HomeMy WebLinkAboutA003 - Development Application Form, David Carter q C- uk,4-eel I' �n P-,'F Z,
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Property Owner �� �. r r a��-�i — C-0 c't e (,p ,,J
Address 3 `' a 1,9 A
(Street) (City) (State) (Zipcode)
Telephone T 7 4 ' Q Z 6 9 Z -3 Z - Z
(Business) (Home)
Contact Person k- - 4 s C,k!> t
Address
(Street) (City) (State) (Zipcode)
Telephone
(Business) (Home)
(Fax) (Mobile/Cellular)
Projects Name and Project Description:
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Street Address or Boundary Description:
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Legal Description: (The legal Description must be correct or the application cannot
be processed.) Attach if lengthy.
Check Applicable Items: d
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I(We)certify that I(we)am(are)familiar with applicable state and local codes and ordinances,
the procedural requirements of the City of Ames and have submitted all the required information. r
Owner's Signature: Date: i (Z
Preparer's Signature: � Date:
C�
(For Corporation Only) • •
The undersigned, is duly authorized to act for the , a
corporation with an office at
Title:
Title:
(all petitioners must sign this petition)
STATE OF IOWA )
)ss:
COUNTY OF STORY )
Oil this.. day of , 19 , before me,the
undersigned; a notary public in and for the St of Iowa, personally appeared
Qa d. Cc�r�� — '�.�;is , to me known to be the identical person(s)
named in and who executed the same as voluntary act and
deed.
ota Public in and for the State of Iowa
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STATE OF IOWA
)ss:
STATE OF IOWA, COUNTY OF STORY: SS
On this /-� day of �Q./���.( 19 9b , before me, the
undersigned, a Notary Public in and fo said State, personally appeared
SGt C�r�e� - c.�,'S to me known to be the
identicl person named in and who executed the foregoing instrument, and
ackzowledged that he/she executed the same as his/her voluntary act and
deed.
NOTARY PIUBLIC - STATE OF IOWA
My Commission Expires:
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Property Owner��`-fie v e r, k• t�:�Q l i n
Address <j(7 my r�J mod Rd_ l.,W(IQ tag M`J-
(Street) t (City) (state) (Zipewe)
Telephone 61) (qf t) - q 7A - 7$? 9
(Business) (Home)
Contact Person L y n n C:
Address Eme.rsor lQ \Yn e 3 17,A _SZ�oI
(Street) (City) (State) (Zipcode)
Telephone 515 9 a —NOS S IS - ca9 a - /O n
(Business) (Home)
/Is- lo i3
(F-) (iviubile/cellular)
Project Name and Project Description:
Street Address or Boundary Description:
Legal Description: (The legal Description must be correct or the application cannot
be processed.) Attach if lengthy.
Check Applicable Items:
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I(We)certify that I(we)am(are)familiar with applicable state and local codes and ordinances,
the procedural requirements of the City of Ames and have submitted all the required information.
Owner's Signature• Date:
Preparer's Signature: Date:
STATE OF MINNESOTA )
) ss.
COUNTY OF HENNEPIN )
Helen Patricia Peterson, being first duly sworn on oath, deposes and states
that on the 27th day of January, 1998, Steven K. Champlin did personally appear
before me, and is known personally by me, and did sign the attached Development
application Form.
Subscribed and sworn to before me
this 12th day of February, 1998
Notary Public
HELEN R PUERSON
NOTARY PUBLIC-MINNESOTA
My Commission Exgros Jan.31,2000
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Property Owner I 14 7 4�Pk-
Address 33"Z q Dlj k-Ne W, 1-141UE A C,5
(street) (City) (State) (Zipcode)
Telephone L ) �q�
(Business) (Home
Contact Persoi&racy Clark(292-8231) De Troy Green(292-7923) Darrell Coy(292-8119)
Address Dartmoor Lane Ames, Iowa 50014
(Street) (City) (State) (Zipcode)
Telephone
(Business) (Home)
(Fax) (Mobile/Cellular)
Project Name and Project Description:
Voluntary annexation of pPrsnnalr ro pertvTin_EerquSnn cub-divicinn
Street Address or Boundary Description:
Property on Dartmoor Rd.,Dartmoor Drive, & Dartmoor Lane
Legal Description: (The legal Description must be correct or the application cannot
be processed.) Attach if lengthy.
SEE ATTACHED LIST
Check Applicable Items:
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I(We)certify that I(we)am(are)familiar with applicable state and local codes and ordinances,
the procedural requirements of the City of Ames and have submitted all the required information.
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Owner's Signature: Date.
Preparer's Signature: Date: �� l�
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Owner's Signature Date: /D 9 7
Date: r l
State of Iowa
County of Story
Signed or attested before me on Nfo b e r J a, l qQ 7 by
_a 6. Clark and TrcLoke L. C, Jav k
NOTARY PUBLIC
My commission expires 6uj&. I&JOno
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Property Owner L o y
Address— DSO rA '� am f Y TA-TA- Soo /Y
(Street) (City) (state) (Zipco&)
Telephone (-5/,S -� 9 J 30
(Business) (Home)
Contact Person �Ct Yrv,
Address
(Street) (City) (State) (Zipcode)
Telephone
(Business) (Home)
(Fax) (Mobile/Cellular)
Project Name and Project Description:
00 V)-e X aii n n
Street Address or Boundary Description:
Legal Description: (The legal Description must be correct or the application cannot
be processed.) Attach if lengthy.
A ++c-4 (h,e REQEI:VEED
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F'L:A 01Js
fft-2t) 1998
PIP,A r.
LJDEPT.'bF'pr� S,IOWA
NKNG&H01JS1JNG
Check Applicable Items:
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I(We)certify that I(we)am(are)familiar with applicable state and local codes and ordinances,
the procedural requirements of the City of Ames and have submitted all the required information.
Owner's Signature: —r-f�-t— Jot, Date: a d 0
Date:, <
UMPW&JS Signature:
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