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V. SIGNATURES (This application must be signed by the applicant/petitioner. If the applicant is not the owner of the property, a separate owner authorization form must be submitted - see pg. 5 ) A cAe/aGis . as agent/attorney Signature of Applicant/Petitioner Russo Developers & Builders, Inc. Print name of Applicant/Petitioner State of New York; County of Erie On the ¶ day of year Z0Zibefore me, the above individual app are rsonally known to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and ackn • edged to me that he/she/they executed the same forth rp herei ta Notarii Public SARK R MCNAMARA .ary Public, State of New York (Notary stamp) Reg. No 02MC6090444 Qualified in Erie County zommission Expires April 14, 20_Z - Office Use Only: Date received: Receipt #: Application reviewed by: ECDP ZR-1 form sent to EC: Hearing publication date: PREVIOUS APPEAL(S): A previous appeal to the Zoning Board of Appeals ( ) has ( ) has not been made with respect to this property. Previous appeals: Date: Type of Appeal: Granted Denied Date: Type of Appeal: Granted Denied 3