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Get Rezoning Affidavit Date: I, October 20, 2011 (enter Date Affidavit Is Notarized) Frank W

Do hereby state that I am an applicant applicant's authorized agent listed in Par. 1(a) below I/") i / J / f J s- (A PCA 83-L-074 (enter County-assigned application number(s), e.g. RZ 88-V-001) and that, to the best o f my knowledge and belief, the following information is true: 1(a). The following constitutes a listing of the names and addresses o f all A P P L I C A N T S , T I T L E O W N E R S , C O N T R A C T P U R C H A S E R S , and L E S S E E S of the land described in the appli.

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