HomeMy WebLinkAboutOwners 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: la5�
(Property caner. Attorney, or Power of Attorney)
Printed Name: *1 6-} , �—. +-
STATE OF INDIANA
SS:
County of .�Q��pr0 Before me the undersigned, a Notary
g y Public
(County in which notarization takes place)
for County, State of Indiana, personally appeared
(Notary Public's county of residence)
w k+ and acknowledge the execution of the foregoing instrument
Pr v ner Attorney, or P wer of Attorney)
this day of 20
Teresa K. Anderson
Notary Public Notary Public Signa_ture
(SEAL)SEAL
Hamilton County, State of Indiana
Commission # 679125
My Commission Expires 04/01/2024 Notary Public —Printed Name
My commission expires: __ 6?.________
Page 11 of 12 Filename: Hearing Officer Development Standards Variance Handout 2022[6398] Revised 12/29/2021