Executed Zoning Board Application Form submission

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 application are true. | am aware that if any of the foregoing statements are willfully false, Iam subject to punishment. Applicant's Signature: Date: 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, Applicant’s Signature: Date: OWNER’S AUTHORIZATION — MUST BE SIGNED Thereby certify that I reside at NGS Ree \ Os Hoon fal LAnS in the County of K orcas and the State of “New Jere ai cane : and that I am the owner of all that certain lot, piece or parcel of land known as Block(s)_ 105 f Lot(s) 64.01 on the Tax Map of _34 which property is the subject of the above application, and that said application is hereby authorized by me. Furthermore, | authorize inspection of the site paw #/lb {25 which is the subject of this OW Owner’s Signature: 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 BRD\Ducument Library\PN-ZBA Application 420-15.loe