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Chvner Name: <br />'a- Business License #: ,7 1 7 <br />Company: <br />Address: <br />City, State Zip: <br />DOTE: The licrson subanittin this )rotest must be the owner of the business referenced <br />above. Please complete and submit this form to the Clerk of the Council during or prior to the <br />public hearing; scheduled for July 1.. 2013. <br />The Public Hearing will be held at 5:45pm at: <br />City Council Chamber <br />22 Civic Center Plaza <br />Santa Ana, California 92702 <br />This form can be mailed to the Clerk of the Council at: 20 Civic Center Plaza, Wh Floor, manta <br />Ana CA 92702; however, it must be received prior to the date of the hearing in order for the <br />protest to be considered. <br />U-1 am protesting the assessment in its entirety. <br />El 1 am protesting the following; specific types of improvement or activities: <br />h,_ f :k <br />Print Name <br />Signature <br />Title <br />Date <br />