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HomeMy WebLinkAbout06040071 Application City of Carmel/Clay Township Permit #: (Ie O,-!OtJ 7( COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory 'Buildings BUILDER of RECORD: NAMtt~ ~~~ PHONE""",, AI ~<D FAXe?A ""co o-=::, .:::::c::,OU L.>*rs -<5'C:.J S STA~ ZIP. 03, BEST MffiiOD OF C~~ SO I A.4. CJ STREET ADDRESS iB STREET ADDRESS I , _ (02\ L\ UX-\ ~ D ~ BUILDER'S EMAIL ADDRESS/./l._ ~ Cas fV\ 6$ @... ~ A,.t L u '-0.' NAME~ ?~ C&v~ C He. ~~s. >.- _ 5:'<-<- ~b Srj' _ <;;~. llf 'S ~O d:)u FAX 848~8~ g /J . . STAm A ,ZI~ UYifV\St.. <sC-..., '-'<kJ~ L PROPERTY OWNER: Address of Shell Building (If different than Address of Construction) Lot # and 5 704. M~ ion (If R. TAX MAP PARCEL #: Ii:, -09 - sS -ci:)-d2. -002--; A. PLUM SQUARE 3?"'''''. :7{J FOOTAGE::::::J....>-J ESTIMATED COST OF CONSTRUCTION: I ZC\ 'i"c\",," . (EXCLUDING LANO VALUE) V VJ-J c~ LOCATION &. PROJECT INFO: ADDRESS OF CONSTRUxn~N '70 A.f)~ . (If Applicable) BUIt.qn>jG, PROJECT, OR TE~ ~E: . I PAc. {\j c.. =t 12, V STATE COMMERCIAL , 1120 OESIGN RELEASE #: :3 I WATER UTIll'l'7P PROVIDER: <-\.,;.~~ ZONING: SCOPE(S) OF 0 FON 0 STR 9&-RCH d MECH RELEASE: M ELEC 0 SPKLR OTHER(S): r... SEWER UTIlllh PROVIDER: C ~ # of Floors: \ Elevator or Uft: 0 YES BLDG. CONSTRUCTION TYPE: OCCUPANCY CLASSIFICATION: PLAN COMMISSION / BZA / BP DOCKET NUMBERS; AND/OR ) COUN1Y WELL AND/OR SEPTIC PERMIT #'S (If Applicable): N'~ TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: ~OMMERCIAL 0 NEW STRUCTURE (Privately owned hospitals 0 ADOmON and medical offices/centers 0 Room(s) are commerdal) _ 0 Porch o INSTITUTIONAL 0 Mezzanine or Deck o Muniapal/Pubhc Bldg p~ODEL o School RELEASED FCl'l2R ~1mtJ!mi6ION FOUNDATI~ ~~':,ch(CheckiW~llld.ta :an IP~'Ctf~);lRQJliflr~tlans applY,!9r the new construction area} af::;!a:e 4:J:11~~~~ ~~ [0" SLAB 0 c~PsIlA&F CC,'tiMldl!tblmwe ~j:ES o POST&BEAM 0 OtVlE0F CAf1ME:U:m~>V~RlP (or POST & PIER) WALKOUT:_Y_N PJq iLltJON .., \ dass 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 und.er authority of I.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only kite ,d floor drams are connected to the sanItary sewer I further certify that the construction will not be used or occupied until a Certificate of eyor bstantial Completion has been issued by the Department unity seQ~~ ln~ ~ 13C O~ Signature of owner or Authorized Agent " Date ,. RMATION: Early Release ~ Manufactured . ~/ Permit: Y ~ Trusses: rrfiY I/'N Lot Split: y' N Sump Pump: _y ~ Does any part of the property li<:.Jlilhin a special Flood designation area: -y ~ ik PL~~r~~~~CT~O~,~ <::::. ~ , ",,<i-J::;u Plumber's Indiana state License #: bc.?lm CD lO \ OFFICE USE ONLY: ******************* INSPECTIONS REQUIRED: ********************* ********************* ~Eiling-Fees: /0 ,,00 i\\~(.- Base Inspections: rJ.- 00 , CJ V ~ Cert of Occupancy: ,/ & '/, CJ 0 ~~:~~() # Charged Re- Reviews Upper Footing LO\NerFooting ~9h 10 Meter Base Under Slab \11'(\ Revle {Approved: Dept. of Community Servi S:Permlts!Forms/ILP COMMEROAl Additional Fees ,. .,