HomeMy WebLinkAbout06060147 Application
City of Cannell Clay Township Permit #: {)01Xo0117
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 \
III PROJECT
INFO:
NAME
CAf,tol (i/ou4r..cI,'(W SVGS JNc..
STREET ADDRESS
Cj~3o
BUILDER'S EMAlL ADDRESS
C WJ..ee.ler e
PHDNE
,5"'l'{-5"~
FAX
,IJ.., - 5"fi,l
ZIP
'i&;l.i'r:>
Or;
CITY
::r;..,.tpls
STATE
;r/tl
BEST METHOD OF CONTACT:
e-"'.....t
e.j.. (4....
NAME
ColI.ers T....I~ tVIar~"N T...c.\<e..-
STREET ADDRESS
'Oil f. S-.J.,.,.I.
PHONE
fi'7o - 'J 0011
CITY
FAX
)'70, ?fXO
ZIP
~~O
/00
I~
:r.
ADDRESS OF CONSTRUCTION
">50 N, Me,.""."", S'.{,.
Address of Shell Building (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
.:t',Hr A
STATE COMMEROAL
DESIGN RELEASE #:
WATER UTILITY
PROVIDER:
AlIA-
SUITE # (If Applicable)
,2.10
Lot # and Subdivision (If Applicable)
TAX MAP PARCEL #:
SQUARE
FOOTAGE:
'lb>7
SEWER UTILITY
PROVIDER:
/'1/ t100 e
PLAN COMMISSION / BZA / BPW OOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: (;
Elevator or Ufl::: "YES 0 NO
TYPE OF CONSTRUCTION:
Iii:I COMMERCIAL
(Privately owned hospitals
and medical offices/centers
are commercial)
o INSTITUTIONAL
o Munidpal/Publlc Bldg
o School
o Church
FOUNDATION TYPE: (Check all which
a~PI for the new construction area)
SLAB 0 CRAWL SPACE
POST & BEAM 0 BASEMENT
(or POST & PIER) WALKOUT: V
BLDG. CONSTRUCTION TYPE:
OCCUPANCY CLASSIFICATION:
TYPE OF IMPROVEMENT: PROJECT INFORMATION:
o NEW STRUCTURE Early Release \/1 Manufactured Y'
o AOOmON Permit: _V ~ Trusses: _vC:c..fl
8 ~o:(S) Lot Split: _V ~ Sump Pump: -vA
cf 0 Mezzanine or Deck l.. Does any part of the property lie within a spe dal Flood
_. REMQp.~I I\~. . /\
NEWTENANT IS IIh~ designation area: _V _N /,/~
ACCESS UILDING --..... PLU BI G NO:. ~ r:~ :\\:\
o DETACHED GARAGE ~\\V\\\ \\\
o ATTACHED GARAGE ~!'? ',o:;.y \.~
o CELL TOWER (New) s Indiana State.t1ce..se.#: \\)
o CELL TOWER CO-LOCATE <(;:'- \0":;::--- 'Il\101O
N 0 OEMOLITlON \\\'\\ ~ . ~ ~v \,
\\\ \\\ \ /'
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 IA~"h) ~in expiration timeframes for
beginning and completing construction. \ \\\ \ \ .../
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any'chang~in ;!:e,tl~of land or ctures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning '~n~'tt of Carmel bldtana - 1993" (Z~
289) and amendments, adopted under authority of I,e. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory there;tvf'h.Jrther certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used k occupied until a Certificate of
Occupancy or Su . tan. Completion has been issued by the Department of Conununity Services, Cannel, Indiana. \.,../
OFFICE USE ONLY: ************************************************************************
r/7fJ . S 3
( 0
? c:X!). 0
/07000
~ /7 7 .:::-? Additional Fees
TOTAL: rr . u-1
~ ~ (f (ZJ 5?}7G>
CI'~1e.J tJ..eel e--
6/"{"6
Date
Print
Filing Fees:
INSPECTIONS REQUIRED:
Upper Footing
~~.
~'
# Charged Re-
Reviews
Lower Footing Under Slab
Meter Base ~. Site
Base Inspections:
Cert. of Occupancy:
\
Reviewed/ proved: Dept. of Community Servi
S:PermltslFormslILP COMMERaAL