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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 />180127" Street <br />Vero Beach, FL 32960 <br />FROM: Island Manor Development, LLC. <br />(Property Owner) qnn 20th PlarP <br />Vero Beach FL 32960 <br />Property Tax I.D. #: 31-39-26-00000-0100-00008.0 <br />Property Address: 6510 Jungle Trail <br />The undersigned is hereby authorized MBV Engineering, Inc. 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 />u Future Land Use Amendment <br />m Rezoning <br />Island Manor Development, LLC.j I4i �i GRE/N.�o� <br />Owners N e (Print) -Q <br />Owners ignature <br />H <br />STATE OF Ff701ZM7t <br />COUNTY OF S v I <br />Date <br />zv K <br />The foregoing instrument was acknowledged before me by means of Xvhysical presence or ❑ online <br />notarization, this (2,1— day of �-v. ,6V , 20 -�-3 by s4 01 <br />Personally know ❑ OR produced identification F(o r+�� °� S/ }-c ��' �.cr �S L i «` Lr -e <br />(SEAL) <br />Ivan von Has3e11 <br />NOTARY PUBLIC, STATE OF NEW YORK <br />4. NO.01v06432568 <br />QUALIFIED IN SUFFOLK COUNTY <br />TERM EXPIRES MAY 2,2026 <br />NOTARY P LIC: <br />Sign: <br />Printed Name: ���'� ✓� ' '�"��s� // <br />Commission Number: 4 4- VU Gk3.2 S'7 &' <br />Commission Expiration: AAA .2-1 e -a <br />164 3 <br />