. . b~~
(Date) Fee Received by:
Reviewed! pprovec!: Dept of Community Services
S:PermIts/Fo sJILP COMMEROAl