HomeMy WebLinkAboutAffidavitAFFIDAVIT OF ACCEPTANCE
STATE OF CALIFORNIA
COUNTY OF LOS ANGELES
CITY OF DIAMOND BAR
ADMINISTRATIVE REVIEW RESOLUTION NO.2019-01 related to Minor Conditional
Use Permit for property located at 233 Gentle Springs Lane, Diamond Bar, CA
[i] [WE] the undersigned state:
[I am] [We are] the owner/applicant of the real property described in the above -numbered
Administrative Review Resolution.
[I am] [We are]. aware of, and accept, all the stated conditions in said Administrative
Review Resolution No. 2019-01.
[I] [We] certify (or declare) under the penalty of perjury that the foregoing is true and
correct.
{Where fhe owner and applicant are not the same, both must sign)
Type or Print
Applicant
City,
Signature,
Owner Name�tcrq
k
Address �]77
City, State ®r
Signature
This signature must be acknowledged by a notary public. Attach appropriate
acknowledgements.
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 1/0p -(" )
On �}(� .� � Q1(I before me, k VA4(A AiYa Yjr Oyj1 as y
(ini e-I name and title of the officer)
personally appeared � "1;f
who proved to me on thtisfactorV4vidence to be the person(a) whose name(4e is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/hw4their-authorized capacity(ies , and that by his/har4l tr signature(s) on the instrument the
person(sa, or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal. LE NotaryPublic, CaliforniaJR
V--M
Los Angeles County
Commission # 2155598
�A Comm, Expires Jun 3, 2020
Signature
(Seal)