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Home My WebLink AboutProject Packet) A"f'fLl c # 7Cf.3 cuP r j1.,v«-C• v~ ~ 4 ~~ IA-CL,,t.iZA VtlA(a-~ f{e,,u,,vP you>~d 11w' /6 / -st- City of ORONO RESOLUTION OF THE CITY COUNCIL NO. APPROVING A LOT AREA VARIANCE FOR RECORD LOT NO 6 :Z PURSUANT TO ORDINANCE N0.246, SECTION 34.366 BE IT RESOLVED by the City Council of Orono, Hennepin County, Minnesota: 1. FINDINGS That is (are) the -,--,-----,--------,----,-----------------------owner (s) /taxpayer (s) of record of the following described property located within the RS Seasonal Recreational Zoning District of the City: Lot 47, Morse Island Park, Hennepin County, Minnesota 2. That in adoption of Ordinance No. 246, the City Council reviewed ownership, development and use patterns on -the-islands and has determined that all the above described property combined is and shall hereinafter and henceforth be one "RECORD LOT" as defined in Section 34.366 of said ordinance. 3. That all the above described property when combined as one RECORD LOT is still less than the minimum lot size required for new lots in the RS District, but that this _RECORn LOT is being used and/or may be used in the future for any permitted use in the RS District without adverse affect upon public health, safety, or welfare. CONCLUSION The City Council of Orono hereby grants a lot area variance to the above described RECORD LOT based on the above findings and subject to the following Conditions: 1. This RECORD LOT including all the above described property combined shall henceforth be continued in common ownership by the same person or persons even if recorded as separate lots or tax parcels, and it shall not be subdivided, sold in parts, reduced in area or otherwise separated without application for and approval of a subdivision by the City. ·This condition shall not preclude futur~ sale or transfer of the complete "RECORD _LOT" as a singl E¼ unit. 2. Granting this variance means this RECORD LOT may be used for one- family seasonal recreationai use without a structure; or a single new seasonal dwelling may be built; or an existing seasonal dwelling may be used, improved, added-onto or replaced; all without requiring further City Council review of lot size, but subject to strict comp- liance with all building permit, setback, hardcover, on-site sewage treatment and other performance standards for development in the RS District. PAGE 2; RECORD LOT NO. /J ~ : RESOLUTION NO. ------ 3. Granting this variance shall not vest any rights in the property other than as specifically provided in Ordinance No. 246, and shall not preclude a future City Council from amending, modifying or other- wise limiting development rights and/or performance standards in the RS District. 4. The undersigned has read and understood the terms of this resolution and on behalf of himself, his heirs, successors and assigns, agrees that the above described property constitutes · a single RECORD LOT; agrees that the RECORD LOT use may be so limited by the City; and agrees to the recording of tttis resolution in the chain of title of the property. Adopted by the Orono City Council on the day of , 1983. ---------- ATTEST: CITY OF ORONO City Mayor (1) (2) _____________ _ known to me to be the person(s) desc instrument, and acknowledged that free act and deed. I · G~ .,, 'DITH A FROMMEs · ' • : • ,'.;(, V p~ "'.7 Ai ll\lf\l i:('·, I '•'I ,' If,-. ,\ . '•-' ' -'_lQfil l,.IN T'\' .. COMMll!S ION ~~" ri c:o 1141'· 14', ( ·-~ ..... and who This document is being recorded for the benefit of the City of Orono per Minnesota Statutes 386.77. State Deed Tax Due Hereon: Exempt This instrument was drafted by: City Of Orono P.O. Box 66 Crystal Bay, Mn. 55323 473-7357 the foregoing as his (their) CD CITY of ORONO __ Post Office Box 66 • Crystal Bay, Minnesota ~5323 • Municipal Offices On the North Shore of Lake Minnetonka ORDINANCE NO. 246 RS SEASONAL RECREATIONAL ZONING OFFICIAL RECORD LOT NOTICE FEBRUARY 15, 1983 473-731 (/ This notice is provided to the owner/taxpayer of record according to Ordinance #246, Section 34.336. The following Record Lot classification will be considered accurat~ and final unless you have some reason to dispute the facts used to make the classification. Record Lot identification fonns the basis for the granting of automatic lot