PB 24 13 IMMC Health Complete Application

J. VERIFICATION AND AUTHORIZATION SIGNATURE IS REQUIRED FOR ALL OF THE FOLLOWING: APPLICANT’S VERIFICATION I hereby certify that the above statements made by me and the information contained in the papers submitted in connection with this applicatian are true. [ am aware that if any of the foregoing statements are willfully false, I am subject to punistim: / / Vv in pate; 07/01/2024 Applicant’s Signature; CONTINUANCE f \ Should the Planning Board/Zoning Board of Adjustment have a full and heavy agenda, or discussion and meeting regarding this applicati quiring carrying the matter past the statue time limit, the applicant grants permission for such P, sor ( a 2024 Applicant’s Signature: U _/) Date: 07/01/20: OWNER’S AUTHORIZATION “4 ST BE SIGNED Thereby certify that [ reside at in the County of Essex 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) 172.02 Lot(s) 6 on the Tax Map of W. Orange which property is the subject of the above «application, and that said application j hereby authorized by me. Furthermore, [ authorize inspection of the site which is the subject ofthis application. | Se ; G pate, 07/01/2024 Owner's Signature: { fom . THIS APPLICATION DOES NOT RELIEVE THE APPLICANT FROM COMPLYING WITH OTHER TOWNSHIP ORDINANCES SUCH AS THE TREE REMOVAL ORDINANCE AND OBTAINING THE NECESSARY APPROVALS AND PERMITS UNDER SUCH ORDINANCES. TAPLANNING DRDWocument LibrarPR-2BA Applicaton 4-20-15.dne