HomeMy WebLinkAbout06120057 Application
C't .~c IIC" '" h' Permit#: Q&POQ5'}7
t y 0.1 arme lay .L owns tp
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMll.. Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, 8< Accessory Buildings)
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
c'n#-rAUUliIt'J PHO~n~14. t?4BB
~tA Gf<.. ~ I N~PI.~ r:r
NAME: Mf ,.ro L-
STREET ADDRESS:
q<b"70
NAME:
fP (ZGAU'/
lJN~
~~
STREET ADDqSg::uJ I3PwfEt<-
ADDRESS OF CONSTRUCTION:
44C31J W~nN PDI t-lTE b~
Address of Shell Building: (If different than Address of Construction)
BUILDING, PROJECT, OR TENANT NAME:
~ &8,MN
STATE COMMEROAL
DESIGN RELEASE #:
6'dMAN
SCOPE(S) OF 0 FDN 0 STR t'f!iJ ARCH 1: MECH )ti
RELEASE: 'JO ELEC 0 SPKLR OTHER(S):
SEWER UTIllTY A A P u. A CJ ESITMATED COST OF CONSTRUCTION: .. j
PROVIDER: (/+\"rv~ (EXCLUDING LAND VALUE) ;;;<ID.'3DLf
WATER UTIllTY
PROVIDER:~L-
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; AND/OR
CQUtfTY WElL AND/OR SEPTIC PERMIT #'5 (If Applicable):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
)2( COMMEROAL 0 NEW STRUCTURE
(Privately owned hospitals and medical 0 ADDmON
offices/centers are commercial) 0 Room(s)
o IN5TITlJTIONAL 0 Porch
o Municipal/Public 81dg 0 Mezzanine or Deck
o School 0 REMODEL
o Church }J!!f: NEW TENANT FINISH
o MULTI-FAMILY 0 ACCESSORY BUILDING
Number of units: _ 0 DETACHED GARAGE
. 0 ATTACHED GARAGE PLUMBING CONTRACTOR:
FOUNDATION TYPE: (Che'f!l~'-tl'Ach 0 CELL TOWER (New) 12f:.-' I PUIAA.t7IN{~
apply for the new constru'S'~=SED FIfIR ~T~ CO-LOCATE V [",-1/ Y
~ SLAB 0 c~gjPAtliomPI@,~gEi<'ibiih\:ll'fOCTION Plumber's Indiana State License #:
. O~tau, ~ wlt~.~~,lflnu/"'; Ad () /1~,_ t./GC<
o POST & _BEAM ~O'F' C05l!~lltt:ll~~'eOO'es~rOnSN) ~ ~ V (.E. L _
Class I structure permits are sub tcGA4if~nel~dfeftrltlVe_ lrl b{~~ of In~ana (See 675 lAC 12) regarding expiration time frames for beginning and
L}<\ y f~PkQnlJ. ~9~tructlon.
I. the undersigned, agree that any construction, recJ~4~/\,ft'Alargement, rerdc'V:~li;l:iIhtlteration of a structure, or any change in the use of land or structures requested by
this application will comply with, and conform to, all applica61ellfal"s of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana - 1993W (Z- 289) and amendments,
adopted under authority of LC 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 Cero1icate of Occupancy or SubstJUJtial Completion has been
iSS; b theDep tmentofCommunityServices,Cannel,lndiana. J- 4/l-? ~I
L- . \\\ +0:-,~( _^-__::;;>~'f
.J., . 00 I I
# of Floors:
~o
BLDG. CONSTRUmON TYPE:
I
Elevator or Uft: c;J YES
FAX'
"?11, 1714 c;4-<Jz.
ZIP:
4U>~60
BEST METHOD OF CONTACT: '" },
~'"
UWI
01E4 G4-g G>
CITY:
IN1JPL-f,.
FAX:
. <6?,q - :2IJC7L
4U;Z 80
STATE:
IN
sum #: (If Applicable)
101)
Lot # and SuOdivlsion: (If Applicable)
~4
- e.v l&1, q
.. . f.
. Ij,
~
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release
Permit: _Y _N
Lot Split: _Y XN
Manufactured
Trusses:
?'<Y N
-yXN
Sump Pump:
FLOOD ZONE AREA DESIGNATIONCSl
N/^
FOR THIS PROPERTY:
OFFICEUSEONLY:************************************************************************
INSPECTIONS REQUIRED: Filing Fees: 'B'tJ. 00 .
?fJ1J, 00
/07. DO 0
. I ~,()
Upper Footing Lower Footing ~er Slab
e MeterBase ~ Site
~B
Reviewed/ Ap roved: Dept. of Community Services
S:Pennits/FormS/l P COMMERCIAL
(Date)
Base Inspections:
Cert. of Occupancy: