METROPOLITAN DEVELOPMENT COMMISSION
METROPOLITAN BOARD OF ZONING APPEALS
HEARING OFFICER
OF MARION COUNTY, INDIANA
PETITION
Continued
Docket No:
DMD use onl
y
Address of Subject Property:
Petitioner(s) Name:
Phone:
Address of Petitioner:
FAX:
Zip
Code:
Email:
Owner(s) Name:
Phone:
Address of Owner:
FAX:
Zip
Code:
Email:
Request is for (check all that apply):
Variance of Use Variance of Development Standards
Regional Center Approval Appeal of Administrator’s Decision
Modification of Site Plan Modification of Commitments or Conditions
Approval of Use in Special District Approval of Development Plan in Special District
Modification of Development Statement
Special Exception for:
Rezoning of the Primary Classification to:
Rezoning of the Secondary Classification to:
Legal Description (check one):
Complete Metes & Bounds legal description attached.
Platted site within a recorded subdivision, copy of plat map attached.
Subdivision Name:
Lot Number(s): Section Number(s):
Recorded in Plat Book number: page(s):
or recorded as Instrument Number: in the Marion County Recorder’s Office.
Does the petitioner own one hundred percent (100%) of the area involved in the petition (yes or no)?
Tax Parcel Numbers:
Acreage: Township(s):
METROPOLITAN DEVELOPMENT COMMISSION
METROPOLITAN BOARD OF ZONING APPEALS
HEARING OFFICER
OF MARION COUNTY, INDIANA
PETITION - - PAGE TWO
/PET4ALLa-2006 4/25/17
Is this property the subject of any code enforcement action (yes or no)?
Was this property the subject of any previous petition (yes or no)?
If yes, list the previous petitions’ docket number(s):
Current Primary Zoning Classification:
Current Secondary Zoning Classification:
Current Comprehensive Plan recommendation:
Existing Use of the Subject Property:
Existing Improvements on the Subject Property:
Provide a detailed description of the proposal. Attached additional pages or documentation if
necessary.
Specify any specific ordinance(s), standard(s), condition(s), commitment(s), and/or regulation(s)
sought to be modified. Attached additional pages or documentation if necessary.
Oath: The above information, to my knowledge and belief, is true and correct.
Signature(s) of Petitioner(s) Signature(s) of Owner(s) (if different than petitioner)
STATE OF INDIANA,
COUNTY OF MARION, SS:
STATE OF INDIANA,
COUNTY OF MARION, SS:
Subscribed and sworn to before me this Subscribed and sworn to before me this
day of , 20 day of , 20
Notary Public Notary Public
Printed Name of Notary Public Printed Name of Notary Public
My Commission expires: My Commission expires:
My County of residence: My County of residence:
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