2024 07 01 Affidavit of Ownership

J. VERIFICATION AND AUTHORIZATION | SIGNATURE IS REQUIRED FOR ALL OF THE FOLLOWING: APPLICANT’S VERIFICATION I hereby certify that the above stateme: submitted in connection with this application arg willfully false, | am subject to punishment. Applicant’s Signature: its (made by me and the information contained in the papers true. I am aware that if any of the foregoing statements are Date: CONTINUANCE Should the Planning Board/Zoning Board and meeting regarding this application requiring ¢ grants permission for such an extension. Applicant’s Signature: BCI apiley4 | “o} of Adjustment have a full and heavy agenda, or discussion jarrying the matter past the statue time limit, the applicant Date: OWNER’S AUTHORIZATION — MUST BE SIG} Thereby certify that I reside at 244 21 Jey Wachine}on P) in the County of id the State of MN i and that I am the Lot(s) application, and that said application is hereby on the Tax Map of | which is the subject of this application. Owner’s Signature: - owner of all that certain lot, piec! aul ot parcel of land known as Block(s) which property is the subject of the above jorized by me. Furthermore, I authorize inspection of the site Date: THIS APPLICATION DOES NOT RELIEVE TOWNSHIP ORDINANCES SUCH AS THE 2fifzy THE APPLICANT FROM COMPLYING WITH OTHER TREE REMOVAL ORDINANCE AND OBTAINING THE NECESSARY APPROVALS AND PERMITS UNDER ay UCH ORDINANCES. TAPLANNING.BRD\Document Library\PB-ZBA Application 3-15-18.doe