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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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III. AUTHORIZATION OF PROPERTY OWNER AND OWNERS ASSOCIATION <br /> J. PROPERTY OWNER: In signing this application, I, 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 <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. / L <br /> Name(Pls.Print): RC/iLQ% Mick`A Daytime Telephone: I li9 /I2- 3, .3 <br /> Telephone: VAA �S cc i - 2Afrr v li <br /> Other Tele ((/ <br /> 1 Company: P <br /> / t/ <br /> Address: ,_/-97(,,A ik-P C 7.-At <br /> . Fax: (�/����+% - y,3jr <br /> City: /'�E/a /J7vN Zip: 995S-g E-mail 4 fr.z h_yvv,C C Ad. C c,r <br /> Signature: / �' ---( Date: <br /> K. OWNERS ASSOCIATION: Is the property subject to the rules or guidelines of a homeowners association(HOA)or a <br /> business owners association? <br /> o Yes 0 No <br /> If yes,did the proposed project receive approval from the HOA/business owners association? <br /> o Yes o 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(Pis. Print): Daytime Telephone: <br /> Association Name: Other Telephone: <br /> Address: Fax: <br /> 2 City: Zip: E-mail: <br /> L. 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): C/(/;4 PA'L'`7-247-2.- t' . ,' ' e il-,-;?, c 4 e <br /> Daytime Telephone: <br /> '' ' <br /> Company: Other Telephone: <br /> Address: 34, _3 3 £[ACIEC ' T ply Fax: <br /> City: 7:k L A-V I A %�C/✓ Zip: / 'L S JS 5 E-mail: C.(' T i t —e-- „. /' <br /> � - Signature: ;— 7-;/-°% .=-%�A - Date: <br /> M. NOTE ANY OTHER PARTY(IES)WHO SHOULD RECEIVE STAFF REPORTS AND NOTICE OF <br /> APPLICATION ON A SEPARATE SHEET AND ATTACH TO APPLICATION. <br /> IV. 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? <br /> 0Yes (No <br /> If yes,please attach a copy of the signed agreement. 00/08/081 <br />
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