HomeMy WebLinkAbout06110037 Application
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City of Carmel/Clay Township Permit #: 0 ~ H~7
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory ~uildings
BUILDER of
RECORD:
L ~ONE 0/+ FAX 3/:;' -
d. .f- 000
STREET ADDRESS ZIP
0 >: '7 ~ ~s+ aD
BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
Q CD e 'l
PHONE FAX
BUILDING, PROJECT, OR TENANT
~
~C1__
STATE COMM OAL
DESIGN RELEASE #:
\ l
c~
STATE
/
ZIP
PROPERTY
OWNER:
LOCATION
&: PROJECT
INFO:
ADDRESS OF CONSTRUCTIprj
... k/ -e
Address of Shell Building (If different than Address of Construction)
WATER UTILITY
PROVIDER:
SCOPE(S) OF ~ FDN 0.. STR
RELEASE: ~ ELEC 0 SPKLR
SEWER UTILITY (\
PROVIDER: 0 ~ CA- )
-0 <55 00
SQUARE
FOOTAGE: :5 'I .;:L q
GoI
CL
OF CONSTRUgION:
(EXCLUDING LAND VALUE) .:p '7 r;, :f
as-$
PLAN COMMISSION / BZA / BPW NUMBERS~~R
COUNTY WELL AND/OR SEI'T1C PERMIT #'5 K~~~Ys
# of Floors: H EI )~~'i:l,., ","~ 0 N,?" BLDG. CONSTRUCTION lYPE:
PE F((,: 0 ~o~~0~tB'~c,~MPROVEMENT:
~ ;J.\")'\I' ~:'Nm' NEWSTRUCTURE
S\l'O va~~W.st..hO)i~h\1~~, ,t.'1 ,\0" 0 ADDmON
and m lE!!I @Ice,j~qtefCV' 0 Room(s)
~'''rda~WI'C-\..- ~f>- 0 Porch
o ,~\N0\~ 0 Mezzanine or Deck
,.~ niciPWPuO!c Bldg .lr~EMODEL
vI tj School e5tv'1" ,~NEW TENANT FINISH
o Church "6 ~&l. 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which <:l 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
~ SLAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLmON
OCCUPANCY CLASSIFICATION: ~ \;<cN
PROJECT INFORMATION:
Early Release Manufactured
Permit: _Y 4N Trusses: _Y 4-N
Lot Split: _Y~ Sump Pump: _Y-f-N
Does any part of the property lie within a special Flood
designation area: _Y -4N I
PLUMBING CONTRACTOR:
K I"-~ 1'\ t>,rJ
Plumber's Indian tate LIcense #:
Q P I?' (1--(" 0 ( '-f I d---.
dass 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 structu~
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 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 o~
cyor Substantial Com letion hi been issued by the Depar~ent of Community Services, Cannel, htdiana. ,
- 1 O-rJ'--I c.. I-+-_r-J.. ,~ 11-3 -0<.,
Signature of Owne or Author ent Print l J Date
OFFICEUSEONLY:************************************************************************
. INSPECTIONS REQUIRED: (5 Filing Fees: . , c;
. I 0 ~ ,,"'" # Charged Re-
Upper Footing Lower Footing Under Slab if 'J.iJv Base Inspections: u. VL/ Reviews
~ Meter Base C Final..7 Site Cert. of Occupancy: I 0 .
~~(P.
[..[
tl/1-'1/?(/J
Additional Fees
TOTAL:
o
jApproved: Dept. of Community Services
rms/lLP COMMEROAL
00"
(Date)