PB 26 01 Application

TION AND AUTHORIZATION SIGNATURE [S REQUIRED FOR ALL OF THE FOLLOWING: APPLICANT'S VERIFICATION (hereby certify that the above statements made by me and the information contained in the papers submitted in connection with this appfication are true. Cam aware that if any of the foregoing statements are willfully false, 1 am subject to punispffent, Applicant's Signature: Date: Liylee f t 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 extgns} Applicant's Signature: ¢ y— Date: a 1; Y /: 26 OWNER’S AUTHORIZATION - MUST BE SIGNED Thereby certify that {reside at_ 43 Edgewood Avenue, West Orange, NJ 07052 in the County of __ Essex and the State of_New Jersey and that Lam the owner ofall that certain lot, piece or parcel of land known as Block(s) _4 58 : Lot(s) 28.01 on the Tax Map lest Orange which property is the subject of the above application, and that said application } which is the subject of this applicatign, / hereby authorized by me. Pucthermore, { authorize inspection of the site Date: 1) 1y fe é Ovner'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, TAPLANNINGORINDUcu nent Lian APH-ZKA Applicition 120-1 Sve NK J, MATERIA A AT LAW STATE OF NEW JERSEY