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,SKTIt?fit 6 .1 y 7,=N4Wil OjOW ACIKNQW4E PPEE MENT{Oise name per t), i l i ,.;: G ,? <br /> .,,21 El Person 0 Business El Trust ❑Guardian <br /> Legal Name: <br /> CPI SUNDIAL OWNERS LLC Phone:503-244-2300 <br /> - ,•f , (last,first,middle) <br /> 46 <br /> Mailing Address:18150 SW BOONES FERRY ROAD <br /> � � City:PORTLAND State:OR ZIP:97224 <br /> Email: <br /> Right of ❑Yes ❑No <br /> 21" Survivorship: //' <br /> ., * Signature: / /_A f/t�--'._ Date: .' =�r <br /> sx1 `k El Person El Business El Trust El Guardian <br /> y a Legal Name: Phone: <br /> 1..„, 1 (last,first,middle) <br /> ,` 114.w Mailing Address: <br /> x . City: State: ZIP: <br /> Email: <br /> Right of ❑ ❑Yes No <br /> : Survivorship: <br /> Mitt Signature: Date: <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> Ii' Legal Name: <br /> ,I (last,first,middle) Phone: <br /> 1; d <br /> ��pf Mailing Address: <br /> , Aw City: State: ZIP: <br /> ,w Email: <br /> i ,Right of <br /> ' Survivorship: ❑Yes ❑No <br /> .Signature: Date: <br /> ❑Person El Business ❑Trust ❑Guardian' Legal Name: Phone: <br /> -..-_ (last,first,middle) <br /> a,< r , <br /> ,: Mailing Address: <br /> li i;,` City: State: ZIP: <br /> ,ry Email: <br /> Right of <br /> sar` = Survivorship: ❑Yes ❑No <br /> r32. Signature: Date: <br /> NEW OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP <br /> I affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the sale or change <br /> of ownership.'I understand that the home cannot be relocated without first completing this application and purchasing a trip permit <br /> from the Building Codes Division or through one of its county agents. <br /> I understand that the seller/owner is responsible for submitting this application within 30 days after the close of the sale,and that all <br /> buyers and sellers will be notified by mail when the application is approved.If the application has not been submitted after 30 days,I <br /> may complete the filing under ORS 446.64(1). <br /> I understand that each lessor,mortgagee,trust-deed beneficiary, lien holder of record,and security interest holder must be listed on <br /> this notice.If none are listed,the structure must be free and clear of all mortgages,deeds of trust,security interests,and liens. <br /> Page 3 <br />