HomeMy WebLinkAbout07090041 Application/ii c? e'qq _ 1
City of Cannel/ Clay .Township Permit:
if CONINORCIAL/INSTITUTIONAL/NULTI-FAMELYIMPROVEMENT LOCATION PERMIT
\?aoten??-/ APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
BUILDER NAME: PHONE' FAX: .
pp. - r:
6? 114 /4) e=E 17 n6 7 79
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RECORD: STREET ADDRESS: i CITY: STATE: ZIP:
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BUILDER'S EMAIL ADDRESS: BEST METHOD OF CONTACT:
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C2 0 L. r 1-2
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PROPERTY NAME: PHONE: FAX,
OWNER: r
STREET ADDRESS: CITY: 57ATE: ZIP.
7 n r CC M I I
LOCATION ADDRESS OF CONSTRUCTION: SUITES: (If Applicable)
& PROJECT
INFO: Adcress of Shell Building: (If different tnan Address or Construction) i.et t and Subdivision: (If Applicable)
O]ECT, OR TENANT NAME:
BUILDI ZONING: TAX PAP PARCEL:
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I- r ! 00 DA9
STATE COMMERCAL SCOPE(5 OF C FDN C STR ? ARCH ? MECH C. PLUM SQUARE
DESIGN RELEASE el: All RELEASE: •a ELEC •? SPKER OTHER(S) : FOOTAGE: Of
WATER UTILITY DER UTILITY ESTIMATED COST OF CONSTRUCTION:
PROVIDER: ^
' PROVIDER: (EXCLUDING LAND VALUE)
V
PLAN COMMISSION / BIAI BPW DD
OCKFf NUMBERS: AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT 4'S (If Appli[_a61e):
u of Floats: Elevator or Lift: i7 YES O BLDG. CONSTRUCTION TYPE: OCCUPANCY CIASSIFICATiON:
TYPE QF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
D COMMERCIAL D NEW STRUCTURE Early Release Manufactured ?/
X
(Privately owrrd hospitals and meYirzl ADDITION Permit: Y ?{J Trusses: _ Y
effceslcentersan mmmerual) D Room(s)
D
S
Y Sump Pump: _
Lot Split:
Y -XN
IN
TITUTIONAL L? Porch _
? Municipal/Public Bldg p Mmanineor Deck
? School O REMODEL FLOOD ZONE AREA DESIGNATIONIS) R THIS PROPERTY:
O Church D NEW TENANT FINISH
?RL MULTI-FAMILY P'?CCESSORY BUILDING
Number of units: ..,• `ice D ACHED GARAGE
O A T {?. [\
PLUMBING IYTRACTOR:
w ? 10
ACHEp GARAGE
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FOUNDATION TYPE: (ChecWall;wh7c?r •, O'u
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Class [s[ ??iqy '?t5s't'tbj¢eL•LO,?T?te?iem
I, the und?, - gree cwt any x+nstrnecion, reco
this apph wtll comply with, and conform to, all
adopred ander authority of 1 C 357 et seq. Geneal A
connected to the sam:rry sewer I further certify the
issued by the Department of Commamty Senices'
Admiuistrauve Rules of the State of Indians (See 675IAC T2) regardiug eapiraames for beginning and
completing corar nod .
action, enlargement d, dor_orafreraum of a strvoture, or any char. a in the use of lend or structures requesrcd by
ilieable la vs8f the Sate of Icdfana, and the "Zoning Ordinance of Carmel Endiana -1993" (Z-289) and amendments,
ably cf t},e State cE lndiwsand?all Acrs aznendatoxy r6ereta €further cettify rher oily kitchen ba:'t and floor drains ax
oe consrruafon will not be aseti or occupied t ntat a Certiffure of orenpanry orSebstac tial Completion has been
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