HomeMy WebLinkAbout07030181 Application
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/"~,,,,:",;.'.<'<\\ y of Carmel/Clay Township , Permit #: () 7 n:f)/~\1
!, , i COMMERCIAL/INSTITUTIONAL/MULTI-F AMIL Y IMPROVEMENT LOCATION PERMIT
", APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
FAX:
BUILDER
OF
RECORD:
NAME:
~~Vl! \S~
PHONE:
s-\'\Cc.
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STREET ADDRESS:
Il-\?c>o C I'
D1-V17.
PROPERTY
OWNER:
(,..,d
~
LOCATION
& PROJECT
INFO:
Cl1Y:
STATE: ZIP:
Lj(..O-;;Z-
~
BEST METHOD OF CONTACT:
1>..\
PHONE:
FAX:
Cl1Y:
. ~ .UT2<o 7"'0
SUITE #: (If Applicable)
ZONING:
Lot # and Subdivision: (If Applicable)
t,llMHDrl A~b.. 'F
5-1
BUILDING, PROJECf, OR TENANT NAME:
L\I'\ ~ y Dou, EO
SCOPE(S) OF 0 FDN '" STR '" ARCH
RELEASE: ~ ELEC 0 SPKLR OTHER(S):
STATE COMMERCIAL
DESIGN RELEASE #: ?
WATER lfTIUTY
PROVIDER:
'?'1 c; c;
SEWER UTlLl1Y
PROVIDER: (..u,..'-{ ~0\Ot'\lIo.L-
oe:; DGoO \ B
~~9.-
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNlY WELL AND/OR SEPTIC PERMIT #'S (If AppUcable):
# of Floors:
\
Elevator or Uft: Q YES
~ NO
BLDG. CONSTRUCTlON TYPE:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
f)ll' COMMERCIAL 150 NEW STRUCTURE
(Privately owned hospitals and medical 0 ADOmON
offices/centers are commercial) 0 Room(s)
o IN~f1IA.L_. 0 Porch
o ~"" i~~aJJI!FOR COMe- 0 Mezzanine or Deck
o """WJ8Ct to CO' Ill> T~~n~'
o Church of S rnPIJanc8 wifE) a/f'J~ ,l'l1' I'lNISH
o MUL1H+tl\!!.r, tate and loca8:; 11' \ltmsILDING
Numbe~~,?~OMMUNn2i3 ~'(J~ACHED GA~~~
FOUNDATION TYPE: (t:he ~ / ClJW ~hQ (Ne)
apply for the new construction amblA 0 1 tEL'l "t19 fb'~OCATE
~ SLAB 0 CRAWL SPACE NA 0 DEMOLITION
o POST&_BEAM _PIER 0 BASEMENT (WALKOUT:_Y_N)
o MECH
SQUARE
FOOTAGE:
~).........--
D
GO
EST1MATED COST OF CONSTRUmON:
(EXCLUDING LAND VALUE) ~ \\e>.ooo. ,d
S<.-\
V-~
OCCUPANCY ClASSIFICATION:
1"?
PROJECT INFORMATION:
Early Release
Permit: _Y"LN
Lot Split: _Y LN
Manufactured
Trusses: _Y ~N
Sump Pump: _Y "'N
FLOOD ZONE AREA DESIGNATIONCSl FOR THIS PROPERTY:
X-lAS1S ~
PLUMBING CONTRACTOR:
k 'M~~
Plumber's Indiana State License #:
Cp
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 - 1993ft (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.
s;.n~~.,~rA~'
~\"~.4 Ll~.;l \.~-J
'31Z'/ZW7
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OFFICE USE ONLY: ************************************************************************
I CTIONS REQUIRED: Filing Fees: 5'" '3&, (pO
Under Slab V Base Inspections: So (). 00
~ )\1\0."."'0=","'" ~o
Y(');Da7te-)D7 TOTAL: . (mn, : / .5 (g 0
Reviewed/Appr ved: Depl. DC Community Services ~ _
S:Permitsjforms/ILP OMMEROAl Fee Rec~=- '-'" Date