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Town of Aurora Zoning Board of Appeals 575 Oakwood Avenue Application East Aurora, NY 14052 Owner Authorization www.townofaurora.com 112. 6 Blalte le, Rd. [EB My... 452. identified as Tax Map (SBL)#../ S10 0-5-5 e y hereby authorizes ... | ‘veet Bann a fa- ... to bring an application for ( ) area variance ( ) special use permit ( ) use variance ( ) interpretation before the Town of Aurora Zoning Board of Appeals 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. Robert Bannister of [17 [26 Owner (print) Date Owner (signature STATE OF NEW YORK ) Ss COUNTY OF ERIE ) On this day of ,20___, before me, the undersigned, a notary public in and for said state, personally appeared , personally known to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their 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. Notary Public