HomeMy WebLinkAbout07010006 Application
\""fty of Carmel/Clay Township Permit #: (J 7fJ/o et>/p
"lMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
,
'T~ICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
.cCORD:
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
STATE COMMERCIAL ~
DESIGN RELEASE #:
.(
~J:) L . f PHONE'.!/ ~,x:r;.
1. ~rrp/6 )x)'
BEST METHOD OF CONTACT:
. t.ovt
PHONE: FAA:
.:3 I t3d3~tZZJ
1fbA /AJ
E;OOF CON=,Uczr(p--lh St
Address of Shell Building: (If different than Address of Constructlon)
utJ.I>t!!..L
SUITE #: (If Applicable)
Lot # and Subdivision: (If Applicable)
ZONING:
e&
SCOPE(S) OF 0 FDN 0 STR 0 ARCH 0 MECH 0
RELEASE: 0 ELEC 0 SPKLR OTHER(S):
WATER UTILITY /I i1 t) A A
PROVIDER: L.f1 t:,..-IVI f1-
SEWER UTILITY
PROVIDER:
ESTIMATED COST OF CONSTRUcnOrw -:z-.,.
(EXCLUDING LAND VALUE) ff '-'0
0-
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'$ (If Applicable):
PE
)c$
# of Floors:
Elevator or Uft:
YES Q NO
BLDG. CONSTRUCTION TYPE:
.' R CONST . ROVEMENT:
~<;If1\-comOljan. c~ with ail (E@lI~~RUCTURE
,':lt~iy .!'Y'~I~(t~05I1lW.~'I"MJ~lebdE!SJ ADDrnON
offlces{_..lii\!~ofNrli!!rOlaQ~.. SERVI~S Room(s)
o IffifflJifI~~OMMUNITY . . . . i1t/rch
'tJ'Ji!\lDi?p~llRubliE-~dg.. CLA.. :or TOWN \~ezzanlne or Deck
CrEf iGlfioOl'Al1iV1t:' ~ REMODEL
o Church INDIANA O. NEW TENANT FINISH
o MULTI-FAMILY 0 ACCESSORY BUILDING
Number of units: 0 DETACHED GARAGE
o ATTACHED GARAGE
o CELL TOWER (New)
o CELL TOWER CO-LOCATE
o DEMOLfTION
FOUNOATION TYPE: (Check all which
apply for the new construction area)
tp... SLAB 0 CRAWL SPACE
~ POST&_BEAM _PIER 0
BASEMENT (WALKOUT:_Y_N)
OCCUPANCY ClASSIFICATION: 5
PROJECf INFORMATION:
Early Release \ /
Permit: _ Y -l6-:-N
Lot Split: _Y iLN
Manufactured
Trusses: _y AN
Sump Pump: _Y ~
FLOOD ZONE AREA DESIGNATIONfSl FOR THIS PROPERTY:
;.0 l{7LL<:)ft ~
~G CONTRACfOR:
~s Indiana State license #:
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 conform 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 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 Certificate of Occupancy or SubstJUltial Completion has been
i ,db tb,D',pa1(m olCum unltyS"os,C",md,Indlana. ~bL, 'J:u rJbrJ I J-~/o1
Signature of OWner or Authorized A nt Print Dabf
Under Slab
Base Inspections:
Cert, of Occupancy:
Upper Footing .," .Lower Footing
Site
Fee
Date