HomeMy WebLinkAbout06060143 Application
City of Carmell Clay Township Permit #: O~ ~O /t13
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of NAME
RECORD:
PHONE
, (.1 J7
CITY
St. I hd Jr.
FAX
STREET ADDRESS
PROPERTY
OWNER:
Zqlo W.
STATE
IW
ZIP
BUILDER'S EMAlL ADDRESS
@
In
LOCATION
& PROJECT
INFO:
ADDRESS OF CONSTRumON q q q 8
Address of Shell Building (If different than Address of Construction
So..Y>'\t.
BUILDING, PROJECT, OR TENANr~AME:
I-'o..+io
STATE COMMERCIAL
DESIGN RELEASE #: .3) 7 73 q
WATER UTILITY
PROVIDER:
('
SCOPE(S) OF FDN)( STR
RELEASE: Jll. ELEC 0 SPKLR
'-~
ZONING:
r- J
~ ARCH 0 MECH
OTHER(S):
o
S7fo So Q
SEWER UTILITY
PROVIDER:
one.
ESTIMATED COST OF CONSTR!ifITON:
(EXCLUDING LAND VALUE) '1i /.
oD
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR IJ
COUNn' WELL AND/OR SEPTIC PERMIT #'S (If Applicable): DDC.lec 0 0
# of Floors: Elevator or Uf!: c;J YES It NO BLDG. CONSTRUmON TYPE: Ste..I ("" r. J.
TYPE OF CONSTRUcnON: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
'fj( COMMEROAL 0 NEW STRUCTIJRE Early Release \.A Manufactured '" .
(Privately owned hospitals 0 ADOmON Permit: Y ;"'VN Trusses: L!L...... Y _N
:~:c~'rOR CONSrnUcgI0Mm(s) Lot Split: Y XN Sump Pump: _Y LN
o INSllT1l'l1GIl!IGt to Compliance with <111 rog't::iticl:i~nine or Deck Does any part of the property lie within a special Flood
o Munidpalftllfi~!lll1d Local Ci(ITJ8fREMODEL . .
lIl!fiT OF C 0 MMUNITY~:~.~~NTFINISH designation area: _Y XN
o rc!k",~.,....^ "''''':t'j C ,,;g.O' ~.q:~O!W.,BUILDING PLUMBING CONTRACTOR:
FOUNDATIO : 1{(ln1!CllOl1\!Wmcn U...., QJ 1)i!t)iSH!'Ot(lARAGE f
apply for the new construi:tio;;'.i1l'N~ IANA 0 ATTACHED GARAGE ,. () fl e
'fj! SLAB 0 CRAWL SPACE 0 CELL TOWER (New) Plumber's Indiana State License #:
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE AI / A
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLITION ._tt
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 - 1993" (Z~
289) and amendments, adopted under authority of r.c. 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
Occupanc or ubstantial Completion has been issued by the Department of Community Services, Carmel, Indiana.
cr CLJ.r-l,r JJA,'n/Jr-Rcr 6-qJ{J/;
Print ' , Date
OFFICEUSEONLY:************************************************************************
CTIONS REQUIRED: Filing Fees: "'i ~.g · 1'1
. . :3 0 0 # Charged Re-
Upper Footing ower Footing Under Slab Base Inspections: , ,0 Reviews
Rough In Meter Base ~ Cert, of Occupancy: 7, 1[)
90S, If.
- ~~~^'--
fti.
Additional Fees
Review d/Approved: Depl. of Community Servic.s
S:Permlts/FormS/ILP COMMERQAl
(Dale)
Fee Received by: