HomeMy WebLinkAbout07030111 Application
. Permit #:
~ City of Carmel! Clay Township
I
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, A s)
BUILDER
Of
RECORD:
NAME:
-+
PHONE:
FAX:
STREET ADDRESS:
CITY:
'17 f?3s:'-- o,<::n~
ZIP:
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
NAME:
TK
~.
LOCATION
&. PROJECT
INfO:
ADDRESS OF CONSTRUCTION:
:;J~':;:5- N. DiD
BEST METHOD OF CONTACT:
PHONE:
'11.." DO
FAX:
-, 3- ;)Ic~
CITY:
2'""1.',, c,
STATE:
-;:~'
SUITE #: (If Applicable)
IG'~
ZIP:
BUILDING, PROJECT, OR TENANT NAME:
C.
Lot # and Subdivision: (If Applicable)
ZONING:
0.< COS" . COO
D.STR ~ARCH 0 MECH 0
'ELEC. 0 _ SPK~ OTHER(S):
.2 '-100
,
Elevator or Uft: Q YES l?I NO BLDG. CONSTRUCTlQN TYPE: '~ OCCUPANCY CLASSIFICATION:
TYPE OF IMPROVEMENT: PROJECT INFORMATION:
o NEW STRUCTURE Early Release
(Privately owned hospitals and medical 0 _ f\DDmON Permit: _Y -X...-N
offices/centers are commercial) --<\O~ 0 Roomes)
o INSTTTUTlONAL . V-0C \ "sO Porch Lot Split: _Y ~N
o Municipal/Public B-\~~;~ '. "3'0-\0.\\0 0 Mezzanine or Deck
o School ~ C.r:),,~ 'ij\\ ,e~ 0 ~ODEL
~,,<\,yO ell 'tl'" GOoe~.:ail\~NANT FINISH
o ~~~~ tXfl\\)\''0.1\c, ,,"C') {~\?"b' A DRY BUILDING
~ 'i:.'i.~f:jiJi11f$;c. ~" '\'~\\ _-;'Q~1iS ACHED GARAGE
FOUND~~e TY~.S~~'l<\~1 \.J k"hy:-i \ l:J ATTACHED GARAGE
_ 'ouet a w....~ 0 CELL TOWER (New)
apply for the ~ €Pnstr~ \'M~p.. 0 CELL TOWER CO-LOCATE
(];( SLA~~ or ~ CR\~~ACE 0 DEMOLITION
o PO~_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
STATE COMMER IAL
DESIGN RELEASE #: 3.;2 L/ <.j <.,;l..
WATER UTILITY SEWER iJiiLlTY
PROVIDER: ~f N\L \ PRqYIp~~:\
1'1 \i
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR\ :
COUNTY WElL AND/OR SEPTIC PERMIT #'$ (If APPlicabri)': l.'o L-..
# of Floors:
TYPE OF CONSTRUCTION:
C!3'"COMMERCIAL
: ; ;~STIMATED COST OF CONSTRucrrON:
: ; ,<,EXCLUDING LAND VALUE) 50 000
1'0
~
Manufactured
Trusses:
_Y -LN
_YLN
Sump Pump:
FLOOD ZONE AREA DESIGNATIONISl FOR THIS PROPERTY:
F
x: - w16 h ~o.{e,ci
. .
PLUMBING CONTRACTOR:
rYl..",.., '?i...._~'iug .
Plumber's Indiana State License #:
PO li'-")()oOi ~.( ,
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 l.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 Substantial Completion has been
issued by the Departmen ommunity Services, Carmel. Indiana.
&1>-. ...10>
Print
-.S"o<., {)L...
.3 j 1'1;01
Date ,
OFFICE USE ONLY: ************************************************************************
INSPECTIONS REQUIRED: Filing Fees: /, y<7, 00
UPP<rF- . 9- d::? . 00
00
.00
Site
Reviewed Approved: Dept. of Community Services
S:Permits/F s{ILP COMMERCIAL
Date
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