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City ofCarme//Clay Township Permit #: n 7D0'010e
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
PHONE:
Sn-7
CITY:
PUf
BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
'SOE SW,:!V\ ar Eo.<>-11.^"L.Nd- P).,<>'c!'
T(Yl<&/! frr..:,ferf6J;nJ.e.-3'?' PHONE: ? FI;"<57190 FAX
" wL<1-.d Li! :3
p. O. 50/< 1'1/~ CITY: c~ STATE ~AJ
BUILDER
OF
RECORD:
NAME:
SM
5 Call
STREET AODRESS: &5 7 2
W<')'r Lovr c
PROPERTY
6WNER:
NAME:
LOCATIO
& PROlE
INFO:
STREET ADDRESS:
I
DRESS OF CONsrRumON: t 4: f
,5 b((.uI1\J( (k
ress 0 She I Building: (If different than Address of Construction)
BUILDING, PROJECf, OR TENANT NAME:
,
'"Dc.w Pov~t
SCOPE(S) OF 0 FDN
RELEASE: 'l'! ELEC
FAX:
SIl -bsy-nj
STATE:
M,'
ZIP:
'l'd<l12.
~'" 1/\
.ZIP ytp08 ~
10
(Jr
SUITE #: (If Applicable)
-:I~
Lot # and Subdivision: (If Applicable)
ZONING:
SQUARE '< ~
FOOTAGE: J...JO 0
TAX MAP PARCEL #:
STATE COMMERCIAL
DESIGN RELEASE #:
o STR !< ARCH
o SPKLR OTHER{S):
i1' MECH 0
32 5~ b'J
~
SEWER UTILITY A) ^
PROVIDER: . f.Xl.P\:./ OOvJ[)
WATER UTILITY
PROVIDER:
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'5 (If Applicable): N A
# of Floors:
Elevator or Lift: 0 YES G;,I NO
BLDG. CONSTRUcnON TYPE:
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
~ COMMERCIAL 0 NEW STRUCTURE
(Privately owned h.~tals a~~di~-rdllCAOOltiON
~_ ~ IlUl\l~')1r""''';:J .,
. ~\~~ er.cl, ~ .. \ oQn~oom(s)
o I _ 9,~~-~", iio.l'\G<1 with all mgu ad Porch
SiDbIMg"idpaI!P~b?'c ~I~g cr"'; ntlClf,S. 0 MellOnlne or Deck
o SChOO' SteW till." ',.,,'.... <,@\rl'llM56iL
Q:~~~~F COII,~MUNil ( '~~~T~liANTFlNISH
o ~tW j!,-Y('ARUn::L I CLJ'c,Y' :t9"'i>.ttE'~S6RY BUILDING
,,,,,,,'D..- .nlt!< U' \ "NA 0 DETACHED GARAGE
IN~' 0 ATTACHED GARAGE
FOUNDATION TYPE: (Check all which 0 CELL TOWER (New)
apply for the new construction area) 0 CELL TOWER CO-LOCATE
~LAB 0 CRAWL SPACE 0 DEMOLITION
o POST & BEAM PIER 0 BASEMENT (WALKOUT: Y N)
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE) I 10 DD
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
Early Release \. /'
Permit: _Y ~N
Lot Split: _Y +.N
Manufactured
Trusses:
Sump Pump:
_y~
_yjS..N
class I structure permits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) tegarding expiration t~&lllnes 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 wi!! comply with, and conform to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Carmellnrnana - 1993n (Z- 289) and amendments,
adopted under authority of I.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 t~~e 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 t ' epactment of Com ..--. ity Services, Carmel, Indiana.
~LOtT 'STUR 'f'I\ 5-;)C/-07
OFFICE USE ONLY: ****************************~~*********************~******************
INSPECTIONS REQUIRED: Filing Fees: y: q , {} ()
Upper Footing Lower Footin Base Inspections: ---;, 0'0,1')0
Cert. of Occupancy: ~ I 11 00
.. '" ro~ l ;;; . 00
Fee~ I 1
Signature of ~nerlor Authorized Agent
'('.
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Date
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