HomeMy WebLinkAbout07060075 Application
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City of Carmel! Clay Township
COMMERCIAL/INSTITUTIONAL/MOL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings) I
Permit #:
070&0075"
BUILDER
OF
RECORD:
NAME:
G/.
PHONE:
ENE~A~ ~e>NrR. Tr>~ "'&.
CITY:
FAX: ('3/17)
~3 4-.J;"J
STREET ADDRESS:
STATE: ZIP:
PROPERTY
OWNER:
.,..J
".J ~ I+~
,v A/'.&>,L
STATE:
/,v
sum #: (If Applicable)
ZIP:
CITY:
c: ~ar
~
LOCATION
&: PROJECT
INFO:
ADDRESS OF CONSTRUCTION:
e>(5.s-
lot # and Subdivision: (If Applicable)
BUILDING, PROJECT, OR TENANT NAME:
C
ZONING:
'flA.;
TAX MAP PARCEL #: '(?o ~
'TV S &'1}
fjS{f ~
00
STATE COMMERCIAL
OESIGN RELEASE #: 3.;? I.f
WATER UTILITY
PROVIDER:
SCOPE(S) OF ~ FON ~ STR '1( ARCH
RELEASE: ~ ELEC 0 SPKLR OTHER(S):
c
SEWER UTIUTY
PROVIDER:
G,12 WD
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable):
# of Floors: I Elevator or Uft: 0 YES Pi' NO BLDG. CQNSTRUcnON lYPE: y _ OCCUPANCY CLASSIFICATION:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
}iCf COMMERCIAL Il!I NEW STRUCTURE Early Release
(Privatelyownedhospita!sandmedJcaJ 0 ADOmON Permit: _Y ~N
offices/centers are commercial) 0 Room(s)
o INSTlTUTlONAL p,.\~ Lot Split: _Y....LN
o MuniCipal/Public Bldg 1(:''11'\\)8,' Mm~lne or Deck
o School 01'\ COI'\L) ~f>l!r FLOOD ZONE AREA DESIGNATIONISl FOR THIS PROP'ERTY:
o .;;.h~C~ p,stD r C8.,.1\1I1':5'\\ \iw TENAfI!']:..FINISH V_I 1 ,A c.. L -=-/, ~ 1\
o MULl1-,'f\P~:=- GOff\?\\BJ\ cat:90(AttE600lRUVILDING A:r- V\J~U ~ ~
NumberafJ\9\\?:;\ \Q >e a"cl cO \~ 'b\;"rXCHf~E
b' (lfS'W", , I~\ U 1'\ Arn!lNi='b'CARAGE
FOUNDATION TYPE: (Che"",a1GiHll!h C'dl:iCELL TOWER (New)
apply for the newe'!'-~i'UCt/o~ ~~).t:.\-I ,,01 CELL TOWER CO-LOCATE
.0 SLAB C\~~~LSPA.~D\J\\u' DEM0UT10N
o POST &_BEAM _PIER 0 BASEMENT (WALKOUT:_vA)
Manufactured
Trusses:
Sump Pump:
V ./i'N
- ---r
_V v:'N
PLUMBING CONTRACTOR:
.4t"n~
Jl!:'L V,..,,e /,,)<:6
Plumber's Indiana State License #:
Pc
J 9%c>c>eS-
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. tbe 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 l.c. 36-7 et seq, General Assembly of the State of Inmana, and all Acts amendatory thereto. I further certify that only kitchen, bath, and floor drains are
connected to the sanitary sewer. I funher certify that the construction wUl not be used or occupied until a CertihC3.te of Occupancy or Substantial Completion has been
issued by the Department of Community Services, Carmel, Indiana.
/~.r~~ -
'signature of OWner or Au .zed Agent
I-!t>WAAA
Print
L,
I::J t..>&A",J
,(p /7,/ &> 7
Date
OFFICE USE ONLY: ************************************************************************
ECTIONS REQUIRED. e Filing Fees: / '3 7/ ' ~ 0 '
r;//~ Base Inspections: ~ 2- i. (')()
Cert, of Occupancy: / ( f . o-v
TOTAC~'J:t;:;t/)&. A't~b7
~d by: Date
Reviewed/ Appr ved: Dept. of Community Services
S:PermitsjFormS/ILP OMMEROAL
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