area variances th.1.t "Grandfather" existing properties of less than 5 acres in area. RECORD LOT means all the contiguous or abutting land owned in common by the same person or persons as of November 9, 1981, (the effective date of the island moratorium) or at any time such common-ownership may occur thereafter, including one or more separately platted lots or unplatted parcels of land, and/or one or more separately identified tax parcels. Because of the unique circumstances and actual use patterns existing on the islands, also included within the definition of a "Record Lot". is commonly-owned land that is contiguous except for being separated only by platted unopened public right-of-way. Record Lot f/62 Jean A. Deggendorf Box 334 Ex~els~or, MN 55331 APPROXIl-!ATE SIZE o-lB ACRES & CLASSIFICATION: (size is exclusive of any wetlands) OVER 10 ACRES, (may be SUBDIVIDABLE) --OVER 5 ACRES, but LESS THAN 10 ACRES --(conforming but not SUBDIVIDABLE) .2{_sUBSTANDARD/BUILDABLE (less than 5 acres; a new seasonal cabin may be built, or an existing seasonal cabin may be improved, added-onto or replaced, subject to setbacks, permits, etc., but without requiring further City Council review) UNBUILDABLE (means a vacant lot of less than --1/2 acre; may be used for recreational purposes without a cabin, but requires a Council approved variance to be built on) This RECORD LOT consists of ---1 tax parcel(s) as follows: EXISTING USE CLASSIFICATION RECREATIONAL USE ONLY (without a cabin) --SEASONAL CABIN, used 180 days or less/year --(if your cabin is used more than 180 days/ year, please complete the YELLOW application) )( Seasonal Cabin plus a PRIVATE GUEST CABIN --Other CO NDITIONAL E -(,( PLEASE VERIFY THE ACCURACY OF THE ABOVE INFORMATION. If there is an error or a change, please mark the correction and return this page to the City in the enclosed postage- paid envelope. We want this permanent record to be correct. IF YOU WISH TO CHALLENGE THE RECORD LOT DETERMINATION AND/OR THE CLASSIFICATION OF YOUR PROPERTY, you must file a fonnal written appeal before July 1, 1983, or the record lot will remain classified as above. Sign below and return along with a separate letter stating the problem and facts supporting any change. Additional information may be requested to verify any chillenge such as surveys, utility bills, copies of recorded deeds, etc. ;? z_ ~- I I ,,,. Owner/Taxpayer Date / I (, /" Phon e MINNETONKA 1 )NKA I BE ,;CH ~ HUNTINGION POINT DEERING ISLAND . INSERT OFFICIAL RECORD LOT MAP ORDINANCE NO . 246 -DECEMBER 30, 1982 RS SEASONAL RECREATIONAL ZONING DISTRICT NOT TO SCALE ,,>i✓. ,.T ;fr~_-<;:>_) ~:-;7/ /~iiG ISLAfiri 1 r ··'P'/_. 1/ ,:,;.•;~~:;i--.. ,--:-·--'· ,."" :Y ' ( ,{ •·t,~. ,~ ~ ,, ., .. -"'.q,· a -•• 110,. . . -, ·: .:.ef:,r.. -~ _·_. r.:.,_ ~-... · :/;:~. flennep .i.n Pa.11.ll Rue.1Lve V-i..t,.vr.,ie,t VIL. _M.thl.Llt Allen Wildli6e Re 6u.ge ~-\f:~ :'·'._;)f:;<< __ __ 1.,~-~-\ r .·Jf,.lf.'_;_•:-1 .• ✓-...... -.. • ~~~t~ .. if.'.'.-:_·:_'.<-~~\~~'{\~;·:~:.){:;- I CROWN POINT , • • I t8 • I' I . ., ·•, . S.ta..te. 06 M.i.nn • 6.i.g 11>.la.nd V e..tl!/lai11> Ca.mp ., ,, ',, , . • , • . /:y,:_:;--,t~ "<--· . . . . ..... POINT CHARMING t NORTH Telephone 473-7357 CITY of ORONO Post Office Box 66 • Crystal Bay, Minnesota 55323 • Municipal Offices On the North Shore of Lake Minnetonka May 13, 1983 Mr. Jean A. Deggendorf Box 334 Excelsior, Minnesota Re: Big Island Dear Mr. Deggendorf: 55331 Lot Enclosed is information regarding the island zon~ng ordinance adopted last December and how that ordinance may affect your property. I recommend that you consider completing and returning the variance resolution (Form #2) which will ensure that you receive the full "grandfather" benefits of the ordinance designed to protect building rights on those lots with existing cabins. I have also enclosed two yellow conditional use permit application forms (#4-1 & #4-2). These need to be completed and returned if you wish to record use of a guest house ·and/or use of your property as your principal year-round residence. If you choose to apply for these permits, they will be reviewed by the Planning Commission and City Council. Final approval of these permits and any conditions required will be included in a single lot variance resolution that will replace Form #2. The information asked on the