ZB 25 12 Pullman 12 Knollwood Drive ZBA Application Amendment Verification and Authorization Page rcd 4 21 2026

L J. VERIFICATION AND AUTHORIZATION | SIGNATURE IS 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 application are true. am aware that if any of the foregoing statements are willfully false, 1 am subject to punis Applicant’s Signature: Date: 4] Leni | 2026 Met DD coy 4 [20(2026 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 eygeng We Date: {|>» )rory “Wepa(Wtae wn ~Y(20(Ze2£ OWNER’S AUTHORIZATION ~ MUST BE SIGNED Ihereby certify that [reside at_ V2 kwolwood DR. WELT ORANGES in the County or_ CAS EK and the Sateot NEW) De : and that | am the owner ofall that certain lot, piece or parcel of land known as Block(s) Ll. 'O) Lot(s) 2A on the Tax Map of WEST SRANEEhich property is the subject of the above application, and that said application is hereby authorized by me, Furthermore, | authorize inspection of the site Applicant's Signatur which is the subject of this application. Owner's Signature: le, {lve } 2°LL iQue 4/22/2226 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. TAPLINNING BRDDecument Library \PIEZIA Application 420-15 dae