HomeMy WebLinkAbout05080282-ApplicationBL .
RECORD.
PROPERTY
OWNER:
City of Carmel~Clay Township Permit
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or ]nstitutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
PHONE FAX
BE/ST HEFHOD OF CONTACT: J
PHONE
LOCATION
& PRO3ECT
INFO:
Address of Shell Building (If different ~han Address of Consl~uc~on)
', PROJECT, C
ZONING:
SEWER UTIUTY
PROVIDER:
COUNTY WELL AND/OR SEPTIC PERHrr #~ (If Applicable):
rUff: g YES.,~NO
~ COMMERCIAL
! (Privately owned hosp;~.als
and medical olflces/centem
are commen:ial)
[] [N~ONAL
[] Munidpat/Public Bldg
[] Church
(Check all which
the new' construction area)
[] CRAWL SPACE
TYPE F MP _ . NT:
[] NEW STRUCTURE
[] ADDITION
[] Room(s)
[] Porch
[] Nezzanlne or Dam
[] REMODEL
'~ NEW TENANT FINISH
~ ACCESSORY BUILDING
[] DETACHED GARAGE
A'FI'ACHED GARAGE
[] CELL TOWER (New)
CELL TOWER CO-LOCATE
S~UARE
Early Release ~ Manufa.ctured \/
Permit: Y ~N Trusses. Y ~.N
Lot Split: YX~N Sump Pump: _Y~N
Does any part of the properb/lie within a special Flood
dnslgnation area: Y.~N
· ~ . = · --" OR:
C 12) regarding exp~raO, on t~e frames fo~
I, the under-~g~ed, agree t~t my com~uc~on, ~ons~cOon, e~emm~ ~l~a~on, or ~te~Uon of a s~c~, or my ch~ge in ~e use of l~d or s~ctu~s
~u~ted b~ ~ application wi~ comp~ ~, md co~o~ to, ~1 app~eable ~ws of the State of ~, md ~e Zon~ O~ce of Ca~el In~ - 1~3 (Z~
~9) ~d ~en~, adopt~ un~r au~o~ of LC. 3~7 et s~, G~e~l ~bly of ~e S~te of In~a, a~ ~1 Acts ~en~to~ ~e~to. I fu~er cer~ ~at o~y
tchen, ~, md floor ~ ~ connected to the ~ sewer. I ~ e~ ~t ~e eom~eOon ~ not be us~ or oeeupi~ ~ a C~re o~
ecu~c~ Su~C~pl~ ~n i~ued by ~e De~t of ~ ~s, C~, ~m~ ~
3F~CE USE ONLY: ************************************************************************
Filing ~s: ~ ~ ~' ~
~unJty Services
Base Inspec0ons:
Cert. of Occupancy:
TOTAL:
# Charged Re-
Reviews