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(To be Filed in 3hee �
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'ne undersIF7-ed agrees *hat any construction, reconstruction, on- v
largenent. relocation or alteration of struCLureg or any ehgnee in they
i:se o* land or structures requested by this application x111 Comply with,
=nd conform to. all applicable 1"s of -ht State of Indiana, and the
"Zo^.lac Ordinance of Carrel, Indiana -1961." adopted under the authority
of Chapter 174 of the Acts of 194?. General Assembly of the state of
Indiana, and a12 Acts mandatory the e
I ame of Applica.1j/�'9�
Address of f.pplieant./-��,_ s"
NAme of Owner
Address Or Owner-&L�>
Location of Property. Lot No.
�
Street yo. or other description
r , sent Use of 1'r'operty
1'roposed Use of Property
Zoning Class/fication of pe:rty
le ,,,_,;_,_Phone tio.r'p.s 3 . y
T
L„_.Addi tion1L:����_,r�s�
O"tion
" A PP1 l ce: tl or, for an Iaproveae►nt Loos tion Aes�tl t oust be AC
twO blueprints of a plot plan of tl:e OA111ee! :�
location of any exists p;'propoy ditwn to "also Wu! ammine
F detailed written explanationofthe! !p �a" stsuotUres �oawt with
f o-"=tl ori &s may be required. P posed lap"►oser►ts. and other in.
SIG'.
Owner
Zt�t
J Permit Fee of Jotst Ott ,.� :r.:; s
I��MR3lu.�
Kermit Fee received
APPROVED,
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.01
BUILDING ".MONER
CLAY T( fNSHIP
HAUMTON COUNTY
10
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