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' - Rev.6/26//2001 <br /> Page 5 of 5 <br /> L <br /> Respondent Information:r" _ <br /> Name: mr d" YS• J(n �So j-- <br /> r` <br /> Title: n 0 LYS <br /> Firm: <br /> 'L Property Address: �O u mG` lv <br /> o <br /> a <br /> ` Mailing Address (if different): 7 S, k)a <br /> 'S-t-0 C&to&� e7i � 2 J S <br /> Property Assessors Parcel Number: <br /> Phone: P G �)_ y 5-1,o <br /> Respondent Relationship to Site: Owner_Occupant Renter <br /> Type of Property: Commercial Industrial Residential <br /> ` Preparer represents that to the best of the Preparer's knowledge the above statements and facts are <br /> true and correct and to the best of the Preparer's actual knowledge no material facts have been <br /> suppressed or misstated. <br /> ser's Signature Date <br /> � r Z <br /> Preparer's Signature Da <br /> Respondents Signature Date <br /> L _ <br /> L <br /> L <br /> PA3916 East Main Street Development (Grupe)\3U916 E Main Street Development Phase I\Correspondence\Letters\Phase 1 <br /> In Questionnaire Turbetti.doc <br /> Initials <br />