HomeMy WebLinkAbout07110029 Applicationw .
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Early Release
Permit _YN
Lot Split: _Y __?_N
BUILDER NAME' PHONE: I? - FAX: 3I I
OF 30 ?(s 4
RECORD: STREET ADDRESS: C STATE:
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T ZIP:
6
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BUILDER's EMAIL ADDRESS: BEST METHOD OF CONTACT:
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J e- Q_ I c ba ? s a rC'j L , Cam -
PROPERTY N PHONE:
A`Z /} FAX: vi
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OWNER: ? kC {<e? _ oR -Cc D(o c, roE
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Si REET ADDRESS: CITY:
1? o G 9 Cn?- Se ??k STATE:
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LOCATION
& PROJECT ADDRESS OF CONSTRUCTIO`: c
01 C) n ?? J r z SUITE #: (If Applicable)
JS"S'
INFO: Address of Shell Building: (If different than Address of Construction) Lot # and Subdivision: (If Applicable)
n F? s
BUILDING, PROJECT, ORT NAME: ZONING'
? TAX MAP PARCEL #:
3
o f? -1
-(a oe oo_oi3 n
STATE COMMERCIAL SCOPE(S) OF C FDN C] STR 6C ARCH
E PKLR OT ER(S}:
RELEASE CMECH CAt
_LUM SQUARE
FOOTAGE:
_
O C
I
DESIGN RELEASE # : " O
WATER U71LIT
PROVIDER: I • SEWER UTILITY
PROVIDER; f----L ( ESTIMATED COST OF CONSTRUCTION:
EXCLUDING LAND VALUE) ( O C
.
. j `7 C
PLAN COMMISSION / BZA j W DOCKET NUMBERS; AND/OR -
COUNTY WELL AND/OR SEPTIC PERMIT #5 (If Applicable):
# of Floors: Elevator or Uft. YES Q NO BLDG. CONSTRUCTION TYPE: 5FI4 OCCUPANCY CLASSIFICATION: 13
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT:
COMMERCIAL O NEW Sj?URE
;Privately owned hospipais and medical
offices/centers are commeroal) lc
O INSTITUTIONAL ' GO att t t Porch
O Munitipol/ ?I?gP`'p lth
0\ e Ge06 64par& or Ord
O V ck to (N FMISH
O MUO`T r5t6 Ot Stat, Xy4Kq ANCCESSOR RU ING
Numbet?tpf units: nG Ci
ME- i W'
NATTACHED DETACHEO GARAGE GARAGE
FOUNDATION CELL TO
TYPED ttt aRh7vtlicftiN ?P W
?• CELL TOWER (New)
apply for the new on area) D CELL TOWER O-LOCA
SLAB O CRAWL SPACE O D`
Permit #:0711o02,9
Manufactured
Trusses:
Sump Pump:
_Y _? N
_Y -JN
FLOOD ZONE AREA DESIGNATION(S) FOR THIS PROPERTY:
PLUMBING CONTRACTOR: 4 ^+'? I-z0 ix-14%
Plumber's Indiana State License #:
O POST$_BEAM -PIER B` ?EMIf?IT?(VY?LK6 `.1 YN)
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Class I stmcturepetmiu aresubject t h General.4dmin j }??C?V gHe1Ru1 o e State of Indiana (See 675 LAC 12) regarding expiration rime frames for beginning and
C? coiGUp1 dngcoostruction.
I, the undersigned,agreethat any construe etc oon.enlargement, re)oc on, or ala=aeon ofastrucruz, or any charge it the use of land or structures requesoedby
,his application will comply with, and conic all applicable laws of the Sia ndima, and the Zoning Ordinatce of Carmtl Indiana -1993" (Z-2E9) and amendments,
adopted undtr authority of LC. 36-7 er seq, era] Assernbly of tl. and all Acts amcndato;p thereto. I further certify that only kitchen, bath and floor crmns are
connected to the _mitary sewer. I further cc hat coon will not be used or occupied until a Cerofimce ofOccupancyorSuGsrandkl Completion has been
issued by the Department of Comm -ty Se armel, Indiana
cl= 11 1 0rdyC_ /D-30 C?
Signature of Owner or A')orizi Awd Print Date
OFFICE USE ONLY: ***********************»*s******************************s***************
INSPECTIONS REQUIRED: Filing Fees:
Upper Footing Lower Footing nder Slab Base Inspections: ??'• D d
Cert. of Occupancy:
Rough Meter Base Site
Mc Nbvl 8167 -MTTAL 2_0
Reviewed/App ved: Dept. of Community Services (Date) 10-7
?.,._...,?...? ,........? r Date
City of Carmel/Clay Township
COB/LNERCIAL/INSTITUTIONAL/MUTI-FAMILY IA4PROVEMENT LOCATION PERMIT
APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)
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