HomeMy WebLinkAboutAffidavit-restaurant ownerAFFIDAVIT OF ACCEPTANCE`'r
STATE OF CALIFORNIA 0
COUNTY OF LOS ANGELES ;% ? :3 HAR
CITY OF DIAMOND BAR
AbMINISTRATIVE REVIEW RESOLUTION N0.2019-01 related to Minor Conditional
Use Permit for property located at 233 Gentle Springs Lane, Diamond Bar, CA
[lj [WE] the undersigned state:
[I amj [We arej the awner/applican# of the real property described in the above -numbered
Administrative Review Resolution,
[I amj [We are] aware of, and accept, all the stated conditions in said Administrative
Review Resolution No. 2019"01.
[i] [Wej certify (or declare) under the penalty of perjury that the foregoing is true an
correct.
(Where the owner and applicant are not the same, both must sign}
Type or Print
Applicant Name S��Isn� ct+���PyLcHv,�t� �,,,
Address �+ 6`3 q 2.,M
Signature
Owner Name
Address
City, State
....Signature
This signature must be acknowledged by a notary public. Attach appropriate
acknowledgements.
SPQ /UG�Pry
CALIFORIN ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document, to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
On Gf qLt S 1 2 �4 0l / before me
AIMCa'den (,k, Mtf✓i Notary Public personally appeared
who proved to me on the basis of satisfactory evidence to be the persons) whose names)
is/are subscribed to the within instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s), or the entity upon behalf of which the
person(s) acted, executed the instrument.
I certify under PENALTY OF PERNRY under the laws of the State of California that
the foregoing paragraph is true and correct.
Witness my hand and official seal
Signature of Notary Public �G_ea
AMANDAHICKMAN
OMM. #2154471
V NoCtary Public - Calffoi nia 91
a LOS ANGELES COUNTY AP
My Comm Exp. May 24, 2020
Descripflon of Attached Document I �
Title or Type of Document: I L7'C/
Document Date:A'1.( Number of Pages: