HomeMy WebLinkAboutApplication w/Affidavit* This is a PDF version of -the application. The official application should be filled out online at the link below or at
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DEVELOPMENT PLAN / DP AMENDMENT APPLICATION
Fee*: $1,185 plus $153 per acre
DATE:12/13/2022
(Check all that apply)
DOCKET NO
❑✓ DP ❑ DP Amend ❑ ADLS/ADLS AMEND Attached
Name of Project: 116th & Rangeline - Redevelopment
Project Address: 1701 E. 116th Street, Carmel, IN 46032
Project Tax Parcel ID #:
16-14-06-01 -01 -001 .000
Legal Description: (Please use separate sheet and attach)
Name of Applicant: S-Mart Real Estate, Inc.
Applicant Address:
Contact Person:
Email:
8925 Prairie Trail, Avon, IN 46123
Warren Johnson
Warren@starmidwest.com
Eplan Review Contact: Rachael Keesling
Email: rkeesling@carmel.in.gov
Name of Landowner: S-Mart Real Estate, Inc. Phone:
Landowner Address:
Parcel Size:
Phone:
317-694-6500
Phone: 317-571-2417
317-694-6500
8925 Prairie Trail, Avon, IN 46032
District:
Overlay Zone:
Rangeline Overlay Zone
.
Vacant - Former Valero Gas Station
Present Use of Property:
Proposed Use of Property: Banking Center and Office Space
*Note that required fees are due after the application has received a docket number, and not at the time of
application submittal.
Page 1 Filename: Development Plan and DP Amend Application 2022 Rev. 5/12/2022
OWNERS AFFIDAVIT
The undersigned agrees that any construction, reconstruction, enlargement, relocation or alteration of structures,
or any change in the use of land or structures requested by this application will comply with and conform to
all applicable laws of the State of Indiana and the Unified Development Ordinance of Carmel, Indiana,
adopted under the authority of Acts of 1979, Public Law 178, Sec. 1, et seq., General Assembly of the
State of Indiana, and all Acts amendatory thereto.
Signed::
Owner
Brian Johnson
(Typed/Printed)
STATE OF INDIANA
SS:
Agent
(Typed/Printed)
The undersigned, having been duly sworn upon oath says that the above information is true and correct and he is informed
and believes. 6a42n=—=
(Signature ofPetitioner)
County of r [flt�ri ri��S _.__ _Before me the undersigned, a Notary Public
(County in which notarization takes place)
for ?1AVI4 n County, State of Indiana, personally appeared
nn (Notary Public's county of residence)
,J f ?'A /f d D h n s 0► l and acknowledge the execution of the foregoing
(Property Owner, Attorney, or Power of Attorney)
J
instrument this 1 `� day of ! � aVC"h*— 20_2 Q_•
(day) (month) (year)
JEANIE MURPHY
NOTARY PUBLIC
SEAL
PUTNAM [AUNTY, STATE OF
COMMISSION NO. NPOli%
MY COMMISSION EXPIRES 10-1
(kA�� n�
l!otary Public --Signature
J-66n., G r�vr lT
� S
Notary Public—PrintedIryped Name
y commission expires: 10 —13 - D 0 3 D
Page 2 Filename: Development Plan and DP Amend Application 2022 Rev. 5/12/2022