HomeMy WebLinkAbout06050041 Application
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City of Carmel/Clay Township Permit #: f)(q,05 (J Ot.{ \
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
tJh;-+e CONS!.
PHONE
3i7~76f-43f5
FAX
317-
- S:J~7
t;; 100 IV
s
STATE
:J7..
ZIP
f)/l.. 26/-46'16
PROPERTY
OWNER:
NAME ()
JeNfJi+elL
STREET ADDRESS
54-0 !Jesf-
~
FAX
317- ~ 9 -.sS67
CITY
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSTRUCTION
SL/o 5~olc
meL
STATE
IN,
SUITE # (If Applicable)
ZIP
46032-
WATER UTIlllY
PROVIDER: CA RAl e L
SEWER UTIlllY
PROVIDER: dJ'A
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) f So t!! CO, o~"
Address of Shell Building (If different than Address of Construction)
,sAMe
BUILDING, PROJECT, OR TENANT NAME:
I
ZONING:
SCOPE(S) OF 0 FDN 0 STR 0 ARCH 0 MECH 0
RELEASE: 0 ELEC 0 SPKLR OTHER(S):
PlAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNlY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
BLOG CONSTRUCTION TYPE' WO(FlJ
. . l'tIlAl€-
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
GZI COMMEROAL 0 NEW STRUCTURE Early Release \/l Manufactured 'VI
(Privately owned hospitals ~ ADD maN Permit: y JV'N Trusses: _ Y ~N
and ~I.effIl:~centers r 0 Room(s) %""'- - V.. '"
~()E[ FOR >> Porch Bq,et: It ''"'""l LotSplit: _Y -l'=L" Sump Pump: ~Y_N
o IND M . a1trOp'cqIJCB'ld' COrvSTr::iIJ,...,Q MezzanineorDeck i DOeSanypartotthepropertv.li.eWithinaspeCiaIFIOOd
unlclPv SJb.!,lf g'tiC9 'vV/H r rgJ'" IREM~n --.ilte,.I" , . . \."
me:: I :-.8 'Jr, ,: Lr,,- " ~,d/t:9Q,NI;W~ANT ANISH~ designation area: _Y ~N .,/ .
},dPF C'OM^/.' '" ,,'" ,",GCE) ACCESSORY BUILDINGP.~ PLUMBING RACTOR: ,/:::. -;:~:.::;,\
FOUNDATI ""'F(~heck al"whlch', IT ;/ c. '6), DETACHED GARAGE . .y~, ,:(', \\ '\\
appIYforthenewconstll"C!iltinrale~)CI ^y~"O,vAmd:iEDGARAGE _ </n~<; ': ';~,\\ \"
I,"~ .1-\ J 'EJ' "r"""fttvER (N ) ~~/'-' ',"\' ',',1\ \\\, ,
o SLAB g) CRAWLSPP,,!'E.\ . """<"'" ew Plumber's Indiana state License #:. / ,\\ \
o POST & BEAM 0 BASEMENT.r 0 CELL WER CO-LOCATE ,',c:=:. \','~ ':" \',"'.\8JI\
(or POST & PIER) WALKOLIT: Y N 0 DEMOLmON , ,..;.. ".'
\\\ \\\
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) ~ka'rding'" tion tIme ~aJ.!les 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 apphcatIon wIll comply With, and conform to, all applIcable laws of the State of Indiana, and the ""Zonmg oidipan2tz.ofC::a~el Indian> 1993::-(Z~
289) and amendments, adopted under authonty of I C 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 dr occupied until"; Certificate of
Occu cy or Suhstan "al f!.mpletion has been issued by the Dep~ent of Community Services, Carmel, Indiana. \....-~ I
Iv L:- -:P6,vAl'l tJh,'.j.~ ~4/06
Signatu~ ner or Authorized Agent Print I Date
# of Floors:
/
Elevator or Uf't: 0 YES
~ NO
OCCUPANCY CLASSIFICATION:
OFFICEUSEONLY:*****************************************************~******************
, ONS REQUIRED: Filing Fees: 6 Jlr: (} iF
, H ~ # Charged Re'
Upper Footing ower Footing nde(S) Base Inspections: ~O 0 (} Reviews
~ /~OU9h In Meter Base Final Site Cert. of Occupan<;y:' / 0 '1. {} ()
l_ ~ ~/ /J 0 Additional Fees
r -, .. TOTAL: ~' '::U/c, tJ(}
\ W(q ~t4 /~~
\l.eviewed/ proved: Dept. of Community Services
~:Permlts/Forms/ILP COMMEROAL
I
Fee Received by: