HomeMy WebLinkAboutApplication w/Affidavit *This is a PDF version of the application.The official application should be created and submitted online via the
Public Portal: https://cw.carmel.in.gov/PublicAccess/template/Login.aspx*
HEARING OFFICER DEVELOPMENT STANDARDS VARIANCE APPLICATION
FILING FEES: Single Family (Primary Residence) $192 for the first variance, plus$112 for each additional section of the
ordinance being varied. All Other$786 for the first variance, plus 389 for each additional section of the ordinance
being varied.
DOCKET NO. . PZ-2U1Z- 000 6 5 DATE RECEIVED:
1) Applicant: 6/ham A I Lclssvov)
Address: /3108 guvr�;son �, / C.r tame/ / /1v U40?3
2) Project Name: Phone:
Engineer/Architect: Phone:
Attorney: Phone:
Contact Person: Ell^ab,, Al hassovn Phone: 11- &3 Z-fi•3 7 Z-
Email iota arZI Yrd,ev. eo✓r7
ProjectDox Uploader: Phone:
Email:
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: /�[r�iays2 ;� 2.4 % .,<•L, � /��Nd �2,•, % r� 'x_ �e5
BSc 1 L.v N 12
Tax Parcel ID No.: I -lb - 2S'- 01 - 0) - 067, DOJ
7) Explanation of requested Development Standards Variance: (State what you want to do and cite the section
number(s)of the Unified Development Ordinance that appliesl and/or creates the need for this request.)
We afe ad/ '" 8 X I 1 dee--.k l�l l L( �.v�1' 4 oK✓ blot, , we - Ii Coven- 4 /
14414 pet"dal a,d acieki a ,Svmccfl vv'f S X ti O✓ec 1Ine �n,�� Po-c h
8) Reasons supporting why the BZA should grant the Development Standards Variance: (Additionally, complete the
attached question sheet entitled "Findings of Fact-Development Standards Variance").
?he p/'oJCJ ,, al lel- I/5 be aide )-o enjv7 14e f moo.✓- &yeU
oat," h00se ClkV i't t.✓,'II ?d1 a model.' Iwuch /o 1-1e lavasc •
9) Zoning district classification of property: S
Page 9 of 11 File:Hearing Officer Development Standards Variance Handout 2022 Revised:01/03/2022
9a) Overlay Zone of property(if applicable):
10) Size of lot/parcel in question: acres/sq.ft.
11) Present use of property: Alf ► 12 e.,JPvi ce
12) Describe proposed use of property: /lla,n i2 eSi'clenc.e
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,
instrument no., decision rendered and pertinent explanation. ✓O
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 appeal is granted, when will the work commence?
AS s- As p�Ss,'b/e
17) If the proposed variance is granted,who will operate and/or use the proposed improvement for which this application
has been filed?
fa c l e coif
NOTE: Three modes of public notice are required.
LEGAL NOTICE shall be published in the NEWSPAPER according to the Chart on page 5 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 8.
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: o.5//3/24,22_
The applicant certifies by signing this application that he/she has been advised that all representations of the
Dept. of Community Services are advisory only and that the applicant should rely on appropriate Unified
Development Ordinance standards and/or the legal advice of his/her attorney.
Page 10 of 11 File:Hearing Officer Development Standards Variance Handout 2022 Revised:01/03/2022
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:
(Property Owner,Attorney, or Power of Attorney)
Printed Name: E ia1M ! '��GtSSbovt.
STATE OF INDIANA
SS:
Countyof L t 7L�N
Before me the undersigned, a Notary Public
(County in which notarization takes place)
for t'4) L I County, State of Indiana, personally appeared
(Notary Public's county of residence)
1 A L l`A . D and acknowledge the execution of the foregoing instrument
(Property Owner,Attorney, or Power of
Attorney)2
this ( /' day of MA / , 20
Notary Public--Signa ure
(SEAL)
FRANCIS A AMPIL I �`-'� 5 '/ ' ' "` C-
Notary Public -Seal Notary Public—Printed Name
( State of Indiana
Marion County
My Commission Expires Mar 1,2023 My commission expires: ' — 12
Page 11 of 12 Filename:Hearing Officer Development Standards Variance Handout 2022 Revised 12/29/2021