HomeMy WebLinkAboutApplication_w/Affidavitl h s is a PDF version of the application. The official application should be creatc.d ngd submitted via the onfine
Application Portal: i�.au �� f
FILING FEES: Single Family (Pri€nary Residence) $1 gg 50 for the first variance, plus $116 for each additional section of
the ordinance being varied. All Other $817 for the first variance. plus $404.50 for each additional section of the
ordinance being varied.
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1) Applicant:
Address: Cj 11 FAST
2) Project Name: __ RA%`%h,Phone:(.._...1�?-� 3c7
Engineer/Architect: _ L),f Prone:
Attorney:� _ _. . Phone:
Contact Person ^rr t� C Phone:
Email: %1A
ProjectDox Uploader:nf[EkElp SSEN Phone: _,1q,9&1-- -191-30
Email: (S
3) Applicant's Status. (Check the appropriate response)
(a) The applicant's narrte is on the deed to the property (b) .l..lie applicant is the contract
purchaser of the property. (c) Other:
4j If Item 3) (c) is checked, please complete the following.
Owner of the property involved
Owner's address: Phone:
fi record of Ownership: Deed Book No /Instrument No.
Pages _ Purchase state: _ �°� �—_.._
(3) Common address of the property involved:
Legal Descriptiow _L� RGS �0� oe . .., d J (� N0bK
Tax Parcel ID No.. S ffeT(ou I to-r �4
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 applies andior creates the need for this request.)
8) Reasons Supporting why the BZA should grant the Develop€Trent Standards Variance: (Additionally, complete the
attached question sheet entitled "Findings of Far t-Developrrlent Standards Variance").
gr Zoning district classification of property:
Page 10 of 12 File: Hearing Officer Development Standards Variance Handout 2023 Revised: 02/03/2023
9a) Overlay Zone of property (if applicable):
19) Size of lot/parcel in question: _� 3G _C_._i� L' _ acres/sq.ft.
11) Present use of property . .._PELkpa- T AMY._
"2) Describe proposed use of property
1 3} is the property: Owner occupied _ Renter occupied - Other
14) Are there any restrictions, laws, covenants, variances. SpeCial rases, or appeals filed in connection with this property
that would relate or affect its use for the specific purpose of this application's If yes, give date and docket number,
instrument no., decision rendered and pertinent explanation.
i 5) Has work for which this application is being filed already started? If answer is yes; give details:
Building Permit Number: _W .. ac o23<3
Builder:
1 u) if proposed ap2eal is granted, when will the work commence?
17) If the proposed variance is granted, who will operate andfor 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 nane 5 MANDATORY 29
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 Past Office at least 20 days prior to the public hearing date), CAR
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 regUfired; see a .
THE BURDEN OF PROOF FOR ALL. NOTICES IS THE RESPONSIBILITY OF THE APPLICANT.
The applicant understands that docket numbers will not be �assi�€fie l r€=�tii mil( st�aortinq infc�r,a€ation has been sub€pitted to
the; Der)artrraent of ComnlLinity Services,
Applicant Signature:
Date:
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 arid/or the legal advice of his/hei attorney.
Page 11 of 12 File: Hearing Officer Development Standards Variance Handout 2023 Revised: 02/03/2023
I hereby swear that I arn the ownericontract purchaser of property inuoived in this application arid 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 Namea A/
r sroperty Owner, Attor€ €ey: or Power of Attorney)
Printed Name � F
STATE OF INDIANA
SS
County of ► &fit 0.N _ ..
(County in which notarization takes place)
Before me the undersigned, a notary Public
for _ }� �� s __.._ _ County, State of Indiana, personally appeared
(Notary Public's county of residence)
(Property Owner, Attorney -or Power of Attorney)
this-2-6 ' day ofyn'pekL-
and acknowledge the execution of the foregoing instrument
2 r,_?%")__
L�
Notary Public —Signature
&r\E6f-T->
Notary Public —Printed Name
My commission expires: _�t VAv,4 22-0 Z(o
Page 12 of 12