Application For Land Division And/or Boundary Adjustment Page 4

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SIGNATURE OF OWNERS (All property owners’ signatures must be notarized.)
Property Owner’s Signature:
Date: __________
Property Owner’s Printed Name:
STATE OF MICHIGAN
)
) ss
COUNTY OF GRAND TRAVERSE
)
The foregoing instrument was acknowledged before me this _____ day of
___________________, ________, by ______________________________.
,Notary Public
County of __________________, State of Michigan
My Commission Expires:
Acting in the County of
Property Owner’s Signature:
Date: __________
Property Owner’s Printed Name:
STATE OF MICHIGAN
)
) ss
COUNTY OF GRAND TRAVERSE
)
The foregoing instrument was acknowledged before me this _____ day of
___________________, ________, by ______________________________.
,Notary Public
County of __________________, State of Michigan
My Commission Expires:
Acting in the County of
City of Traverse City
Office of the City Clerk
400 Boardman Avenue, Traverse City, MI 49684
231.922.4480 (Office), 231.922.4485 (Fax)
tcclerk@traversecitymi.gov
K:/tcclerk/landdivisionforms/land division boundary adjustment application.doc
Last Updated: February 25, 2014
Page 4 of 4

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