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16
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2012
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051512
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16
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5/11/2012 11:28:51 AM
Creation date
5/10/2012 3:43:02 PM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
1/10/2012
DESTRUCT DATE
15Y
DOCUMENT NO
16
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1)7 '/ <br /> i <br /> III. AUTHORIZATION OF PROPERTY OWNER AND OWNERS ASSOCIATION <br /> I. PROPERTY OWNER: In signing this application, 1, as property owner, have full legal capacity to, and hereby do, . <br /> authorize the filing of this application. I understand that conditions of approval are binding and agree to be bound by those i <br /> conditions, subject only to the right to object at the hearings or during the appeal period. I certify that the information and <br /> exhibits submitted are true and correct. <br /> Name(Pls. Print): Daytime Telephone: <br /> Company: Other Telephone: <br /> Address: Fax: <br /> City: Zip: E-mail: <br /> Signature: Date: <br /> J. OWNERS ASSOCIATION: Is the property subject to the rules or guidelines of a homeowners association(HOA)or a <br /> business owners association? <br /> 0 Yes Q No <br /> If yes,did the proposed project receive approval from the HOA/business owners association? <br /> 0 Yes 0 No 0 The HOA/business owners association does not review any proposed construction projects or use changes <br /> — If yes,please attach a copy of the HOA response. <br /> Association Contact(Pls.Print): Daytime Telephone: <br /> Association Name: Other Telephone: <br /> Address: Fax: <br /> City: Zip: E-mail: <br /> • <br /> K. APPLICANT OTHER THAN PROPERTY OWNER: In signing this application,I,as applicant,represent to have <br /> obtained authorization from the property owner to file this application. I agree to be bound by conditions of approval,subject <br /> only to the right to object at the hearings on the application or during the appeal period. If this application has not been <br /> signed by the property owner, I have attached separate documentation of full legal capacity to file the application. I certify <br /> that the information and exhibits submitted are true and correct. <br /> Name(Pls.Print): l l� /-�' t " / Daytime Telephone: t � ^i',/ 2 373 Is <br /> Company: Other Telephone: Q)5=' .zoo- 336 <br /> ,c 107 4i'vtioc o-LL <br /> Address: 3,(3-43 Caw ci �' : �T '�Z,,;✓,, Fax: <br /> City: ���.c�lc ./ Zip: 7z�G E-mail: C wFPc nt f3,sr.,p/X'' 661/ <br /> Signature: CiI,,/d/`_ ... Date: <br /> L. NOTE ANY OTHER PARTY(IES)WHO SHOULD RECEIVE STAFF REPORTS AND NOTICE OF <br /> APPLICATION ON A SEPARATE SHEET AND ATTACH TO APPLICATION. <br /> D.T. SCHOOL FEE AGREEMENT(If a residential project,answer the question below) <br /> Have you signed a School Fee Agreement with the Pleasanton Unified School District? 0 Yes 0 No <br /> If yes,please attach a copy of the signed agreement. <br /> WI 0106) <br />
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