Notarized Form rcd 9 3 26

Township Of West Orange FORM PH-4Z Zoning Board of Adjustment TOWNSHIP OF WEST ORANGE Application No. zB-Z6- 0l Filed STATE OF NEW JERSEY COUNTY OF 3SÉY Mao Grossmn of full age, being duly sworn according to law, deposes and says, that (s)he resides at S AlStre in the Municipality of_Vst County of Ess Ex and State of_WeJesy_that (s)he is the applicant in a proceeding before the Zoning Board of Adjustment of West Orange Township, New Jersey being an (appeal or) application under the Zoning Ordinance,and which has the application No. )^ - l_and relates to premises : (Name) (Location) Block #Y6,Lot # 72that on T/ 3 20 26,(5)he gave writen notice of the hearing on this application to each and all of the persons upon whom service must be heard, in the required form and according to the attached lists,and in the manner indicated thereon. Date of Serving Notice Y/3)2024 Applicant's Signature MELANIE RSCHOWALTER Sworn toyand Subscribed before me NOTARY PUBLIC this STATE OF NEW JERSEY MY COMMISSION EXPIRES JUNE 10, 2029 Munb5noNattnNOTE:Progf of sersiceof notices required by statute must be filed and verified with board secretary at least twe (2) days priorte hecting or case may be postponed. Attach list of all persons served. TARY Commented [DC4]: All noticingdocuments for genda submission must be into thisofficeten (10)days priorto the meeting date. G:Forms & AwardsPH-FORMS\PH4Z doc