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City of Carmel - Fence Permit Application
Department of Community Service
Building and Code Services
One Civic Square, Carmel IN 46032
Phone: 317-571-2444
Property Owner Information:
Name: 9 4R Oil, -J `- P-e
RELEASED FOR CONSTRUCTION
Subject to compliance with all regulations
of State and Local Codes
DEPT OF COMMUNITY SERVICES
CITY OF CARMEL / CLAY TOWNSHIP
INDIANA
Address: (O ! `{ 3 !" cGfrNJ00
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Phone: 3 l ? " cl3 s.
G 3 g3 Email:
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Contractor Information:
Name: P 1.0
Address: P.O. Roy- J 111,0& es-yi IIle
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Phone: 3!?— ?7�I - 0 ! �l rf Email: A,!4+Oil P G3ylnLSE
Fence Location and Type:
Property Location: 10! y3 /1/lcrr�eoolT�,,�l Ge%S� pr �it1 Yb 7- eD
Interior Lot Corner Lot Residential Commercial Construction
Fence Height and Material to be used:
Material; Wood E3 Vinyl 17 other
Height: G'
Application Submittal Requirements
A mpleted Application form
A sit an showing the location of the fence
signed and notarized Waiver of Liability (when placing fence in easement)
$28.00 Waiver of Liability recording fee (if applicable)
�1 $S3.00 Application Fee fee exem t if replacing old fence with new)
Submit to Carmel Building and Code Services, attn: Ibrown@carmel.in.gov
City of Carmel - Fence Permit Application page 2
The undersigned affirms that the information included in this Application is correct.and acknowledges a final
inspection is required and does hereby authorize City Staff permission to make site inspections as -may be
necessary. Further, if the Application is approved, the undersigned will comply with all the requirements of the
City of Carmel Unified Development Ordinance and certifies that the measures proposed to mitigate adverse
impact will be completed in a timely fashion. The contractor/property owner is responsible for properly locating
the property lines; locating pins or surveying property. Also, the contractor/property owner is responsible for
contacting Ind1ana811 to locate underground utilities, and for scheduling the required final inspection.
Please contact the Building and Code Services office at 317-571-2444 to schedule your final inspection.
If an inspection is not called in after completion, a late fee of $696.00 may be applied.
Signature: ADate: ly, Z.
p ' nt
OFFICE USE ONLY•
Tax Parcel Number: _` l �� "J f I �3 �����2 . UV 0
Zoning District . �^ I Overlay Zone
Notes
rence: Approved Denied
Signature: Date: I �.7ej
City of Carmel
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WAVER OF LIABILITY CONCERNING ENCROACHMENTS BY FENCES
and 50t G :Th"P-s , ("the Landowners") on behalf of themselves, their
heirs, assi , and successors in title to the following described property acknowledge as follows:
I. The Landowners acknowledge that they ale the owners of the following described real property:
was r� , 3
(hereinafter referred to as "the Real Estate"). _
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2. The Landowners have applied to the City of Carmel.("the City") for a permit to construct a fence upon the
Real Estate.
3. The Landowners further acknowledge that the City will not inspect the location of the fence and,
therefore, in approving a permit for the fence, the City does not represent or warrant that the fence is, or
will be located within the boundaries of the Real Estate, or that the fence will not encroach into, or across,
any easement or right of way (collectively an "Easemenf') which restricts the use of any part of the Real
Estate.
4. The Landowners, therefore, acknowledge that to the extent any part of a fence and/or any other
improvements which may be installed by the Landowner encroaches upon an. Easement, whether a
drainage, utility, or any other easement, the City or any utility or unit of government benefited by such
Easement may:
a. Require the fence and/or other improvements to be removed upon the earlier of three (3) days of
written notice or as provided in any Easement or other governing document,
b. In the event of an emergency, remove the fence and/or other improvements without notice;
C. In the event the fence and/or other improvements are not removed, the City, utility or unit
benefited by the Easement, may, or through their agents and contractors may, remove the fence
and/or other improvements, and cause the materials of the fence and/or other improvements to be
stacked upon the Real Estate.
The Landowners agree to release the City, or any utility or unit of government, its officers, officials,
members, .employees, invitees, licensees, agents and contractors from any liability to the Landowners,
their heirs, assigns or successors in title, for the removal, damage, or destruction of the fence and/or other
improvements.
6. The Landowners agree to indemnify and hold harmless the City, or any utility or unit of government, its
officers, officials, members, employees, invitees, licensees and agents from and against any and all losses,
liabilities, damages, claims, judgments, reasonable attomey fees and costs arising from the location of the
fence within an Easement.
Fences placed near a drainage easement must not impede the flow of storm water. In the event the flow of
storm water is impeded, the City shall have the rights set forth in Section 3 above to mitigate or alleviate
such condition.
ALL OF WHICH IS ACKNOWLEDGED by the undersigned Landowners this f 3 day of ,.'tic , 20 Z- .
LANDOWNERS
Z4:�/
Lw1wa-d"Inie
STATE OF INDIANA )
) SS:
COUNTY OF HAMILTON )
Subscribed and sworn to before me, a Notary Public this rZ�, da of J VAC , 20 � personally
appeared the within named _ f 1 AjJ J-� .10A a 5 and ,; G� '�-�- - u�� S , as
Landowners, and acknowledged the 6xecution of the foregoing document.
WITNESS my hand and official seal this/ - day of dot t 20-Z,, .
Gale Harpring
Notary Public - Seal
Printed Name NotaryPublic State of Indiana
Marion County
My Commission Expires Residing in A A 2Vc� MyC RItfm Commission Expires 63 7/2023
4��imission No. 666387
This instrument was prepared by
I affirm, under the penalties for perjury, that I have taken reasonabl care r act each and every Social Security
number from this document, unless it is required by law.
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Mkol 10d
k City of
Carmel
Invoice #
Receipt#: 724
Carmel City Hall: 317-571-2400 Date: 6/19/2020
One Civic Square
www.cannel.in.gov
NEW
Tender Type / Description Amount
CHECK- Check 28.00
Sub Total: 28.00
Fees:
Feb Codes / Description Amount
IMPFNCWVR- Fence Waiver 28.00
Sub Total: 28.00
Total Amount Due: 28.60
Total Payment: 28.00
Received By: ]brown Code: DEFAULT_ Recpt724_19_6_2020_lbrown Page: 1 of 1