HomeMy WebLinkAbout04120033 Application
City of Carmel/Clay Township Permit #: fj1f2CO 33
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
BUILDER of
RECORD:
STREET ADDRESS
CITY
STATE
~
BEST METHOD OF CONTACT:
~ (Y)cll
BUILDER'S EMAIL ADDRESS
PROPERTY
OWNER:
LOCATION
&. PROJECT
INFO:
TAX MAP PARCEL #:
SQUARE
FOOTAGE: 'd,<t;
ESTlMATED COST OF CONSTRUcnON:
(EXCLUDING LAND VALUE)
WATER UTILITY
PROVIDER:
SEWER UTILITY
PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Roars: Elevator or Ufl: [) YES BLDG, CONSTRUcnON l'IPE:<.. \L OCCUPANCY CLASSIFICATION:
TYPE OECONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
~COMMEROAL 0 NEW STRUCTURE Ear1y Release /" Manufactured . /
(Privately ownedA~itals 0 ADOmON Permit: Y ~ Trusses: -=JV'N
and medical offil!(~t~ 0 Roam(s)
are commerdaISUb.'<.J1Sl:0 FaA 0 Porch Lot Split: _Y N Sump Pump: _Y N
o INSTITUTIONAL ~/lCI 10 Co ' CO! Mezzanine or Deck Does any part of the prop~rty " within a special Flood
o MunidllQ.l/Public '!l\l~t fT/Pftancs' '{jjijf;i/t"J
o SchoolUl:Pr OF ate a/)d '-0 II WrrJfJWJT:I!'MsH designation area: _Y N
F 0 Ch~7V f),.. COMMU I ~OR'f'il\:lfi.~ING PLUMBING CONTRACTOR:
TION : (Che"tPr.lIOJ/hU:~. .' ED GARAGE Ii' h
apply the new construction are'a'fV/CL / C~ E n I l/\.QJ rry)
~ SLAB 0 CRAWL SPAlktOIAN C liJ () Plumber's Indiana s'eJe LIcense #:
o POST & BEAM 0 BASEMENT CELL TO - OCATE r p { \ L' \" -,-, (' A
(or POST & PIER) WALKOUT:_Y_N 0 DEMOliTION _' ~~ nO I d, )}O
Class I structure pennits 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 ofle. 36'7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
\.Gtchen, 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
'Jccupancy or Substantial Completion has been issued by the Department of Community Services, Cannel, Indiana.
\CiA~aul / K~ CJIU/ (i-i'cJ(
'1ature ner or Authori~ Agent Print I
\ '
ICE USE ONLY: ********** *** ******** * ** ******** ** ****************** ***'~ * * *** *** *******
\ INSPECTIONS REQUIRED: Filing Fees: t-t rf () , Iw
., /.q7 ~,4) # Charged Re-
'~otlng Lower Footing Under Slab Base Inspections: CJ' (/' V Reviews
\tJi-- c9 - ~;:~P'""',lf ,~~~.~r
\U(llMk~" ,'Q)~.S,D4-- C---~~~
'ed: Dept. of Community Services (Date) Fee Received by:
'MMERCIAL
l;:r 1.0- oy
Date
Add~ees-