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The appaal sulxniieal --hall also provide a vvntteii argurnerr[ to subslen iate the claim of the identified <br />oandapp including supporting do rovidei:ation or evidence as neressaiy. hi tho space I-+rovidcd below, <br />pleas e) all in dcfail the basis for each of the appeal conditions icientificd above that the appeal is <br />based, including the corresponding physical or hardship parameter nurniaer (e.g., "AG"). if additional space <br />is required, please attach the cxpla.natior, to this form along with a.ny s1.1pporting CIOCLIMentatlOn. <br />Detailed Explanation: <br />By my signature on this form, 1 hereby declare that, to the best of knowledge, the information provided is <br />true and accurate. ---) • , , I I-!-- - <br />Name of Property Owner <br />Signature of Property Owner.® <br />;l <br />Dare 0 ,b�1,���l" nn ,,.,nn,„n•,,nnon„nn+„nn•,,, nnn„nnnn„ <br />nanuonnonnnuu nn., .,nnou ono unn ounoounnoirn <br />.n oounouunvor <br />I, f6.-rj , <br />Date of i�hmitl i 1�_> e <br />S-11•0pGlty PIN <br />Dail of Coen�oil Iple iigl'.hpeal heo.rrl ct,.—,�_a <br />�ccep'ted� <br />(1 <br />Stay aripioyea <br />Data i\ppeal INklICIratnm by ,-iopei ey I --�. <br />