HomeMy WebLinkAbout05090202-ApplicationCity of Cannel~ Clay Township
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
PHONE FAX
BEST METHOD OF CONTACT:
PROPERTY
OWNER:
LOCATTON
& PRO3ECT
INFO:
ADDRESS OF CONStrUCTION
SEWER UT[13TY
PROVIDER:
PLAN CO~MISSION ! BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERNIT #'~ (If Appticao~e):
[] INSll~OflN. ~
POST & BEAM C3 BASEMENT
(or POST & PIER) WALKOUT:YN
PHONE
CITY
FAX
(If Applicable)
~~,,D. COST OF CONSTRU
[] NEW STRUCTURE
~3-~ITION
Room(s)
PorCh
Mezzanine or Deck
~ ~,C~.,~ODEL
~E~ TENANT FINISH
- ~ ~!~ ~,' ~c~i:~SORY BUILDING
[] DETACHED GARAGE
C~3 A"J"fACHED GARAGE
CRAWL SPACE [] CELL TOWER (New)
[] CELL TOWER CO-LOCATE
CD DENOLITIO~
' :RMA'I/ N_:
Early Release ~ Manufactured
Per~it: Y
Lot Split: Y _~
Does any part of the prope?~dthln a special Flood
designation area: y___~N
~~'-~-Plumber's Zn~diana State Li~e #: __
kitchen, bach, a~d floor dcains are comxected ~o the sanitary sewer. I further cert~ that thc constraction will not be used or occupied until ~ Cert~t~cafe o£
Occuj:~acy ~r~Subst~nt~J C~m~letion~ms been.i~ue~i by the Depar truest of Community Services, C~e], Indial~.
_ '
Signatu~te of Owner or Authorized ~/~ent Print Date
OFF[CE USE ONLY: ************************************************************************
ZNSPECT/ONS REQUIRED: Filing Fees: ~ --
Upper Footing Lower Footing Under Slab Base Inspections: ~ # ChargedReviewsRe-
Ced: of Occupancy:
· 113 %
TOT L.