HomeMy WebLinkAbout06080084 Application
City of Cannell Clay Township 51 (- ) '-t'1 V Permit #: [XDO'D DOrff
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
.-.-
STREET ADDRESS
t!'>3<; J.
*"l
9.
ZIP
z--} . 3 ..L
BEST METliOO OF CONTACT:
3n-?~{ .~ c...16 0
STATE
-LvJ
BUILDER of
RECORD:
PROPERTY
OWNER:
1')-1%'60
FAX
STATE
ZIP
<-) 10 ).;)- ()
LOCATION
& PROJECT
INFO:
ADDRESS OF CONSTRUCI1DN
'-I I
sf.
-i
sum # (If Applicable)
D
Address of Shell Building (If different than Address of Construction)
# of Aoors:
Elevator or Uft: 0 YES
BLDG. CONSTRUCI10N TYPE:
BYI~ING, PROJECT, OR TENANT NAME:
\J;!lQ (....- [r,'t r"
STATE COM EROAl
DESIGN RELEASE #:
WATER UTIlITY :lRIaIlIl
PROVIDER: ~
SCOPE(S) OF D FDN D STR DURCH D MECH D
RElEASE: ?\JELEC D SPKLR ~(S):
SEWER UTIlITY .L.-.-W. .... C Tf:! Wi) ESTIMATED COST OF CON
PROVIDER: ~\ll( L ,LJ (EXClUDING LAND VALUE
PlAN COMMISSION I BZA I BPW DOCKET NUMBERS; ANDIOR
COUNlY WELL ANDIOR SEPTIC PERMIT #'S (If Applicable):
TYP OF CONST UCTION: TYPE OF IMPROVEMENT:
COMMERCIAL 0 NEW STRUCTURE
(pnvately owned hospitals c:?1r@PmoN
R~.-=rol;r1'7~rCONSTRU Ul'tJ Room(s)
o ~O~~Qmptlance Wltrl all rr;~JlJat\OnGJ Porch
,~ I.... .... ,I ~ "'~ 0 Mezzanine or Deck
o MunidpaJ/I'ulllit:BlogCa U..,~, ~ODEL
D~-pct'??1 CCli,1MUr'Jil'{ See NEW TENANT FINISH
nl.,E ~lu~c)1 '-D W::1 I (' 1 A Y T G V :' Sl'ct!BSORY BUILDING
FOUND!Yl!UN uI'ElJ(Qleck-sH whlCti . 0 DETACHED GARAGE
aiPI for the new construCl!<!lDi(ea)A 0 ATTACHED GARAGE
SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT.. '. '.' 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT: Y~N 0 DEMOUTION
Class I structure pennits are subject to.{he 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, Dr 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, bath, and floor drains are connected to the sanitary sewer. I funher certify that the construction will not be used or occupied until a Certificate of
:'_'/ 5ubsWltial Completion has been issued hy the Depar~ of Community Services, Carmel, Indiana,
~~ L4~) f{~ _ <;}-/tj-O(C
Signature of Owner or Authorized Agent Print Date
OCCUPANCY CLASSIFICATION:
.,
PROJECT INFORMATION:
Early Release \ /1 Manufactured V.
Permit: _Y ----P,.LN Trusses: _Y ~N
Lot Split: _Y -J(N Sump Pump: _YA-N
Does any part of the prope~ie within a special Flood
designation area: _Y
PLUMBING CONTRACTOR:
)Jo i]L:>>o,LI:Z ~I'J7 Dart<=--
Plumber's Indiana S te License #:
-7 raM
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: :3 0 ;;Z ~ () 0
Lower Footing Base Inspections: 1.., D f) , O()
Cert of Occupancy: 1 ~' ()~
TOTAL: $_~ 1, _0.
Meter Base
# Charged Re-
Reviews
Site
A
Additional Fees
ommunity Services
Fee Received by: