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� W 6 <br /> �� ' ,O 6 ,,. G NEW dWtd1ERAZKNOIAft.JE~DGE11+1ENtoOne'na»e pet baxj" $ tl ` <br /> ,,,-, -s, El Person� �� ❑® Business ❑Trust ❑Guardian <br /> p„ Legal Name:CPI SUNDIAL OWNERS LLC Phone:503-244-2300 <br /> A* (last,first,middle) <br /> Mailing Address:18150 SW BOONES FERRY ROAD <br /> , City:PORTLAND State:OR ZIP:97224 <br /> 3�a Email: <br /> r • Right. of <br /> s ❑ ❑ <br /> rX .. Yes No <br /> Survivorship: <br /> Signature: 7(....,---,—, r-7_-� <br /> �� Dater <br /> o, K ❑Person ❑Business El Trust El Guardian <br /> i . Legal Name: <br /> Phone: <br /> t, i (last,first,middle) <br /> Mailing Address: <br /> ,' City: State: ZIP: <br /> r . <br /> T <br /> , Email: <br /> Right of ❑Yes ❑No <br /> r 4 Survivorship: <br /> r.4-15,44 <br /> , Signature: Date: <br /> " a` <br /> h � a <br /> ❑Person El Business El Trust ❑Guardian <br /> 1 <br /> A <br /> 55, ti, Legal Name: <br /> ,4.s (last,first,middle) Phone: <br /> ,t Mailing Address: <br /> City: State: ZIP: <br /> " ,, <br /> Email: <br /> 4i 5 Right of <br /> a <br /> Survivorship: . ❑Yes El No <br /> 9 e ;w�t= <br /> “ , Signature: . Date: <br /> ❑Person El Business El Trust ❑Guardian <br /> a, .., Legal Name:. . . <br /> 41 (last,first,middle) . Phone: <br /> ?'`WO Mailing Address: <br /> " City: State: ZIP: <br /> t <br /> Email: <br /> Right of <br /> Survivorshi ❑Yes ❑No <br /> 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 /> -L-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 />