HomeMy WebLinkAboutHomeowners Affidavit Nz -zo z_- voIsz-v
• AFFIDAVIT Pz - 2 OLL - 00 / s 3 1l
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:
roperty Owne , Attorney, ower of Attorney)
Printed Name: Jer�r���tf —Tin or!nbe('V)
STATE OF INDIANA
SS:
County of k1I V-40►J Before me the undersigned, a Notary Public
(County in which notarization takes place)
for it-4141c-ION County, State of Indiana, personally appeared
(Notary Public's county of residence)
3€n)kJ r FE 1--H a c N T 3E L°X.,Y and acknowledge the execution of the foregoing instrument
(Property Owner, Attorney, or Power of Attorney)
this 18 day of AUGUST , 20 9
Not Public--Signature
.... ALIX LEI VOLLMER
' Marlon
'' My Commission licires �2-1 X L t �-C-V�t�'
ty
► � March3,2024 Notary Public—Printed Name
My commission expires: 03 0 3 - 2021
Page 11 of 12 Filename:Hearing Officer Development Standards Variance Handout 2022 Revised 12/29/2021