HomeMy WebLinkAbout04120032 Application
City of Carmel/Clay Township Permit #: (!jf-:A,V03;<.
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT AP LICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, 8r. Accessory B'uildings
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CITY
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BUILDER of NAME
RECORD:
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FAX
BUILDER'S EMAlL ADDRESS
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
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NAME
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LOCATION
& PROJECT
INFO:
ADDRESS OF CONSTRUCTION
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SUITE # (If Applicable)
Address of Shell Building (If different than Address of Construction)
Lot # and SubdivIsion (If
BUILDING, PROJECT, OR TENANT NAME:
La..c....e....
ZONING:
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STATE COMMEROAL
DESIGN RELEASE #:
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o ARCH
SQUARE
FOOTAGE: c:::.. fY"."
J,u::..A.J
WATER UTILITY
PROVIDER: -:s:.rJ, Qf\
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SEWER UTILITY
PROVIDER: cJ Q:
ESTlMATED COST OF CONSTRUCTIO!j:
(EXCLUDING LAND VALUE) ~ ~O 0
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS: AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors:
L OCCUPANCY CLASSIACATION:
PROJECT INFORMATION:
TYPE OFC NSTRU ,'" :
COMMEROAL of pb__a~(i'!f' .~~
(Privately ow~J& et:gW€!rtoEJlI \\oom0N
and medlcaldfll~~w.o~N;!I;r:y1 ~S
o IN~o~~lffi\IJj!0 _' ~l,R""k
o Mumopal/Public Bldg INDIA' REMODEL
o School ,.. '0" NEW TENANT FINISH
o Church 0 ACCESSORY BUILDING
FOUNDATION TYPE: (Check all which 0 DETACHED GARAGE
apply for the new construction area) 0 ATTACHED GARAGE
rn"S'LAB 0 CRAWL SPACE 0 CELL TOWER (New)
o POST & BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
(or POST & PIER) WALKOUT:_Y_N 0 DEMOLmON
Manufactured \.../.'
Trusses: _Y ~
Sump Pump: _Y ~
Does any part of the propertpie within a special Flood
designation area: _Y ~N
PLUMBING CONTRACTOR:
b n\-.e rpr\-tW'
Plumber's Indiana State License #:
Early Release ,/,
Permit: _Y ~N
Lot Split: _Y vN
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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 Carmel 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 Substantial Completion has been issued by the Department of Community Services, Cannel, Indiana.
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Print - 1
1')- {; -01..{
Date
,
,
OFFICE USE ONLY: **************************************** ********************************
INSPECTIONS REQUIRED: Filing Fees: -Ill ("5" ~ GO I
J 7... rJO # Charged Re-
Upper Footing Lower Footing Under Slab Base Inspections: : 'if I Reviews /
~ Meter Base Q Site Cert. of Occupancy: tJ , 0 0 M
LA.... v 5: Additiona es
Reviewed/App oved: Dept. of Commu ity Services
S:PermIt:sfForms/l CQMMEROAL