HomeMy WebLinkAbout06050128 Application
City of Carmell Clay Township Permit #: V~ Q 5' 01 A .g
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
8< PROJECT
INFO:
NAME
~(#( COf'Jr-l-nu17OlJ 5l1cs
STREET ADDRESS
"ffi'JO Stl.CAV flr,1/c.
BUILDER'S EMAlL ADDRESS
CVJhee.Jv-
.-.fof CO/llJIr....cf-. CO;.,
NAME
CoH,V', h...r/
/V1tVf,w T IU- '"
STREET ADDRESS
,o,f/ E f.2_",J.S-In-c..+- S'k.. {OJ
ADDRESS OF CONSTRUmON
1I'7D N, fYlen-.L.~ S/.r-ee+
Address of Shell Building (If different than Address of Construction)
,,~SO N. YI1"",-&itMJ >+.-ee.f-
BUILDING, PROJECT, OR TENANT NAME:
56e. r".,t,-"",,,-
STATE COMMERCIAL
DESIGN RELEASE #:
",fA.
SCOPE(S) OF 0 FDN 0 STR
RELEASE: ELEC 0 SPKLR
WATER UTIlllY
PROVIDER: C Wi"e-\
SEWER UTIlllY
PROVIDER: Cw
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: G
Elevator or Uft: ~ YES Q NO
BLDG. CONSTRUmON lYPE:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
@ COMMERCIAL 0 NEW STRUCTURE
(P"v'llt~~ !101!'ll<ls . 0 ADDmON
and Eli~~~.~~Atl.i"OR CONSTRUOO()fllj>m(s)
o IN~~~to tomplii1nce with all rCSjUQio!;q(ch ,
O . @f ~IM'" '''lrj i C "~I C~.,., t::l M&zanlne or Deck
~a PUJjlc~dg " - "'- 'E!'SREMODEL
o ~o' F COMMU~lITY $a:F;~NTFINISH
FOUNDATI~~~fch~~~",~~~ CLAY 8J~~~~g~NG
apply for the new construction /'~IANA 0 ATTACHED GARAGE
)g:[ SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOlITION
PHONE
"~'f- 5'1iif'
FAX
5'? 'f - )La.2
CITY
STATE
:nv
ZIP
'f"~
If
BEST METHOD OF CONTACT:
F",,,,, I
PHONE
570- 7()oo
FAX
5'70- ?o10
ZIP
LfI2S'O
CITY
(/
STATE
;eN
J
o MECH 0 PLUM
SQUARE
FOOTAGE:
30'73
ES11MATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE) J {J tl&D
OCCUPANCf CLASSIFlCATION:
PROJECT INFORMATION:
Early Release --i. Manufactured X
Permit: Y N Trusses: _ Y ~N
- .
Lot Split: _Y ~N Sump Pump: _ Y -XN
Does any part of the property lie within a special Flood
designation area: _Y_N
PLUMBING CONTRACTOR:
N/.4
Plumber's Indiana State License #:
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 - 1993n (Z~
289) and amendments, adopted under 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
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 S, tantial Completion has been issued by the Department of Community Services, Carmel, Indiana.
c.1,..-{<J tu4edl:/ S//5/0b
Print
Signa ure of Owner or Authorized Agent
Date
OFFICE USE ONLY: *** * ***** * ********** *************** ******* *** * *********grf!t*** ******* ***
INSPECTIONS REQUIRED: Filing Fees: <i la (g , I
<l AI 0 JIlO # Charged Re-
Upper Footing Lower Footing Under Slab Base Inspections: f'. v ,V Reviews
~ Meter Base ~ Site Cert. of Occupancy: 00
3
. f)OOc.,
roved: Dept. of Community Services
LP COMMEROAl
Additional Fees
,