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I the undersigned, to the best of my knowledge and belief, submit the above information as trueand correct.
Signature of ,�
Applicant: Title:
i
L.....: Date:
(Printed Name)
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STATE OF INDIANA
SS:
The undersigned, having beendulyswornuponoathsayttheaboveinformationistrueandcorrectandhe
st
is informed and believes.
(Signature of Petitioner)
County of J Ot4N5L^ J Before me the undersigned, a Notary Public
(County in which notarization takes place)
for
(Notary Public's county of residence)
County, State of Indiana, personally appeared
5T,rr N LE C h and acknowledge the execution of the foregoing
(Property Owner,Attomey, or Power of Attorney)
instrument this 3U
(day)
day of _j A N u A -icy 201.
(m onth) (y car)
Notary Public—Signature
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Notary Public --Please Print
My commission expires:
Revised: 1/24/2018 Filename: ADLS&ADLSAmm,12018
EXHIBIT A
LEGAL DESCRIPTION
TRACT 1:
Beginning 838 3/ 4 feet North and 33 feet East of the Southwest corner of Section 30, Town ship 18 North, Range 4
East, Hamilton County, Indiana; and run thence East 165 feet; North 57 3/4 feet; West 165 feet; South 57 3/4 feet to
the Place of Beginning; said tract being known as lot 5 in Gideon Newby's Addition to the Town of Carmel, as
recorded thereof in Deed Record 119, pages 10-11, in the Office of the Recorder of Hamilton County, Indiana.
TRACT 2:
Begin 47 1/3 rods North and 33 feet East of the Southwest corner of Section 30, Township 18 North, Range 4 East,
Hamilton County, Indiana; run East 165 feet; thence North 57 3/ 4 feet; thence West 165 feet; thence South 57 3/ 4 feet
to the Place of Beginning; being known as lot 6 in Gideon Newby's Addition to the Town of Carmel, as per plat thereof,
recorded in Deed Record 119, pages 10-11, in the Office of the Recorder of Hamilton County, Indiana.
TRACT 3:
Lot 12 in David W. Kinzer's Addition to the Town of Carmel, as per plat thereof, recorded in Deed Record 52, page 440,
in the Office of the Recorder of Hamilton County, Indiana. AND the North half of vacated South Street (an area of 20
feet by 165 feet immediately adjacent to aforesaid Lot 12), which South Street was vacated pursuant to a resolution of
the Carmel Board of Public Works on or about June 13, 1983.
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