Homeowners AffidavitAFFIDAVIT
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:
(Pr erty wner, Attorney, or Power of Attorney)
Printed Name. Z.• ��42� bv;..tn4v
e.
STATE OF INDIANA
SS:
County of 144Wron
(County in which notarization takes place)
Before me the undersigned, a Notary Public
for /''lteie0j County, State of Indiana, personally appeared
(Notary Public's county of residence)
W. 4,jZ>2E#j L-rtg/aa c and acknowledge the execution of the foregoing instrument
(Property Owner, Attorney, or Power of Attorney)
this 1 day of Ala✓e -,4t e 20 22
(SEAL)
Notary Public --Signature
�pcLvEu� Jrti+J1�6,2SoN
JAQUELINE A SANDERSON Notary Public —Printed Name
Notary Public - Seal
Marion County - State of Indiana
Commission Number NP0742427 M commission expires: Uv� l-7 Z° 3 d
My Commission Expires Jul 1 �, 2030 y p
Page 11 of 12 Filename: Hearing Officer Development Standards Variance Handout 2022 Revised 12/29/2021