Application
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Rev. 1 - 1 -61
ZA. Form
\. i...J
fi~~d in duplicate) Date
PC Form
SPECIAL EXCEPTION
APPLICATION FOR Ir.1PROVEMENT LOCATION PERMIT AND CERTIFICATE 0' OCCUPANCY
CHANGE IN DEVELOPMENT PLAN
No.
Da te Filed
The undersigned agrees tha.t -any construction, :veconstruction, enlargement., re-
location or alteration. of structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws
of the State of Indiana, and the "Zoning Ordinance of Camel, Indiana _ 1961 rI, adopted
under the authority of Chapter 174 of the Acts of 1947, General Assembly of the State
of Indiana ,and all Acts amendatory thereto.
Name of Applicant
MCL. Inc.
Phone No. 257 5425
Address of Applicant 2730 E . 62nd Street, Indianapolis, Indiana
.Name.of Owner MCL ,rne. under Contract to Purchase
Phone No.
Location of Property: Lot No.
Addition See Schedule A attached
Street No. or other description of location / I
v
Present Use of Property unimproved real estate
Proposed Use of Property MCL Cafeteria
Zoning Classification of Property B4
NOTE: Application for an Improvement Location Permit must be Accompanied by two blue-
prints of a plot plan of the property drawn to scale~ and showing location of
any existing structures or proposed structures together with a detailed written
explanation of the proposed Improvements~and other information as may be re-
quired.
SIGNED:
MCL, Inc.
Owner
~j k~j * 0'P1.~{- yp
. OAgent. ()
A Penni t Fee of $
must accompany this application.
Permit Fee received by
Ti tle
To
V;' L
..--'S ~..2 p;-- '77 Time .11 D <D AI
Date
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Area Code Number Hleosio/J
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TELEPHONED
CALLED TO SEE YOU
WANTSTO SEE YOU
PLEASE CALL
WIll CALL AGAIN
URGENT
RETURNED YOUR CALL
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Operator
EFFICIENCYCil UNE NO. 2725 AN' AMPAD PRODUCT
60' SHEETS'
3~'5Y j/#l. ~/77
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