PB 25 12 Application

J. VERIFICATION AND AUTHORIZATION SIGNATURE IS REQUIRED FOR ALL OF THE FOLLOWING: APPLICANT'S VERIFICATION | hereby cemity 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, [arm subject to punishment, / / syste sgnaee SNM Let ba: 2) 6-5 CONTINUANCE Should the Planning Board/Zoning Board of Adjustment havea full and heavy agenda, or discussion and meeting regarding this application requiring carying the matter past the statue tie lit the applicant grants permission for such an extension f sntcissinune_ SLM Le ome Ib OS OWNER’S AUTHORIZATION — MUST BE SIGNED Thereby certify that t reside at_» 2/7 Rosser, Ne in the County of / ich mun and the State of __[/ ew YO Y and that Lam the owner of all that certain lot, piece or parcel of land knawn as Blocks) 114 : Lot(s) 55 on the Tax Map of West Orange which property is the subject of the above application, and that said application is hereby ia by me. Furthermore, { authorize inspection of the site which is the subject rs sn Owner's Signature? LU dh ‘ied! Date: Wy ¢ ‘a S 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. TAPLASMINGARDDacument bray PRA Application bSbel See