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<br />. " <br /> <br />OWNERSHIP AFFIDAVIT <br />FOR INDIVIDUAL <br /> <br />STATE OF <br /> <br />Public Hearing No. <br /> <br />COUNTY OF <br /> <br />Before me, the undersigned authority, personally appeared <br />hereinafter the Affiant. who being duly sworn by me, on oath, deposes and says: <br /> <br />l. <br /> <br /> <br />2. <br /> <br />3. Affiant understands this affidavit is subject to the penalties of Jaw for peIjury and the possibility of <br />voiding of any zoning granted at public hearing. <br /> <br />Witnesses: <br /> <br />Signature <br /> <br />Affiant's Signature <br /> <br />Print Name <br /> <br />Print Name <br /> <br />Signature <br /> <br />Print Name <br /> <br />Sworn to and subscribed before me on the <br /> <br />day of <br /> <br />,200 <br /> <br />Affiant is personally known to me Or has produced <br /> <br />as identification, <br /> <br />Notary (Stamp/Seal) <br /> <br />Commission Expires: <br /> <br />1m":" <br /> <br />City of Stinny Isles Beach <br /> <br />'7 <br /> <br />~ <br />Planning and Zoning Department <br />