HomeMy WebLinkAbout06030081 Application
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City of Carmell Clay Township Permit #: () ~ 0 30lY{f
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
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BUILDER of NAME
RECORD:
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BUILDER'S EMAlL ADDRESS
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PROPERTY
OWNER:
NAME
K....1,
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Re.-t 6,
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LOCATION
8r. PROJECT
INFO:
BUILDING, PROJECT, OR TENANT NAME:
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VI:- y::.ifT5
PHONE
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FAA
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STATE
iJ
ZIP
(,On
STATE
IN
FAA
3/7- SlJ7 -Iry:i'
ZIP
W.OS2..
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SUITE # (If Applicable) . /oM ,u
/)J ;L'kJE' ;2"30- ;>.&>
I
TAX MAP PARCEL #:
/ 'O<:y S~ OO0C0'72.000
"1. PLUM
SCOPE(S) OF 0 FDN 0 STR ~ ARCH ~ MECH
RELEASE: F ELEC 0 SPKLR OTHER(S):
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STATE COMMERCIAL
DESIGN RELEASE #: 3 16 8'
WATER UTILITY
PROVIDER: Car d
SEWER UTILITY
PROVIDER: Cc. r 1'>1~
,
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS: AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Roars:
Elevator or Uft: Q YES Ql:: NO
BLDG. CONSTRUCI10N TYPE:
2..
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~ COMMERCIAL AE~EASED FOR CS..~QliRE
(Pnvately ownSl.JbiGl!lll'to . Ei'~'1\'t:id!llli(jN I ION
and medical officesrcen"'~ compllanco with Il[)e~n
are commerci2!) 0 State and LocI)1 c~ Porch S
o INSTlTUl10NAiJEPT OF COf\AMUI\/L"rv sMezzanlne or Deck
o Mu~'t\iFB~9. I 'CJ' 'R .5WICES
o School ARMEL / ~'jQE/lOWN)IiUlIlltj;H
o Church . . IN 0 IA ACCESSOR'i''1lUtlDING
FOUNDATION TYPE: (Check all which DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
tIC! SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
t5 POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLITION
SQUARE
FOOTAGE:
'too
ESTIMATED COST OF CONSTRUCI10N:
(EXCLUDING LAND VALUE) .3b (9 0 C!)
tr1
OCCUPANCY CLASSIACATION:
PROJECT INFORMATION:
Early Release Manufactured
Permit: _Y LN Trusses: _Y--x"N
Lot Spilt: _Y iN Sump Pump: _Y LN
Does any part of the property lie within a special Flood
designation area: _Y ~N
PLUMBING CONTRACTOR:
C f? l11eJ.Q/l{'uJ
Plumber's Indiana State License #:
fC-'il88o "02-
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for
beginning and completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 199J" (Z'
289) and amendments, adopted under authority of I.c. 36,7 et seq, General Assembly of the State of Indiana, and aU Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupan Substantial tpletion has been issued by the Department of Community Services, Cannel, Indiana.
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Si Print / Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: 4 Filing Fees: r; 3 J-/ , 00
. \ j l C; ~ ~O"\ # Charged Re-
Upper Footing Lower Footing Under Slab "5 P Base Inspections: I ^, (J 'U Reviews
~~ Meter Base ~ Site Cert, of Occupancy; '3. 00
, (TOTAL: ,,150 Additional Fees
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Reviewed/Ap roved: Dept. of Community Services
s:PermIts/Forms/I COMMEROAl
Fee Received by: