HomeMy WebLinkAbout04120028 Application
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citY of Cannell Gay Township 7 I / ,J ermit:, /' f L-!.(g'
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, Br. Accessory Buildings
BUILDER of
RECORD:
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PHONE
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FAX
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CITY STATE ZIP
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BESTMETliOOOFCONTACT: ca/le..d '7f)E 1:z!IC
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BUILDER'S EMAll ADDRESS
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PROPERTY
OWNER:
PHONE
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FAX
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LOCATION
s.. PROJECT
INFO:
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ADDRESS OF CONSTRucnON
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CITY
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STATE ZIP
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sum # (If Applicable)
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BUILDING, PROJECT, OR TENANT NAME:
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ZONING:
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~ECH
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Address of Shell Building (If different than Address of Construction)
"r ARCH
OTHER(S):
SQUARE
FOOTAGE: :2.000
WATER UTIlITY SEWER UTIlITY
PROVIDER: DP L~ Lv...<<" PROVIDER: c.. L
PlAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WEll AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Aooo;: ~i'itPE: ~ OCClJPANCYClASSIFlCATlON: 'R~\... -l
TYPE OF CONSTRUCTION: of Stat I ons PROJECT INFORMATION:
S,
6l.. COMMEROAl ~PT OF CO,J:;;J" ~T!$ICES EarlyRelea~ /' Manufactured
(Privately owned h rvt:jI'1t[jotrtON> Permit: !!!'Z.Y V N Trusses: _Y ~N
and med,cal offl OF CARMEL / cmA'jloq~WNSHIP , L'
are commercial) I.Q Porch Lot Split: _Y ~N Sump Pump: _Y ~N
o IN5TITUTlONAl NDIA,'i!!' Mezzanme or Deck Does any part of the property lie within a special Flood
o Munidpal/Public Bldg 0 REMODEL
o School ~ <l& NEW TENANT FINISH designation area: _Y.Jlb.N
o O1urch - ~ 0 ACCESSORY BUILDING PLUMBING CONTRACTOR:
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE I
apply for the new construction area) 0 ATTACHED GARAGE C,.,.J~""'PrIS~ E/6:..-I-r.C,4/ o.J'l",,,A<itVlc... tD,
tl!$! SLAB 0 CRAWL SPACE 0 CEll TOWER (New) Plumber's Indiana State License #:
o POST & BEAM 0 BASEMENT 0 CEll TOWER CO-lOCATE ,. / ...., A
(or POST & PIER) WAlKOUT:_Y_N 0 DEMOlITION '-erp 3030061'i I rL I o~ 00 '1CJ-'1
ESTIMATED COST OF CONSTRUcnON:
""'.....I..A.,'( (EXClUDING lAND VAlUE) -f ~,OOO
Oass 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 [0, 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 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 SubstJUJtial Completion has been issued by the Department of Community Services, Carmel, Indiana.
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Signa of OW=r or Authorized Agent Print
CA"-''I+Ot\-
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Date
OFFICEUSEONLY:************************************************************************
INSPECfIONS REQUIRED: Filing Fees: t 2~~ ~~
Upper Lower Footing der Slab Base Inspections: '3. # R:~~e:;S Re-
Rough I: Meter Base Site Cert, of Occupancy: 0 0
TOTAL:
I
Reviewed/Ap roved: Dept. of Community
s:PermIt5/Forms{tlP COMMERaAL
(Date)
Fee Received by: