HomeMy WebLinkAboutSP202000002 Ownership Documents 2020-01-22CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany this zoning application if the application is not signed by the owner of the property.
I certify that notice of the application for, 5pF-5 %A%-- use 9"W\N-1 --ram SpZoLo ouo3(�
[Name of the application type & if known the assigned application #]
was provided to Grt-.o ctGe-f
[Name(s) of the record owners of the parcel]
the owner of record of Tax Map and Parcel Number _ c 4 6 0 0 - cj o - o o - p 113 C o
by delivering a copy of the application in the manner identified below:
l► - D P.� ToP1 H w+.V G.kt V \GE.- 9YLz-s ► Ve
F-71Hand delivery of a copy of the application to
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the
recipient of the record and the recipient's title or office
for that entity]
on
Date
= Mailing a copy of the application to
on
Date
to the following address
[Name of the record owner if the record owner is a
person; if the owner of record is an entity, identify the
recipient of the record and the recipient's title or office
for that entity]
[Address; written notice mailed to the owner at the last
known address of the owner as shown on the current
real estate tax assessment books or current real estate
tax assessment records satisfies this requirement].
Signatur of Applicant
MA,-c a.3 Ar�Lc> s kQQ: , 4E'bq, -k�� c� it-
mO Nm [en- p So c.CAML G.a-�
Print Applicant Name
2-1
Date