HomeMy WebLinkAboutPC Resolution 22-06 - 125 1st Court DenialRecorded at the Request of and Mail to:
CITY OF HERMOSA BEACH Community Development Department 1315 Valley Drive
Hermosa Beach, CA 90254
CITY OF HERMOSA BEACH
AFFIDAVIT OF ACCEPTANCE
PROPERTY
ADDRESS:
Assessor’s Parcel Numbers:
I, (We), ,
hereby declare under the penalty of perjury that I (we) am (are) the owner(s) of the above-described
property.
I (we) am (are) aware of, and accept, all conditions of approval in Resolution No(s). attached
hereto and incorporated herein by reference.
PROPERTY OWNER’S INFORMATION
Signature CAPACITY CLAIMED BY SIGNER
INDIVIDUALS CORPORATE OFFICER(S)
Print Name Date PARTNER(S) ATTORNEY-IN-FACT
Address TRUSTEE(S) OTHER
City, State, Zip Code
SIGNER IS REPRESENTING:
Telephone NAME OF PERSON(S) OR ENTITY(IES)