owners consent · 132002.220269.1

a

 

dD relies, LD heits0 LR fcet name nfl)

‘as owner of premises identified as follows

= deseri sP146048
[insert street address, lot on plan description, or coordinates of the premises the subject af he application)

hereby consent to making this application for a change to a development approval by

 

Ne n Plannit lnsert name of applicant)

{signature of owner)

signed on the. Lee day of LP, A 20.