HomeMy WebLinkAbout06030219 Application
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City of Carmel/Clay Township Permit #: tJ reO 30:<'/1
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
8r. PROJECT
INFO:
NAME
13t/J Zt::
SlREET ADDRESS
NAME
k
12
/I
ADDRESS OF CONSlRUcnON
Address of Shell Building (If different than Address of Construction)
srATE COMMERCIAL
DESIGN RELEASE #:
WATER UTILITY
PROVIDER:
o
Pl.AN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
SEWER UTILITY
PROVIDER:
# ofFlcars:
Elevator or Uft: 0 YES ~NO
~,~~~~f~~~NST ,'~ TY~IMPROVEMENT:
SU C~P~~~nc~ Wi'h "H~;d,~,~:ON NEW STRUCTURE
(. ",(~ly~~~JyJ?~~~~ ~ospttars{A" .:-~" ,o.\luIlSO ADDmON
u'ahlf-ilMdi<alOltiCeSfcerit.;;neJes. 0 Room(s)
DEPT og"e , "!UNiTY Sr:r,NI,cr:s 0 Porch
CI- 0...IN , Al., u.., , - 0 Mezzanine or Deck
I Y Ut- I aI/l1Ubli(l.i!fdg C\Vi~SHIIEJ REMODEL
o SQ'JQRl)IAN.<\ 0 NEWTENANTFINISH
o Church ' 0 ACCESSORY BUILDING
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)
POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOliTION
_ PHONE
o .1'1
FPX
CITY
srATE
..c:::;
ZIP
Y"~
BEsr ETHOD OF CONTACT:
PHONE
.."I- ;O~J7(/. :rveo
CITY srATE
C~
FPX
SUITE # (If Applicable)
Lot # and Subdivision (If Applicable)
Old
~v\-
&r
coO
ZONING:
cY1iRCH 0 MECH 0 PLUM
OTHER(S): __
SQUARE
FOOTAGE: S~SF
ESTIMATED cosr OF CONSlRUcnON:
(EXCLUDING LAND VALUE) ~;? Clf9tJ ~
-'3
PROJECT INFORMATION:
Early Release Y Manufactured \...-0
Permit: Y ~ 'N Trusses: _Y fr..N
Lot Split: Y 'f..N Sump Pump: _ Y..,&N
Does any part of the property lie within a special Flood
designation area: _Y ~
PLUMBING CONTRACTOR:
4/'/ /l
Plumber's Indiana State License #:
/1// ;e;
Class I structure permits 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 Cannel Indiana ~ 1993" (Z~
289) and amendments, adopted under authority of l.c. 36~7 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
OccuJ1S11. '1' s. tanJJl~~ n issued by the Department of Community Services, Cannel, Indiana.
.,~ #'Ch~ c: g~ ,J-ZI-O&;
Print ~ Date
OFFICEUSEONLY:************************************************************************
. ONS REQUIRED: p, . Filing Fees: "17 7~ (PO
'. l/ /) a at <-1 r # Charged Re-
Lower Footing Under Slab h\OlP Base Inspections: '^ 0 Q, I~ Reviews
Meter Base. c9 Site ~\ Cert. of Occupancy: I tJ '3 . () n
./ _ q. ::z,r- Additional Fees
TOTAL: l//,/ ;., ~
0(,
proved: Dept. of Community Servi s
s/ILP COMMERCIAL