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CITY OF CARMEL
PERMIT RECEIPT
OPERATOR: lstewart
COpy # 1
See: Twp: Rng: Sub: Blk: Lot:
PARCEL ID ........: 161028000039000
DATE ISSUED.......: 06/08/2006
RECEIPT #.........: 22281
REFERENCE ID # ...: 06050229
SITE ADDRESS ...... 13170 HAZEL DELL PKWY #120
SUBDIVISION ......:
CITY .............: CARMEL
IMPACT AREA ......:
OWNER ............: PLUM CREEK PARTNERS
ADDRESS ..........: 11911 LAKESIDE DR
CITY/STATE/ZIP ...: FISHERS, IN 46038
RECEIVED FROM ....:
CONTRACTOR .......:
COMPANY. .........:
ADDRESS....... ...:
CITY/STATE/ZIP ...:
TELEPHONE .........
JACOB GILLIATTE
LIC # GILLGEN
GILLIATTE GENERAL CONTRACTORS
2515 BLOYD AVE
INDIANAPOLIS, IN 46218
(317) 638-3355
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 1,200.00 511.00 0.00 511.00 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 : 818.00 0.00 818.00 0.00
METHOD OF PAYMENT
AMOUNT
NUMBER
CHECK
TOTAL RECEIPT :
818.00
8243
----------~-
------------
818.00
CITY OF CARMEl / CLAY TOWNSHIP
IMPROVEMENT LOCATION PERMIT APPLICATION
For: Remodels & Tenant Finishes: Commercial, Industrial, or Institutional
Permit #: 06050229
Date: 06/08/2006
PARCEL 10 #: 161028000039000
LOT & SUBDIVISION:
ADDRESS OF CONSTRUCTION: 13170 HAZEL DELL PKWY #120 CARMEL, IN 46032
Township?: Zoning: Flood Zone: N Lot Split: N
PROPERTY OWNER INFORMATION:
Name: PLUM CREEK PARTNERS
Ph. #: 3176969595 Fax #: 3178444678
Street Address: 11911 LAKESIDE DR FISHERS, IN 46038
TENANT INFORMATION:
Name: WHITE BOX-FUTURE SHROUT CHIROP
Address: 13170 HAZEL DELL PKWY#120 CARMEL, IN 46032
CONTRACTOR INFORMATION:
Name: GILLlATTE GENERAL CONTRACTORS
Ph. #: (317) 638-3355 Fax #: (317) 634-5997
Street Address: 2515 BLOYD AVE INDIANAPOLIS, IN 46218
Email:
Plumber's Name: JVC PLUMBING Codes for Project: IPC
PERMIT TYPE: COMTENANT COMMERCIAL TENANT FINISH
Water Service by: CARMEL County Well Permit #:
Sewer Service by: CARMEL County Septic Permit #:
Foundation Type: SLAB Estimated Cost of Construction: $20000
Manufactured Trusses: N Sump Pump: N
Usage Class: COM Construction Type:
State Design Release #:
Square Footage: 1200
SPECIAL CONDITIONS/NOTES:
WHITE BOX-FUTURE SHROUT FAMILY CHIROPRACTIC-HAZEL
DELL CORNER LOT 3/PHASE 3 BLDG. NO STATE RELEASE.
PLUMBER LISTED. PERMIT #: 06050084 IS REMAINDER
OF TENANT FINISH FOR THIS SPACE.
** both pennits on this white box need
to be finaled before do can be issued,
#06050084,06050229
This permit is valid only if construction commences within one (I) 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.
T, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or nlteration 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 Carme1lndiana -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, 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
511.00
APPLICANT NAME:
JACOB GILLlATTE