HomeMy WebLinkAbout05100137-ApplicationCONEV[ERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMTY APPLICATION
For Commercial or Institutionah New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
BUZLDER of
RECORD:
PROPERTY
OWNER:
LOCATZON
& PRO3ECT
ZNFO:
STAT~ COMMERCIAL SCOPE(S) OF
PHONE FAX
NAME PHONE FAX
STREET ADDRESS __~JJ~ STA"~E
__~_1~'o ~cj~ ~~~,~~
ADDRESS OF CONSTRUCTION SUITE # (If Applicable)
Address of Shell Building (If different than Address of Consb'u~on) / LOt # and Subdivision (If Applicable)
Cl~E(:H C~UM
ESTIMATED COST OF CON STRUCTiON:
(EXCLUDING LAND VALUE)
BLDG. CONSTRUCTION TY~: ~r,,'-J-I'~,~ [ OCCUPANCY CLASSIFICATION:
TYP F IMP VEM :
[] NEW STRUCTURE
CD"'-Room(s)
ED Porch
[] Mezzanine or Deck
REMODEL
[] NEW TENANT FINISH
ACCESSORY BUILDING
O E NFORMA :
Early Release Manufactured
Permit: ____Y ~ Trusses: ~
Lot Split: ___Y ~ Sump Pump: Y ~
N
Does any part of the property lie within a special Flood
designaUon area: __Y ~
PLU ]'NG OR:
(Check all which [] DETACHED GARAGE
0 ATTACHEg~C~P~. '
~ ~WL~$PACE ' Plumber's Zndiana State License #=
[]POST&BEAM ~ BASEMENT LJ CELL~O~ERCO;LOCATE
(or POST & PIER) W~Ai~O~j~F,~ N [] DE'MOrON
~uested ~ ~ application ~ comply ~th, and confo~ to, ~ applicable laws of the Sta~ of India, ~d the 'Zoning O~n~ce of C~el Indi~a - 1993" (Z-
289) ~d men~enB, a~pted under au~ori~ of I.C. 36-7 et seq, General Assembly of the State of Indiana, and ali Acts ~endato~ thereto. I h~er cer~ ~t only
~tch~, M~, ~d floor ~ ~ co~ected to the s~it~ sewer. I ~er ce~ that ~e constmc~on
~nR~cX o~u~m~M Comple~on h~ ~n i~ued by ~e Depmmt of Co~mty Se~ces, C~el, ~&a.
OFFZCE USE *****************************************************************************
Filing Fees: ~
Base Inspections: ~
cert. O0
TOTAL
CT/ONS REQUZR~~
Lower FooUng
# Charged Re-
Reviews
Fees
r.OS
(Date)