HomeMy WebLinkAboutApplication TAC RECEUVLLJ
DOCKET NO. TAC DATE RECEIVED: APR 2 1 2017
For Department Use Only DOGS ./A
TECHNICAL ADVISORY COMMITTEE
APPLICATION&PROCEDURES ` p`6
4 0 a 14 ^Fee: $345.00
Property Information
Tax Parcel ID*: Area Area(acres): 12.8 +/-
Property Address: SE Corner of 121 st Street and West Road
Zoning District: S1 -ROSO Overlay District(If applicable): 116th Street
Legal Description:(To be typewritten separately.)
*Please attach a separate list for projects with multiple parcels.
Attorney Information
Name:
Address:
Phone: Fax:
Email Address:
Engineer Information
Name: Alvin E. (Rusty)Skoog, Jr., PE, PS
Address: 10505 College Ave., Indianapolis, IN, 46280
Phone: 317-846-6611 Fax:
Email Address: skoogr@weihe.net
Owner Information
Name: /
Paul Shoopman , /
Address:_/ / 3 C O( A Cr Q t l� � Z i ONE V � �� c�/ A) '1t/
O 15 7 7
Phone Day:317-714-2406 / Evening:
Email Address: paul@shoopmanhomes.com
Project Description
Please include a brief summary/history of the project:
Section 5A of The Sanctuary at 116th consisting of 13 lots.
Affidavit:I,hereby swear that I am the owner/contract purchaser of property involved in this application and that the foregoing signatures,statements
and answers herein contained 'nformation herewith submitted are in all respects true and correct to the best of my knowledge and belief. I,the
undersigned,authorize t pplicant to ct on my behalf with regard to this application and subsequent hearings and testimony.
Signature of Owne : / II Date:
(Printed Name) a.►\ 'h t n.OrN
_ kt
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