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HomeMy WebLinkAboutJuly 21-July 27 ACSSD Support Forms Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: I/We the undersigned owner(s)want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: Chu 4 _ Ls�v 1z� c� � -04 -t Signat Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date. PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representative(s) of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on / / 2y /2015 at • CAM/ 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: c? ' T 0 P,-/ I/We the undersigned owner(s)want to (check one) _ Protest Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representatives) of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on _ / /2015 at :(9�M/I M 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: 33b2- I/We the undersigned owner(s)want to (check one) _ Protest V Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. S' Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representative(s) of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on / /2015 at vuA P 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: I/We the undersigned owner(s)want to Zsupport (check one) Protest the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: KAI I 7 zZ is Signature: rin ed N me: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: G20 Mop7jk 13 `zF—MAtJ L(.G Property address or legal description: &Z O jQ 30-Le vAt,1 U z tI ANT 5S 'l l S Me the undersigned legally authorized representative(s)of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Sign at e: Pr' ed Name: Title: D e: DY tbt{f LLc- 7 zz �S— Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received b 1 City Clerk on / I /2015 at [ :��AM/ 2 Jul 17 2015 17:39 MSU TTO 14069944152 page 1 Arterial and Collector Street Special District ' ,•� Protest/Support Form PART 1 -Property owned by individuals lease complete this section. Property address or legal description: --- I/We the undersigned owners)want to (check one) _ Protest >Q Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Sign e: Printed Name: Date: Slg ature: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 -Property owned by corporations, LLC, trusts or other organizations please complete this section, Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representalive(s)of the organization that owns the above listed property want to (check one) — Protest _ Support the creation of city-wide,perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY �4 Received by City Clerk on l 12015 at AM/P . 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: I/We the undersigned owner(s want to (check one) _ Protest Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Sign n �� f Printed Name: n Dat , Signature: P inted Name: e: Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representatives) of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on `7 /_ZL/2015 at AM M. 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: I e the undersi ed owner(s)want to (check one) _ Protest _� Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: Alma e, i n ture: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: 'Z Property/address or legal description: I/We the undersigned I gally authorized representa ive( of the organization that owns the above listed property want to (check one) _ Protest Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Dsia P ' teal Na7 I F Date: r rinted Name: Ti e: ate: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on / /2015 at `A 2 A special note for condominium owners: An owner of property created as a condominium may protest the creation of the district only through the president, vice president, secretary, or treasurer of the condominium owners' association who timely presents to the City Clerk the following information: (a) a writing identifying the condominium property (b) the condominium declaration or other condominium document that shows how votes of unit owners in the condominium are calculated; (attach the declaration to this form) (c) original signatures of owners of units in the condominium having an undivided ownership interest in the common elements of the condominium sufficient to constitute an affirmative vote for an undertaking relating to the common elements under the condominium declaration; and (d) a certificate signed by the president, vice president, secretary, or treasurer of the condominium owners' association certifying that the votes of the unit owners, as evidenced by the signatures of the owners, are sufficient to constitute an affirmative vote of the condominium owners' association to protest against the creation of the district and its improvements. PART 3 - Property owned as part of a condominium, please complete this section. Name of condominium: � 4z Street address or legal de ription of condominium: ate, "A 4AM4` , 17 We the undersigned nwiiers have an undivided ownership interest in the common elements of the above named condominium present the following original signatures to the Bozeman City Commission indicating our support or protest of the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Condo owner signature: Printed Name: )/ IN address: (Check one) Date: I Id I1J� So � �� — Protest �J 6 -/ � �' u o rt r'`�` `� Condo owner signature: Printed Name: Property address: (Check one) Date: Protest Support Condo owner signature: Printed Name: Property address: (Check one) Date: —Protest Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest _Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest _Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest _Support Certificate of Condominium Officer I certify that the above listed signatures of the owners having an undivided ownership interest in the common elements of the condominium sufficient to constitute an affirmative vote for an undertaking relating to the common elements under our condominium declaration hereby (check one) _ Protest Support the creation of Arterial and Collector Streets Special District for our condomini M. Signature of condo offic r: Title: a FOR CITY CL��EK' ....OFFICE USE ONLY Received by CityClerk on I'LI /2015 at :04Mf�11d 3 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: e l v VfoC-\ _D2i v e. 9 —t I c� I e he undersigned owner(s)want to (check one) _ Protest .Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: Signature: Printed Name: Date: A 31 q Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representative(s) of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on / /2015 at :e A PM. '' 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: I/We the undersigned owner(s)want to (check one) _ Protest Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: Sign e: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: J Property address or legal desc ' ion: I/We the undersigned legally authorized representative(s) of the organization that owns the above listed property want to (check one) _ Protest _ support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signat Pr' ted Name: Title: Date: r i Signa(u e: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on / 12015 at `'WA/pm. 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: a 140 * 6&rov, I/We the undersigned owner(s) ant to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining poions of the city's transportation network classified as arterial and collector streets. Signature ,'` Printed Name: Date: Signature: Printed Name: Da Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representative(s) of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on / 0 /2015 at ,f : ' Z2A M' 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: INVe the undersigned owner(s)want to (check one) _ Protest Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: 1)4 /I( � ��2 71 E ` _._ I/We the undersign d gall thorized representative(s) of the organization towns the above listed property want to (check one) _ Protest Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: ? P inted Name: Title Da ..