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Location of the property (street address, or if not addressed, state the neareet intersecting street or known landmark. Also, please give the name of the river mile location of the proposed floodplain and/or greenway development). If the proposed use or development is within the floodplain as identif- ied on the official zoning maps of Marion County, please fill in the following: (a) Land elevation at the development site (USGS mean feet above sea level). (b) The elevation above sea level of the highest elevation or extent of the floodplain on the subject property (o) The elevation above sea level of: 1) the lowest floor (ino~uding basements) of the proposed structure or development, 2) the lowest floor of any existing structures and other developments, and 3) the top of any proposed fill. (1) proposed use (USGS mean feet above sea level) (2) existing use(e) elevation (3) proposed fill elevation THE APPLICANT(S) SHALL CERTIFY THAT: (a) If the application is granted, the applicant(s) will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. (b) Ail the above statements and the statements in the plot plan, attachments and exhibits transmitted herewith are true; and the applicants so acknowledge that any permit issued on the basis of this application may be revoked if it is found that any such statements are false. (c) The applicants have read the entire contents of the applica- tion, including the policies and criteria, and understand the require-ments for approving or denying the application. this day SIGNATURES of e~ owner (husband and wife) of the subject property.