HomeMy WebLinkAbout04120041 Application
Address of Shell Building (If different than Address of Construction
,.5'75
BUILDING, PROJECT, OR TENANT NAME:
We-Sf SiP/;' #1Aj,.J~a FAc"..IT-y'
STATE COMMEROAl SCOPE(S) OF X FDN ~STR
DESIGN RELEASE #: RELEASE: iElEc 0 SPKLR
\ PlAN COMMISSION / BZA / BPW OOCXET NUMBERS; AND/OR
\ COUN1Y WEll AND/OR SEPTIC PERMIT #'5 (If Applicable): 0
\~ of Roars: 1- Elevator or Uft:: c;l YES ~ NO BLDG. CONSTRUcnO !,YP . ^ 1 ~
'~E OF CONSTRUCTION: ~l.€'-'l TYPE OF IMPROVEMENT:
Q COMMEROAL SIJ6ject S€'O idJ. NEW STRUCTURE
\ (Pl1vatelyowned hospitals to Co,.,.,' C3'f111DQl;T.10N
and medical OfflCes/~ Of St 'PI/af) .l9'I\~.
'< are commerdal) Crn. .,.. Of:" ate <If) Ce lBti)~ VCr-
\NSTmJT10NAL , r nl:: COA. (j (0 AI r'iJGtv
o Munidpal/Public BTIl'g C-'lf1A ;V/WJ CfOOtie OI'at/Of!
..;:s:: School 'VIE:.~ FINISH S
\ 0 Church IN CAwt:tis G
tON TYPE: (Check all which 0 ~rnc
,e new construction area) 0 - ATTACHED IP
\ 0 CRAWL SPACE 0 CELL TOWER (New)
" BEAM 0 BASEMENT 0 CELL TOWER CO-LOCATE
... PIER) WALKOUT:_V_N 0 DEMOUTION
,
\
~cture 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.
ed, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
'application will comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993" (Z~
I~ts, 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
floor drains connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certi/fcate of
\- at tion has been issued by the Department of Community Services, Cannel, Indiana.
, CH4Z> t-IoB~
Print
BUILDER of
RECORD:
PROPERTY
OWNER:
LOCATION
& PROJECT
INFO:
y ofCarmellClay Township Permit #: () if ;L_tl6~ ~
COlMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, &. Accessory Buildings
NAME
Pl-AL1aHC-K /Ale,
,
PHONE, )
317 841-07'18
STATE I,.)
STREET ADDRESS
i ! r." q 7 1AJTC-KtJ !<oAt::>
mY
FlsH;;.R.S
BUILDER'S EMAIl ADDRESS BEST METHOD OF CONTACT:
chobsone-P{QU hednc, CoWl
NAME
CARME.L (lAy SCi-l~L CaRP_
t-MA-IL
PHONE )
317 8iE;-31tP2
FAX )
{317 57!- 4089
ZIP
LfR033
STREET ADDRESS mY STATE
5It!>'5 EAST /3/ ~-r 5TR.i&r CARMi3-L 1..1
ADDRESS OF CONSTRUcnO~ SUITE # (If Applicable)
/2q-25" SHr;.L.f30R.NE ReAD c.At?,..,~/...- ,,J
lot # and SubdMsion (If Applicable)
.
ZONING:
-I
,'kp AROi ,l,1 MEOi
OTHER(S): j"f{ ,
TAX
ARCEL #:
000001-000
SQUARE
FOOTAGE:
PLUM
37c>o
f.L-I
~
I
Early Release '" Manufactured \i?
Permit: V ....lLN Trusses: V .,LlLN
Lot SPIi~ '1!V X-N Sump Pump: _V-&N
Does any part of the property lie within a special Flood
designation area: _Y ~N
PLUMBING CONTRACTOR:
MISS ION tv1e-C+/ArJ / CAt..
Plum~ i~i~f~'~:
7-01
I
/2.
r Authorized Agent
Date
'ONS REQUIRED:
\er Footing ~ ----=>.
,
~
Y:***********************************************************
Filing Fees:
Base Inspections:
Celt. of Occupancy:
TOTAL:
\
\ :i) \)~
'ommunity Services
\ (".6A..
(Date)
Fee