HomeMy WebLinkAboutA003 - Development Application Form dated October 16, 1997 y:•M:: 4fj•„},aY'::�'<i i' :5.7C6^/:^. ;;a4iro-'
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Property Owner North American Islamic Trust
Address 2622 East Main, Plainfield, IN 46168
(Street) (City) (State) (Zipcode)
Local contact: Darul Argum Masvid
Telephone 515-292-3683 ---------
(Business) (Home)
Contact Person Scott Renaud
Address 1531 Airport Road, -Ames, Iowa 50010
(Street) (City) (State)
(Zipcode)
Telephone 515-233-0000 N/A
(Business) (Home)
515-233-0103 515-290-2248
(Fax) (Mobile/Cellular)
Project Name and Project Description:
rna-M>ol Arrn,m 4iihriivision
Street Address or Boundary Description:
1212 Iowa Avenue, Ames, Iowa
Legal Description: (The legal Description must be correct or the application cannot
be processed.) Attach if lengthy.
See attach
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: /� WW- MtH-e Date: /D r/'b -
Date:10-i
Prepalrer's Signature: —��