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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 271' Street <br />Vero Beach, FL 32960 <br />FROM: Theta Capital Partners LLC <br />(Property Owner) 1175 19th StraPt Vero Baarh, <br />Florida 32960 <br />Property Tax I.D. # <br />Property Address: <br />32390300000500000015.0. 32390300000500000016.0, 32390300000500000017.0 <br />7045 & 7085 US Hwy 1 Vero Beach, Florida 32967 <br />The undersigned is hereby authorized 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 />q Future Land Use Amendment <br />q Rezoning <br />Eric Taylor R jra <br />Owners Name (Print) Date <br />Owners Signature <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER <br />The foregoing instrument was acknowledged before me by means of ill: physical presence or 3::I online <br />notarization, this 3 1 day of Sd>A.,..» , 20 23 by IFr-re 7"e„0 <br />Personally know W OR produced identification ):::( <br />(SEAL) <br />Attachment 3 <br />NOTARY PUBLIC: <br />Sign: <br />Printed Name: -►H., At Ge,M.«•�-. <br />Commission Number: H 320 i W <br />Commission Expiration: <br />BRIAN UGGOWAN 3 <br />yibptz°� E)(PIRES: Oet W 11, 2028 <br />389 <br />