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6761 <br /> OMO: <br /> i • AW"to Pie all Monnntlon required or requested by the PMrNnp Dena mwA <br /> I • /,Mw of {surf tlnM not cogs a In the odour No pap.m�t)and or coraui�nt nocpwmm inarnrd ln <br /> • Cer*VW the hfon u*m supplied is true and aDned to the beat of hMw IQwwiedge.The aWkant and owner mcognim <br /> that IM arse solely reaponsble for aLdxMng a oornpiste aI Icegon being swan that upon fWk n to do o%tta smf has <br /> j no allerni ve but to reject tt until It Is oomplete or to noornmend the request for dere d of the request mpm lass of w <br /> i <br /> Potential MWIL <br /> ( • The Owner hereby acbwwledges and apnea ID thh application and further authorizes rwonable entry onto the <br /> byoMty <br /> SW oorwift t ,agents,Comndssion and Cound Members for ponoses of hvasWon and verromon d teas <br /> • Applicant andlor Owner acknowledge they must be present ata scheduled review memdngs of the p"Wng Corr mlealon <br /> and Council. If an applicant andbr owner Is unable to attired a sdNduled meeting,please make&wWnm*to hm an <br /> m*wrind reprsswtdvs attend lnphos d tha applla-Ua uu - r and adWw the Clty P i mer aWgned b your P <br /> ojaoL <br /> • Information WE be mauled via entail. <br /> Applicant Signature: Date: ,(�7 <br /> Applicant Signature: Dobe: <br /> Property Owner Signatum:_ Ste--Vw1-L,L- <br /> ftpeft <br /> c. <br /> Owner Signature Date: <br /> S9"ft Cn APPkmftn—JM y 2017 <br /> Pea e <br />