Submitted Application 10232024 4872 5331 9410 v1 rcd 10 23 24

J, VERIFICATION AND AUTHORIZATION SIGNATURE IS REQUIRED FOR ALL OF THE FOLLOWING: APPLICANT'S VERIFICATION Thereby certify that the above statements made by me and the information contained in {he papers submitted in connection with this application are true. 1 am aware that if any of the fo-egoing stat¢ments are willfully false, I am subject to punishment. Applicant's Signature: Mall Date: 10- lf 4- XU 2Y CONTINUANCE Should the Planning Board/Zoning Board of Adjustment have a full and heavy agenda, or disclission 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: lo! bp Date: 10- ef - PO2Y OWNER'S AUTHORIZATION — MUST BE SIGNED Thereby 7 that [reside at 56 Lran bly Yn Ave est Chuge AS in the County of and the State of___ A/ = G : and that | am the owner of all that certain lot, piece or parcel of land known as Biock(s) 2QOL3Y ; Lot(s) 74 — 3 } on the Tax Map of 0705 2 which property is the subject of the above application, and that said application is hereby authorized by me. Furthermore, | authorize inspection pf the site which is the subject of this appl|cation, Owner's Signature: wel’ yp Date: 10- /4- de 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. TAPLANING HAD Dacinavent Sibearg PN 2IM Application 430-45 de