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PROPERTY OWNER CONSENT FORM
The undersigned, jZe being the owner of tll'e property
commonly known as 10110 DITCH RD, CARMEL. IN, 46032 hereby authorizes Kimley-Horn s
and Associates, Inc. and/or Gradison Design Build to file land development petitions, applications and
supporting materials necessary for the aforementioned address. This consent shall remain in effect
until revoked by a written statement filed with the City of Carmel Planning and Zoning Department.
S'gnat re( of 6wner (s)
S ATE OF INDIANA,
COUNTY OF MARION SS:
Jr-66 -
Subscribed and sworn to before me this r! day of J6uw , 2021.
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Notary Public Notary Public
Printed Name of Notary Public �]
My Commission expires:
My County of residence:
ELENA BRODSKIY
NOTARY PUBLIC
[STATE OF INDIANSEOUNTY OF HAMILTON