yellow forms is necessary to prepare that resolution. I apologize for the delay in getting this information to you. You will note that the ordinance and attached forms include a July l; 1983 deadline for your response. I would appreciate your response by that date, but because this notice was delayed, we will extend the actual deadline to September 1, 1983. Thank you for your cooperation. Sinz:~L ~Olson . City Planner APO/ams February 15, 1983 Record Lot //62 Jean A. Deggendorf Box 334 Excelsior, MN 55331 Dear Island Landowner: CITY of .ORONO Post Office Box 66 • Crystal Bay, Minnesota 55323 • Municipal Offices On the North Shore of Lake Minnetonka The purpose of this letter is to provide you with information regarding the recent zoning changes on Big Island, and how these changes may affect your property. The new RS Seasonal Recreational zoning regulations were established by City Council adoption of Ordinance #246 on December 30, 1982. This action also ended the development moratorium that had been in effect since November 9, 1981. A summary of the ordinance is attached. If you are interested, a complete text of the ordinance is also available for a nominal charge of $3.00 to defer printing and mailing costs. Your property is identified in the ordinance by the Record Lot Number shown above and on the attached blue page. This identification is part of a special section that inventories lot by lot the ownership patterns and existing uses of island property. Based on this record, the ordinance then "grandfathers" building rights for these Record Lots by making them eligible for lot area variances. This means that for the first time even if your lot is less than five acres (or two acres under the previous ordinance) that you may now build a new seasonal cabin, or if you already have a cabin, that it may continue to be used, improved, added-onto or replaced with a new cabin, subject to building permits and setback regulations, etc., but without questioning its use for building purposes, and without requiring any special City Council review. In order for you to automatically receive the benefits of the lot area variance, you should review and complete the following before July 1, 1983: 1. Please verify the Record Lot information on the attached blue page and notify the City if there is a problem or a change. BUILDING & ZONING -473-7357 ASSESSING • ADMINISTRATION & FINANCE -473-7358 (over) • PUBLIC WORKS -473-7359 Island Landowners February 15, 1983 Page 2 2. If the Record Lot information is complete, please sign, have notarized and return the white Variance Resolution. State law requires that all zoning variances be recorded with the County Recorder in resolution form. Returning this resolution is optional, but if you choose not to do so, you may be iequired to pay a fee and file a formal variance application in the future if you ever plan to do any building on the property. There is no fee for having this automatic variance recorded at this time. 3. If your Record Lot consists of two or more separate tax parcels, a green form for requesting a combined assessment is enclosed. Please sign and return this to the City to allow your tax records to be changed into one parcel cortsistent with the zoning and to assure the most favorable tax rate possible. 4. A conditional use permit issued by the City Council is required for certain land uses in the RS District, including the following residential uses: 4··1 a) ,4 .z b) If you use or have . used your cabin FOR MORE THAN 180 DAYS/YEAR. If you have MORE THAN ONE CABIN on your property. Refer to the enclosed yellow sheet for a definition of these uses including a description of when a special permit is or is .not required. If you wish to a pp 1 y for a permit , mark I: he y,e...l~.g...e-a-R-a-ret·ur·Tl it ~~~ ;w iL1 ..s.e..n..d-;y.0-U-:-&•l:i-e-a-p -p-r--0,p-i;...i..a..t.e-a..p..p.J..i.c..a.t..i.o.n_f..o..r,m by r-e-t-t1 ·r-n-m-a-i--±-.-. Fe r-t't"l. ..s (J. r·-e. €.:tU C / 01'$ eel A postage-paid envelope is enclosed for your use in returning the above forms to the City. If you have any questions about this, please call Alan Olson or Jeanne Mabusth at 473-7357. On behalf of the City Council and Planning Commission, I want to take this opportunity to thank each and everyone of you whoie inter~st and participation this past year has helped so much in the completion of this planning process. I have certainly enjoyed meeting all of you and learning so much about your island. I hope this last step can be kept as · simple as possible so that your property rights can be correctly recorded for your future benefit. Sincerely, t: / t,t;;,:____ .41:~ 1. 