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Form (To be wi t. 14 i:. i te.) L::zte
C Form
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The undersigned agrees that- any construction, reconstruction, e..:^.-
1..^r�ement, relocation or alteration of structure, or any change in t"'
of land or structures requested icy this application will comply v:ith,
,-.nd conform to, all applicable lass of _' e State of Indiana, and
"Zoning: Ordinance of Carmel, Indiana -1961," adopted under the authority
of Chapter 174 of the Acts of 19417, General Assembly of the State of
]Indiana, and all Acts amandatory thereto.
:ame of Appiicant_��� Phone No.
Address of Applicant _/�ln (O� ''^-•� �n� ����
Name of Owner
Address of Owner il
Phone No.
I-,ocation of Property. Lot No. Addition
Street No, pr other description of l.oc:tio-r
Present Use of Property
Proposed Use of Property
Zoning Classification of
oiler
TOTE_.: Application for an Improvement Location Permit must be Aceomnanied by
two blueprints of a plotplanof the property drawn to scale, and showing
location of any existing structures or proposed structures together with
n. detailed written explanation of the proposed Improvements, and other in-
formation as may be required.
=',IG\ED:
Ow er Agent
yd
A Permit Fee of must accompany this application.
Permit Fee received by
BUILDING COMMISSIONER
1'i tl e
A Pvt1u, V sof
BUILDINC COMMISSIONER
CLAY TOWNSHIP
ti HAMILTON COUNTY
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