HomeMy WebLinkAbout06030091 Application
City ofCarmellClay Township Permit #: tJ&O '3:JtJ'j/
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
NAME
s. 0 i1/ Co (Y\ I;)
PHONE
lC:.s. &:'"3 5. - &,.SOo
FAX
&ss gOIO
P~NN.
'"
STREET ADDRESS
0), ')
STATE
ZIP
'( " :<. &-' 0
BEST METHOD OF CONTACT:
trJ'-, COY'-'7
PHONE
FAX
PROPERTY
OWNER:
NAME
leu' o,t'\J
STREET ADDRESS
cm
, ('
,9 A.J
1/ 00
11.10 ,;
LOCATION
8< PROJECT
INFO:
ADDRESS OF CONSTRUCTION ,
/ N / . iLL. I,vO I'
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
C re. (;-1'0<.1 i)
STATE COMMERQAL SCOPE(S) OF ~ j:. FDN LA'11.STR
DESIGN RELEASE #: 3 I ,5'-71 'f ~ RELEASE: (I'I:1'cLEC r'lDrKLR
WATER umm SEWER UTILm
PROVIDER: t2J PROVIDER: G-'-
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNlY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors:
BLDG. CONSTRUCTION TYPE:
Elevator or Uft:: 0
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
c::JV'COMMERCIAL RELEAS 0 NEW STRUCTURE
(Privately owned ho~~IL ED FCIQ) C~l;lmoN
and medical offlces/ct/rfk/i!3CI 10 COmp/i'one .' ,. tt.)~J1. n41r-TlON
are commercial) of SI I ,.,$ 'G' Eportllgul f
o INSTITUllONAL ~PT 0 .a e ,d'\} loC,0::;lM_nine~!Ba~
o Municipale;~ cBldg F COiVIP6JJ.(I'!!'!'1ooa:o.
o School OF CARMEl cr ':'t{~1tNANt';fjNl5fS
o Church '-[!) CAGQ;SSORY\B.UI~"
FOUNDATION TYPE: (Check all which INCtIll,f\DETACHED GAAAG'E 11P
apply for the new construction area) 0' ATTACHED GARAGE
o SLAB ~ CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM BASEMENT 0 CELL TOWER CO,LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOUTION
STATE
,-.
A-I
SUITE # (If Applicable)
5-(, S-
Lot # and Subdivision (If Applicable)
TAX MAP PARCEL #:
SQUARE
S): FOOTAGE: 3 J.. 0 C)
EsnMATED COstCOF CONSTRUCTION: 6 Co
(EXCLUDING LAND VALUE) ./7 / 'i5 0 0 C) cs--
OCCUPANCY CLASSIFICATION: .
PROJECT INFORMATION:
Early Release v< Manufactured /
Permit: Y '-~ Trusses: _Y --7"NVN
Lot Split: _Y XN Sump Pump: _Y--.0
Does any part of the prope~ within a special Flood
designation area: _Y_N
PLUMBING CONTRACTOR:
fC,'(' Kd f,y. M ec~
Plumber's Indiana State License #:
/0 fc., S:5 2.
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 -1993n (Z~
289) and amendments, adopted under authority of Le. 3&-7 et seq, General Assembly of the State of Indiana, and all 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
Occupancy or Substantial Completion has . - d by the Department of Conununity Services, Cannel, Indiana.
vJfe/'/"YIenJ 120(/'<-
Print Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: '[1/.00 ~
. . () 00 # Charged Re-
Upper Footing Lower Footing Under Slab Base Inspections: /1..,0. Reviews
~ Meter Base ~ Site Cert. of Occupancy: I () '7 I 00
~ TOTAL. 4t / .. 0 Additional Fees
2B. ()(, I .
,6''11010'"
Reviewed/Ap roved: Dept. of Community Services
S:PermIts/FormS/ COMMERQAL
Fee