HomeMy WebLinkAbout06110112 Application
City of Carmel! Clay Township Permit #: tyro.! I CJ .I / ';)..
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUILDER of
RECORD:
FAX
6s
PROPERTY
OWNER:
ZIP
~'58
LOCATION
& PROJECT
INFO:
lot # and SUbdiV1Z ;f;LIlf;l3
TAX MAP PARCEL #:
WATER UTILITY
PROVIDER:
SEWER UTILITY
PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: I
Elevator or Un:: 0 YES )( NO
BLDG. CONSTRUcnON TYPE: /1 - 8
OCCUPANCY CLASSIFICATION:
/VI
TYPE OF CONSTRUcnON: ROVEMENT:
. COMMERCIAL C01:'\5\ \J\~UCTURE
(PrIvate,y~wn~~B .J ',\\'11 ::;\\ 1r' ADOmON
and lfjW/tente\laJ1c8 "" ~OCeS. ~$oom(s)
O a a~l/., cO(1'\?' \'10 \_Oca\ v SE5'\\}\~~,~~\01
IN GM\~ -",cr\e g, IN\\'! \I"I'l6lM.\lza",n~ or Deck
u",ap8l;PObg~~~\\~ 'v' \J'. 'i rrP P.I:MODEL .... .":.te.R>,,
o S~ Of \:.\...1 C ., NEWTENANTFINISH ~
o Ull\i.f'~ (",h'?<"':~u;-,\p..Np.. 0' ACCESSORY BUILDING
FOUNDATIO~: ~eCk all Wfli<:n' 0 DETACHED GARAGE
apply for the construction area) 0 ATTACHED GARAGE
D 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 DEMOUTION
PROJECT INFORMATION:
Early Release V Manufactured ~..
Permit: _Y -AN Trusses: _Y ~~
Lot Split: _Y ~N Sump Pump: _Y ~
Does any part of the property lie within a special Flood
designation area: _Y XN
PLUMBING CONTRACTOR:
.J Ai c...
\
'.\\
II
\ \
)
\ '",.....
\
Plumber's Indiana State License #:
8ago 180Co
~
.,{\\
1'1,"" . ..' ,.-
Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames f~__~'~
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 la.nd 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 - 19~ (Z;--
289) and amendments, adopted under authority of LC. 36-7 et seq, General Assem y of the State of Indiana, and all Acts amendatory thereto. I further certifY that only
kitchen, bath, an - _.-'. nected to the sanitary sewer. I furtherce . that the co ctl n will not be used or occupied untUa-CertuJ teol
cy. u aJ Completi . y e ent of onununity rvices, armel, Indiana.
....
Print
OFFICE USE ONLY: **************************************** ********************************
S 1/, 00
3' 00,00
ItJ7.oo
'j 0
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INSPEcnONS REQUIRED:
Site
Filing Fees;
Base Inspections:
Cert. of Occupancy:
# Charged Re-
Reviews
(')
/ Approved: Dept. of Community Services
rmS/lLP COMMERCIAL
lo
Additional Fees
c
Fee Rece