Revised Application Signed 72924

[ J. VERIFICATION AND AUTHORIZATION SIGNATURE IS REQUIRED FOR ALL OF THE FOLLOWING: APPLICANT'S VERIFICATION 1 hereby certify that the above statements made by me and the information contained in the papers submitted in connection with this application are true. | am aware that if any of the foregoirlg statements are willfully false, | am subject to punishment. Applicant's seo EF Date: Fi thes fox CONTINUANCE Should the Planning Board/Zoning Board of Adjustment have a full and heavy agenda, or discussion and meeting regarding this application requiring carrying the matter past the statue time limit, the applicant grants permission for such an extension. ea . Date: coe bea © _— OWNER’S AUTHORIZATION — MUST BE SIGNED I hereby certify that horsistoen business address is 750 Eagle Rock Avenue, West Orange, NJ 07052 in the County of __Eseex and the State of New Jersey ;and that [am the owner of all that certain lot, piece or parcel of land known as Block(s) 174 :Lot(s) LOL onthe Tax Map of _West Orange which property is the subject of the above application, and that said application is hereby authorized by me. Furthermore, [ authorize inspection of the site which is the subject of this application. Owner's. mim, ¥E ON i Date: “7 Htulry Crestmont Country Club THIS APPLICATION DOES TO: NEC, VOT RELIEVE THE APPLICANT FROM COMPLYING WITH OTHER SHIP ORDINANCES SUCH AS THE TREE REMOVAL ORDINANCE AND OBTAINING THE SARY APPROVALS AND PERMITS UNDER SUCH ORDINANCES. TAPLANNING.BRD\Document Librars\PR-ZBA Application 3-1 S-1S8.doe ws