HomeMy WebLinkAbout06080133 Application
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~ Ci!y"'t;JQh>,hitJ-Yay Township 'B germit #: 6fome>\33
o~~: COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
"'''0' ,,- For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of NAME
RECORD:
PHONE
,
STREET ADDRESS
~?O\ <;;.
~
<Q..\.~
PROPERTY
OWNER:
NAME
FAX
STREET ADDRESS
31000
~L,~
LOCATION
8< PROJECT
INfO:
ADDRESS OF CONSTRumON
+.
Address of Shell Building (If different than Address of Construction)
lot # and Subdivision (If Applicable)
o ARCH 0 MECH
OTHER(S):
SQUARE
FOOTAGE: \ D 5;
TAX MAP PARCEL #:
WATER UTIUlY
PROVIDER:
~
ESTIMATED COST OF CONSTRUmON:
(EXCLUDING LAND VALUE) 1-cD (6Di) , .;-
PlAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUN1Y WEll AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Aoors: t
Elevator or Lift: Q YES
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION
o ~~=~~$P:~fO~:STRUC~o~g~~cruRE ~:~%i~:elease Y~N: ru.=;:wred tJ/J
and meCfj~!.om~es/cen,tef'S \Nlll) aIJ re~]UlationsO Room(s)
are cOrllMerdal)J anCi Locai Codes 0 Porch Lot Split: _Y Sump Pu : _.Y ~
o D~p~~-",~ .,[ "liT". 0 Mezzanine or Deck Does any part of the property II ithin a special Flciod
C/-rvO,~jJ(l!f'PfV~g!'IIi: BI~~' Y 0ERVliDEllEMODEL
';.s}S6mlOHIV--LlCL.^YTOWt~~TENANTFINISH designation area: _Y' CiA'-.e>\.,./' '." _ .
V""-Church INn,- 1\11 . ~lI.tCESSORY BUILDING PLUMBING CONTRACTOR: ~" ~
FOUNDATION TYPE: (ChecK ~ItW~1ch 0 DETACHED GARAGE d. ^ ^ - e I n ~\ Q, , I
apply for the new construction area) 0 ATTACHED GARAGE ~ ~~ J I LU \ ~ \ l!..\ trD _"
o SLAB ~RAWL SPACE 0 CEll TOWER (New) I
90r:~ :=:~::::t:othe :ncr~A:::::: R::::~Es t~ oflndi~ (See 675IAC 12) r~~g exp::~~t~:~::~~ ~'\.il
beginning and completing'construction. ! . . ,\ I ..! j II
It the undersigned, agree that any construction, reconstruction, .'~" ~... ~,'!". , or any change in: the uJitt9Gmlor3trQaOOs i I ) I
requested by this application will comply with, and conform to, f. ", . f. '," e :', crring Orpinal}~e .Of ca.rmel Ind.iana - 1993~ (Z' \ \ I
289) and amendments, adopted under authority of l.e. 36,7 et seq. .;:. .," , ts amendatory ~ereto. I further certifY. that only i
kitchen, bath, and floor drains are connected to the sanitary sewer. I further ertify th . ill" fonstruction will not be used 6r occuidedUiliiI aCertiliC8.te of :
Occupancy or Substan Oal Completion ha.s been issued by the Department. ~f c~mm.m;;i:y Servie,", Cannel, Indiana- i -.(:)-4 __~_ __:
~)f'vV\lAA L. -m------~&3 ~
ent Print \ ~ Date
OFFICEUSEONLY:********************************************************~*******~*****
IJ~ONS REQUIRED: Filing Fees: K ff 0/, (; '-1
. . # Charged Re-
~er Footing ower Footing Under Slab Base Inspections: ?PO .< 00 ReViews
Rough In Meter Base ~Site Cert. of Occupancy: I 00 I
~ TOTAL: ____ /' 7 AdditiOral Fees
C. --~~ M
Review /Approved: Dept. of Community Services
S:PennIt:s/FOrmS/ILP COMMERCIAL