Loading...
HomeMy WebLinkAboutApplication DP Page 1 Filename: DP - DP Amend Application 2018 Rev. 1/24/2018 DEVELOPMENT PLAN / DP AMENDMENT APPLICATION Fee*: $1,070 plus $141 per acre DATE: _________________ DOCKET NO.___________________ (Check all that apply) ___ DP ___ DP Amend ___ ADLS/ADLS AMEND Attached Name of Project: ___________________________________________________________________________ Project Address: ____________________________________________________________________________ Project Tax Parcel ID #: __ __ - __ __ - __ __ - __ __ - __ __ - __ __ __ . __ __ __ Legal Description: (Please use separate sheet and attach) Name of Applicant: _________________________________________________________________________ Applicant Address: _________________________________________________________________________ Contact Person: ______________________________________________Telephone: _____________________ Email: __________________________________________________________________________ Name of Landowner: __________________________________________ Telephone: ____________________ Landowner Address: ________________________________________________________________________ Plot Size: ________________________ Zoning Classification: _______________________________________ Overlay Zone: ______________________________________________________________________________ Present Use of Property: _______________________________________________________________________ Proposed Use of Property: ______________________________________________________________________ *Note that required fees are due after the application has received a docket number, and not at the time of application submittal. Page 2 Filename: DP - DP Amend Application 2018 Rev. 1/24/2018 OWNERS AFFIDAVIT The undersigned agrees that any construction, reconstruction, enlargement, relocation or alteration of structures, 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 Unified Development Ordinance of Carmel, Indiana, adopted under the authority of Acts of 1979, Public Law 178, Sec. 1, et seq., General Assembly of the State of Indiana, and all Acts amendatory thereto. Signed: ____________________________ Owner ______________________________ (Typed/Printed) _________________________ Agent ______________________________ (Typed/Printed) ************************************************************************************* STATE OF INDIANA SS: The undersigned, having been duly sworn upon oath says that the above information is true and correct and he is informed and believes. ______________________________________ (Signature of Petitioner) County of _______________________________________Before me the undersigned, a Notary Public (County in which notarization takes place) for __________________________________________ County, State of Indiana, personally appeared (Notary Public's county of residence) ____________________________________________ and acknowledge the execution of the foregoing (Property Owner, Attorney, or Power of Attorney) instrument this ____________ day of ___________________________________, 20_________. (day) (m onth) (y ear) _______________________________________ Notary Public--Signature (SEAL) ________________________________________ Notary Public--Please Print My commission expires: ____________________________________________ *************************************************************************************