HomeMy WebLinkAboutCertificate of OccupancySheet 1 of 2 sheets
-1.61
�+o be Piled in :: �A" Al ` ZAte r
porn (
Form 3
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The unders:rued so -reel tnat any corstruCtion, reconstructiong en-
:-rrement. relocation or alteration of str-4ct-�:re, or any chance in thn
••fig• of land or structures requested by this arplicatlon will cocply w1 th,
-1d contorts to. all applicable laws of the State�of Indernag theand
th(,ity
"Zor:np ordinnnce of Camel e Indiana-1961,Nadopted under
Of Chapter 174 of the Acts of 1947. General Assembly of the State of
ndiana, and all Acts amandatory thereto.
: &sse of Applicant J A. Ary� 9`- ti� �'�t. Phone No.
dre sss of t ppll cant l ' j'-6&`j`u<<A.
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::#Rme of Owner `, So s, Phone No.
E ddress of owner y0• iTi-
S
ocatior. of Property. Lot No. Addition 4 veal 4 ir-
Ftreet No. or other description -of location
rog2tgj Ai Pd.JWgI4-
r resent Osii of Property-
i,ropos*d Use of Property -
20ni er classifloation of'Property
co
,% : Application for an Improvement Location. Permit must be Ac mpgni ed b y
�77)Nlseprints of a pint plan of the property drawn to scale, And showing
r,--Ation of any existing structures or proposed structures together with
f written explanation of the proposed ImproveWcntse and other 1n-
f'-jr=&tion as may be required.
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Owner Agent
l Permit Fee of i . .LSL accompany this application.
ren: L Fee received by
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