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appeal the decision made by the <br /> (Your Name ) C-, <br /> Planning Division on �Yc��7 if _) 1q 2 regarding <br /> SC c( (Date of Action) <br /> Nth - _ �.� — <br /> (File Number and Name of Item) <br /> BASIS FOR APPEAL <br /> Be thorough--only the findings and facts you <br /> include in your appeal will be considered at <br /> the appeal hearing. Attach additional sheets <br /> if necessary. <br /> State the basis of the appeal (list any findings of fact made by the <br /> review authority which were wrong and the reasons why they are wrong ) . <br /> If you wish to appeal a specific condition list it and the reasons <br /> the condition should be changed or removed: <br /> 2 �� - <br /> State facts contrary to the decision ( list any facts that support your <br /> appeal ) : <br /> I realize that this appeal will prevent action on this item from <br /> becoming effective and that no permits will be issued until final <br /> action on the appeal is taken. The above is true to my own knowledge, <br /> information or belief . <br /> DO NOT SIGN UNTIL YOU HAVE READ THIS FORM. <br /> I certify under penalty of perjury that the foregoing is true and <br /> correct and that I am (check one ) : <br /> Applicant <br /> Q _Agent (If an agent, attach proof of the applicant's consent <br /> to the appeal . ) <br /> Q I am dir ctly and adver ly a fZD <br /> y this decision. <br /> Signed , ^"'"� to <br /> Name ��P>{l � ��v/FnJS 4n+2-D CO _ <br /> Addressi <br /> City/Zip Code �oLFnn i Q( E �q �, Telephone 2 �l�]_ <br />