HomeMy WebLinkAbout06100054 Application
City ofCarmellC/ay Township Permit #: Ole 1010051
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLIC~TION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, 8r. Accessory Buildings
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
LLC. PHONE 751-0/
L Lc..
Address of Shell Building (If different than Address of Construction)
J:N
SCOPE(S) OF
RELEASE: .. ElEC ~
WAlER lI11LITY C SEWER lI11LITY
PROVIDER: RIl>~ PROVIDER: C A
PlAN COMMISSION I BZA I BPW DOCKET NUMBERS; ANDIOR
COUNTY WELL ANDIOR SEPTIC PERMIT #'S (If Applicable):
t:Z
# of Floors:
/
Elevator or Uft: Q YES liC NO
BLDG. CONSTRUCTION lYPE:
TYPE OF CONSTRUCTION:
ll1 COMMEROAL
(Privately owned hospitals
and medical Offices/centers
are commercial)
o IN5TlTUTJONAL
o Municipal/Public Bldg
o School
o Church
FOUNDATION TYPE: (Check all which
apply for the new construction area)
I8l SLAB 0 CRAWL SPACE
o POST & BEAM 0 BASEMENT
(or POST & PIER) WALKOLrr:_Y_N
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ADDmON
o Room(s)
o Porch
o Mezzanine or Deck
o REMODEL
1i( NEW TENANT ANISH
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o CELL TOWER (New)
o CELL TOWER CO-LOCATE
o DEMOLmON
FAX
CITY
C,
STAlE
ZIP
LfG
~
IaL
PHONE
7S 3-()/
CITYC
FAX
SUITE # (If Applicable)
Lot # and Subdivision (If Applicable)
MECH
SQUARE 8
FOOTAGE: 00
$3 s: 00
TAX MAP PARCEL #:
ESTIMAlED COST OF CONSTRUCT10N:
(EXCLUDING LAND VALUE)
OCCUPANCY CLASSIFICATION:
Early Release.J Manufactured \/
Permit: _Y J'LN Trusses: _Y-A-N
Lot Split: _y.JtN Sump Pump: _y::1...-N
Does any part of the property lie within a special Flood
designation area: _Y ~N
PLUMBING CONTRACTOR: R.OrJ 1\ "-It) E:/l..S"tJ
e;<O.L f\b>1.-t-\A,.ilU4L. ,TNc
PlumbefS Indiana State License #:
LO (;.. ~ \ u.."
Class I structure pennits 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 Carmel Indiana -1993" (Z~
289) and amendments, adopted uncler authority of J.e. 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 Certifica.te of
Occu cy or SUbsJt:ti Completion has been issued by the Department of Community Services, Carmel, Indiana. I :
'I. 'lit K ,OH"F"Pf Mv/lt/\l ~ g/blOfc,;
Signature of OWner or Authorized Agent Print Date
OFFICE USE ONLY: *******************************************~)j**~*********************
INSPECTIONS REQUIRED: () TV Filing Fees: tf..35.0~. Iir-~
\, I .., A'I /t") /?"\ # Charged Re-
Upper Footing Lower Footing Under Slab ~d Base Inspections: ~ ,() U " L/' ( ./ Revier
c9 Meter Base C Fi;.;o Site / () CJCJ ;
Additional Fees
c,
(Date)
Fee Received by: