HomeMy WebLinkAbout07060166 Application
City of Carmel/Clay Township Permit # :LJ 7 ()re{) I W'J7
COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
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LUM SQUARE 7'"1 (', 8
FOOTAGE: ./....:s <- Cl
'2/2./ 00 D
NAME: ~ jL-f1r
BUILDER
OF
RECORD:
STREET ADDRESS:
1,
Ar
BUILDER'S EMAIL ADDRESS:
PROPERTY
OWNER:
NAME:
PHONE:
;<5
cm:
.5-/
STREET ADDRESS:
LOCATION
& PROJECT
INFO:
ADDRESS OF CONSTRUCTION:
5~h'
Lot # and Subdivision: (If Applicable)
STATE COMMERCIAL
DESIGN RELEASE #: g 'l
WATER lJT1LI1)-y /J
PROVIDER: LJrJ /?v>-f./
,. '(f
SCOPE(S) OF ~. r;;. ~ 0 STR
RELEASE: ~... 0 SPKLR
Cl1-MfCH'
SEWER UTILITY
PROVIDER: ~
PLAN COMMISSION I BZA I BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #'S (If Applicable):
# of Floors: '2-. Elevator or lift: VES Q NO
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
CfV'COMMERCIAL 0 NtW'~RE
(Privately owned hospitals and medical 0 ADOffiON
offices/centers are commercial) 0 Room{s) r_
o INSTTTUTIONAL ^<(B,,;'porc~.C~-' ~
o Municipal/Public Bldg ,0' .Of' 'l1ez:~.,- :<!?~k
o School ,CF -BEli1Q!5EL<;: ~
o Church (~~1l:ritAT'l~ISH
o MULTI,FAMILY 00"@"~..,m;E5s~RY::SUILDING
Number of umts: (. ^',",v'b""'mAch E> GARAGE
- "..,'t~ ~l.'
~(" ",' SJ.:An o GARAGE
FOUNDATION TYPE: (Chec~ all ",00' ,,0 U'kE4-T. (New)
applYforth~constructlon (0 0'\.'1i .&.~~~ERCO'LOCATE
~ 0 c:R'AIoiLpAW /.~ LmON
,< ~v :<:>' 0'< ~'~"
o POST & _BEAM '''" ~R r;;t ~SIiME~T (WALKOUT:_Y_N)
OCCUPANCY CLASSIFICATION:
PROJECT INFORMATION:
-'
Early Release _ .-/Manufactured
Permit: _Y ~ Trusses:
Lot Split: _Y~PPump:
'I
ZIP:
. ({ 2)~6
~Y7 -5'2. 5J>
FAX:
/-/6-03
B
Y/
-Y~
FLOOD ZONE AREA DESIGNATlONfS) FOR THIS PROPERTY:
Class I structure permits are subject t eneral Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
0- 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 confonn to, all applicable laws of the State of Indiana, and the "Zoning Ordinance of Cannel Indiana - 1993~ (Z-289) and amendments,
adopted under authority of r.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 the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of Occup:mcy or Subsomtial Completion has been
issued by the Department of Community Services, Carmel, Indiana.
OFFICE USE ONLY: ************ ************************************2****fi.***************
INSPECTIONS REQUIRED: FIling Fees: ,'1(,'. )
Base Inspections: ~? 0 if'. 00
Cert. of Occu pa ncy: / / / () ()
a. . ~Ljo
\. ,p~-A
FeRe ed y: .,
Plumber's Indiana State License #:
. -f'i Y-'1. z at) I. 7( _ . :}
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Sig
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Print
Site
Reviewed/Appro ed: Dept. of Community Services
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