HomeMy WebLinkAbout14070048 Application 4*�T�ti#��pF!
CITY OF CARMlL / CLAY TOWNSHIP Permit # � C�LK��
PHONti:317-571-2444
��.� °.� �AX: 3(7-571-2999
�NOIRNP TEMPORARY USE APPLICATION
SAd�I:��L OLITDOOR
S./i._.c .�a.:!� .�.�.r,:, {�
APPLICANT INPORMATION
APPLICANT NAME: � \ C I ASS I G �r'�/� �n�� pHON�: �+I �J�"�J�plj�; {1 O�3"�S"�
�
ADDRES�133� �/• D�� S"r CITY: �5 STA"CE:�"'v ZIP��'�V
PROPERTY OWNER NAME: 1lY• C���br WY� �L1�K11(\S PHOIYE.3�� � �S " �Io1'� 1
PROPERTY OWNER ADDRESS: '�O W. I O V� \�f . CITY:T�d�I S STATG'��v "LIP ����v
TEMPORARY IISE INFORMATION
NAML OF BiiSCNESS/ORGANIZATION: ��• ���'�h G� �e✓Ki n S
ADDRLSS OF TGMPORARY II58: � L� ' � � ^ IS � I�
llA"CGS O[PROPOSGD i1SG: � I '�U�- O 9 ��HUiI F OPERATION.SPm to /I� 3o PM
D�CRIPTION OP 1'tiMPORARY iiSE Q VL�S a 1� r(M �
WILL A"CGMPORARY STRLICTIIRE BG RGQUIRGD? YGS NO
ILSU,WHAT7YPL?���e.nsr�NU�cnTr:sizeauumonnaeurirrcznnF�cn'rslt� ,3�, A '7 �,/ l �=��
J
ADLS DOCKET NO. DA7'E OF APPROVAL
CERTIFICATION AND NOTICE OF INTENT TO COMPLY
1111!RIiBV C[R fIPY i'I IAT I IIAVF.if IE AUTIiORITY TU MAKE TFIL FORE4UIN4 APPLICAIIUN,TI[AT THF:APPLfCAT[ON AND PLANS PII.kD W[TI I TI IT:
APPllCA710N AAG CORRCCT,AND 7'HAT iHE OPF.RATION AND CODUCI'Of THC TF.MPORAftY IISC WII.L(ONFROM'1'O THE REG W.ATIONS OF l'HL
CARM[L'LOMNG bftU1NANCti.FAILURIi TO COMPLY W ITI I 1HG TCRMS AND CONDI"fIONS OP THIS PIiRMIT MAY RESUCC W A CITATION
AND ADDI7'IONAL PEES
C.�� C���- 7- q- � � �, �-��y
S1GNA7'UAP OFAPPLICAN'I'(RLQIII]{ED) DA7'E SIGI TUR• P PROPERTY OWNER{REQUIRGD) DATE