HomeMy WebLinkAbout06100210 Application
City of Carmell Clay Township Permit #: () fA I Oi 0 ;Z /0
,
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLmATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. AccessoryiBuildings
BUILDER of NAM~ Qo PHONE 3/1- FAX 3/1-
RECORD: l,,-- "- "'" Ai<> cf> 8'CJ -en () Od /fo
STREET ADDRESS CITY STATE ZIP
06 [' au ~ ~ <f6d.
BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
r:..s. . U> ~ YV\..~
PROPERTY NAMED 3{..j FAX :J I:;'
OWNER: ~r:- " 6'0
STREET ADDRESS CITY STATE ZIP
La 00 2. Cz (,,1>, s+,,,,,,-+ do ~ -:r::,J
LOCATION ADDRESS OF CONSTRUCTION 9 ~ S4, SU # (If Applicable)
&. PROJECT (yoo 2. ~ I dO
INFO: Lot # and Subdivision. (If Applicable)
~LOING, PROJEC'hOR TENANT NAME:
D LL t( \' \,J La 1='
STATE COMMERCIAL
DESIGN RELEASE #: 3 d I II' L E?
ZONINGQ /
c'e.^, , U '+'
SCOPE(S) OF 0 FDN 0 STR \y ARCH ~MECH
RELEASE: vf ELEC 0 SPKLR OTHER(S):
TAX MAP PARCEL #:
Ifp-I-3-/J-D 't-I't-"O(. D/O
.,('PLUM SQUARE
FOOTAGE: 9- .3 (.,
SEWER UTIlITY
PROVIDER: ~ G.
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUN1Y WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) ISo Cl
# of Roors: Elevator or Lift: 0 YES 0 NO BLDG. CONSTRUCTION TYPE: \\-'0 'S'?'I-. OCCUPANCY CLASSIFICATION: ~ \i: E. M
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
r'x! COMMERCIAL 0 NEW STRUCTURE Early Release V Manufactured V
't\ (PrIvately owned hospitalS 0 ADOmON Permit: _y ~N Trusses: _Y..6...N
and medical officeS/centers 0 Room(s) /v; \,.,
arecommerdal) 0 Porch Lot Split: _y_,,,N Sump Pump: _y~
o INSTITIJTlONAL 0 Mezzanine or Deck Does any part of the property lie within a special Flood
o Municipal/Public Bldg ~ REMODEL N
o School 0 NEW TENANT FINISH designation area: _ Y..LLN
o Church 0 ACCESSORY BUILDING PLUMBING CONTRACTOR:
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE 1/ (
apply for the new construction area) . ,c.~g\j~:ffACt'jER GARAGE -'1'-- II"., 5 " "r ^ J
.~ SLAB 0 CRAWL SPACE'.Cn'," 0." CE.LprOWER (New) Plumber's Indiana State License #:
o POST & BEAM 0 "'sASE~fENT' . " ~GJ ' CEll TOWER CO-LOCATE 11 poco / 1 J I
(or POST & PIERjt't:5Y~!f9UT:~Y~N' ,0 D~t1~t:f!Q.N L 0 0 l(? 6 I l d-
dass I stru~r~ Penni~ ~~~~_bj~ct t'? the'Ge'nJ~al A~s_d:iti~ 'Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for
0"1'" n~--= C'.....; .. . C\J:d \ 'l5eginnmg and completing construction.
I. the undersigned}&;ee that any cOflSt'CllctionJ re~o~truction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this lPptic~ti@.~ll'comply \~F~l ~d:cO'iiform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana -1993" (Z'
289) and amendnients, adopted under authority of I.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 Certificate of
~0Cr;rSubstantial Completion has been ~ued hy the D~ Conununity Servi/l, Cannel, Indiana.
~ r. ~..e 1S I O-Al~n. ~J .,^) Cr- /O-do-nfc
Signature of OWner r Authorized Agent Print - Date
00"
Filing Fees:
Base Inspections:
/7
Cert of Occupancy:
/
TOTAL :/
'-_-/ t
Fee Received by:
OFFICE USE ONLY: ***********************************************
(!),
J\\~
INSPECTIONS REQUIRED:
Upper Footing Lower Footing Under Slab
Meter Base @ Site
Additional Fees
~ ~eviewed/Ap roved: Dept. of Community Services
~:Permlts/Form COMMEROAL
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