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RESOLUTION NO. 1144
A RESOLUTION OF THE PLANNING COMMISSION OF
THE CITY OF ARCADIA GRANTING A CONDITIONAL
USE PERMIT TO CONSTRUCT A GARAGE AND INDUS-
TRIAL COMPLEX AT 136-140 ST. JOSEPH STREET
WHEREAS, on May 29, 1980, an application was filed by Tom T,
Tanaka, Planning Department Case No. C,U,P, 80-5, to construct a
garage and industrial complex at 136-140 St, Joseph Street, more
particularly described as follows:
Lots 26, 27 and 28, except the westerly 10 feet of
said Lot 28, in Block 79 of A.rcadia Santa Anita Tract,
in the City of Arcadia, County of Los Angeles, State
of California, as per map recorded in Book 15, Pages
89 and 90 of Maps, in the office of said County Recorder,
WHEREAS, a public hearing was held on June 24, 1980, at which
time all interested persons were given full opportunity to be heard
and to present evidence;
NOW, THEREFORE, THE PLANNING COMMISSION OF THE CITY OF ARCADIA
HEREBY RESOLVES AS FOLLOWS:
Section 1, That the factual data submitted by the Planning De-
partment in the attached report is true and correct,
Section 2, This Commission finds that:
1, The granting of a Conditional Use Permit as hereinafter
provided will not be detrimental to the public health or welfare or
injurious to the property or improvements in such zone or vicinity.
2, The use applied for at the location indicated is properly
one for which a:Conditional Use Permit is authorized.
3, The site for the proposed use is adequate in size and
shape to accommodate said use, including all yards, parking, loading,
landscaping and other features required to adjust said use with the
land and uses in the neighborhood,
4. The site abuts streets
pavement type to carry the kind of
use,
and highways adequate in
traffic generated by. the
proposed
width and .
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5. That the granting of such Conditonal Use Permit will not
adversely affect the comprehensive General Plan.
6, The use applied for will not have a substantial adverse
impact on the environment.
Section 3, That for the foregoing reasons, subject to approval
of the City Council, this Commission grants a Conditional Use Permit
to construct a garage and industrial complex upon the following condi-
tions:
That parkway trees, construction of sidewalk and closure
of unused driveway aprons be completed to the satisfaction
of the Director of Public Works,
Since the development will be on three existing lots a lot
consolidation or a Covenant holding the property as one
parcel shall be required, The Covenant shall be recorded
and be approved to form and content by the City Attorney.
This shall be completed prior to issuance of any Building
Permits.
That modifications be granted for the following:
A. Zero side yard setbacks in lieu of 5 feet required
( 9266 , 2 , 2. I) ,
B, Two loading doors to be 2 feet 8 inches from the alley
in lieu of 10 feet required, (9269.10),
4, That all work for the garage use (Tanaka Auto Body) shall
be done inside the building.
5. That external colors and materials shall be subject to the
review and approval of the Planning Department and such
information shall be supplied to the Planning Department
prior to issuance of Building Permits.
6, That C.U.P. 80-5 shall not take effect until the owner and
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2.
3.
applicant have executed a form available at the Planning
Department indicating awareness and acceptance of the
conditions of approval,
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Section 4, The Secretary shall certify to the adoption of this
Resolution and shall cause a copy to be forwarded to the City Council
of the City of Arcadia,
I HEREBY CERTIFY that the foregoing Resolution was adopted at
a regular meeting of the Planning Commission of the City of Arcadia
on the 8th day of July, 1980, by the following vote:
AYES:
Commissioners Hegg, Sargis, Soldate, Brink
NOES:
None
ABSENT:
Commissioners Fee, Hedlund, Kuyper
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Chairman
ATTEST:
/whM(~/
Secretary
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JULY 15, 1980
HONORABLE MAYOR AND
MEMBERS OF CITY COUNCIL
ARCADIA, CALIFORNIA
SUBJECT: PLANNING COMMISSION RESOLUTION NO, 1144
Gentlemen:
The Planning Commission at its July 8, 1980 meeting voted
4-0, with three members absent, to adopt Resolution 1144,
granting a Conditional Use Permit (C,U.P. 80-5) to construct
a garage and industrial complex at 136-140 St. Joseph Street.
Resolution 1144 and the staff report have been attached for
your consideration.
