HomeMy WebLinkAbout06050131 Application
City of Carmel/Clay Township Permit #: () (l2f)5'f) L3f
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
- PHONE
vCTJptJ to - C C!1'l-4133
FAX
'&1 J. 'Ii ;)..,
/./tr;.1:. t
STREET ADDRESS STATE
~/').. 1/ 2/0N5VJUt
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
ADDRESS OF CONSTRUCTIO~ c-\-
, qf'-JJ.
Address of Shell Building (If different than Address of Construction)
L
STATE COMMERCIAL
DESIGN RELEASE #:
SCOPE(S) OF 0 FDN 0 STR
RElEASE: )<(. ELEC 0 SPKLR
SEWERUTIlITY G-r-:'
PROVIDER:
WATER UTIlITY
PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUN1Y WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Roars:
BLOG, CONSTRUCTION TYPE:
Elevator or Lift: YES c;I NO
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
M COMMERCIAL 0 ~tWRUcruRE
'" (Privately owned hospitals ,<,p.gc1.M1'lON
and medical officeS/centers", CONS' la'!iDl\'Room(s)
arecomm",,~aAE.O rOf' 'iI' $-\\ reg\J 0 Porch
o IN~~. r.f\o),<V'lCC1'N:\cOdes, O~,.."nineorOeck
~p'~~F<lI!l"cJlg~,d lOCo '1~'R'1lMOO
oS 001 01 Si8\"" \J i'~ n"< T ANISH
o Church nf CO~N'^ CI..A'I- ~SSORY BUILDING
FOUNDATION ~'C!'~ ~~tI>l . 0 DETACHED GARAGE
apply for the ~~'a~b\t\Nt\ 0 ATTACHED GARAGE
Ix{ SLAB 0 CRAWL ~PACE 0 CELL TOWER (New)
"a- POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEM0l.ll10N
BEST METHOD OF CONTAcr:
C~LU "3lfS- -4-131
FAX
Oi>O
STATE
ZIP
bJ.5'o
Lot # and SubdMsion (If Applicable)
ZONING:
TAX MAP PARCEL #:
}J ARCH 'V\ MECH .ll\ PLUM
6l\iER(S):
SQUARE
FOOTAGE:
5000
ESITMATEO COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
OCCUPANCY CLASSIFICATION:
Early Release III Manufactured X
Permit: Y.....ALN Trusses: Y N
Lot Split: Y ->>-N Sump Pump: Xiv;1l1: N
Does any part of the property lie within a special Flood
designation area: _Y ~
PLU BING CONTRA OR:
DRDo PL.JJ1r1BJ;J 4
Plumber's Indiana State License #:
I D ~4-3b
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 Carmel Indiana - 1993" (Z~
289) and amendments, adopted under authority of r.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 Certi!icate of
cy or Substantial Co rpletion h been issued by the Department of Community Services, Cannel, Indiana,
DAV~ IVICCuL.L.ovGfj
Print
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: /b Filing Fees: /"Z '3 :3, () 0
.. ,,"-. . ~tJ()"'?\ # Charged Re-
Upper F ting Lower FootIng Under Slab b\ V Base Inspections: /-' VV Reviews
Meter Base Site Cert, of Occupancy: Jf I tJ 7 , {) V
I' KI{f) () 0 Additional Fees
~AL: ~. ·
,~bO" ~ tltt)p tidt'lqJn- ,
Fee Received : tf '-'"
5/17)01:,
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