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Page 1 of 12 Filename: special exception application & instructions 2019 rev. 12/6/18 CITY OF CARMEL BOARD OF ZONING APPEALS SPECIAL EXCEPTION APPLICATION - Short Term Residential Rental Units Fee: $102 for first year, $51 for annual renewal Office Use Only DOCKET NO. ___________________________ _____ DATE RECEIVED: ____________________________________ Renewal? Previous Docket No(s). __________________________________________________________ APPLICANT / OWNER INFORMATION: 1) Applicant/ Permanent Resident*: _______________________________________________________________ Address: ___________________________________________________________________________________ * Applicants must be a Permanent Resident (may be an owner or lessee) of the proposed Short Term Residential Rental Unit. Initial applicants shall have occupied the Dwelling for at least sixty (60) consecutive days with intent to establish the Dwelling as their primary residence. Renewal applicants shall have occupied the unit for at least two hundred seventy five (275) days of the proceeding calendar year. 2) Project Name: _____________________________________________ Attorney or Contact Person: __________________________________ Phone: __________________________ Email: ___________________________________________________ Fax: ____________________________ 3) Applicant's Status: (Check the appropriate response) ______ (a) The applicant's name is on the deed to the property ______ (b) The applicant is the contract purchaser of the property ______ (c) Other: ___________________________________________________________________________ 4) If Item 3) (c) is checked, please complete the following: Owner of the property involved: ________________________________________________________________ Owner's address: ___________________________________________ Phone: __________________________ 5) Is the property: Owner occupied __________ Renter occupied ___________ Other _______________________ 6) Record of Ownership: Deed book No./Instrument No.________________________________________ Page: _____________ Purchase Date: ________________________________ PROPERTY INFORMATION: 7) Common address of the property involved: ________________________________________________________ Legal description:____________________________________________________________________________ Tax Parcel ID No.:___________________________________________________________________________ 8) Zoning District: ____________ Overlay Zone (if applicable): _________________________________________ 9) Present use of the property:____________________________________________________________________ 10) Approximate size of lot/parcel in question:____________________________________________________acres Page 2 of 12 Filename: special exception application & instructions 2019 rev. 12/6/18 11) Are there any restrictions, laws, covenants, variances, special uses, or appeals filed in connection with this property that would relate or affect its use as a short term residential rental unit? If yes, give date and docket number, decision rendered and pertinent explanation. __________________________________________________________________________________________ __________________________________________________________________________________________ SPECIAL EXCEPTION PROPOSAL: Note that Special Exception approval is not necessary for specific dates (up to 30 days per calendar year) on which the Mayor has suspended the requirements of UDO Section 5.72. See annual Council Resolution for more details. 12) State explanation of requested Special Exception (e.g. proposed time period(s), intent to rent an individual room(s) or the entire Dwelling). __________________________________________________________________________________________ __________________________________________________________________________________________ 13) State reasons supporting the Special Exception: (Additionally, complete the attached question sheet entitled "Findings of Fact-Special Exception"). __________________________________________________________________________________________ __________________________________________________________________________________________ SPECIAL EXCEPTION ELIGIBILITY: 14) Permanent Residence Verification: Please provide a copy of at least two (2) of the following showing that the proposed Short Term Residential Rental Unit is listed as the applicant’s residence. □ Motor Vehicle Registration □ Driver’s License □ Voter Registration □ Tax Record showing standard homestead credit □ Utility Bill 15) Registered Retail Merchant Certificate: ___________________________________________________________ 16) _______ (Initial) If the proposed special exception is granted, the applicant agrees to post a clearly printed sign on the inside of the front door of the Dwelling that provides information regarding the location of any fire extinguishers and any utility shut-off valves, fire exits or pull fire alarms. 17) Emergency Contact Information: List primary and secondary emergency contact information for use while the dwelling is used as a short term residential rental unit. Information to be shared with the Carmel Police Department if the special exception is granted. PRIMARY EMERGENCY CONTACT Name: ___________________________________ Address: _________________________________ Phone: __________________________________ Email: ___________________________________ SECONDARY EMERGENCY CONTACT Name: ____________________________________ Address: __________________________________ Phone: ___________________________________ Email: ____________________________________ The applicant understands that docket numbers will not be assigned until all supporting information has been submitted to the Department of Community Services. Applicant Signature: ____________________________________________________ Date: ______________________ The applicant certifies by signing this application that he/she has been advised that all representations of the Department of Community Services are advisory only and that the applicant should rely on appropriate Unified Development Ordinance and/or the legal advice of his/her attorney. NOTE: Three modes of public notice are required. LEGAL NOTICE shall be published in the newspaper according to the Chart on page 5 a MANDATORY 10 days prior to the public hearing date. The certified 'Proof of Publication" affidavit for the newspaper must be available for inspection the night of the hearing. Published Notice is not required for renewal applications. LEGAL NOTICE to all adjoining and abutting property owners is also MANDATORY, two methods of notice are recommended: 1) FIRST CLASS MAIL with CERTIFICATE OF MAILING sent to adjoining property owners. (The white receipt should be stamped by the Post Office at least 10 days prior to the public hearing date.), OR 2) HAND DELIVERED to adjoining and abutting property owners (A receipt signed by the adjoining and abutting property owner acknowledging the 10 day notice should be kept for verification that the notice was completed) LEGAL NOTICE via a Notice of Public Hearing SIGN posted on the property is also required; see page 8. REALIZE THE BURDEN OF PROOF FOR ALL NOTICES IS THE RESPONSIBILITY OF THE APPLICANT. AFFIDAVIT I, hereby swear that I am the owner/contract purchaser of property involved in this application and that the foregoing signatures, statements and answers herein contained and the information herewith submitted are in all respects true and correct to the best of my knowledge and belief. I, the undersigned, authorize the applicant to act on my behalf with regard to this application and subsequent hearings and testimony. Signed Name: (P p y Owfiw, Attorney, or Power of Attorney) Printed Name: �f2iS/�,FF»`. �• WLs772lcJ� STATE OF INDIANA, COUNTY OF 4/h 1 u7T r� , SS: The undersigned, having been duly sworn, upon oath says that the above information is true and correct as he is informed and believes. 00 Sig ature of Petitioner) Subscribed and sworn to before me this,�day if OC;To i� frz. , 20.1. .., My Commission Expires: � 3 /©� /?vz Daniel W Homan Notary Public - Se, State of Indiana Hamilton County My Commission Expires N Commission No, NP07' Page 3 of 12 Filename: special exception application &instructions 2019 rev. 1218/18