- � na P I r' me: Title- _ = at FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on / /2015 at t�c%3 AMM. 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: j. Me the undersigned owner(s)want to (check one) _ Protest �_/Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. 49 Entity/Owner Name: , r ? J / Property address or legal description: tit INVe he undersigned legally authorized representative(s) of the organization th owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector street-.. S' at re: " ' ` P i tec N e:R Title: D te: S' ature: P inted Name: Titl FOR CITY CLERK'S OFFICE USE ONLY Received b CityClerk on / ` /2015 at / `k AM4 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: Me the undersigned owner(s)want to (check one) _ Protest Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: Signature: Printed Name: Date: I ,,,-7A Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representative(s) of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on / '�` /2015 at —:etV AM—YPM. 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: I/We the undersigned owner(s)want to (check one) _ Protest Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: L, S. au,,--, -7 t8Its Signature: Printed Name: Date: kil�� /Lca 2 V / s PZ ,.� Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representatives) of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY Received by City Clerk on ,� /2015 at < /PM � 2 Arterial and Collector Street Special District Protest/Support Form PART 1 - Property owned by individuals, please complete this section. Property address or legal description: -2 I/We the undersigned owner(s)want to (check one) _ Protest Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Date: A T1�cti, L o n c 7 / //,!5- Signature: Printed Name: Date: L 7, l Signature: Printed Name: Date: Signature: Printed Name: Date: PART 2 - Property owned by corporations, LLC, trusts or other organizations please complete this section. Entity/Owner Name: Property address or legal description: I/We the undersigned legally authorized representative(s) of the organization that owns the above listed property want to (check one) _ Protest _ Support the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Signature: Printed Name: Title: Date: Signature: Printed Name: Title: Date: FOR CITY CLERK'S OFFICE USE ONLY nta Received by City Clerk on / /2015 at 0 AM/ 2 A special note for condominium owners: An owner of property created as a condominium may protest the creation of the district only through the president, vice president, secretary, or treasurer of the condominium owners' association who timely presents to the City Clerk the following information: (a) a writing identifying the condominium property (b) the condominium declaration or other condominium document that shows how votes of unit owners in the condominium are calculated; (attach the declaration to this form) (c) original signatures of owners of units in the condominium having an undivided ownership interest in the common elements of the condominium sufficient to constitute an affirmative vote for an undertaking relating to the common elements under the condominium declaration; and (d) a certificate signed by the president, vice president, secretary, or treasurer of the condominium owners' association certifying that the votes of the unit owners, as evidenced by the signatures of the owners, are sufficient to constitute an affirmative vote of the condominium owners' association to protest against the creation of the district and its improvements. PART 3 - Property owned as part of a condominium, please complete this section. Name of condominium: Street address or legal description of condominium: We the undersigned owners have an undivided ownership interest in the common elements of the above named condominium present the following original signatures to the Bozeman City Commission indicating our support or protest of the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Condo owner sign ure: Printed Name: �� Property address: (Check one) Date: r M j",1 ) L)" I ��Z lk- Lt��►�ai _ Protest `Z1/9�j� 1/Su ort Condo owner signature: Printed Name: Property address: (Check one) Date: Protest Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest _Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest _Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest _Support Certificate of Condominium Officer I certify that the above listed signatures of the owners having an undivided ownership interest in the common elements of the condominium sufficient to constitute an affirmative vote for an undertaking relating to the common elements under our condominium declaration hereby (check one) _ Protest _ Support the creation of Arterial and Collector Streets Special District for our condominium. Signature of condo officer: Title: FO ITY ER 'S,QFFICE USE ONLY Received by City Clerk on / /2015 at /PM. V 3 A special note for condominium owners: An owner of property created as a condominium may protest the creation of the district only through the president, vice president, secretary, or treasurer of the condominium owners' association who timely presents to the City Clerk the following information: (a) a writing identifying the condominium property (b) the condominium declaration or other condominium document that shows how votes of unit owners in the condominium are calculated; (attach the declaration to this form) (c) original signatures of owners of units in the condominium having an undivided ownership interest in the common elements of the condominium sufficient to constitute an affirmative vote for an undertaking relating to the common elements under the condominium declaration; and (d) a certificate signed by the president, vice president, secretary, or treasurer of the condominium owners' association certifying that the votes of the unit owners, as evidenced by the signatures of the owners, are sufficient to constitute an affirmative vote of the condominium owners' association to protest against the creation of the district and its improvements. PART 3 - Property owned as part of a condominium, please complete this section. Name of condominium: Street address or legal description of condominium: We the undersigned owners have an undivided ownership interest in the common elements of the above named condominium present the following original signatures to the Bozeman City Commission indicating our support or protest of the creation of city-wide, perpetual Arterial and Collector Street Special District in the City of Bozeman to establish an annual assessment and provide for a method of assessments for the purposes of constructing, improving and maintaining portions of the city's transportation network classified as arterial and collector streets. Condo owner Ignature: Printed Name: Property address: & (Check one) Date: / GN &i'iXa�G4--eW a-gWjjvR � �j (5d Vt Matge aldlssri _ Protest WP 2 T V Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest _Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest _Support Condo owner signature: Printed Name: Property address: (Check one) Date: Protest _Support Certificate of Condominium Officer I certify that the above listed signatures of the owners having an undivided ownership interest in the common elements of the condominium sufficient to constitute an affirmative vote for an undertaking relating to the common elements under our condominium declaration hereby (check one) _ Protest _V/ Support the creation of Arterial and Collector Streets Special District for our condominium. Signature of condo officer: Title: FOR ITY ERIK ��FICE USE ONLY Received b City Clerk on / /2015 at /I V. 3