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, . <br />Property Owner/Agent/Applicant Information <br />It is understood by all parties hereto including owner, petitioner, and/or agents that while this application <br />will be carefully considered and reviewed , the burden of proving its need rests with the below named <br />petitioner(s). <br />[ do hereby certify that the information that [ have provided for this application is , to the best of my <br />knowledge, true and correct. <br />Property Owner <br />Address <br />Phone <br />Fax <br />Signature <br />E-mail Address <br />Agent (if any) <br />Address <br />Phone <br />Fax <br />Signature <br />E-mail Address <br />Applicant (if any) <br />Address <br />Phone <br />Fax <br />Signature <br />E-mail Address <br />G It<:. -t IA SO. H: It (3" H y IQ f\f hd,/ It.' II <br />lie z. 70 G I e rt more /?d Go f d H,' II. rJC .280 i I <br />) <br />aWw 0, 7UJl ~ ~ ~ JI~ <br />~: Its fa.rros 8/~ 8 Me; I. C.rp",,-