TOWN COUNCIL/AREA PLAN COMMISSION/BOARD OF ZONING APPEALS
FOR THE
TOWN OF NEW CARLISLE, ST. JOSEPH COUNTY, INDIANA
CONSENT FORM
The undersigned, ________________________________________, being the owner of the property commonly known as _________________________________________, hereby authorizes ________________________________________ to file land development petitions necessary for the aforementioned address.
This consent shall (check one):
remain in effect until revoked by a written statement filed with the Town Council/
Area Plan Commission/Board Of Zoning Appeals.
remain in effect until _________________________ .
remain in effect until these land development petitions are resolved.
__________________________________ __________________________________
__________________________________ __________________________________
Signature(s) of Owner(s) Signature(s) of Owner(s)
STATE OF INDIANA, STATE OF INDIANA,
COUNTY OF ST. JOSEPH, SS: COUNTY OF ST. JOSEPH, 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: ______________
(Ord. 1221, Exh. F, passed 1-26-2010)