HomeMy WebLinkAbout05110048-ApplicationOWNER:
of Carmel~Clay To,~tship permit
or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
or Institutionah New Structures, Additions, Remodels, Tenant Finishes, &
FAX
~ ¢OMM CIAL ·
and meal ca o~c~-ter~: ; :'
am commeroaO
[] Church
F ~.F.~; (Check all which
apply for the new ¢onstrucUen area)
,~ SLAB 0 CRAWL
SPACE
'~ POST&BEAN [] BASENENT
-:- -P VE-
N~rrlON
~ Room(s)
[] Nezzanlne or Deck
[] REMODEL
[] NEW TENANT HN/SH
E3 ~ACCESSORY BuiLDING
E3~ DETACHED GARAGE
ATi'ACHED GARAGE
(:ELL TOWER (New)
[] CELL TOWER CO-LOCATE
Early Re ease \
Permit: Y ~ Tresses: ~3~_Y N
Lot Split: Y._~N Sump Pump: Y
Does any par~ of the property lie within a special Flood
designation a~ea: ~ ~N
LUM ~ - O :
Plumber's Indiana State License #:
(or POST & HER) WALKOUT: Y _N [] DEHOLtT[ON
Class I structure perm]ts ~ subject to the General Administrative Rules of the State of Indiana (See 675 IAC 12) regarding expiration time frames for
begirming ~nd completing construction.
I, the umlersigned, aA,:e¢ t~t an7 constrac?n, r~?nstrucrJon, erJa~mCnt, rdoca~io.n, or aite?.~io~ o£ a s~, ~,~u ~.~ _o~ ~.,uy ~cb~,.~¢ ~n t _br¢~ sc of,l~d~ ~o~f r_r ~;~3.r~z
~qu~tsd by this application wffl comply w]~h, and c.onform to, all applicable laws ot r~¢ Stare o~ _mr .a~.. a, ancz r~, e,,/~.omng ur .a~c¢ ,o~
289) and ~'~¢ndme.~rs, adopted under authority of I.C. 36-7 ct scq, Genea~l Assembly of rbe Stats o[ Indiana. an~ a~ Acts ~suctato~ mcmto, i farmer ccrr~y mat omy
kitch~, h~(~.o r dr~ns ~L~ con~ccr~d ro thc s~nitary s~wer, ! ~rth~ c~if~ that ~.~ con?action will ri. or ,d~S~ or occupi~ unal ~ ~rc o£
Occ~lma~ oz'SabsJ~mtia/¢om£lctdo~ has been issued by the l~p~t of Commum~y~Serwce~, C. armd, In
~lgnature of Owner or Authorized Agent Print Date
OFFZCE USE ONLY: ************************************************************************
Base ~nspections: ~ # CharcJedReviewsRe
Cert, of Occupancy:
TOT~AL.