HomeMy WebLinkAbout06060012 Application
City of Carmel/Clay Township p~~-OO I;L
CO:MMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of NAME tATA-LV/.S"T C.:>r1s-r~cn~E 679~1S-)S-
RECORD:
STREET ADDRESS
S \ S"B ~_
BUILDER'S EMAIL ADDRESS
,) CvuV\ e
bS"~ S=-'I
FAX
$("1-1 $"S{"
OTY STATE
.:r....p. k,..,A-l'"-1 S ,:::,......
ZIP
'-\1c.2-2- ~
BEST METliOD OF CONTACT:
C,AT__,",,- sr'-.... I . c..."",,- ~.'7 - ...., I~I- I t.'-l 0
SCOPE(S) OF 0 FDN 0 SIR '8f ARCH <$ MECH ~ PLUM SQUARE ,.,(
RELEASE: F ELEC 0 SPKLR OlliER(S): __-- ~_, tGE: 1"2-" 0 f'"
__~... ,n\\ 1/1'--'
" =ESl1MATED,COST OF,CONSTR
c(EXCLUDINGIWio-VAtuf)
--. "::---"
PROPERTY
OWNER:
NAME
c...'F .s
?t-ofE~T/~S.
sr ~t';)
...C!__ ~~i
STREET ADDRESS
r2B 2-1
e,
LOCATION
&. PROJECT
INFO:
ADDRESS OF CONSlRUCTlON
/z. '70 3 mEe.-r""-'c, H->v~€ ft.-O
Address of Shell Building (If different than Address of Construction)
BUIlDING, PROJECT, OR TENANT NAME:
vv'E-"'1" c.c.~ LPtt'6-
STATE COMMERCIAL
DESIGN RELEASE #:
~IBS>(
PHONE
s-e D - "N'32-
FAX
OTY
S7.
STATE
.J:.-.,.}
ZIP
L/~o~ 2.-
C I'll- ~l--
sum # (If Applicable)
CAf.""li-L- ~.... '-'Ilo~z...
lot # and Subdivision (If Applicable)
SEWER lffiLITY
PROVIDER: Ct.A-"!
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS: AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
WATER lffiLITY
PROVIDER: ~ ~
# of Floors: I Elevator or Uft: Q YES ;( NO
TYPE OF CONSTRUCTION: ~ ~!tIl l?~T:
~COMMEROAL...t:\ l=ASEO FO nce~\1~UCTURE
(Privately Ow~~I!O COrn9\le LO@I <Ao!ifflgtJ.\r,ES
and medical ~ts State end '<j- .- \Rdt!m~[ n
O arecommeraal) 0\ OMM\.II'-l\\ ~1i'ItllIN~\-I\r
INSTlTUl10NALr:'\Cp" ~r c I~\.A '14emnine or Deck
o Muniap_bli~ B tARNlE.L rlU'MODEL
o SChOOIC\1'f 0 \1'10\ '1llEW TENANT ANISH
o Church 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
~ SLAB " c:r> CRAWL SPACfl" CELL TOWER (New)
o POST & BEAM 0" BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOlIT:_Y 0 DEM0LlT10N
- , 2006
OCCUPANCY
Ear =t Manufactured l/)
Permit: Y N Trusses: Y ^-'" N
Lot Split: Y Sump pump:" _ Y ~
Does any part of the property lie within a special Flood
designation area: _Y LN
PLUMBING CONTRACTOR:
M.,-t "'<<>-1 "" l2.:...H-
Plumber's Indiana State License #:
PC B l 0 '57'-1 EJ p
dass 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 I.c. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, , and floor drains are connected to the sanitary sewer. I further ce that the construction will not be used or occupied until a Certificate of
Occu Substanti mpJetion has been issued by the ent of Corom . ervices, Cannel, Indiana.
~o--l ~ It-I. (,
Signature 0
OFFICE USE ONLY: ********
INSPECTIONS REQUIR
Upper Footing Lower Footing
~0 Meter Base
TO
OO~
Fee Received by:
Date
# Cha'9ed Re-
Reviews
Additional Fees