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CERTIFICATE OF ACKNOWLEDGEMENT BY PROPERTY OWNERS <br /> I(We)the undersigned owner(s)of property located at <br /> (Stree Address,Location or Legal Description of Property Involved) <br /> DO HEREBY AUTHORIZE 2LL Ai,z,ez rGz 1 0 <br /> (Check) AS MY AGENT O AS LES AS BUYER () <br /> ADDRESS <br /> to request <br /> (Use Permit,Vdriance or Reclassification Requested <br /> on the above-mentioned property;and do further authorize <br /> (�x 7 a 3 Wo sign any adall <br /> papers in my(our)stead relating to this request. <br /> SIGNED <br /> ADDRESS &tg ///�l <br /> DATE <br />