HomeMy WebLinkAboutOwners Affidavit 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: %.-
((ir..erty Owner, Attorney, or Power of Attorney)
Printed Name: X ,,...r—,,..
STATE OF INDIANA
SS:
County of _ini� l( litn Before me the undersigned, a Notary Public
(County in which notarization takes place)
for k\ ' l`b{) County, State of Indiana, personally appeared
(Notary Public's county of residence)
and acknowledge the execution of the foregoing instrument
(Property, '
this ) r, tome , or Power of Attorney)
day of I , 20 2
J'IT'''- ' Cief—.
' Notary Public--Signature
(SEAL) U
Notary Public— rinted Name
My commission expires: J.l(5_ '
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Page 11 of 12 Filename:Hearing Officer Development Standards Variance Handout 2022 Revised 12/29/2021