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---------------------------------- IF O\VNER OF PROPERTY IS A CORPORATION, FILL IN LOWER SECTION TO SIGN AS AGENT FOR PROPERTY OWNER: IN ACCORDANCE WITH THE TOWN OF AURORA BUILDING CODE ORDINANCE (SECTION 65-8 B. 2) I, Jenn 0. Jh;wzfk-S STATE THE PROPOSED WORK IS AUTHORIZED BY THE PROPERTY OWNER AND I AM a : D~ $ 1 ; ;!CATION FOR A BUILDmG PEfuMJT. °nae of Applicant) srATE oF N-e"" Yo vll COUNTY OF~t ........__; t:.\......_ t _ _ __ TOWN O(thid Q~ worn to before me this _2k_ day of.....,,_...}U~ Yl~l ' - - - - 20 llo Notary Seal SAMANTHA L THOMAS .~t:Y~ ( ignature of otary) NOTARY PUBLIC-STATE OF NEW YORK No. 01TH0046171 Qualified in Erie County ---------------------------------- My Commission Expires 0 1-28-2030 IF PROPERTY OWNER IS A CORPORATlON, COMPLETE: STATE OF NEW YORK COUNTY OF ERIE ss _ _ _ _ _ __ _ __ _ _ _ _ being duly sworn deposes and says that he is the applicant (Name of individual signing application) above named. Be is the _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _of said owner or owners, and (Corporate Officer, etc.) is duly authorized to perform or have performed the said work and to make and file this application: that all statements contained in this application arc true to the best of bis knowledge and belief, and that the work will be performed in the manner set forth in the application and in the plans and specifications filed the rewith. (Signature of Applicant) Sworn lo before me this _ _ day of _ _ _ _ _ _ lo_ Notary Seal (Signature of Notary)