01 son City Planner Enclosures 0 CITY of ORONOc·· Post Office Box 66 •_Crystal Bay, Minnesota ('>532:3 • Municipal Offices '.-: On the North Shore of Lake Minnetonka ORDINANCE NO. 246 RS SEASONAL RECREATIONAL ZONING OFFICIAL RECORD LOT NOTICE FEBRUARY 15, 1983 473-7357 This notice is provided to the owner /taxpayer of record according to Ordinance l/246, Section 34.336. The following Record Lot classification will be considered accurate and final unless you have some reason to dispute the facts used to make the classification, Record Lot identification forms the basis for the granting of automatic lot area variances th.1.t "Grandfather" existing properties of less than 5 acres in area. RECORD LOT means all the contiguous or abutting land owned in common by the same person or persons as of November 9, 1981, (the effective date of the island moratorium) or at any time such common-ownership may occur thereafter, including one or more separately platted lots or unplatted parcels of land, and/or one or more separately identified tax parcels. Because of the unique circumstances and actual use patterns existing on the islands, also included within the definition of a "Record Lot". is commonly-owned land that is contiguous except for being separated only by platted unopened public right-of-way. Record Lot 1162 Jean A. Deggendorf Box 334 Excelsior, MN 55331 APPROXIMATE SIZE o-/8 ACRES & CLASSIFICATION: (size is exclusive of any W::?tlandsl OVER 10 ACRES, (m.iy be SUBDIVIDABLE) --OVER 5 ACRES, but LESS THAN 10 ACRES --(conforming but not SUBDIVIDABLE) 2{_sUBSTANDARD/BUILDABLE (less than 5 acres; a new seasonal cabin may be built, or an existing seasonal cabin may he improved, added-onto or replaced, subject to setbacks, permits, etc,, but without requiring further City council review) UNBUILDABLE (means a vacant lot of less than --1/2 acre; may be used for recreational purposes without a cabin, but requires a Council approved variance to be built on) This RECORD LOT consists of l --------tax parcel(s) as follows: ;? '3-117-~3 Jl2 ooor EXISTING USE CLASSIFICATION RECREATIONAL USE ONLY (without a cabin) --SEASONAL CABIN, used 180 days or less/year --(if your cabin is used more than 180 <lays/ X year, please complete the YELLOW application) __ Seasonal Cabin plus a PRIVATE GUEST CABIN Other co:mITIONAL E -ti PLEASE VERIFY THE ACCURACY OF THE ABOVE INFORMATION. If there ·is an error or a change, please mark the correction and return this page to the City in the enclosed postage- paid envelope. We want this permanent record to be correct. IF YOU WISH TO CHALLENGE THE RECORD LOT DETERMINATION AND/OR THE CLASSIFICATION OF YOUR PROPERTY, you must file a formal written appeal before July 1, 1983, or the record lot will remain classified as above. Sign below and return along with a separate letter stating the problem and facts supporting any change, Additional information may be requested to verify any challenge such as surveys, utility bills, copies of recorded deeds, etc. Owner/Taxpayer Date Phone City of ORONO RESOLUTION OF THE CITY COUNCIL NO. APPROVING A LOT AREA VARIANCE FOR RECORD LOT NO b« PURSUANT TO ORDINANCE NO.246, SECTION 34.366 0 BE IT RESOLVED by the City Council of Orono, Hennepin County, Minnesota: 1. FINDINGS That is (are) the --,--,-,----------:-----:----------------------- 0 w n er ( s) /taxpayer ( s) of record of the following described property located within the RS Seasonal Recreational Zoning District of the City: Lot 47, Morse Island Park, Hennepin County, Minnesota 2. That in adoption of Ordinance No. 246, the City Council reviewed ownership, development and use patterns on the islands and has determined that all the above described property combined is and shall hereinafter and henceforth be one "RECORD LOT" as defined in Section 34.366 of said ordinance. 