HomeMy WebLinkAbout06050056 Signed Demo
Demolition Permit Requirements
City of Carmel! Clay Township
Building & Code Enforcement; City of Carmel
One Civic Square; Carmel, IN 46032 Ph. (317) 571-2444 Fax (317) 571-2499
TO BE SUBMITTED WITH APPLlCATION*: Two copies ofa site location map--clearly
identifying the structure or structures to be demolished, the Tax Map parcel number;for
the parcel on which the demolition is to occur, and this form signed by the appropriate
departments. (*Application is a three-part form available from the Building & Code
Enforcement Office)
.NOTE:
· A separate permit application must be completed per parcel.
· Certain inspections are required relating to private wells, septic systems, and fuel
tanks, prior to demolition.
· Should approvals be required from other State or local government entities, or
utilities (other than those addressed herein), it is the sole responsibility of the'
contractor of record to obtain such approvals.
ExistinQ well: Well must be plugged according to Well Ordinance A-52.
,
ExistinQ septic: Septic system must be pumped and filled with sand, or removed. If septic
system is to be reused, it must be plugged off until ready for re-use.
Fuel Tanks: Fuel tanks must be pumped and removed from building andlor property.
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Address of .demolition Tax Map Parcel #
G~/Cor 'Red' CsM Ve-ve-lo,om4 thd::Z;7t/"",;/m~
OWher(s) Name and Address
Additional Structure(s) on site: ft;;;; / No (If yes, please list the number and type(sl of
structure on the lines provided. If~of the structures has a separate street address than thel
primary structur~ on the parcel-please also include that information.)
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The City of Carmel and/or Hamilton County Health Dept. must perform an inspection prior to
demolition. In order to approve the demolition permit, the applicant is required to sign this form
and obtain the siQnatures of the individuals listed below. (This can be done by FAX to their
offices, at the numbers listed below) Include this completed form with all appropriate ,
siQnatures (ON THE REVERSE OF THIS PAGE) when you submit your application package.
1. Morris Hensley, Supervisor: Water Treatment Operations, City of Carmel; .-
Phone (317) 571-2673. FAX (317) 571-2265.
2. Barry McNulty: Hamilton County Health Dept.;
Phone (317) 776-8500. FAX (317) 776-8506.
S:Permits\Demolitlon permit handout
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05/04/2006 13:26 FAX 3177768506
~iAY-03-~006(WEO) 15: 00
HAM CO HEALTH DEPT
ss,al'2ees 14:23
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Demolition PermJt Requirements
City of Carmel' Clay Township
f1u1ldlnll & Code fiIltarcemenr; City or Cannel
OnIlOurcSC!U8IW; CannGl.IN -46OS2 ,,".(317)$71.2444 FeII;(317)571-24S9
I .; Two copies of a site location map-c:learl)'
identifying the ctl,... or structu.... to be d.moll..hed, the Tsx Map pan:el number for
the parcel on v ch thla d.molltlan Is to oGOur, and this fonn signed by tha appropriate
depllrCmsnts. 'ApplJt:alia,., Is a th,..""rt form availlible from 1119 Sulldlng " Coile
EnIorcermmt ~
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.
.
ai1lta permll appllCdon must be completed per parcel.
Inllpl!ctions am "'Cjuirecl re/stIng tc prlvstl!l ~115, septic systems. and fuel
I prfCtrtodamolltfoh.
ld ap~rovars be required from otner Slate or local government entities, Qr
(other than those addressed herein). It 19 !he sole nasPDl1Slbllity (If !he
dor of record to obtzlln such approvals.
Well must be plUgged a=ordlng io Well Ordinance A..42. We/t fl/~~& ",
Sepl:Io S)Stem must be pumped and filled with sand, ot I'emoVlld. If septic ?
systtm Is to be reusod. It mu.t be plugged off until ...dy for ro.u... .
Fu" iom.... must be p"'m~ and removed tram Widing .ndlPr jgperI.Y.
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"(8) DIJ ~rt:-j) I Ng (It yes. please list the number and lype{s) of
provlded. If of the atruc:lures has a ssp.rate street address then the
the pan::eJ-p''''~ a1solnc:luQe that ;11fl..rma1Jon.)
The CIt1 af CBrm
dernolltJon. In 0
lInd~"fn the
offlCes.lIfar. n&
sf,,"~ (ON,
1.
anellOI' HII1TlJ/trm County Heelth Dept. must perfDrm an Irrspedjon prlortrJ
Co approve the tJomoJiUon'permlt. thlt lappfwant Is reqult'8d fa . this ft>>:m
n ISO Ii rlMd . (Th&C8nbedonebyFAX~ their
bfJIS J/.#;ed belaW) Inr:/utla this cornp/.tedform Y'llt/lItU lIDDRmI'/i1~
'E Rt!\'ERSE 01= THIS PAGE) when ,YtloU $Ubmlt yQur appllcafJan pIJdllI(Ie.
. Supv.rJsor, w.,.,. 7l1wtmGnt oparatklM, CIty or cannel;
571-2673.. fl:AX(a17} S71-22u" ,
: Hem/1tQn County Health Oept..;
If..8.! FAX (317) 776-BSOIt -
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05/04/2006 13:28 FAX 3177768506
MAY-03-~006(WEO) 15:00
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HAM CO HEALTH OEPT
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CERTIFICATE OF AUTHORITY
Under the puna
Information I h
bMI. of my Imo
omltt.d an)'l
of CGl'Mlunlty
of ptr.ll.lry (lndlan& Cade 35044-2~1), I h.re~ am nn, under CIlIth, lflat all of the
provided in thiw.ppllcation for demolltJon pennlt Is truD IInd IItl:Uratlt, ta the
g. Iln~ "ltet, and that! haw not knowingly or Ineentloncllly provided or
aDon that would t8ncl to hide, obsc:ul'B, ar otherwise mislead !he DepMmellt
& rea~rdlng the truth of the rmdtBl5 Bddl'lilssed ttJereln.
lenl the propel"ly QWllor, orth_ 41uthorlz-.l and lawfullyappolntQd .gent of
I hIM! express mSIo~ and perm_let! fretnl the owner(8) (and anyone with a
or Gth.r lrarMt In Ills pro~), to take this requ8stDd action, and that I as,...
hold harml... tho CI1y of Carma' from IIII)' clllm, lawsuit, demand, or damage.
II out at, or IS II *ull of, this ,.qlloft or the ectfo". of the City of Carmel.
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Date
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Applicants Phone tI
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51
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a~".ared
s~ \~'cy County, StlIee of Indiilnll, p'~llnell~
and ack"owIldged the execution onne furegol",
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