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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 />app €Ica €ion or have been empowered to sign as the property owner can behalf of a <br />corporation, partnership, business, etc., as evidenced by separate instrument attached <br />herewith, 1 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 />declare under penalty of perjury that the foregoing Is true and correct, <br />Executed on (Date) �m _ at %/I California <br />Property Owner's Signature i <br />Property Owner's Printed Name. 4gn? _ � � r Gr•, t 3a <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 inliial 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 revislon$i, 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 litigations 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 (gate) j S at r lru California <br />Applicant's Slgnature <br />Applicants Printed Name <br />Nee 4 of 4 <br />SPleniin�V.; ll• ICbi�ea ?in:aifaezrsti+OOtiir�Alcaiirn <br />ti'I5 <br />32A -67 <br />
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