HomeMy WebLinkAbout05090200-ApplicationRECORD:
OWNER:
& PRO3ECT
ZNFO:
City of Carrnel/ Clay Township
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or ZnstituUonah NewSttuctures, Additions, Remodels, Tenant Finishes, &AccessoryBuildings
SIREET ADOR. ESS /~' f~ ~' Q'CC STATE
BUILDER'S EMAIL ADD~I~SS ,~ . BEST H~FHOD OF CONTACT:
PHONE FAX
STR~ ADDRESS
ADDRESS OF CONSTRUCTION
~ of Shell
5UrCE #~ ~L~(If Applicable)
Lot # and SubdMslon (If Applicable)
BUILDING, PRO5 ~T, OR TENANT NAME:
ZONING:
STATE COMMERC/AL SCOPE(S) OF O FDN
DESIGN REL~ #: RELEASE: ~ EL~C
WATER UTILITY SEWER LrfILITY
PROVIDER:
PLAN COMMISSION t BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERM,1' #'S (If Applicai~e):
- F --; -1 TYPE , :- "EM:-=-' : .E ! : - 1'[ :N:
Eady Release Manufactured
Permit.' Y _~N Y _~__N
Lot Split: Y/e::~_N~'~ Sump Pump: Y ~N
Does any part of the property lie within a special flood
designation area: Y._~N
MB!N _ - - _~:
Plumber's ]:ndiana State Ucense #:
~ COHMERC~L [] NEW STRUCTURE
(Privately owned hospitals [] ADD[~r[ON
and medical ofllces/cen:ers [] Room(s)
are commercial) [] Porch
[] INSTtTIJTJONAL [] He~zanineorDec~
[] Nunidpat/PublicBIdg [] REMODEL
[] School ~1 NEW TENANT FINISH
[] Church [] ACCESSORY BUILDING
which [] DETACHED GARAGE
(or POET & PIER) WALKOUT:
ZNSPECl'[ON$ REQUI'RED: Filirlg Fees: / ~)A/~', ,~'_~
Upper Footing Lower roofing Under Slab ~ase Inspections: ! - ,,~0 # Charge~ReviewsRe-
Site
Cert. of Occupancy:
Additional Fees