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32A - TRACT MAP - 1406 N HARBOR BLVD
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05/17/2016
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32A - TRACT MAP - 1406 N HARBOR BLVD
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Last modified
7/7/2016 9:24:30 AM
Creation date
5/13/2016 8:51:37 AM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Planning & Building
Item #
32A
Date
5/17/2016
Destruction Year
2021
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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)`f%e��g ata„California <br />Property Owner's <br />Property Owner's Printed Name DIA A 2L A G — <br />APPLICANT'S AFFIDAVIT <br />I hereby certify that the statements furnished above and in the attached exhibits <br />represent the date and intormatlon 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, t 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 prop” 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 applicantis a corporation, partnership, business, etc., a separate <br />document verifying the euthorization to sign for such applicant is required, <br />1 declare under penalty of perju that the foregoing Is true and correct. <br />Executed an (Date) 2 I ( S at✓ ✓I t� California <br />Applicants Signature_ <br />Applicant'sPrinted Name <br />c�,/� <br />Page 4 of 4 <br />9; Plannin9��letical-CwMer FormalHtlbapliliretlan <br />vi9 <br />1) P <br />32A-64 <br />
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