HomeMy WebLinkAbout06090095 Application
Permit #:
Ofo09()otts-
City of Carmel/Clay Township
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
STREET ADDRESS:
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BUILDER'S EMAIl ADDRESS:
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NAME:
~'-O
STREET ADDRESS:
"1'>1 . ~(,.o:::" L.,..,~
ADDRESS OF CONSTRUCTION:
NAME:
j~
. ........
PHONE:
{.l
FAX:
CITY: STATE:
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BEST METHOD OF CONTACT:
ZIP:
,,"-,
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PHONE: FAX:
c., 41, '"S'-
em: STATE: ZIP:
c..,./l.I\o\t' IN Y <.>,
SUITE #: (If Applicable)
,.,~
Address of Shell Building: (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
+-2>
Lot # and Subdivision: (If Applicable)
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of C:;tate ""SEWERUT1UTY(_.S~
....... ..... <:.! I~PROV'I1)ER:.,'._;l:'0 .
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WATER UTILITY
PROVIDER:
. TAX MAP PARCEL #:
o ARCH
OTHER(S):
- 0- ...00_
SQUARE ~
FOOTAGE: fC/
ESTIMATED COST OF CONSTRUCTION: ~ Z.Sf''30.-
(EXCLUDING LAND VALUE)
o MECH
o PLUM
",.
)/Irs".
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PlAN COMMISSION I BZA-tBPWDOCKE;1iNUMBERS; AND/0Ry TOV"NSHIP
COUNlY WELL AND/o"R'SEPtH:'PERMIT #"sldf;Appllcab"le):-1 'J j
l"lnl^"'f\ N ,..,~w "'Z.c::.J<:..l
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# of Floors: Elevator or Uft: Q YES q NO BLDG. CONSTRUcnON TYPE:
TYPE OF CONSTRUCTION:
~ COMMERCIAL
(Privately owned hospitals and medical
offices/centers are commercial)
o INSTlTUTlONAL
o Municipal/Public Bldg
o School
o Church
o MULTI-FAMILY
Number of units: _
ING CONTRACTOR: ._
__<'~. ~~';.Jl
_,_ ..-;.- _ I'. ,-J \
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mber's Indiana~Stite Lice'nse"#: \'.\ '\ \
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Class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) r'eg~din~ expi on time frames fOf~nning and\
completing construction. \\\ \\ \ ,~.---:.--
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any chirige'inthe 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 Cahhel Indiana-=- 1993ft (2- 2ll:9) and.wendments,
adopted under authority of LC. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further\ertify that onl~l<itchen, bath, and floor drains are
connected to the sanitary sewer. I further certify that the ction' not be used or occupied until a Certificate of OCcupancy-or Substantial Completion has been
issued by the Departme of Community Services me!, Indiana. \,........./
(! 'i' or
dO
FOUNOATION TYPE: (Check all which
apPI~wr the new construction area)
~ ~LAB 0 CRAWL SPACE
o POST & _BEAM _PIER 0
TYPE OF IMPROVEMENT:
o NEW STRUcruRE
o ADDmON
o Room(s)
o Porch
o Mezzanine or Deck
REMODEL
NEW TENANT FINISH
ACCESSORY BUILDING
DETACHED GARAGE
ATTACHED GARAGE
CELL TOWER (New)
CELL TOWER CO-LOCATE
DEMOLITION
o
o
o
o
o
o
.'t"s
o
BASEMENT (WALKOlfT:_Y_N)
p
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OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release
Permit: _y iN
Lot Split: _Y....!...N
Manufactured
Trusses:
_Y+N
_Y-4-N
Sump Pump:
FLOOD ZONE AREA DESIGNATIONrSl FOR THIS PROPERTY:
It...~
"\ - ""- CI (.
Date
Upper Footing
INSPECllONS REQUIRED:
*****************************************************
Lower Footing Under Slab
Final~
Filing Fees:
Base Inspections:
Cert. of Occupancy:
TOTA :
2~
(Date)
Reviewed/Ap roved: De t. of Community Services
S:Permitsjforms/I P COMMERCIAL
Fee ReceIved by:
Date