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NOTE: Attach drawing of land showing Improvements and Proposed Jr � <br />Improvements. <br />SUPPORTING DATA: (Here list any reasons for request or otherT l <br />information showing hardship.) _ i _ � r®%% <br />The above information is true and correct to the best of my <br />knowledge and belief. <br />me of Owners: Or <br />STATE OF INDIANA ) <br />) SS: <br />COUNTY OF MORGAN ) <br />Subscribed and sworn <br />to before <br />me, a Notary Public, in and <br />for e ounty of Morgan, <br />State of <br />Indiana, this 27 day of <br />20/77. <br />� <br />{V-ULB ANGELA KA7H <br />i� COMMISSION EXPIRES <br />DECEMBERI9, 2022 <br />Notary <br />ublic <br />// ��/� <br />RESIDENT OF MORGAN COUNTY <br />(/1/A/�11 [���� <br />Printe / /� [ulGtq /1GCTd'� <br />My Commission <br />Lt ires: <br />My County <br />of Residence: <br />