HomeMy WebLinkAbout05110108-ApplicationCity of carmd/ Clay Township permit #:~
COMMERCIAL or INSTITUTIONAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Commercial or Institutional: New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings
EECORD:
& PRO3ECT
INFO:
ADDRESS OF CONb-fRUCTION
STATE
$U1TE # [If Applicable)
DESIGN RE[EASEi
r
SCOPE(S) OF ~ FDN ,~ b-'l'R ~J~ ARCH
RELEASE= L
WATER UTILITY SEWER UTELITy
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR
COUNTY WELL AND/OR SEPTIC PERMIT #~ (If Applicable):
#of Room: YES [~ NO
COMMERCIAL
(Privately owned hospitals
and medical office~
are commercial) '~ ~ ~
INSTITOTIONAL
,~ SLAB [] CRAWL SPACE
'U POST&BEAM ,~ BASEMENT
(or POST & PIER) WALKOUT:~N
,-:-p .V:- = -:
[] NEW STRUCTURE
[] ADDiTiON
[] Room(s]
REMODEl
[:3
[] DETACHED, GARAGE
~C3 ATTACHED GARAGE
~ CELLTOWE~ (New)
[] CELL TOWER CO~LOCATE
[] DEMOLITION
EST[NATED COST OF CONSTRUCI3ON:
(EXCLUDING LM4D VALUE)
Early Release
Permit:. Y ~ Trusses:
LOt Split. _Y_~N Sump Pump:
Does any part of the pro~ lie within a special Flood
designaUon area: YL:~N
beginning and completing constxucrion.
l, the uwdersigned, agxee that any construction, reconstruction, enlargement, relocation, or alteration o£ a structure, ~r any change in the use of land or srrucru.re~..
t~luested by rhls applicarion will comply with, and conform to, all applicable laws of the S~ate of Indiana, ~d ~e "Zo~ ~ce of ~el InCa - 1993 (Z-
289) and arn~ents, adopted under authority of I.C. 3~-7 et seq, General Assembly o£ the State of Indiana, and all Acts amendatoxy thereto. I further certify that only
kitchen, bath, and floor draim are connected to the sanitary sewer. I further certify that the constracrion will not be used or occupied until a Cert~'cate o£
O~c~o~? has been issued by the Department of Community Services, CarnY, IndiamL
OFFT~I~ I.j$1~ ONLY.· ************************************************************************
INSPECTIONS REQUIRED:
Upper Footing Lower Footing Under Slab
Site
Reviewed/A!pproved: Dept. of Community Services (Date)
S.'Perflllt~Yor~d~a COMM~C~L
# Charged Re-
Reviews
Cert, of Occupancy:
Additional Fees