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32A - TRACT MAP - 1010 S HARBOR
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08/04/2015
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32A - TRACT MAP - 1010 S HARBOR
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Last modified
8/3/2015 10:45:13 AM
Creation date
7/30/2015 5:40:41 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Planning & Building
Item #
32A
Date
8/4/2015
Destruction Year
2020
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Property OWNER'S AFFIDAVIT <br />I hereby certify that I am the legally authorized owner of all property involved in this <br />application or have been empowered to sign as the property owner on behalf of a <br />corporation, partnership, business, etc., as evidenced by separate instrument attached <br />herewith. I hereby grant to the applicant submitting this form full power to sign all <br />documents related to this application, including any conditions or litigation measures as <br />may be deemed necessary. <br />I declare under penalty of perjury that the foregoing is true and correct. <br />Executed on (Date) _ ee / t J Rat Ylv ^ California <br />Property Owner's Signature 7l <br />Property Owner's Printed Name � <br />+na- few, cf�c. <br />APPLICANT'S AFFIDAVIT <br />I hereby certify that the statements furnished above and in the attached exhibits <br />represent the data and Information required for this Initial evaluation and that the facts, <br />statements and information presented are true and correct to the best of my knowledge <br />and belief. Further, should the stated information be found false or insufficient, I agree <br />to the return of this form for appropriate revisions, understanding the City of Santa Ana <br />cannot process this form until all applicable information is corrected or provided by the <br />applicant. I hereby certify that I have been legally authorized by the property owner to <br />present this application and to sign on behalf of all documents related to this application, <br />including any conditions or litigation measures as may be deemed necessary. <br />Note: When the applicant is a corporation, partnership, business, etc., a separate <br />document verifying the authorization to sign for such applicant Is required. <br />I declare under penalty of perjury that the foregoing is true and correct. <br />Executed on (Date) <br />Applicant's Signature <br />Applicant's Printed Name <br />'5; _OL <br />S:planninglClarbal•0nuntar Fo mmH00aPNlcmlon <br />at California <br />Page 4 of <br />32A -32 <br />
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