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u <br />SIGNATURE <br />I certify under penalty of perjury that I am (check one): <br />Legal owner(s) (All owners must sign as their names appear on the <br />deed.), <br />Corporate officer(s) empowered to sign for the corporation, <br />Owner's legal agent having Power of Attorney for this action (a <br />LJ notarized Power of Attorney document must accompany the <br />application), <br />X <br />and that the foregoing is true and correct. <br />�— <br />(Date) <br />4- 19 - 54 <br />(Date) <br />nature) <br />LTURE AND COMMERCE <br />(Signature) <br />Senior Vice President <br />(Signature <br />Signature) <br />Major Subdivision <br />(Date) <br />(Date) <br />(7/84) <br />- ,,.���Wl1Uah�khi?Q ,U. v nlr ::. � 4th; u+ ' � , x <br />'�. w:�#i;� <br />