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" Oct 18 0604:25p
DEREK WELLMAN
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Dale
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317-335-9054
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Fees: 'Sign only: $267.00, plus $53.50/sign
BUild~S7~ $534.5~tltJ~$53.50/aere
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ADLS AMENDMENT APPLICATION
Architectural Design, Lighting, Landscaping and Signage
Name of Project:
Address:
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Type of
Project:
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Applicant:
Contact Person/Company:
Phone No.
Address:
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Legal Description: To be typewritten on a separate sheet
Area (in acres)
Zoning
~ 671"L
Owner of Real Estate: ~ I '/~
Cannel: ~Clay Township:
Other Approvals Needed:
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Phone No. 2-d / ;2 -
Email :
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Annexation: Y or N
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No. of Spaces Provided:
No. Spaces Required:
Type of Building:
No. of Buildings:
Desilm Information
Square Footage:
Height:
Exterior Malerials:_ Colors:
Maximum No. of Ten ants: Type of Uses:
Water by: Sewer by:
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No. of Stories ___
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. Oct 18 06.04:25p
DEREK WELLMAN
317-335-9054
p.3
:
LIGHTING
Type of Fixture:
Height of Fixture:
No. of Fixtures:__.__ Additional Lighting:
* Plans to be submitted showing Foot-candle spreads at property lines, per the ordinance.
SIGNAGE
No. of Signs:
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Type of Signs:
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Location(s):
Dimensions of each sign:
Square Footage of each sign:
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Total Height of each sign:
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LANDSCAPING
* Plans 10 be submitted showing plant types, sizes, and locations
********************************************
I the undersigned, to the best of my knowledge and belief, submit the above
intormation as true and correct.
Signature of
Applicant: ~--
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Title:
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(Print)
********************************************
Date:
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State of Indiana,
ss:
County of
Before me the undersigned. a Notary Public for
State of Indiana, personally appeared
execution of the foregoing instrument this
My Commission
County,
and acknowledged the
,20_
day of
Expires:
Notary Public
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