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r . <br /> OWNERSHIP AFFIDAVIT <br /> • FOR LIMITED LIABILITY COMPANY <br /> STATE OF 4 to ►A- <br /> COUNTY OF H 4'41'1 -1■ <br /> Public Hearing No. <br /> Before me,the undersigned authority, personally appeared, -3. ALex,s 11, io,, <br /> hereinafter the Affiant(s),who being first duly sworn by me,on oath,deposes and says: <br /> 1. Affiant is the manager, or managing member of the; PAL-ex/J-(0 oico. („4G <br /> ^--� Limited Liability Company with the following <br /> address: <br /> ,J 191 SrneT; Sv;r>< SC", A40.0144,, 33i,o <br /> 2, The Limited Liability Compan owns r. lease(circle one)the property, which is the <br /> subject of the proposed hearing. <br /> 3. The subject property is legally described as: <br /> ilk NW* IOO .TOri -‹/OUT)J -110 r 0f1Lor-e2 -Mr/HS ae.44,1 <br /> PuK so eow,s,tl a eLAT -,a (er. e ' , Hi H'/,- 6911Xn <br /> 4. Affiant is legally authorized to file this application for public hearing: <br /> 5. Affiant understands this affidavit is subject to the penalties of law for perjury and the <br /> possibility of voiding of any zoning granted at public hearing. <br /> 6. Affiant understands that the matters attached to and made part of the application are honest <br /> and true to the best of my knowledge and belief.I understand this application must be <br /> complete and accurate before the application can be submitted and the hearing advertised. <br /> Witness <br /> S Ore (VA 1 M t ga. Affit�n Signa <br /> Print Name <br /> Signature <br /> , <br /> Signature,. <br /> Name <br /> Sworn to and subscribed before me on this I 'day of Occolot. 2021. Affiant is personally <br /> known to me or has produced :as Identification. <br /> 0',r DANIEL J.MIER <br /> '• <br /> � row. <br /> W Ma•I rio it Notary(Stamp/Seal) <br /> r � <br /> * <br /> 4 IMO Commission Expires: <br /> .i: <br /> City of Sunny sles each Community Development Department <br />