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Indian River County <br />Future Land Use Map Amendment/Rezoning <br />Authorization Form <br />TO: Planning Division <br />Indian River County <br />1801 27h Street <br />Vero Beach, FL 32960 <br />FROM: Patricia L. Mach, Co -Trustee <br />(Property Owner) 3005 51st Place <br />Vero Beach, FL 32967 <br />Property Tax I.D. ##: 32392200000100000003.1 <br />Property Address: 2980 Industrial Boulevard Vero Beach FL <br />The undersigned is hereby authorized Bruce Barkett to act as agent and/or make <br />application to Indian River County for the above referenced property for the following applications (please <br />mark the appropriate box): <br />El Future Land Use Amendment <br />E] Rezoning <br />4 f:�ak,r►c_ j rj L- 1� �1 <br />Owners Name (Print) <br />Owners Signature <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER <br />r 241 2 <br />Date <br />ry—� GJ--, <br />The foregoing instrument was acknowledged before me this (A day of <br />claw: j j �— 120,21 byAWIA ftGk7 'Owner, who is personally known to me <br />or who has produced nrivesy Loa- W- (passport or driver's license) as identification. <br />NOTARY PUBLIC: <br />Printed Name: <br />Commission Number: <br />Commission Expiration: <br />/ UIZolZDZ`1 <br />Attachment 1 <br />224 <br />rya °J=LINDSEYA <br />GARCIA':��tate of FloridaHH 016125es <br />Ott 20, 2024 <br />NOTARY PUBLIC: <br />Printed Name: <br />Commission Number: <br />Commission Expiration: <br />/ UIZolZDZ`1 <br />Attachment 1 <br />224 <br />