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Town of Aurora Special Use Permit 575 Oakwood Avenue Application East Aurora, NY 14052 Owner Authorization www.townofaurora.com The undersigned, who js the owner of the premises know as: SD, BaP TUONO IM OA OI IM) 1S. identified as Tax Map ispiye..101 00-1 -Ib (address) hereby authorizes t eh) aca, LBACA Ber TIT iY) Ing ham A to bring an application for a special use permit before the Town of Aurora Town Board for review and potential approval. The undersigned further permits the Town or its authorized representative(s) access to the property to review existing site conditions during the review process. “Votrick, Dotte, | 01: 20- Awals Owner (print) 4 Date Fdruih Owner (signature) Duby Vf f STATE OF NEW YORK _) $s COUNTY OF ERIE ) On this ae day of sly , 20 ob, before me, the undersigned, a notary public in and for said state, personally appeared Loser. “Distt. , personally known to me on the basis of satisfactory evidence to be the individual(s) whese name(s) is (are) subscribed ta the within instrument and acknowledged to me that he/she/they executed the same in his/her/thelr capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. 0 LD, , 1) \ - MICHAEL . SAMULSKL. ih hel) NOTARY PUBLIC. ; TATE Notary Public-~ 6 OF , ERIE County “YY YORK LIC. # 01SA6399 COMM, EXP. 06 045 /03/2027