HomeMy WebLinkAbout06060024 Application
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Ctty of Carmell Clay TownshIp Permit )(:
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, 8< Accessory Buildings
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FAX
/gl7 s-t.~- 3Is-
BUILDER of
RECORD:
NAME
CoN
PROPERTY
OWNER:
CITY
ZIP
'L-
A1Q
t?
",,-,...-#-1. /oJ rr-
PHONE
ut:.
FAX
LOCATION
&. PROJECT
INFO:
Address of Shell Building (If different than Address of Construction)
STATE
AP. Ll ~ AI
SUITE # (If Applicable)
177i! OS'
Lot # and Subdivision (If Applicable)
ZIP
o
SCOPE(S) OF 0 FDN 0 S1ll
RELEASE: ;zt ELEC 0 SPKLR
TAX MAP PARCEL #:
BUILDING, PROJECT, OR TENANT NAME:
STATE COMMERCIAL
DESIGN RELEASE #:
3iBO
f3r 08
??~ 000
WATER umUlY /" _ SEWER umUlY
PROVIDER: c...-.AeNloe:;t- PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors:
I
Elevator or Lift: 0 YES
~(r.:.. "~'I-CO.NS1llUcnON -p1'~:::7~""r OCCUPANCY CLASSIFICATION: ---
\, ,--.. 1..-..., " ' ,l_., II \\./ I...., ,r-'~,'~ .J;;1I'
TYPE OF CONSTRUCTION: TYPE oFii'MPROVEMENT:-"._.:=.PRoJECr INFORMATION:
y COMMEROAL ctt',~~ STRU,c;ruRJ;'-,~-"i- ':~". I ~J,~'U~I~~;;' i Manufactured
(Pnvatelyownedhospllals CD \AOOm ,--",(t, .0'6'" PeI-"lIIt::\il \\IV LN Trusses: V XN
andmed,caloffiC-""'SE IJJ Ii' : 5 - --1fT I: 1~\""1T\ - -
are commercial) 11L;L.~ D F'OFl,l[J' ,iff -ION Lotsplit: \ ..l:..v XN Sump Pump: _v XN
o INSTIlUTIO M ONALI/pSubblJeBcldt to cornpll11flto,w7 ,- ~f. eIl!!lfiW~'... 2 ~Bi..,\,~,p,.rl::~fthe property lie within a special Flood
umapa u IC ll>f State ''n''~' _ \t\ll'l I II \ ;, \ v .
o School D <. "Ie. . , . design,ati!l!!:;;rea: V ~N
o Church ~I~T OF COM!\" El...;jIACC' - 'FlN1~_PUlMimJG CO~TRAcroR:
FOUNDATION TYPE: ltil1dCkal'iIffi:ll.RMEL GJ"'LOET HEP!PI\.~ C' _ _ I
apply for the new construction area} IND,'G:J'" ATIA~'HEb~(;)ill'AGEIP ~-ReJsc
':./. . ..>JI'
~ SLAB 0 CRAWL SPACE ~ CELL OWER (New) Plumber's Indiana State License #:
o POST & BEAM 0 BASEMENT CELL TOWER CO-LOCATE C.c7/0<2 OOO/I?
(or POST & PIER) WALKOUT:_V_ 0 DEMOLmON r I;;:> 7.
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 confonn 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, 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
O~:?tan4.:omPledonhas heenissued hythe Deparnn~=C::::armel.Indiana. 64~~
Signature of Owner or Authorized Agent Print Dale
OFFICEUSEONLY:************************************************************************
/17.s: 6 ;)..,
2tJO, 00
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INSPECllONS REQUIRED:
Filing Fees:
IIfn
Reviewed/A proved: pt. of Community Servi
S:Permlts/Form LP COMMERCIAL
).7)'(/(,
# Charged Re-
Reviews
Upper Footing Lower Footing Under Slab
Meter Base @ Site
Additional Fees
Fee Received by: