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t <br /> I Tetra Diamond , Inc . appeal the decision made by the <br /> (Your Name ) <br /> Planning Division on September 12 , 1990 regarding <br /> g 9 <br /> ( Date f Action ) <br /> Minor Subdivision Application No . MS-90-12� <br /> (File Number and Name of Item) <br /> 5MM- <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 /> See attached page <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 /> �pplicant <br /> Q Agent (If an agent, attach proof of the applicant ' s consent <br /> to the appeal . ) <br /> Q I am directly and adversely affected by this decision. <br /> Signed Date <br /> � 1 <br /> Name <br /> Address r 511 ^ <br /> City/Zip Code _ �' I Telephone , <br />