HomeMy WebLinkAboutCLE201800194 Application 2018-09-11CERTIFICATION THAT NOTICE OF THE
APPLICATION HAS BEEN PROVIDED TO THE LANDOWNER
This form must accompany zoning applications (Home Occupation, Zoning Clearance, Zoning
Administrator Determinations or Appeals, Sign Permits, Building Permits) if the application is not the
owner.
I certify that notice of the application, C"Y-"nce-
[aunty application name and number]
was provided to ]f oYjy4 f'} 'B6Ylk qutf) the owner of record of Tax Map
[name(s) of the record owners of the parcel]
and Parcel Number 2331 5cm r aft LA Sir 30 by delivering a copy of the application in the
manner identified below:
QHand delivering 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 (V Orr�n6.Y� CJY t1�ty�D. t/1
[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 g 2 3/1$ to the following address:
Date
21-3 Ivu Pi S-te B2\ 4A 22903 ftiorrh r rk%ihlcmwco.c.om
[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].
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� gna� of Applica
Print Applicant Name
8 �3%t6
Date
D(4er Rt�sical
TKwc�-p 9
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