HomeMy WebLinkAbout06100123 Application
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City of Carmel/Clay Township Permit #: tJlOlDO/2 g
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
MGr2JDI/.UJ J\"GDrUlL Ac,c,QGrA'T>".0/00. C ,0,1'1' 575'01"10
STREET ADDRESS: CITY: STATE:
40\ PGd'-'NS'iL.VA-NIA PA-I2-lClCAY 't-JDI/\--NAPC:>uS IN
ADDRESS OF CO UCTION: SUITE #: (If Applicable)
I 2- e:TH M(d7 i b I A-r0 STl2CrST J>reA,\6L . II\J
Address of Shell Building: (If different than Address of Construction) Lot # and Subdivision: (If Applicable) I '10q..3
SA-Iv'\(::: As BOV<E:=. !\JOT A-PPuCAo"""LE:;
BUILDING, PROJECT, OR TENANT NAME: ZONING: TAX MAP PARCEL #:
G-SGULAPJU5 f\,~GDI SPA B0l
STATE COMMERCIAL SCOPE(S) OF 0 FDN 0 STR '~' ARCH iM. MECH .~ PLUM
DESIGN RELEASE #: RELEASE: '>Il. ELEC 0 SPIQR OTHER(S):
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
WATER lJT1UTY
PROVIDER:
NAME:
L !>'-l,)'1,4
'O"-.JS.T e..oC:':T I Ot-J , LLG
STREET ADDRESS:
40\ P"",I0IJS'ILlJ A-.J 1 A PA-R-cwA.'1
BUILDER'S EMAIl ADDRESS:
M \,'E::::N'IJ lV\ I bLI A. Ll\-UT1+, 10 <:::;:;T
NAME:
SEWER UTIUTY
PROVIDER: CA-e.Jv\ o=L.
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WEll AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: .3
Elevator or Uft: )( YES 0 NO
PHONE:
(31'-) 848 -[oecD
FAX:
(.31'1) '348.- Lobi I
CITY:
\NIJIAIJI\-Pou~
STATE:
10
ZIP:
4 L-,Z-ff.)
BEST METHOD OF CONTACT:
C- -1\..AA-IL
PHONE:
FAX:
(-3 If;,) 5<:0 4 - 3 I .4Q
ZIP:
4G 2<2;0
3AS
O()
.C'.
~
~
SQUARE
FOOTAGE:
5) 12Cj
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) 41- 4S'5 I eeL:>
BLDG. CONSTRUCTION TYPE: E X5T,:::.F'I< OCCUPANCY CLASSIFICATION: B 1 eE:H
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
I)Q COMMERCIAL 0 NEW STRUCTURE
(Privately owned hospitals and medical 0 AQOmON
offices/centers are commercial) C\\(O,,1. Room(s)
o INSTITUTIONAL ~\S\?-\.i \S\Sporch
o MuniCipaI/P,:,,~c.BI,dg,O\~ II (09\Nl- 0 Mezzanine or Deck
o Sm.opl,-~) \'. ~~ e 'o/.J\\n 3- rful;. R~~Q!>E~
_0.;\ <';!lurch', n("~"&' ,C OC3-1 CO;\Rr>-'I'l6WTENANT FINISH
o MiJt:f.r-F~}.bY)\.-'_~\'j ,\('J \.. ~\\'I~' I\~C!?...sORY BUILDING
Nurjjbl)r of U",ls::~,I\iI'J ,/ L\lObEtACHED GARAGE
_ ".-<: C'.Y":':.. I clY"o ATTACHED GARAGE
FOUNDATIO'1 'P'~E:, (C~"c~all.\,,!,.hich ~ 0 CELL TOWER (New)
apply for the new c~~tr\!ction ,~U\~~ 0 CELL TOWER CO-LOCATE
~ SLAB C\\'I 0 CRAWL SPACE 0 DEM0LfT10N
o POST &_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
PROJECT INFORMATION:
Early Release V
Permit: _Y ~N
Lot Split: _Y 1N
Manufactured
Trusses:
Sump Pump:
_ylLN
y..x.N
FLOOD ZONE AREA DESIGNATIONfSl FOR THIS PROPERTY:
<Jj. :.. I _1"- . DLe.. X l.t ns~ed
PLUMBING CONTRACTOR:
(..S <l- 1\..'\
1\,~ <=e..H A-W I CAL CD Nbr; j I NG.
Plumber's Indiana State License #:
PO I 0 (,,43'T
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 be~inning and
completing construction. l : "\ 'J. ?GG'o
I, ~he un~er~igne~, agree that .any construction, reconstru.ction, enlargement, relocation, or alteration of a .structure, or any change;n the use oClai\"C\" or struGtures requested by
thiS application will comply With, and conform to, all applicable laws of the State of Indiana, and the gZomng Ordinance of Cannel IndIana - 199'3'J.I(Z~ 289) and amendment~,
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 diains are
connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of Occupancy or Subsl:1u1tial Completion has been
issued by the Department of Co~~ Se~~}~~I, Indiana.
~ ~ t~? -;?-'---'- tv1A~V VblJT1"--'IIC=-tL/flr
Signature of OWner or Authorized Agent
Print
10/13/0(0
Date
OFFICE USE ONLY: ************************************************************************
INSPECTIONS REQUIRED: (!J ./ Filing Fees: IM7. 0'/
Upper Footing Lower Footing Under Slab I ~1-S Base Inspections: ~d < (!J 0
~ ()1.00
~ Site 5" ~,S;
o 0010
Reviewed/Ap roved: oept. of Community Services (Date)
S:PerrnitsjFormS/1 COMMEROAL
Fee Received by:
Date