HomeMy WebLinkAboutApplication_Lot Cover AFFIDAVIT
I hereby swear that I am the owner/contract purchaser of property involved in this application and that the foregoing
signatures, statements, and answers herein contained and the information herewith submitted are in all respects true and
correct to the best of my knowledge and belief. I, the undersigned, authorize the applicant to act on my behalf with regard
to this application and subsequent hearings and testimony.
Signed Name: J ( ,
(Property wner,Attorney, or Power of Attorney)
Printed Name: /�YG,f.; C_. ig(4)Etz
STATE OF INDIANA
�r
County of �- t I Before me the undersigned. a Notary Public
(County in which not:,.,nation takes place)
for a. -l ( County, State of Indiana, personally appeared
Notary Public's county of residence)
•
Pb I.� � and acknowledge the execution of the foregoing instrument
(Property Owner,Attorney, or Power of Attorney)
this day of \--L""',"` , 20 �a--
Notary Public--Signature
(SEAL I if n
LISA MOTZ
NotaryNotaryPublic—Printed Name
Hamilton •County•State of of Indiana
CommissionNumber NP078
My Commission
9,on Expires Jun 2029
My commission expires
Page 11 of 12 Filename:Hearing Officer Development Standards Variance Handout 2022 Revised 12/29/2021