HomeMy WebLinkAboutApplicationRev. 1-1-61 Sheet l,,of 2 sheets
ZA Form (To be Filed in Duplicate) Date
PC Form
APPLICATION FOR IMPROVEMENT LOCATION PERMIT AND CERTIFICATE OF
% OCCUPANCY
No. ! 0
Date filed_ ���/., %D
The undersigned agrees that any construction, reconstruction, en-
largement, relocation or alteration of structure, 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
"Zoning Ordinance of Carmel, Indiana -1961,11 adopted under the authority
of Chapter 174 of the Acts of 1947, General Assembly of the State of
Indiana, and all Acttsamandatory thereto.
Name of Applicant__�-,X/077z ff/i/aM,oS'oA,1, -Z;00, PhNo. Ale-S/x6 /
Address of Applicant ��35/ /%�L,�7/i�f/t/� S7 • 32��„
Name of Owner �i9faG Phone No.
Address of Owner
Location of Prooerty. Lot No.Addition
Street No. or'.other description or.,location
//7/
Present Use of Property_
Proposed Use of Property_ 6S/ Ti 1 i
Zoning Classification of Property
NOTE: Application for an Improvement Location Permit must be Accompanied by
two blueprints of a plot plan of the property drawn to scale, and showing
location of any existing structures or proposed structures together with
a detailed written explanation of the proposed Improvements, and other in-
formation as may be required.
SIGNEu
Owner Agent
A Permit Fee of —" must ac com ny this application.
Permit Fee received by r
BUILDING COMMISSIOW
Title
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BUILDI�'X ;01WIMISSIONF; 61 'a
CLAY _TOWNSHIP 8 �`
HAMILTON COUNTW