3. That all the above described property when combined as one RECORD LOT is still less than the minimum lot size required for new lots in the RS District, but that this RECORD LOT is being used and/or may be used in the future for any permitted use in the RS District without adverse affect upon public health, safety, or welfare. CONCLUSION The City Council of Orono hereby grants a lot area variance to the above described RECORD LOT based on the above findings and subject to the following Conditions: 1. This RECORD LOT including all the above described property combined shall henceforth be continued in common ownership by the same person or persons even if recorded as separate lots or tax parcels, and it shall not be subdivided, sold in parts, reduced in area or otherwise separated without application for and approval of a subdivision by the City. This condition shall not preclude future sale or transfer of the complete "RECORD LOT" as a single unit. 2. Granting this variance means this RECORD LOT may be used for one- family seasonal recreational use without a structure; or a single new seasonal dwelling may be built; or an existing seasonal dwelling may be used, improved, added-onto or replaced; all without requiring further City Council review of lot size, but subject to strict comp- liance with all building permit, setback, hardcover, on-site sewage treatment and other performance standards for development in the RS District. PAGE 2; RECORD LOT NO. 6 ,;2 : RESOLUTION NO. ------ 3. Granting this variance shall not vest any rights in the property other than as specifically provided in Ordinance No. 246, and shall not preclude a future City Council from amending, modifying or other- wise limiting development rights and/or performance standards in the RS District. 4. The undersigned has read and understood the terms of this resolution and on behalf of himself, his heirs, successors and assigns, agrees that the above described property constitutes a single RECORD LOT; agrees that the RECORD LOT use may be so limited by the City; and agrees to the recording of tttis resolution in the chain of title of the property. Adopted by the Orono City Council on the ___ day of _______ , 1983. ATTEST: CITY OF ORONO City Clerk Mayor (1) (2) ______________ _ Property Owner(s) STATE OF MINNESOTA) ) s s . COUNTY OF HENNEPIN) On this ___ day of ______ , 19 , before me, a Notary Public within and for said County, personally appeared ------------------- known to me to be the person(s) described in and who executed the foregoing instrument, and acknowledged that he (they) executed the same as his (their) free act and deed. NOTARY PUBLIC MY COMMISSION EXPIRES This document is being recorded for the benefit of the City of Orono per Minnesota Statutes 386.77. State Deed Tax Due Hereon: Exempt This instrument was drafted by: City Of Orono P.O. Box 66 Crystal Bay, Mn. 55323 473-7357 CITY of ORONO Post Office Box 66 • Crystal Bay, Minnesota 55323 • Municipal Offices On the North Shore of Lake Minnetonka ORDINANCE NO. 246 APPLICATION FOR CONDITIONAL USE PERMIT (& VARIANCE) SECTION 34.363(a): TO AUTHORIZE PRINCIPAL DWELLING USE: meaning any home or cabin that is used or occupied for 181 days or more in any one year; or any dwelling regardless of the duration of use if you wish to claim a Minnesota "principal residence" homestead tax credit. If the property is not homestead, and if your total annual usage is less than 180 days (6 months),then your use is allowed by the ordinance and you do not have to apply for this special permit. Note that even if you use the property a few days every month, it is the total number of days that count, not how these days mig h t be spread throughout the year. ! ) Applicant's Name (if different) and Telephone --------------------- Mail Address ----------------------------,----------- as to why this permit should be approved: /J L I l ~ ., 1. Ownership is by: Fee (Deed) ,'>( :Contract for Deed : Other ----------- // :__ 2. Date Property was Purchased: ~ -, Is deed/contract recorded? ,,,. Yes No --'--~----- 3. Approx. Property Size: .,") J ft. wide X / ft. deep; or acres. --'---'----~------- 4. Is this your only residence? X yes no. If not, what is the address --- of your other residence(s)? 5. Have you filed for a "Homestead" property tax credit on this property X Yes No If yes, what is the first year you so filed? ? BUILDING & ZONING -473-7357 ASSFl;SINr. • -~--- QUESTIONS CONTINUE ON BACK ADMINISTRATION & FINANCE -473-7358 • PUBLIC WORKS -473-7359 I 7 j I / ,,z;.,✓, ■ ORDINANCE NO. 246 RECORD LOT NO. ), ,;' t. • ,:____J_, PAGE -2-' -==~ APPLICATION FOR PRINC.1rAL DWELLING CONDITIONAL USE PER1· .