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Home My WebLink About14070070 Signed Demo The City of Carmel and/ar Hamilton County Health Dept. must perform pn inspection prior to demolition. In order to `� ' �° ' approve the demolition permit, the applicant is required to sign this form ond obiain the sianatures of the individu6/s listed below. (This con be done by FAX to their offices, at the numbers listed belowJ Mclude this completed form with oll6paroariate siqnatures(ON THE REVERSEOF THIS PAGE)when you submit your application package. 1. Brett Ransford: Carmel Utilities. Pfione (317) 733-2855. FAX(317)733=2053. 2. Barry McNulty: Hamilton County,Health Dept. Phone(317)776-8500. FAX(317)776-8506. Signature: Brett Ransford (or representative) Date Signature: Barry McNulty(or representative) Date CERTIFICATE OF AUTHORITY Under the penalties of perjury(Indiana Code:35-44-2-1�,I hereby affirm,under oath,that all of the information I have provided in this application for demolition permit is true and accurete,to the best of my knowledge and belief,and that 1 have not knowingly or intentionally provided or omitted any information�that would tend to hide,�obscure,or otherwise mislead the Department of Community Services regarding the truth of the matters addressed therein. further, I assert that I am the property owner,or the authorized and lawfully appointed agent of the owner(s),that 1 have ezpress autharity and permissian from the owner(s)(and anyone with a recorded�interest or other interest in the property�,to take this requested action,and that I agree to indemnify and hold harmless the City of Carmel from any claim,lawsuit,demand,or damages whatsoever arising out of,or as a result of,this request or the actions of,the City of Carmel,regarding same. �i�� '`� �_ �� D� /� Applicant s Signature Date �� 7Z^ � S�o y �Name printed) � Applicants Phone# ApplicanYs Address City, ST Zip STA7E OF INDIANA ) otoa'�P,r NICHOLAS F: MISHLER SS * �i:,,�i, ° County of Res:Hamitton County of Nt 'I to� � My Comm,E�ires 02-21•2019 Comm. No.62459G Before me,the undersigned, a Notary Public for /%AM%lf�ti County, State of Indiana, personally appeared G'a,-1 1°��y and acknowledged the execution of tfie foregoing instrument this �O dayof Tu+y , 20�. �,G;� ��Iz�lyo,� Notary Pu61ic My Commission Expires: �l I,NOL/�'$ I'�� I�I �S� IQ/ (Print) ' ,��^F�aqM Demolition Permit Requirements � Jam�rr��,`�� \ ' ' ° City of Carmel/Clay Township �bf°� Building &Code Services �y"' . / One Civic Square, Carmel, IN 46032 !!uoiana ` ph: (317) 571-2444 Fax: (317)571-2499 Review and Issuance of a permit rectuires that the followine must be submitted: 1. Completed Application (Application is a three-part form available in the Building & Code office) Note:A separate permit application must be completed per parcel 2. Provide a Utility Disconnect Receipt or Letter from each provider on Location 3. Two Copies of a Site Location/Site Plan ( on paper no larger than 11"X 17")with the following information and nothing less: • Tax Map Parcel Number for the parcel on which the demolition is to occur • Location of all structures on the lot,with the structures dimensions • Property boundaries and dimensions including distances to the structure(s)to be demolished • All neighboring structures within 100 feet of the proposed demolition • Streets, alleys, other manmade or natural features, north arrow, sidewalks, aprons, etc. • Location of proposed dumpster, if used • Location of all Utilities 4. Provide Certified Plumbing Contractor information (Controctor who will cap the sewer line at the property IineJ 5. Rightof Way Permit required from the City of Carmel Engineering Office (317) 571-2441 6. If the project will disturb'/<acre or more, then a Storm Water Permit must be obtained from the City of Carmel Engineering Department. Please call the Storm Water Administrator at 317-571-2441 for more information. (1/4 acre=1,890 square feet or approximately 100'X110') 7. Historic Preservation Committee approval required. Building &Code Services will notify committee members. 8. This form completed and signed by the appropriate departments. The followina must be complied with once oermit is issued: • A demolition permit will be issued when a structure is to be removed completely, including the foundation, and the property must be graded and seeded after removol unless new construction will take place within ninety(90) days on the location. • Work shall start immediately and must be completed thirty (30) days from issuance • The progress of the work shall be executed so as not to create a danger to the public • All rubble and debris from demolition to be removed from parcel before site inspection can be � performed • Must meet all requirements of the codes and Ordinances(existing well, septic,fuel tanks) • The applicant or owner is responsible for obtaining a certified plumbing contractor to cap the sewer at the propeity line. NO PERMIT REQUIRED FOR SEPTIC TANK CRUSH AND FIIL if applicable. Removal and/or crush and fill of tank to be included on demolition permit;septic tank to be pumped and either filled or crushed as park of demolitiomtontractors responsibility Comqlete the Pollowin�: � • Address of demolition Tax Map Parcel N Owner(s)Name and Address Additional5tructure(sJ on site: Yes / No (Ifyes, please list the number and type(s) of structure on the lines provided. If one of the structures has a separate street address than the primary structure on the parcel—please also indude tliat information.)