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<br /> <br />B. <br /> <br /> <br />9. Signature: The above statements are true and correct to the best of m)j <br /> <br />Applicant Signature: <br /> <br />Property Owner Signature: <br /> <br />Date: <br /> <br />Phone #: <br /> <br />Fax #: <br /> <br />E-mail Address: <br /> <br /> <br /> <br />Revised December 24, 2003 \\Victoria\CommDev\Planning_Zoning\Application Forms\Interim Use Permit Application.doc <br /> <br />Page 2 of 2 <br />