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Page 1 of 12 filename: special use application & instructions 2019 Revised
01/10/19
CARMEL BOARD OF ZONING APPEALS
SPECIAL USE / SPECIAL USE AMENDMENT APPLICATION
Filing Fee: $1,099 plus $144 per acre
DOCKET NO. ________________________________ DATE RECEIVED:_______________________________
1) Applicant: ____________________________________________________________________________
Address: _____________________________________________________________________________
2) Project Name: __________________________________________ Phone & Fax: _____________________
Engineer/Architect: ___________________________________________ Phone: _____________________
Attorney: ___________________________________________________ Phone: _____________________
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) Record of Ownership:
Deed book No./Instrument No._______________________________________________________________
Page: _____________ Purchase Date: _______________________________________________________
6) Common address of the property involved: _____________________________________________________
Legal description:_________________________________________________________________________
Tax Parcel ID No.:___________________________________________________________________
7) State explanation of requested Special Use: ___________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
8) State reasons supporting the Special Use: (Additionally, complete the attached question sheet entitled
"Findings of Fact-Special Use").
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Office Use Only
Page 2 of 12 filename: special use application & instructions 2019 Revised
01/10/19
9) Zoning district classification of property: _______________________________________
9a) Zoning Overlay (if applicable): ________________________________________________________
10) Present use of the property:_______________________________________________________________
11) Size of lot/parcel in question:_____________________________________________________acres/sq. ft.
12) Describe the proposed use of the property: __________________________________________________
_____________________________________________________________________________________
13) Is the property: Owner occupied _______ Renter occupied______ Other__________________________
14) Are there any restrictions, laws, covenants, variances, special uses, or appeals filed in connection with this
property that would relate or affect its use for the specific purpose of this application? If yes, give date and
docket number, decision rendered and pertinent explanation.
_____________________________________________________________________________________
_____________________________________________________________________________________
15) Has work for which this application is being filed already started? If answer is yes, give details:
Building Permit Number: ______________________________________
Builder: ___________________________________________________________________________
16) If proposed special use is granted, when will the work Commence?
_____________________________________________________________________________________
17) If the proposed special use is granted, who will operate and/or use the proposed improvement for which
this application has been filed?
_____________________________________________________________________________________
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 20 days prior to the public hearing date. The certified "Proof of Publication" affidavit for the
newspaper must be available for inspection by the night of the hearing.
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 20 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 20 day prior 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 7.
THE BURDEN OF PROOF FOR ALL NOTICES IS THE RESPONSIBILITY OF THE APPLICANT.
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.