HomeMy WebLinkAboutResidential ILP Application 4permit #:O / 1DOi
ic''• ,`% City ofCarmel/Clay Township
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RESIDENTIAL IMPROVEMENT LOCATION PT APPLICATION
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� iam� For Single Family, Multi-Family,&Two Family: New Structures,Additions,Remodels,&Accessory Structures
BUILDER of NAME PHONE FAX
RECORD:
STREET ADDRESS CITY ,, STATE ZIP
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BUILDER'S EMAIL ADDRESS BEST METHOD OF CONTACT:
PROPERTY NAME PHONE FAX
OWNER:
STREET ADDRESS CITY STATE ZIP
LOCATION LOT# SUBDIVISION NAME SECTION ZONING:
&PROJECT
INFO: ADDRESS OF CONSTRUCTION SQUARE 9��
FOOTAGE:
SEWER UTILITY WATER UTILITY 9..L 10006 'l ESTIMATED COST OF CONSTRUCTION:
PROVIDER: PROVIDER: (EXCLUDING LAND VAL >
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NAME OF UTILITY EXCAVATION CONTRACTOR;PLAN COMMISSION/BZA/BPW DOCKET � ! v E
NUMBERS;TAC DATE(S);AND/OR COUNTY WELL AND/OR SEPTIC PERMIT#'S(IF APPLICABL ): „ ,- ;
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR: unit — 3 2004
O SINGLE FAMILY O NEW STRUCTURE U Il?
O TOWN HOME O ROOM ADDITION(S) Plumber's Indiana State License#:
O TWO FAMILY O PORCH ADDITION(S)
—.—j#of units: O REMODEL
O MULTI-FAMILY O ACCESSORY BUILDING /Which plumbing codes will be applied to the construction:
#of Units: O DETACHED GARAGE' O International Res��idten Tal C d w ents
O RESIDENTIAL(For �,�{ 4E A L✓ F R ul\�ItiU� UtV
O ATTACHED GA GFk 7Iy Um ' ;Iv ren. 4Additions, Remodels, Etc.) O DEMOLITION �� JA's (Mutti3�� icy n`�p�e `''PROJECT INFORMATION: atA ul�o cal Codes.
new
Early Release Manufactured FOUNDATIotTY(P.EPAVAi kltill'th�E� ISE a
Permit: Y N Trusses: Y N constimabARMEL/ CLAY TOWNSHIP
O CRAWLSPACE l�f,'eST&BEAM
Lot Split: Y N Sump Pump: Y N O SLAB :ASEMENT
Does any part of the property lie within a special Flood designation area: Y N WALKOUT: Y N
For Single Family and Two Family dwellings,additions,remodels,and/or accessory structures,this permit is valid only if construction commences
within 180 days of the date of issuance of the building permit,and must be completed(Certificate of Occupancy issued)within 18 months of the
issuance date. Class I structure permits are subject to the General Administrative Rules of the State of Indiana(See 675 IAC 12)regarding expiration
time frames for beginning and completing construction.
I,the undersigned,agree that any construction,reconstruction,enlargement,relocation,or alteration of a structure,or any change in the use of land or
structures requested by this application will comply with,and conform to,all applicable laws of the State of Indiana,and the"Zoning Ordinance of Carmel
Indiana-1993"(Z-289)and amendments,adopted under authority of I.C.36-7 et seq,General Assembly of the State of Indiana,and all Acts amendatory
thereto. I further certify that only kitchen,bath,and floor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occupied until a Certificate of Occupancy has been issued by the Department of Community Services,Carmel,Indiana.
Signature of Owner or Authorized Agent Print Date
OFFICE USE ONLY: ************************************************************************
Filing Fees: 13 1 a . (9D
INSPECTIONS REQUIRED:
.______ , Base Inspections: A620 , 00 #Charged Re
Upper Footing, Lower FoO- Under Slab Reviews
_ Cert. of Occupancy: 50 . 0 0
Rog-In Meter-Base Final Site 5 l , b
P.R.I.F.: Additional Fees
♦ ' . ------' , TWL: 4 7,,1'-1q tf) n
Reviewed/Approved: Dept, of Community Services (Date) % ��di
S:Permits/Forms/ILP RESIDENTIAL Fee Received by: