HomeMy WebLinkAbout06050129 Application
City ofCarmellClay Township Permit #:-O(ofJ5" 0 I~ 1
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
NAME /'0 -
C:::7or-c1o-u
STREET ADDRESS
708"7 IE":Z~ ...u
PROPERTY
OWNER:
STREET ADDRESS
7D'6'i F 20'0 .....-'''''....-f(
LOCATION
8< PROJECT
INFO:
Address of Shell Building (If different than Address of Construction)
STATE COMMERCIAL
DESIGN RELEASE #:
SCOPE(S) OF )!f} FDN V STR 1:1( ARCH
RELEASE: 0 ELEC ~PKLR O-rnER(S):
WATER UTIlITY ol:
PROVIDER: r n
SEWER UTIlITY
PROVIDER:
C/"RW'J
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; ANDIOR
COUNlY WELL ANDIOR SEPTIC PERMIT #'5 (If Applicable):
# of Aoars:) Elevator or Uft: c;:I YES )tI NO
TYPE OF CONSTRUCTION: TYP :OF VEM NT:
~ COMMEROAL ~"( ""~ ~~RE
(Prlvalelyownedhospltals (';';;'@Z('")
and medical officeS/centers ~ G".I,N,\S'- r.C/>10 < ~'\
are commercial) ~O'" (,0' ~ '" <:;; -tiiltirc!,n
o IN51TTUTJONAL ..~<:.9 .1-"'('0 \rf' ~-0 ,-0 Mezzanine or Deck
o MumaPt\><-"l(~~. \'P 0\~ q~~MODEL
o SctIl1tllV C\\O '0<<>'1.(;) ~~ \(IB' NEWTENANTFINISH
o Ch~lO\0 0' (p 'K.\.. ,s.I'-ACCESSORY BUILDING
FOUNDATION TYPE~{Check fihl~~ ~\\)\'LJ DETACHED GARAGE
apply for the new con~'bn~~ \\- 0 ATTACHED GARAGE
PI SLAB c9 ~t: SPACE 0 CELL TOWER (New)
o POST & BEAM ClJ:,\'BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLITION
PHONE A Z2
CITY ,A;b,,:-J
.5 P l' f FAXfrJD? 'l/D
ST~...t' 1-'6(.2.3"
~-
BEST METHOD OF CONTACT:
<;t")O 7" Z.;;-
PHONE 13?() ;z.G.
'1 2. :5"'1 Lf<.(
01. 36 Z (
AX'i5?01PIO
CITY ;I I/W
STATE
:;:r;;;"..#
3~
7'6(Z3
SUITE # (If Applicable)
1-0
SQUARE 17.
FOOTAGE: /~
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
o MECH
o PLUM
-350) 000
- E OCCUPANCY ClASSIACATION:
PROJECT INFORMATION:
Early Release X Manufactured V
Permit: Y N Trusses: ~Y _N
Lot Split: Y KN Sump Pump: _ Y 4N
Does any part of the property lie within a special Flood
designation area: _Y _N f) ,,-"~^- '{\.
PLUMBING CONTRACTOR: ~ ~ IvO ~ v - ~ I .
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 Cannel Indiana - 1993" (Z'
289) and amendments, adopted under authority of LC. 36,7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bat floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certilicate of
Deeupan SUbstantMCum~~~ed by the Depar~z~se:;V;;;::dian~
. ature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: **************************************** ********************************
ECTIONS REQUIRED: Filing Fees: J 7 / 9, {)O
_ - (p, tJO ,no # Charged Re-
Upper Footing Lower Footin Under Slab . . V Reviews
() 0
,00
Reviewed/Ap roved: Dept of Community services
S:Permlts/FonnstIU> COMMERCIAL
Additional Fees