PLANNING DEPARTMENT
~~r~
Assistant Planner \
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Attachments
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A RESOLCTI01\ or THE PLA':;':ING COM:.1ISSI01\ OF
THE CITY OF ARCADIA G~~:;TI:\G A CO~TlITIONAL
ESE PER~llT TO CO::STRl"C A GARAGE AND IXDCS-
TP.IAL CO\IPLE AT 136-140 ST .JOSEPH STREET
WHEREAS. on May 29. 1980. an application was filed by Tom T.
Tanaka, Planning Department Case ~o crp 80-5. to construct a
garage and industrial complex at 136-140 St c10seph Street, more
particularly described as follo\\'s
Lots 26, 27 and 28, excer)t the westerly 10 feet of
said Lot 28. in Block 79 of A!"cadia Santa Ani ta Tract.
in the City of Arcadia. County of Los An~eles, State
of California, as per map recorded in Book 15, Pages
89 and 90 of ~laps, in the off ice of said County Recorder.
WHEREAS. a public hearing \\'as held on June 24. 1980, at which
time all interested persons were ~iven ~ull opportunity to be heard
and to present evidence:
NOW, THEREFORE, THE PLANNI:\G Cml~IISSIOt\ OF THE CITY OF ARCADIA
HEREBY RESOLVES AS FOLLOWS:
Section 1.
partment in the
Section 2.
That the factual cat a submitted by the Planning De-
attached report is true and correct.
This Commission finds that
1. The granting of a Conditional ~se Permit as hereinafter
provided will not be detrimental to the public health or welfare or
injurious to the property or improvements in such zone or vicinity.
2. The use applied for at the location indicated is properly
one for which a Conditional Ese Permit is authorized.
3. The site for the proposed use is adeauate in size and
shape to accommodate said use. including all yards, parking, loading,
landscaping and other features required to adjust said use with the
land and uses in the nei~hhorhood,
4. The site abuts streets ~nd h:=h\\'ays adequate in width and
pavement t~pe :0 carry the kind of craf~ic generated by the proposed
use,
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5. That the granting of such Conditonal Use Permit will not
adversely affect the comprehensive General Plan.
6, The use applied for will not have a substantial adverse
impact on the environment.
Section 3, That for the foregoing reasons, subject to approval
of the City Council, this Commission grants a Conditional Use Permit
to construct a garage and industrial complex upon the following condi-
tions:
1. That parkway trees, construction of sidewalk and closure
of unused driveway aprons be completed to the satisfaction
of the Director of Public Works.
2. Since the development will be on three eXisting lots a lot
consolidation or a Covenant holding the property as one
parcel shall be required, The Covenant shall be recorded
and be approved to form and content by the City Attorney.
This shall be completed prior to issuance of any Building
Permits.
3, That modifications be granted for the following:
A. Zero side yard setbacks in lieu of 5 feet required
(9266.2.2.1).
B, Two loading doors to be 2 feet 8 inches from the alley
in lieu of 10 feet required, (9269.10).
4. That all work for the garage use (Tanaka Auto Body) shall
be done inside the building.
5. That external colors and materials shall be subject to the
review and approval of the Planning Department and such
information shall be supplied to the Planning Department
prior to issuance of Building Permits.
6. That C.U.P. 80-5 shall not take effect until the owner and
applicant have executed a form available at the Planning
Department indicating a\\'areness and acceptance of the
conditions of approval.
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Section 4. The Secretary shall certify to the adoption of this
Resolution and shall cause a copy to be forwarded to the City Council
of the City of Arcadia.
I HEREBY CERTIFY that the foregoing Resolution was adopted at
a regular meeting of the Planning Commission of the City of Arcadia
on the 8th day of July, 1980, by the follo\\'ing vote:
AYES:
Commissioners Hegg, Sargis, Soldate, Brink
KOES:
None
ABSENT:
Commissioners Fee, Hedlund, Kuyper
Chairman
ATTEST:
Secretary
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JUNE 24, 1980
TO:
FROM:
CASE NO:
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CITY OF ARCADIA
PLANNING COMMISSION
PLANNING DEPARTMENT
CONDITIONAL USE PERMIT 80-5
PREPARED BY: WILFRED E. WONG
ASSISTANT PLANNER
GENERAL INFORMATION
APPLICANT:
Tom T. Tanaka
LOCATION:
REQUEST:
EXISTING
LAND USE
8< ZONING:
AREA:
FRONTAGE:
SURROUNDING
LAND USE &
ZONING:
GENERAL PLAN:
136-140 ST. Joseph Street
Conditional Use Permit to construct a garage
(Tanaka Auto Body) and industrial complex with
the following modifications:
A. Request zero side yard setbacks in lieu of 5
feet required (9266.2.2.1)
B. Request two loading doors to be 2 feet 8 inches
from the alley in lieu of 10 feet required (9269.10)
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Two single-family dwellings; Zoned M-l.
22,400 square feet (.51 acres)
140 feet along St. Joseph Street.
North:
South:
West
East
Single-family dwellings; Zoned M-l.
Industrial complex; Zoned M-l.
Single-family dwellings; Zoned M-l.
Industrial complex (under construction;
Zoned H-l.
Industrial
SPECIAL INFORMATION
Buildings:
Building No. I: Contains 4,500 sq. ft. of area and will be divided
into 5 leasable suites.
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C.U.P. 80-5
Building No.2: Contains 4,020 sq. ft. of area to be used for
auto body repair.
Building No.3: Contains 600 sq. ft. of area to be used as an
automobile spray painting booth.
The three buildings will total 9,120 sq. ft. of area and cover 41%
of the lot (Code allows a maximum lot coverage of 60%). The exterior
of the buildings will consit of stained 8"x8"xI6" split face concrete
blocks, the roof will be flat and the bUildings will be one-story, a
maximum of ?O feet in height.
Parking, Landscaping and Buffers:
The proposed development will provide for 19 parking spaces and I
loading zone, which will meet the parking requirements for the site.
Parking stalls will be at a 450 angle.
The westerly driveway will allow for one-way circulation while the
southerly driveway, two-way circulation. There is a twenty foot
wide alley south of the property.
The development will meet all landscaping requirements for the site.
(1380 sq. ft. of landscaping or 6% coverage).
Miscellaneous Information:
Since the subject site is located within the Redevelopment Project
Area. the development required Agency approval which it received on
March 18, 1980. The Agency only approved the development of the site
for an industrial complex and not the use or any modificatIons.
ANALYSIS
The proposed use and development of the site are consistent with
the General Plan and zoning of the area.
Recent projects have been granted the modification allowing for zero
side yards in the M-l zone. Staff believes that the granting of this
modification would allow for an appropriate improvement and uniformity
of development and avoid a possible unuseable space.
It is the Planning Department's opinion that allowing the loading
doors to be closer than the ten feet required would be appropriate
due to the loading zone being located in front of the one of the
doors in question (Building No. I).
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. C.U.P. 80-5
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Pursuant to the provisions of the California Environmental Quality
Act, the Planning Department has prepared an initial study for the
proposed project. Said initial study did not disclose any substan-
tial or potentially substantial adverse change in any of the phy-
sical conditions within the area affected by the project including
land, air, water, minerals, flora, fauna, ambient noise, and ohjects
of historical or aesthetic significance. Therefore, a Negativ
Declaration has been prepared for this project.
Before the Planning Commission takes action on this project, the
Commission should "move to approve and file the Negative Declaration
and find that the project will not have a significant effect on the
environment."
RECOMMENDATION
The Planning Department recommends approval of C.U.P. 80-5 subject
to the following conditions:
I. That parkway trees, construction of sidewalk and closure of
unused driveway aprons be completed to the satisfaction of
the Director of Public Works.
2. Since the development will be on three existing lots a lot con-
solidation or a Covenant holding the property as one parcel
shall be required. The Covenant shall be recorded and be ap-
proved to form and content by the City Attorney. This shall be
completed prior to issuance of any Building Permits.
3. That additional requirements shall be complied with to the
satisfaction of the Director of Public Works when a lot con-
solidation or Covenenat is executed by the applicant.
4. That modifications be granted for the following:
A. Zero side yard setbacks in lieu of 5 feet required (9266.2.2.1)
B. Two loading doors to be 2 feet 8 inches from the alley in
lieu of 10 feet required (9269.10)
5. That all work for the garage use (Tanaka Auto Body) shall be done
inside the building.
6. That external colors and materials shall be subject to the review
and approval of the Planning Department and such information
shall be supplied to the Planning Department prior to issuance of
Building Permits.
7. That C.U.P. 80-5 shall not take effect until the owner and appli-
cant have executed a form available at the Planning Department
indicating awareness and acceptance of the conditions of approval.
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File No. C. .u.E.J30 ~~
CALIFORNIA ENVIllONMENTAL QUALITY ACT
NEGATIVE DECLARATION
CITY OF ARCADIA, CALIFORNIA
A. Description of project: ..fuFt>~ 1"0 ~-n:z.0l:.'" AN
krr~~ ~~LJ.lI''*i ~~TR.\AL. ~..oM~
B.
Location of project: -' Bb- l40 ~T.
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JOf"c:.Rr 5reJ;,6,
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. C. Name of applicant or sponsor:
D. Finding: This project will have no significant effect upon the
environment within the meaning of the California Environmental
Quality Act of 1970 for the reasons set forth in the attached
Initial Study.
E. Mitigation measures, if any, included in the project to avoid
potentially signixicant effects:
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Date:
b/~UJ
Date Posted:
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Pile No. c.o.P. ~
ENVIRONMENTAL, CHECKLIST PORM
A. BACKG1lOtlIlD
1. N_ of Proponent
2. Address and Phone N1IIlIber of Proponent f/Jp.,'1? ~
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B. ERVIlUOCEN'rAL IlG?ACTS
(E:lrplanations of all "yes" and "maybe" answers are required on attached sheeta.)
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f.-!l ..t.en? .. !Iou., wUl t:Qe pnpllllJ&1 rMQlt in.
.. ~ 1D ~i_ ...tee. / .. ~ I'll ui.t.iat lI01.. Mftl.1' ~
~. pettsrJ'l'. or t.lIIlI nta Gsd
_1: of ._face ".ur rmDtn ., bpoIIano of peOple to .__ -L
:L _b. lrNl.?
., &.1ul'nu.. to tbe ___ or
fJ.-r of floo4 .aeen? 7, ~rmc.and ~=~t. :~l~la~,pftp>>al
4, CIaa:noge ill tM _t OIl' ....f__ ,/ .../
..tar 111I ADJ' ..ur body? t. ~~:~ti:~l~l:::.U:O::1 tb~.ut ..
.. D1.eMrge iJrt.o .urfaoe ..te",. (U' p.....nl 01: pl_nMd land OIl. of an .,..a' L
in &IlJ' alt.entiOll of .arf_ ..t.r
.-lit:J'. 1aelOU"," bat aat. U.i~ &0 ~ t, "at.ural ...~.. .Ult.bap~.l
, ~at.ano. 41Iao1.- .,.,.. 0:1' .....11: la'
tam.141t]i" ./
., l...cl:.... 1.. t.Il. rau 01 OIl. of ...
f. Alt.erIU_ of t.M dinot.1oa 0,1! net.ural ",.ource.'
n-ta of flow of ,ftnIN!I _tan'
b. '\I1:I.turt.1al deplet.1_ of allY /
" ~ 1a tJM ...-t.hy of 'rw.d lIIOIlJ'e_alrl."'t.IilI'a1~~'
wRen. .it_.. tbnIop direct. '-1U_ V"
_ .i~_le. _ throaqb iat.e...t.ioo
of &IlJ' aqaif... .., oau ox uenlU_,
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auk of UDa.~. ooe. tl'te propoaal
I.IIVOJ... . 1'18& or-an .-plodCIII. OC
tM rwlea8e of haaardau .m.~
11nclad.1l1'1. _t ~ 11111* to, 011.
pnU~. a.a1_la 01' radJ..t1al1
i. UM _t 01 all aoc1dMlt or
~ ~t~"J
-ht.l~. 11111 tM ,....a1 Alt8r
tJii"'"IOC'itu.. dl.t.riNtlCIII., Geul~.
or trawth r.~ of eM ~ JIClIMll...
tlCIII. of.. .....,
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. >>-Ulov. 01' _u .
~ r01' addtt1oa.al boalt19'
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b. IffMta _ _uUnv pakiaf
fac111U.. ell' a..ad 101' _ panbg1
0. ...tat1al ~ 'IlpOII -t.u.,
u..,.,uu_ ..,.~l
d. A1t~1=Ii to p~t plIt~
of oUaiIht1oa 01' _t of ,.opM
.-I/OI' 9DQ4I1'
u,
'0 Alunti_ to ..t.dIo~. rail
or urtl'.rUC1'
r. I~ 111 tr.fUe u~ to
->>.01' ...tlicl_. blc:ycU.U 01'
pede.trl_l
::'ll~ ':~!a':~l~ ~~~~
-.I for _ _ alU1'Wd 9_~1
8U'Y1_ ill Uf of tM follcwillg
~u,
'0 'iR pE'Ot.lMlt1on1'
b. Poll.. pntUC1:1CIIl'
o..~..,
4. ,an. oc otbP' _t.1_1
tac11iU..'
'0 Itaia~ of publio fMiU-
u.. 1ao11114ia9~'
to ot!IQ' Ill'" _Lal Mnto.1'
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!!!!!JZ.. 11111 U. ~1 r...lt UlI
'0 un of nbnQUal ~ of
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b.~t.1a1s..::r-..h~
'IIpOII..n.t:.1IIg __ or _rnr. 01'
ftqW." tbit ...l.....t of _
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Qt,l.U,~", 111.11 U. ~a1 ren1t
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b. c-..1cU1_ ar-t-.1'
c. Wftut
d. ~ _ .-pUc uab1'
'0 It.OIll...~.UiAllflt'
f, IolJ.d _~ ... ........U
_t.~th. Will t!Ie pnpoM1
.. CreaUOII of ~ bMIUl baUZ'cl en'
pot...U.l IlMlth a..ard laall1lUa9
_tal "-lUlU
b. ____ of ,..1AI to ~a.1
"-!th baau'da'
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11. "-tMUw. Will tba Pr-clPCl'Ial Z'M'dt.
1fI tM ..t:.net.1oII Of aftJ' aoa1e
.lata en' .1_ opal to t!Ie _11e, 01'
.111 tlM pl"ClpOlMl Z'M1Jlt. 1a tba
_U_ Of UI _tbet.101l11, off_1_
du cpa to pelia .to_,
lrirHE' Ifill tr.. ,ropoPl ralJllt
an a1-apoIl th. .-Uqo 0&'
quaat.1qo Of ulat.1Df _tioul
oppoRuaJ. U..,
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o\nIbeolrica~utodaai' _111 t:ha
Pt'CIPOa' roll Ul all . tanUaa of
.. dplU!caat. ar-ab_1ogical or
b!atodcal dU, at.nlCltue, .ject.
or blll.ld1Df'
--;:r ~ooAl~fdie.lf1_.
.. FO" me poc.cadal
to de9ndll t:ha qaaUqo of tbe cwl_t.,
:=~~1~I1~=,":~t.aa~1~
01' .n.lifa popa1.tJ.on to 4:'ap ba1_
.a1!-.1IIIt,a1n11l9 ~..., thn.it4IIl to
aUaluu .. ple.at. or aiN! _1qo,
~ tlM n"'r IN' ....trict. tlM r....,.
of. r.n or ~ plat. or aiNl
or .UalUttl Ulport.Illt. .xupl.. of tbe
..jor par loa of CalU'wal. hJ.atOl'J
or pntllatory'
b. DON t.be ,~jeet. __ tba pot.eDt.hl
to .dli... .bon-tano, to Ute .u..ctYant.to9'
of l-.-ttll'II ...h'_tal 90'1.1, fA
NIort-t..ra 1I9-t. _ t!Ie aavl..-t.
u _ wtliClb oeeun 18 . ral.ti...1,
bri.f, dIIUnlUft plr10d of U. wb1h
lonq-t..a. 111pacta w11.1 n4ue 1NI1.1 lnt.o
the futura.l
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c. 00.. th. projeCl't.""_ ~
w1Udl .n 11141Y14ua11, lilli,*" 1KIt.
~ht.1_1, _1.r_1., It. project.
.., UClaC't. Oft two 01' _n HpU'.ta
~OOl"-'''''nth.i-.pact.OIl.aaIl
l'a._I'OII i..I nht!_!, _1.1, but vtlan
tba .treat. of th. tatal at tboH IJlpMU
_ tAlI ...v1..-t h 11",Ul_t..l
4. Don the project h... ..Y1~tal
.Uacu wtlictl v1U C<lI_ .ub.tanU..l
Mverl. eUact.a 00 b_ be1l!lf1, .1t.hoat.
411'acUr or lnd.incU"
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C. oracassIo. or arn.....,-A&, nutlJd'ICII
6a and b. The proposed garage could
cause an increase in noise when working
on automobiles. However, all work shall
comply with City noise standards and
previous garages have been required to
do all work inside the buildings which
would reduce the noise levels.
D. 1IlSft1llU1lA1'Il*
{to boI COllPl.te4 by die t.acl. A9e1!1GJ'l
011 tba bull of thla 1a1t1al ..,.1_t1oe.
VI Uad tba pnopGMd projeet. COULD 11M blow. Ii aip.1Uout
~ttact. OQ tba ..v1..-t, llDd . Ir&GetYE DBCIMftICIl
w111 ba p~.
C I Un4 U1.t. altlloQP u.. p.rOPOle4 proj.ct. _lll b... .
l1if11Ucant aUact CIfI tba ..v1~t. than ,,111 not.
M . a19Jlifieaat en_t In tbia .:aa. beca_ the IIiU9'U_
___. 4e.cru..d OIl aD .t.tadla4 .1Iae1: b_ __ aMad to
the projeCl't.. A ~IVI: ClllC'LUA1'ICII ifILL H PIlDADD.
o 1 f1...s tba pJ:1lflOM4 P"jact. JlAT _.. .. -.t.,..Ulc..t eUecrIt
01\ tha _vl~t., and .. 1IfYl1OOlEll'l'u, UCPIlC'I' IlEPOft 1a
r-eq1l11'-..1.
_11 ti~~i~,~1?~
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File Ro. t-\-&>-t:;;'
ENVIRONMENTAL INFORMATION FORM
A. Applicant' s Name I Tom T. Tanaka
Address I 8822 Ardendale. San Gabriel. CR 1 ; fornia
8. Property Address (IDeation) I 136-11.0 St. Joseph Street
Arcadia. California 91006
C. General .Plan Designation:
D. Zone Classification. M-l
B. Proposed Use (State exactly wbat use is intended for the property, 1. e., type,
activities, employment):
Bn;' d.iruz No. 1 - A.onrey; m~tel v L. '500 sa. it . divided into '5 sui tea to be le~ sed
for cnmmArci.Q1 or lil2'ht industri:li bu~i neRses.
Bn;ld.:ing No.2 - AODroYimAtelv b.OOO sa.ft. to be used for auto body ren~dl'"
Building No. 3 - Approximately 600 sq.ft. used to enclose an automobile spray
painting booth.
r. Square Footaqe of Site. 22.400 sq.ft.
G. Square Footage of Existing Buildings:
1. To ReIlla.in:
2. To Be RelllOwd: 4500 sq. ft.
B. Square Footaqe of New Buildings. 9 .120 sq. ft.
I. Square Footage of Buildings to be Used for.
1. Coaaercial Activities.
2. Industrial Activities. 9.120 so.ft.
3. Residential Activities:
NUIllber of Units: 6
. 'J. OIl a separate sheet, describe the following:
~ 1. The environmental setting of the project site as it exists.
2. The proposed alterations to the project site.
3. The use and development of the surrounding propert1es.
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ENVIRONMENTAL INFDRMATION FORM
J. The project site is in the Arcadia Redevelopment Agency area. There are
several older wood frame residential and garage structures on the property
which will be removed. The surrounding area is similar to the property in
question, with older residential type bni 1 (jjngs mingled with newer commercial/
industrial developments.
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Envirol\lllental Information Form
K. Check the appropriate answers to the following questions:
1. Will the proposed project result in a substantial alteration
of ground contours and/or alteration of existing drainage
pattern?
2. will the proposed project result in a change in groundwater
quality and/or quantity?
3. Will the proposed project result in an increase in noise,
vibration, dust, dirt, smoke, fumes, odor or solid waste?
4. Will the proposed project result in the use or disposal of
potentially hazardous materials?
S. Will the proposed project result in a substantial increase
in demand for municipal services and/or energy consumption:
..x..
Explain in detail any "YES" answers to the above questions on additional sheets.
L. Provide any additional information which would elaborate on the potential
environmental consequences resultant from the proposed project.
M. certification: I hereby certify that the statements furnished above and in the
attached exhibits present the data and information required for this initial
evaluation to the best of my ability, and that the facts, statements and information
prellented are true and correct to the best of my knowledge and belief.
Date.
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S qnature of APPliCaAt
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