Executed Zoning Board Application Form submission

J. VERIFICATION AND AUTHORIZATION SIGNATURE IS REQUIRED FOR ALL OF THE FOLLOWING: APPLICANT’S VERIFICATION atéments made by me and the information contained in the papers I hereby certify that tf above i am aware that if any of the foregoing statements are submitted in connection with this application\are true. willfully false, 1 am subject to punishment. Applicant’s Signature: a Date: de | ul / cialalll CONTINUANCE and meeting regarding this applicatio) requiring carrying the matter past the statue time limit, the applicant grants permission for ‘\ Gas 5 Applicant’s Signature: VAS Date: 2 [14/22 OWNER’S AUTHORIZATION — MUST BE SIGNED Thereby certify that I reside at in the County of and the State of ; and that I am the owner of all that certain lot, piece or parcel of land known as Block(s) 5 ‘ 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 which is the subject of this application. Owner’s Signature: Date: 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.BRDWDocument Library\PA-ZBA Application 4-20-15.dae