SPECIAL USE PERMIT APPLICATION AN APPLICATION TO AMEND THE OFFICIAL ZONING MAP OF GWINNETT COUNTY, GA. NAME: Joe Garguilo.

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Gwinnett County Planning Division Special Use Permit Application Last Updated 12/20 I S SPECIAL USE PERMIT APPLICATION AN APPLICATION TO AMEND THE OFFICIAL ZONING MAP OF GWINNETT COUNTY, GA. APPLICAN:f INFORMATION NAME: Jacqueline Huley PROPERTY OWNER INFORMATION* NAME: Joe Garguilo ADDRESS: P.O. Box 477 ADDREss: P.O. Box 33623 CITY: Snellville CITY: Decatur STATE: Georgia Z IP: 30078 STATE: Georgia Z IP: 30033 PHONE: 678-982-3585 PHONE: 404-294-4726 CONTACT PERSON: Melody A. Glouton, Esq. of Andersen Tate & Carr, P.C. 770-822-0900 contact's E-MAIL: mglouton@atclawfirm.com PHONE: *Include any person having a property interest and any person having a financial interest in any business entity having property interest (use additional sheets if necessary). APPLICANT IS THE: 111 OWNER'S AGENT D PROPERTY OWNER D CONTRACT PURCHASER EXISTING/PROPOSED ZONING: R-1 00 BUILDING/LEASED SQUARE FEET: PARCEL NUMBER(S): R5042 012 ACREAGE: 1._a9_a_cr_es ADDREss of PROPERTY: 1336 Tree Lane Road, Snellville, GA 30078 SPECIAL use REQUESTED: Community Living Arrangement PLEASE ATTACH A LETTER OF INTENT EXPLAINING WHAT IS PROPOSED SUP' 7 0 0 RECEIVED BY 2 ':.P 1. 5 2017

Type: DEED Book: 52660 Page: 00268 BK s 266 o PO 0268 E H & y.,, A... All that tract or parcel of land lying and being in Land Lot 42 of the.b District. Owinnett County, Georgia, encorupaasing 2.059 acres, designllted as Tnct "A" according bj an exemption phrt prepared for Joe Gargiulo and Peggy Gargiulo by Asrrow Surveying. certified by Lannes K. Burkhalter, Oeorgia Regiitered Land Surveyor No. 2581, dated Decembrr IS. 1999, and btjing more particularly described according to iiaid SlD'Vey as follows: To find the TRUE PLACE OR POINT OF BEGINNING, begin at a point marked by a nail set, s.aid point being located m the intersection o!lhe centerline of Woodland Lake Drive aruj the centerline of Lane (60' RIW), run thence North 02 degrees 31 minutes 53 socands East a distance of 790.98 feet to a point marked by an iron pin set, said point located on the eamrly right-of-way line of Ttte LaMt nm thence along the aforesaid right-of-way line North 01 degreu 37 minutes 23 GeCOnds Wes1 a distance of 122.0 feet to a point, run thence along the are of a curvo an arc distance of 170.39 feet to a point, said arc having a radius of 3216.&o feet and boing subtcnded by a chord beari.a.g and distance of North 00 degrees 06 minutes 21 seconds West 170.37 feet, said point bmng the TRUE PLACE OR POINT OF BEGINNING. From the TRUE PLACE OR POOO OF BEGINNING, as thus established. roo tbent.e a}ong 1he aforeme:rrtumcd righ\-of way \ina along the arc of a curve an arc distance of20.56 feet to a point, said arc having a radius of3216.80 feet and being subtended by a chard bearing and distnnce ofnortb 01 d 35 minutes 41 seconds East 20.56 r nm thence along the aforementioned right-ofwway line North 01 degrees 46 nunutes 22 second.! East a distance of 28.31 feet to a point; run thence along the aforementioned right-of-way line North 02 degrees 31 minutes 07 seconds East a distance of 99.88 feet to a point nm thtnec along the aforementioned rigbt-of.. way line North 01 degrees 4S mmuw 22 serodds East a disunj:tj of BS. I J foot to a point; laaving the afo.rcsald right-ofway line, nm thence. North 71 degrees 50 minutes 45 sccancb East a distance of268.56 feet to n point; run thence South 30 degrees 49 minutes 00 seconds East a distance of 3 J 4.64 feet to a poinr. nm thence South SS degrees 04 minutes 20 seconds West a distance af259.11 feet to a point; run thr:nc:c South 78 degrees 16 mlnuces 06 osc(()nds West a distance of8s.l4 feet to a point; run thence South 84 degrees 47 mmutes 58 seconds West a di!wmce of83.66 feet to a point located on the af.ore.said rightf-way 1ine of Tree Lane, wd point being the TRUE PLACE OR POINT OF BEGrNNING. SUP'17030 RECEIVED BY APR 2. 0 2017

;, ):'?.. I! >;(, :t; I ""!;.. l g 81 a-d= l}i a6sais. [?i. 5 wn s t'j iijii!uu I 7 r-r g '[' R ri' l:$iaeg f\1;- i I e = ---g l ;a IJU dl w 1 ; a i il!haau5 i li1 o Ed- I Cit iiffl!;;j.!! D a \ eg I jui s.= el d= g5ie= i i. 1 g;j!'s 1!ire e=i 2 r e!!ls mi gssi ae; Qiiei! R... t: sr.l" ij!i e H S OJ i2!;j-- 3. E - H;a. s;j a M 2!, :..,, i Ugfi;i ;:1 >'"i-<il -i g., ).. d 8 -.. ui;.. g if.;l. r=e: ;iaa;t;! e.48...: e l 1-! -- S"'l::i Jf ogei 3 : T ' l i "'2iaii aa ;c:::jr.:oiil;,_ g O!'"J;\=::1'">:.1' m lih '! - ;r-..... i j,a u. _,Jil_... r.: t\'p If. @ 'f. ::(:l :tfge3 S g 11 a'" ; n a q:= jir R s I. Bj E q l :o; -.! ;:1 ;. i g i ; i!aii 9.. :;j., ilt;;! I.,...,: "' s 2i ; q...;. e S:....... '<l!i>!.. ' '!.. e' ji "'; i" i; -"s hi -;-. ; pi ;,;.li I! " "' g.:: s5 g 3 t!j i ::tl: c fai:\"'@«iuti7 -.; s i... a}.:._n TREE LANE (60 RfW} -- - - - - -- -..- -.-..- - -...-r:l....... > (().Q w.:.=>w u w 0::: CL..LJ./"'.;... c Q) E 0.. 0 <l) > Q) 0 OJ c c: c: co 0..... CJtaiP170 NnAT FOitJ ;; JOE GARGIULO v..t AND c PEGGY GARGIULO '.....,...,.. :.:;;;;;;;.w7i.;..-:;=;;;;;z:::::::;;:=- - -=:- 2115 COlfNTRj' IJ'',.(LK SN LLPltL Gtr()RQL 3!!059 1'/f. AND FAX 770-9/D-!J!IOO

Gwinnett County Planning Division Special Use Permit Application Last Updated 12/20 IS SPECIAL USE PERM IT APPLICANT'S RESPONSE STANDARDS GOVERNING THE EXERCISE OF THE ZONING POWER PURSUANT TO REQUIREMENT OF THE UNIFIED DEVELOPMENT ORDINANCE, THE BOARD OF COMMISSIONERS FINDS THAT THE FOLLOWING STANDARDS ARE RELEVANT IN BALANCING THE INTEREST IN PROMOTING THE PUBLIC HEALTH, SAFETY, MORALITY OR GENERAL WELFARE AGAINST THE RIGHT TO THE UNRESTRICTED USE OF PROPERTY AND SHALL GOVERN THE EXERCISE OF THE ZONING POWER. PLEASE RESPOND TO THE FOLLOWING STANDARDS IN THE SPACE PROVIDED OR USE AN ATTACHMENT AS NECESSARY: (A) WHETHER A PROPOSED SPECIAL USE PERMIT WILL PERMIT A USE THAT IS SUITABLE IN VIEW OF THE USE AND DEVELOPMENT OF ADJACENT AND NEARBY PROPERTY: SEE ATTACHED EXHIBIT A (B) WHETHER A PROPOSED SPECIAL USE PERMIT WILL ADVERSELY AFFECT THE EXISTING USE OR USABILITY OF ADJACENT OR NEARBY PROPERTY: SEE ATTACHED EXHIBIT A (C) WHETHER THE PROPERTY TO BE AFFECTED BY A PROPOSED SPECIAL USE PERMIT HAS REASONABLE ECONOMIC USE AS CURRENTLY ZONED: SEE ATTACHED EXHIBIT A (D) WHETHER THE PROPOSED SPECIAL USE PERMIT WILL RESULT IN A USE WHICH WILL OR COULD CAUSE AN EXCESSIVE OR BURDENSOME USE OF EXISTING STREETS, TRANSPORTATION FACILITIES, UTILITIES, OR SCHOOLS: SEE ATTACHED EXHIBIT A (E) WHETHER THE PROPOSED SPECIAL USE PERMIT IS IN CONFORMITY WITH THE POLICY AND INTENT OF THE LAND USE PLAN: SEE ATTACHED EXHIBIT A (F) WHETHER THERE ARE OTHER EXISTING OR CHANGING CONDITIONS AFFECTING THE USE AND DEVELOPMENT OF THE PROPERTY WHICH GIVE SUPPORTING GROUNDS FOR EITHER APPROVAL OR DISAPPROVAL OF THE PROPOSED SPECIAL USE PERMIT: SEE ATTACHED EXHIBIT A 3 SEP 1 5 2017 Planning & Oeve\opment SUP'17030

EXHIBIT A- APPLICANT'S RESPONSE SPECIAL USE PERMIT FOR COMMUNITY LIVING ARRANGEMENT 1336 TREE LANE ROAD, SNELLVILLE, GA 30078 A) WHETHER A PROPOSED SPECIAL USE PERMIT WILL PERMIT A USE THAT IS SUITABLE IN VIEW OF THE USE AND DEVELOPMENT OF ADJACENT AND NEARBY PROPERTY: Yes. The proposed Community Living Arrangement is consistent with the residential and nearby commercial uses in the area. There will be little to no impact on adjacent and nearby residential property uses. B) WHETHER A PROPOSED SPECIAL USE PERMIT WILL ADVERSELY AFFECT THE EXISTING USE OR USEABILITY OF ADJACENT OR NEARBY PROPERTY: No. The proposed use of a Community Living Arrangement would be completely contained within the existing property with appropriate buffers and a continued residential appearance. There would be little to no impact on adjacent and nearby properties and the use would not adversely affect these properties. C) WHETHER THE PROPERTY TO BE AFFECTED BY A PROPOSED SPECIAL USE PERMIT HAS A REASONABLE ECONOMIC USE AS CURRENTLY ZONED: The subject property is currently zoned R-1 00 and is surrounded by similarly-zoned property, and accord ingly, the special use request is compatible with the existing uses and usability of the adjacent and nearby property. D) WHETHER THE PROPOSED SPECIAL USE PERMIT WILL RESULT IN A USE WHICH WILL OR COULD CAUSE AN EXCESSIVE OR BURDENSOME USE OF EXISTING STREETS, TRANSPORTATION FACILITIES, UTILITIES, OR SCHOOLS: No. The proposed use would serve as a Community Living Arrangement for adults with developmental disabilities who remain enrolled in day programs during the weekday. Whether stand ing alone, or compared to neighboring residential uses, the proposed use will not cause any additional or excessive use of existing streets, transportation facilities or utilities. There will be no impact on the schools. This property is located in an area with public water and sewer ava ilability, and access to major thoroughfares, highways and interstate. RECE\VED BY SUP '17 U3 0 SE P 1 5 Z017 Plann\ng & Oeve\opment

E) WHETHER THE PROPOSED SPECIAL USE PERMIT IS IN CONFORMITY WITH THE POLICY AND INTENT OF THE LAND USE PLAN: Yes. The Gwinnett 2030 Unified Plan has designated that Community Living Arrangements are contemplated as a special use within certain residential districts. A Community Living Arrangement provides and promotes housing for all citizens within the County, thereby making this application for special use permit entirely consistent with the Plan's guidelines. F) WHETHER THERE ARE OTHER EXISTING OR CHANGING CONDITIONS AFFECTING THE USE AND DEVELOPMENT OF THE PROPERTY WHICH GIVE SUPPORTING GROUNDS FOR EITHER THE APPROVAL OR DISAPPROVAL OF THE PROPOSED SPECIAL USE PERMIT: Yes. The area surrounding the subject property is residential yet the subject property is located on a large tract of land outside a designated neighborhood. The proposed use is entirely appropriate in light of emerging needs for Gwinnett citizens and land uses in the surrounding area. The requested Special Use Permit is necessary to enable the Applicant to operate at this location. The Property Owner also supports this application for Special Use Permit. 3035242_1 RECEIVED 'l7 0 3D SEP 1 5 2017

ANDERSEN I TATE I CARR Melody A. Glouton Email: mglouton@atclawfirm.com Telephone: 770.822.0900 Direct Dial: 770.339.0475 Direct Fax: 770.236.9719 September 15, 2017 VIA HAND DELIVERY Gwim1ett County Attn: Kathy Holland, Director of Planning and Development 446 West Crogan Street Lawrenceville, GA 30046-2440 RE: Special Use Pern1it Application and Letter of Intent for Jacqueline Huley at 1336 Tree Lane Road, Snellville, Georgia, 30078 (R-100 Zoning District) Dear Director and Staff: The Applicant, Jacqueline Huley (hereinafter the "Applicant"), submits this request for a Special Use Permit for a Community Living Arrangement on an approxim ately 1.89 acre tract of land (hereinafter, the "Property") located at 1336 Tree Lane Road, Snellville, Georgi a, Parcel No. R5042 01 2 (the "Subject Property"), located on the east side of Tree Lm e, between Woodland Lake Drive and Webb Gin House Road. The subject property covered by this Application is currently zoned R-1 00. The applicant is not seeking a rezoning of the property. The Applicant is seeking a 2-year Special Use Permit for the purposes of operating a Community Living Arrangement within the dwelling of the Subject Property and agrees to make application to renew the Special Use Permit on or before the 2-year sunset should a continuation of operation be desired. Applicant agrees to reside, and operate the Community Living Arrangement, within the dwelling of the Subject Property. There will be no signage or other outside evidence of the operation of the Community Living Arrangement on the property which shall preserve the exterior character and residential integrity of the dwelling and Subject Property. A Community Living Arrangement ("CLA") is a state licensed residence, whether operated for profit or not, that undertakes through its ownership or management to provide or arrange for the provision of daily personal services, support, care, or treatment exclusively for two or more adults who are not related to the owner or administrator by blood or marriage and whose res idential services are financially supported, in whole or in part, by funds designated through the Georgia Department of Human Resources, Department of Behavioral Health and Developmental Disabilities. RECEIVED BY Andersen, Tate & Carr, P.C. One Sugarloaf Ce ntre Suite 4000 1960 Satellite Boulevard Duluth GA 30097 www.atclawfirm.com SE P 1 5 201 7 SUP '17 03 0

The applicant has been operating as a family-owned business since approximately 2002, known as Morning Star Personal Care, Inc. The applicant currently operates two (2) other locations as CLA's in Lilburn, Georgia. In or around April 2017, the Applicant entered into a lease agreement with the Property owner to continue the operation of a CLA. A Special Use Permit is required for a CLA under the Gwinnett County Unified Development Ordinance. The proposed use of a CLA is for the purpose of helping individuals with developmental disabilities, to help improve their lives and assist their fam ilies with their daily and/or long-term care. The Property will be an ideal location for the Community Living Arrangement as it is a large ranch property, surrounded mostly by wooded areas along the back and side, and is not within an existing neighborhood. The Applicant submits the Property will be fu lly staffed and there will be no more than three (3) individuals (clients) residing in the Property. The Applicant submits the proposed use is a much-needed service to individuals in the Gwinnett community; that the proposed use and business does not create a nuisa nce, noise or traffic issue for the community. Instead, the Property will provide a residential atmosphere to its developmentally disabled adult residents, to help improve their lives and assist their fam ilies with their daily and/or long-term care. The licensed CLA meets and will continue to meet all State and County requirements related to th at business. Each individual client is assigned a Support Coordinator from the Department of Human Resources, who visits the client on a monthly basis. The Property also undergoes annual inspections with the Georgia Department of Behavioral Health and Developmental Disabilities. The Subject Property was recently inspected in anticipation of obtaining the Special Use Permit and no deficiencies were found on the Property. The CLA Property will remain fu lly staffed, and will have little to no impact on the surrounding properties. The Property will maintain its res idential look and feel consistent with the surrounding area. The individual clients are enrolled in day programs, Monday through Frid ay, and typically leave the Property at 7:30 a.m. and return at 4:00 p.m. Upon returning to the Property, they engage in normal activities such as conducting household chores, dining together, and leisure time. On weekends, the individual clients attend recreational and community focused activities that enhance their quality of life. The proposed CLA is consistent with the existing character area. The property is located in a compatible, medium density residential area with convenient commercial uses. The property has access to a public water supply, public sa nitary sewer, and convenient access to co llector streets, major thoroughfares and highways. The Subject Property is an appropriate location for the proposed use, and would have little to no impact on any surrounding properties or to the citizens in nearby or surrounding areas. Applicant and its representatives welcome the opportunity to meet with the staff of the Gwinnett County Department of Planning and Development to answer any questions or to address any concern s. Applicant respectfully requests your approval of this Application. RECEIVED BY Very truly yours, SEP 1 5 2017 SUP I 7 0 Q

