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CITY OF CARMEL
PERMIT RECEIPT
OPERATOR: slillard
COPY # 1
See: Twp:17 Rng:03 Sub: Blk:06 Lot:
PARCEL ID ........: 1713060000028003
DATE ISSUED.......: 06/06/2006
RECEIPT #.........: 22247
REFERENCE ID # .... 06050157
SITE ADDRESS ...... 10801 MICHIGAN RD N #240
SUBDIVISION ......:
CITY .............: CARMEL
IMPACT AREA. .....: 421
OWNER ............: PHT INVESTMENT HOLDINGS
ADDRESS...... ....: 2001 ROSS AVE. #3400
CITY/STATE/ZIP ...: DALLAS, TX 75201
RECEIVED FROM ....:
CONTRACTOR .......:
COMPANy.......... :
ADDRESS ..........:
CITY/STATE/ZIP ...:
TELEPHONE .........
BREMNER, INC.
LIC # BREMHEA
BREMNER HEALTHCARE REAL ESTATE
510 E. 96TH ST. #250
INDIANAPOLIS, IN 46240
(317) 816-8600
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
CIIC/O FLAT RATE 1. 00 107.00 0.00 107.00 0.00
CIIREMOD SQUARE FEET 4,796.00 1194.24 0.00 1194.24 0.00
ICIIFINAL FLAT RATE 1. 00 100.00 0.00 100.00 0.00
ICIIROUGH FLAT RATE 1. 00 100.00 0.00 100.00 0.00
---------- ---------- ---------- ----------
TOTAL PERMIT : 1501.24 0.00 1501.24 0.00
METHOD OF PAYMENT
AMOUNT
NUMBER
CHECK
TOTAL RECEIPT :
1501.24
20719
------------
------------
1501.24
CITY OF CARMEL / CLAY TOWNSHIP
IMPROVEMENT LOCATION PERMIT APPLICATION
For: Remodels & T want Finishes: Commercial, Indwtrial, or Institutional
Permit #: 06050157
Date: 06/06/2006
PARCEL ID #: 1713060000028003
LOT & SUBDIVISION:
ADDRESS OF CONSTRUCTION: 10801 MICHIGAN RD N #240
Township?: 17 Zoning: B2
PROPERTY OWNER INFORMATION:
Name: PHT INVESTMENT HOLDINGS
Ph. #: 3178168615 Fax #:
Street Address: 2001 ROSS AVE. #3400
CARMEL, IN 46032
Flood Zone: N
Lot Split: N
3178168610
DALLAS, TX 75201
TENANT INFORMATION:
Name: DR. HATHAWAY'S OFFICE
Address: 10801 MICHIGAN RD N #240 CARMEL, IN 46032
CONTRACTOR INFORMATION:
Name: BREMNER HEAL THCARE REAL ESTATE
Ph. #: (317) 816-8600 Fax #: (317) 816-8610 Email: KLEACH@BREMNERHEALTHCARE.COM
Street Address: 510 E. 96TH ST. #250 INDIANAPOLIS, IN 46240
Plumber's Name: MCS Codes for Project: IPC
PERMIT TYPE: COMTENANT COMMERCIAL TENANT FINISH
Water Service by: INDPLS County Well Permit #:
Sewer Service by: CTRWD County Septic Permit #:
Foundation Type: SLAB Estimated Cost of Construction: $311050
Manufactured Trusses: N Sump Pump: N
Usage Class: COM Construction Type:
State Design Release #: 318096 Square Footage: 4796
SPECIAL CONDITIONS/NOTES:
DR. HATHAWAY'S OFFICE @ST. VINCENT M.O.B.
CONST. TYPE: EXST, SPK. OCCUP.CLASS: B, REM.
ST.#: 318096: ARCH, ELEC, MECH, PLUM. 20031BC.
ONE CONDITION RE: SANITARY DRAINAGE PIPE SIZE.
. NO NOTES'
This permit is valid only if construction commences within one (1) year of the date of issuance of the State Commercial Design Release. All construction
must be completed (C/O issued) within two (2) years of the issuance date.
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 LC. 36~7 et seq, Geneml 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 has been issued by the Department of Community Services, Carmel, Indiana.
FEES:
COM. IND. INST. C/O
C.1.1. REMODEUTENANT
CII FINAL 100.00
CII ROUGH-IN 100.00
107.00
1194.24
APPLICANT NAME:
KEEVIN LEACH