Boynton Beach Owner Consent FormThe City of Boynton Beach
Development Department
Planning & Zoning Division
100 East Ocean Avenue
Boynton Beach, Florida 334250310
(P): 561-742-6260
www.boynton-beach.org
OWNER'S CONSENT FORM
WAL MART STORES EAST LP / John Davis
the LJ sole owner or Opartial owner of record of the property legally described as:
Property Owner's Name
WAL MART AT BOYNTON BEACH LT 1
If additional space is needed for the legal description, please check hereOand attach additional pages as necessary.
Street Address: 3200 Old Boynton Rd. City: Boynton Beach State: FL Zip Code: 33436
PCN: 08-43-45-19-22-000-0010 states that he/she has thoroughly examined and is
familiar with the application submitted to the City of Boynton Beach Development Services Department—Planning and
Zoning Division, submitted by Jacquie Pedevillano on behalf of WAL MART STORES EAST LP/Jahn Davis
and expressly c senttsms to the use of the subject property for the purpose described in the application.
Y�
Sign lure (must be original signature)
��rr This Section must be completed by the Public Notary
On this,cday of C�GAobe .20ZE the foregoing instrument was sworn to and subscribed before me
by If individual: O and individual
(Naff g of Person Acknowledging)
If corporation: �fnl SA0 . QtJ1S .as sent%Or 6gtiger
(1Name of Person Acknowledging) (Position, Type of Authority, officer)
For -q % S%a(?S bl Sl- P�f Personally, Known or O Produced Identificationiir Soma ) I '6"'4
Type of Identification
gnat re of Notary Public NICK BUTLER
NOTARY PUBLIC
�rG,C I3[lNe� I?7257%S BENTONA�rjA'��COUNTY, ARKANSAS
XR 12/31/33
Name of Notary Printed and Commission Number COM f�1 VNWefIy�WRShbove
Last Revised: 02.27.2023