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25
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2019
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041619
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25
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Last modified
4/10/2019 2:12:01 PM
Creation date
4/10/2019 1:02:28 PM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
4/16/2019
DESTRUCT DATE
15Y
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25 ATTACHMENT 2e
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\CITY CLERK\AGENDA PACKETS\2019\041619
25 ATTACHMENT 4
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Path:
\CITY CLERK\AGENDA PACKETS\2019\041619
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r 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 <br /> those conditions, subject only to the right to object at the hearings or during the appeal period. I certify that the <br /> information and exhibits submitted arc true and correct. <br /> Name(PIs. Print): CIabad o i V 4.1//e v Daytime Telephone: 9 Z.7 -,Y VC - o /.a C) <br /> Company: — �/ Other Telephone: SIO 41 r9 <br /> ei <br /> Address: 31-10 Leo P1.��r eec_J Fax: \, <br /> City: Pte'-c`St4 ca h Zip: 9 V/)t E-mail: /faab;0aL.:.;.s k 1(ZI 1i7 C.1-)(Y) <br /> Signature: .� Date: <br /> K. OWNERS ASSOCIATION: is the property subject to the rules or guidelines of a homeowners association(ilOA)or <br /> a business owners association? <br /> t":Yes 49)No <br /> If yes,did the proposed project receive approval from the HOA/business owners association? <br /> ", Yes . No < The 110A/business owners association does not review any proposed construction projects or use changes <br /> *If res.please attach a copy of the HOA response. <br /> Association Contact(Pis.Print): Daytime Telephone: <br /> Association Namc: Other Telephone: <br /> Address: Fax: <br /> 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, <br /> subject only to the right to object at the hearings on the application or during the appeal period. if this application has <br /> not been signed by the property owner, I have attached separate documentation of full legal capacity to file the <br /> application. I certify that the information and exhibits submitted are true and correct. <br /> Name(PIs. Print): Daytime Telephone: . <br /> Company: Other Teleph e: _ <br /> Address: Fax: <br /> City: \ Zip: E-mail: .--- <br /> Signature: Date: - <br /> M. NOTE ANY OTHER PARTY(IES)WHO SHOULD RECEIVE STAFF REPORTS AND NOTICE OF <br /> APi'LICATION ON A SEPARATE SHEET AND ATTACH TO APPLICATION. <br /> iV. SCHOOL FEE AGREEMENT(if a residential project,answer the question below) <br /> i: I lave you signed a School Fee Agreement with the Pleasanton Unified School District? <br /> --'Yes #No <br /> if yes,please attach a copy of the signed agreement. <br />
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