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City ofCarme//C/ay Township Permit #: CJ 7 ~tf ()! 07
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)'
class 1 structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginnirig 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~ (2-289) and amendments,
adopted under authority of LC 36-7 et seq, General A yo the State 0 "ana, and all Acts amendatory thereto. I further cenify that only kitchen, bath, and floor drams are
connec~ed to the sanitary sewer. I further certif at e construction will not used or occupied until a Certificate of Occupancy or Substantial Completion has been
issue 'by the ar nt CommunityS 'ces,C mel,Indiana.
**********************************************
Filing Fees: 01- I'a 34. CJO
Base Inspections: 1-0 'if, c0 0
Cert. of Occupancy: / / / . {)()
TOTAL: ~~$
Fee Received by: Date
BUILDER
OF
RECORD:
LOCATION
&: PROJECT
INFO:
BUl
STATE COMMERCIAL
DESIGN RELEASE #:
WATER UTIUTY (l ,...._
PROVIDER: 1UI \'fI
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: ( 1
,r
BLDG. CONSTRUCTION TYPE:
Elevator or lift c;l YES
FOUNDATION TYPE: (Check all which
apply for the new construction area)
d SLAB 0 CRAWL SPACE
i#POST & BEAM _PIER 0
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ADDmON
o Room(s)
o Porch
- 0 Mezzanine or Deck
REMODEL
,g NEW TENANT FINISH
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o CELL TOWER (New)
o CELL TOWER CO-LOCATE
o DEM0lTT10N
BASEMENT (WALKOUT:_Y_N)
TYPE OF CON RUCTION:
~COMMERCIAL
(Privately owned hospitals and medical
offices/centers are commercial)
o INSlTTUTlONAL
o Municipal/Public Bldg
o School
o Church
o MULTI-FAMILY
Number of units: _
INSPECTIONS R UIRED:
Upper Footing Lower Footin
Rough I Meter Base
,
Reviewed! Appr ed:' Dept. of Community Services
S:Permits/forms!ILP OMMEROAL
2.fY:>7
(Date)
t.
CITY:
lndpb
BEST~METHOD.OF_CONTACT:
:1'
FAX:
-.,.
STATE:
tsUITE.#:_(lf Applicable)
D2
ESTIMATED COST OF CONSTRUcn
(EXCLUDING LAND VALUE)
000
OCCUPANCY ClASSIFICATION:
PROJECT FORMATION:
Early Release ?$
Permit: _Y.
Lot Split: _Y
Manufactured
Trusses:
Sump Pump:
~~
FLOOD ZONE AREA DESIGNATIONCSl FOR THIS PROPERTY:
X: -Uf6hM(ld
Plumber's Indiana Sta
D'b~(\C\hh.~
icense #:
FP~Tt:fL
/t' (0 . /)7
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