• f 6. Have you filed for a "Homestead" credit on any other Minnesota property? __ Yes:/_N, If so where? 7. 8. ------------------------------------- How many persons reside here as their principal residence (on the average)? / -,-1---- How many days per year is the property occupied? (a) )( Continuously all year; or (b) Part of each year from about _____ to ____ ~ling ____ days; or (c) Off and on throughout the year, totalling days (give example of dates used last year): --------------------------::--==:-----r~---=:---=- , .. 10. Dwelling was built when (approx. year)? r,:; was added onto in what year (s)? ______________________ and was last remodeled in what year-'-?-== 11 A d lli (fl ) ' ft. X ---; Ji f r':0 0 f . pprox. we ng size oar area is:___ ~ t.; or_¥ ____ sq. t.; it has how many bedrooms?_-"'=---and can sleep up to /' persons. · 12. Dwelling construction is frame (wood).,. '---- or what other material? (a) A permanent foundation is required. What exists now? space , : open floor with piers ; other basement -==----crawl ------------------ (c) A permanent heating system is required. What exists now? hot air fu nance ,.. space heater(s) wood stove(s) Y other / / :' z _, I 1-f ------------ (d) Fire retardent roofing will be required for new work. What exist now? asphalt shingles )( : untreated wood____ treated wood ____ _ other ' 13. Plumbing and Septic systems will be required by or before Jan. 1, 1983. What exists now? (a) No. of toilets bathroom sinks ---tub or shower ---------I kitchen sink / : other ---+---------------------------- (b) No. of septic tank (s) _Land size in gallons /~{)/) and (c) Amount of drainfield: No. of lines Z. ; length ,J __ .,__ ___ --::=--=-----:=:---:= total Sq. footage __ ~,/~6._.a.._..O'-'r"-----==-=-== (d) Location tanks/drainfield on lot (direction from house): (e) Date of septic system installation/last repair and name of contractor • / : · _, I --::,--~----,,---=---=-=---===--- 14. What type of domestic water ;upply is available? (a) lake pump~/_· __ gpm~~ (b) well: depth_~ __ ft.; casing diam. ____ inches: flow rate gpm:# pump type: elec.)( ; gasoline _____ other: ______________ _ year drilled ____ by · (contractor's name) ORDINANCE NO. 246 APPLICATION FOR PRINCIPAL DWELLING CONDITIONAL USE PERMIT 15. Basic fire/life protection will be required by Jan. 1, 1985, What eY.ists now and how many? Smoke detector(s) & Portable fire e x tinguisher(~) ----size lAl OBC or larger ,2---: o t her_-"-"'""•-c...1 --'-'-·.· __ ·_,_.,,,.,_r _· ~-,·""4?:~_,_,1_· ~---;;..•·__,,'-+-,..,,,-cc,.,...,,,,__• . ,I -c..,,r_, 16. What additional fire extinguishing equipment is available now (some type is required by Jan. 1, 1988)? (a) Automatic sprinkler system ----- (b) Roseline connected to well ,,A or to lake pump X : ---"''-T,------"'-'--- (c) Alarm system --------------- ( d) Other ------------------- 17. Is your house visible from the lake? Yes ~ No ___ : Could a 4-wheel drive emergency vehicle reach your house from the lake? Yes)('✓No __ 18. one, and Also Do you have an intrusion alarm system? DO NOT ANSWER HERE. If you have please notify Orono Police (473-7710) of the particulars, including type key holder names. Any audible alarm must be of the self-resetting type. consider Operation ID marking of valuables, security locking, lighting and other such measures. 19. How do you dispo ~~of garbag~and qtlie wastes (burying or burning is prohibited): ~--;, h (~ /_, c;;.,1 , '. / J ,-, ·) I hereby apply for this Conditional Use Permit under the terms and conditions of Ordinance No. 246. I understand that in granting the permit the City Council may establish reasonable conditions or timetables for making improvements related to health and safety matters; that the final permit if granted will be in resolution form, will require my signature, and will be recorded in the chain of title of my property; and that there will be no fee charged for this application if made before July 1, 1983. / .,,. (j \ / '/ ,, / -.~ Date Owner's Signature (_,/ 0 , ---~--=--=-------,,,,."-r,------+e---,---- A pp l i cant Is Signature_#_1_'_,__.~./-=r.~,'-',,__=-_...,.,_-'---'--=c'-"--__,'-----1/ -.' , I Date I _z: ., ' J :.2,-, / ~i ' t' ,: .,2 r. --,y ' ,,. _. ~ .,J