HomeMy WebLinkAbout06110021 Application
City ofCarmel/C/ay Township Permit #: tJ hI! O'{)2J
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, llt AccessorY Buildings
I
FAX I
81'5 - 53"?g !
BUILDER of
RECORD:
NAME
~.\2, M~~
PHONE
(t.. SO~~;,-\ClO
dass I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for
beginning and comple' construction.
1. the undersigned, agree that any construction, reconstruction, enlargemen, relocat' n, alteration of a structure, or any change in the use of land or srructures
requested by this application will comply with, and conform to, all applicableVaws 0 he ate of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z'
289) and amendments, adopted under authority of J.e. 36~7 et seq, Genera embl of th 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 ther e' at e construction will not be used or occupied until a Certificate of
Occu~ Substantial Completion has been issued by the D en f 0 'ty Services, Cannel, Indiana.
J,_ ~ .
Signature of Own or Authorized Agent
STREET AODRESS
ot> W.
PROPERTY
OWNER:
BUILDER'S EMAIL ADDRESS
~ 12 OlaZ<O @. ~l.Go
NAME
M2.AI ~\
STREET ADDRESS
(}19 0 LON
Tk,
LOCATION
8r. PROJECT
INFO:
ADDRESS OF CONSTRUCT10N
i<5l<!o L\:Ji'.l<.tH
bR.
Address of Shell BuildIng (If dIfferent than Address of Construction)
? t-11- \loP
WATER UTlUTY
PROVIDER: ~~L
SEWER UTlUTY
PROVIDER: C4(l.t1Il, L-
PlAN COMMISSION / BZA / BPW OOcKET NUMBERS; ANO/OR
COUN1Y WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: "'~'I.-I?_"'. ":' ,iiEJevator or. Uft; 0 YES ~O BLDG. CONSTRUCTION TYPE:
TYPE 0 'C:TiON:~~ 'SO~!STf~'9-1tJWROVEMENT:
~ COMMER~ ~.",~p":nce with:dl /f)~alllew.pRUCTURE
~y @!!,~[I.t#!pffiM:i ',Dca I CodflSP ADDmON
m dl t>ffi~~?W'JiUNI7Y':/[R\;hC 0 Room(s)
r.J~1!!01""9 8' "C:L .. , " as Porch
o '"mSltTtfflONAt,'" hk / CLAy rGVV~\[~I!:UoMezzanineorDeck
o MuniciPal/PulNI!lI8!l.NA d ~~iItODEL
o School , ",' 0 NEW TENANT FINISH
o Church " ' 0 ACCESSORY BUILDING
FOUNDATION TYPE: (eIied< allwhich 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
/'ill, SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
~ POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOlIT:_Y-!LN 0 DEMOLlTION
Print
o
J..Cl:NJ
(Date)
Fee Received by:
CITY
STATE
~~,
ZIP
e..L
BEST METHOD OF CONTACT:
&\\ \.""",,'. S"o8. =&400
.:,?IOO
L
STATE
l
ZIP
L..\l903
Ltl.O'b~
~\.-L
SUITE # (If Applicable)
t"-l .
Lot # and Subdivision (If Applicable)
ZONING:
SQUARE
FOOTAGE: ~ ,1'-\'-1:
TAX MAP PARCEL #:
~ ARCH rJL MECH
OTHER(S):
ESTIMATED COST OF CONSTRU~ON:
(EXCLUDING lAND VALUE) ..q:>
DoC
OCCUPANCY ClASSIFICATION: F.>
PROJECT INFORMATION:
Early Release Manufactured
Permit: _Y LN Trusses: LY_N
Lot Split: _Y jLN Sump Pump: _Y-J(..-N
Does any part of the property lie within a special Flood
deSignation area: _Y IN
PLUMBING CONTRACTOR:
c::;;;-\-u\,~ ~t'alN('f
Plumber's Indiana State License #:
.:: f7 ib\ e '5~ ~(.,.S
\(J- ~ .(t~
Date
Additional Fees