HomeMy WebLinkAbout06120058 Application
Permit #:
o~ P,ODI)'O
City of Carmel! Clay Township
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
# of Roars: Elevator or Uft: 0 YES BLDG. CONSTRUcnON TYPE: OCCUPANCY ClASSIFICATION: \3
PE OF CONSTRUCTION;' TYPE OF IMPROVEMENT: PROJECT INFORMATION:
COMMERCIAL 0 NEW STRUCTURE
(Privately',owned hospitals and medical 0 ADOmON
o IN=rAfH.~IFOR CONs@~BN
o Mu.7PifuliC ilIalflpliance with alllIilgtltatiOllfliO' Deck
o School '.' . of State and LocJ;aJ C~EL
O 0 ch,jj}ffPT OF COMMU~J~C~~~Nlfr-F).NISH
MULTI-FIII>!If(,.,O "'fF ACtESSl)~lAAtDING
Numberbf'ul1ils: FCARMEL / Cti\YD~~E
',' J~iD'A "1Al ATTACHED GARAGE
FOUNDATION TYPE: (Chec~ all whltl'l ' "LJ CELL TOWER (New)
apply for the new construction area) 0 CELL TOWER CO-LOCATE
~ SLAB 0 CRAWL SPACE 0 DEMOLITlON
o POST &_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
Class I structure permits 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 structures requested by
this application will comply with, and confonn to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Cannel Indiana - 1993~ (Z-289) and amendments,
adopted under authority of I.c. 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 diains are
connected to the sanitary sewer. I funher certify that the construction will not be used or occupied until a Certificate of Occupancy or Substantial Completion has been
i ed by the Depart eot of Community Services, Carmel, Indiana.
"II. ~
n ture of OW' r oi uthorized Agent
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
BUILDING, PROJECT, OR TENANT NAME:
US 0
Nc.,
STATE COMMERCIAL SCOPE(S) OFVO FON 0 STR
.DESIGN RElEASE #: Q RElEASE: 1'\ ELEC 0 SPKLR
WATER UTIUlY ~ SEWER UTIUlY
PROVIDER: c.a PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
t\Q..W\)
-
PHONE:
61S-QQj -%44 FAX: SlS- qlPl-,st!
It-
ZONING:
TAX MAP PARCEL #:
/
..
L
EsrIMATED COST OF CONSTRucnON:~.A ~ ceo 00
(EXCLUDING lAND VALUE) ~ '
Early Release ~
Permit: _Y N
Lot Split: _Y N
Manufactured
Trusses:
YAN
-yXN
Sump Pump:
FLOOD ZONE AREA DESIGNATIONCSl FOR THIS PROPERTY:
__ 'i ~\ ~ ~\-\A\)ffi
PLUMBING CONTRACTOR:
1\m ffitUUn
Plumber's Indiana State License #:
VI. 10lP OD~Q'2-
,JtJtl ma. JilkStrvJ
~
Date
Print
OFFICE USE ONLY: ***********************V***.********************~*,******************
INSPECUONS REQUIRED: ~ I ?!Iling Fees: fR?.. '8'
Lower Footing Under Slab 1'111- Base Inspections: /tOll , () 0
~ Cert of Occupancy: 4' /07 , of)
~Site Q ncJ
1k. \6,:2001.. TO~T .L: , 1ir;!S- L ~
Reviewed/A roved: Dept of Community Services (Date) _' ___
S:Permits/FormslllP COMMERQAL Fee ReceIve :
I;) L;)~
ate