HomeMy WebLinkAbout06090032 Application
City of Carmel/Clay Township Permit #: ()(/o 100.3 Jv
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of
RECORD:
NAME
D~t
STREET ADDRESS
&;00 L
'1 &7>, s+
CITY
[Do
PROPERTY
OWNER:
STREET ADDRESS
[
Lv~
LOCATION
&. PROJECT
INFO:
BUILDING, PROJECT, OR
L, N\
STATE COMMEROAL
DESIGN RELEASE #: r:= '1- €-~
SEWER UTILI1f,j I
PROVIDER: ~CL
PLAN COMMISSION / BZA / BPW DOCKET NliMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
Q NO
BLDG. CONSTRUCTION lYPE:
TYPE F 0 STR ON: TY PROVEMENT:
COMMEROAL \'IS\\'. ,\~SrnUcruRE
\ (Pnvately owned hos~\'. cO \.D "II I'G ADDmON
and medical ~oltilelS C8 "'" GOC,8S At-s..oom(s)
a'!.'i"'I'''''fOi'all\.-;~(f\?\'?\\ I oc,,1 c",v,\j\EJ Jl,~\61
o INSl\l'lVfIO"['Jf<l.o ' .18 '3-(\0 III! CV \N~'Mezzanlne or De<:k
Q2,\l"Itll\idp'C\(P(Jl;jhc BIO"jl\J\'J ~ ~:( iXO kEMODEL
o School O't' CO\ ;., I OJ' 5 NEWTENANTFINISH
o A\l~ r'1>.I'\\-1,(." ",:,.f\ 0 ACCESSORY BUILDING
F 0 TIONlWl'.fQieCk'alrwW~\i)lr 0 DETACHED GARAGE
apply for the . n~ctlon area) 0 ATTACHED GARAGE
B 0 CRAVVLSPACE 0 CELL TOVVER(New)
o POST & BEAM 0 BASEMENT 0 CELL TOVVER CO-LOCATE
(or POST & PIER) VVALKOUT:_Y_N 0 DEMOLIllON
PHONE P
L-. .
{. -€'C)f?
&000
FAA
31'}
9U8"-Io~q
ZIP
STATE
~'\/
erhA'
FAA :] /+
O'c)
cm
()
STATE
~ J ~
sum # <If Applicable)
d.- 0 ()
5
~
H - I 3 - II - 0 -/ -MI. 0
o PLUM SQUARE
FOOTAGE: 3 ' :>
<><-<')0
OTHER(S):
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release ~ ~anufactured ~
Penmit: Y _N ~Trusses: Y N .
Lot Split: Y=L-rr Sump Pump: _y~
Does any part of the property lie within a special Flood
designation area: Y N
PLUMBING CONTRACTOR--;--1jII I
Plumber's Indiana State License #:
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 structu~
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 -19931 (Z~
289) and amendments, adopted under authority of Le. 36~7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and or drains oonected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
u C orSu C tionhasbeenissuedby eDepar:s~\~::eM2~~-:~'an~~ G--I if~
Print ~ I ~ Date
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: (J Filing Fees: 15 q U, 70
. . \ \1- O.....dl # Charged Re-
Lower Footing Under Slab rR..~ Base Inspections: '7-.0 I C/V Reviews
, Meter Base~ Site Cert. of Occupancy: ;' () 7, (:)()
TOTAL~ 7$163.1& -~,-
.;).~ ~ 7. L..-I / {~~
Fee Receiv : 9 ({s/oCe
Up
Reviewed/ pproved: Dept. of Community Services
S:Permlts{Fo sjILP COMMEROAL