HomeMy WebLinkAbout06050163 Application
City ofCarme//Clay Township Permit #: a060f{p3
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
& PROJECT
INFO:
NAME /I PHONE FAX
\S~L\..l.~L LDlLP",.z.l!-TI~ ~n--S:,t.-\-IOIS- '3,\i--S'"SL{-lLI{.,
STREET ADDRESS I ~ CITY STATE ZIP
"3/;)., L..o'iN\.WtlO~ fA\z.L"?t-tALE- Sv,no L ::C.'"' ~S::::C/-.-l L{I.aLG~
BunpER'S EMAIL ADDRESS I BEST METHOD OF ODNTACT: w\o i< lL E-
J li."'ivt ':I:! p.uJ/,:l-.v.. ' {.,D<<.<- q 01 - ~t)(p - 0DLI3
~v K..,,- 7'1LI\L'l'\-
STREET ADDRESS . IL( L cf
&00 L. qif {. XL
PHONE
10'i:-lt>~oo
:LJ <,
ADDRESS OF CONSTRUCTION
130'{;?~ \-\CW-{.~ tL L.ro'>s\<t.<
Address of Shelf Building (If different than Address of Construction)
'/JA
BUILDING, PROJEcr, OR TENANT NAME:
C'N,l9-IJLAL W'~SS
STATE ODMMERCIAL SODPE(S) OF 0 FDN 0 STR
DESIGN RELEASE #: RELEASE: 0 ELEC 0 SPKLR
WATER lJTlLnY V ..1
PROVIDER: I ja
SEWER lJTlLnY
PROVIDER:
JJId
{'.\'j) L S
PLAN ODMMISSION / BZA / BPW DOQ(ET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors:
FAX
if m:- L: (il"i?
STATE
J:'4-
ZIP
~Ic.;)'-Io
Glv"~
SUITE # (If Applicable)
~~
Lot # and Subdivision (If Applicable)
NA
ZONING:
TAX MAP PARCEL #:
I Ird1-2/..- 00-00-017.
SQUARE
FOOTAGE: ;2&'3>
13- \
o ARCH 0 MECH 0
OTHER(S):
ESTIMATED COST OF CONSTRUCTION: ~., '-.. '
(EXCLUDING LAND VALUE) ~. <~j ~_\\\ .
>/;rtf!l~;;~
','\
,Jf:. DS: I ;JOt) (
Elevator or Uft: c;J YES 0 NO
BLDG. CONSTRUCTION lYPE:
TYPE OF N ON: FOR ~gl!:pl~R(ill\fM~IIlT:
COMMERClALRELEASEO ~". nc~ PJ1 NEw'STR~
(Privately ow@lll1qspIIDlSO com,.,:,,~' 8: (~9pmPN
and medical offices/cent~ State 8.i 1C~ :~;: ";:~ - ,0.: ~S
O are commercial) T OF COMMc."'" fY 0..IPdrcn
INSTlTUTIONADEP _ r.\ ^.YC:POt.ie\W.s.~eck
o Mum~~~I@ARMt:L I L;r'REMODEL
o SchOOt' IN 0 IAlj;-\ NEw TENANT FINISH
o Church 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apil for the new construction area) 0 ATTACHED GARAGE
SLAB 0 CRAINLSPACE 0 CELL TOINER(New)
POST & BEAM 0 BASEMENT ,gp CELL TOINER CO-LOCATE
(or POST & PIER) INALKOUT:_Y_N 0 DEMOUTlON
\\
\
O'!)
PROJECT INFORMATION\\ \\. ~
\' \ \ \ ..
Early Release V'l\\ ~ \ M~anuf red ~V
Permit: _Y ~\\\I "0 TruSses: _Y0/...N
Lot Split: _Y ~ '\ Sump P : _y.M
Does any part of the prop~'"e within a special Flood
designation area: _Y ~N
PLUMB G CONTRACTOR!
.>
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 -1993n (Z'
289) and ame ents, adopted un er authority of I.e. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, ath, d floor dra: s are onnected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occu ci 'I' ubsr:mti Q etion h~ been issued by the De. partmen~ of Conun~ty Se4ces~el. Indiana. I
,Ii , S. LjotU:~ I./.c.k..<"o,,,--, S-!zz./t:JG.
Signature of Owner or Authorized Agent Print Date t t
OFFICEUSEONlY:************************************************************************
INSPECTIONS REQUIRED: d Filing Fees: "3~1. tJO
. ,v~. ~m #~~
Upper Footing LOW~~ F.ooting Under Slab ?T ~ . ~ Base Inspections: / V v , Reviews
Rough In Meter Base Flna'~ /,'\-;t" Cert. of Occupancy:
~ V Additional Fees
TOT l:
, ~\
11
N\
Fee Received by: