Owner Acknowledgements
CHECK ONE OF THE FOLLOWING:
I will represent the application myself; or
I hereby designate _________________________ (print name of project representative)
to act in the capacity as my agent for filing, processing, representation, and/or
presentation of this plat application. The designated agent shall be the principal
contact person for responding to all requests for information and for resolving all
issues of concern relative to this application.
I hereby certify that I am the owner of the property and further certify that the information
provided on this Plat application is true and correct. By signing below, I agree that the City of
Farmers Branch (the “City”) is authorized and permitted to provide information contained
within this application, including the email address, to the public. The City is authorized and
permitted to reproduce any copyrighted information filed in connection with the application,
if such reproduction is associated with the application in response to a Public Information
Request.
Owners Signature________________________________________ Date: _________________________
STATE OF TEXAS
COUNTY OF ________________
BEFORE ME, a Notary Public, on this day personally appeared ________________________, the
above signed, who under oath, stated the following: “I hereby certify that I am the owner or
authorized corporate representative for the purpose of this application; that all information
submitted is true and accurate.”
GIVEN UNDER MY HAND AND SEAL OF OFFICE, this ____ day of ______, 20____.
My Commission Expires: ________________________
_______________________________________________
Notary Public in and for the State of Texas