ANDERSEN, TATE & CARR, P.C. '/1f4lNlti7't- /.;/1-o ttlc -u Melb; A. Glouton cc: Jackie Huley, Morning Star Personal Care, Inc. 3023530_1 RECEIVED BY SEP 1 5 2017 SUP '17 03.

Gwinnett County Planning Division Special Use Permit Application Last Updated 12/20 IS SPECIAL USE PERMIT APPLICANT'S CERTIFICATION THE UNDERSIGNED BELOW IS AUTHORIZED TO MAKE THIS APPLICATION. THE UNDERSIGNED IS AWARE THAT NO APPLICATION OR REAPPLICATION AFFECTING THE SAME LAND SHALL BE ACTED UPON WITHIN 12 MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS UNLESS WAIVED BY THE BOARD OF COMMISSIONERS. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION BE ACTED UPON IN LESS THAN SIX (6) MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS. Signature of Notary Public Date 4 RECEIVED BY SUP 17 0 3 0 SEP 1 5 201 7

0 9/1 4/2 0 1 7 T H U 11: 4 9 FAX 0011001 Gwinnctt County Plun ni ng Division Special Usc Permit Application Last Updated I 2/20 IS SPECIAL USE PERMIT PROPERTY OWNER'S CERTIFICATION THE UNDERSIGNED BELOW, OR AS ATTACHED. IS THE OWNER OF THE PROPERTY CONSIDERED IN THIS APPLICATION. THE UNDERSIGNED IS AWARE THAT NO A PPLICATION OR REAPP LI CATION AFFECTING THE SAME LAND SHALL BE ACTED UPON W ITHIN 12 MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS UN LESS WAIVED BY THE BOARD OF COMMISSIONERS. IN NO CASE SHALL AN APPLICATION OR REAPPLI CATION BE ACTED UPON IN LESS THAN SIX (6) MONTHS FROM THE DATE OF LAST ACTION BY THE BOARD OF COMMISSIONERS. 9-14 - 2017 Date Joseph C. Gargiulo T ypc or Pr in t Nam e an d Title 9-14 - 2017 Date 5 RECEIVED BY SEP 1 5 201 7 SUP '17 0 3 0

SPECIAL USE PERMIT IN A RESIDENTIAL DISTRICT Gwinnett County Planning Division Special Use Permit Application Last Updated 12/20 IS (Only submit with Special Use Permit Application for a use within a residence) I, the undersigned applicant, understand and agree that the Special Use Permit, if approved, shall automatically terminate in the event that this property is sold, transferred or otherwise conveyed to any other party, or the business which operates the special use is sold, transferred, otherwise conveyed or discontinued. Signature of Notary Public Date 6 RECE\VED BY SEP 1 5 2017 Planning & Oeve\opment

Gwinnett County Planning Division Special Use Permit Application Last Updated 12/20 I S CONFLICT OF INTEREST CERTIFICATION FOR SPECIAL USE PERMIT The undersigned below, making application for a Special Use Permit, has complied with t he Official Code of Georgia Section 36-67 A - I, et. seq, Conflict of Interest in Zonin Actions, and has submitted or attached the required information on the forms provided. Melody A. Glouton, Esq. of Andersen Tate & Carr, PC SIGNATURE OF NOTARY PUBLIC TYPE O R PRINT NAME AND TITLE,,,,... ''''''''''''''""''' M or. '''/'"...: A"R"t:)o' 0 r. DATE Wo" AR.0: : M'i com 2M9 :!$. June 8, ''"::: -.11(''.v- ;--_ u.g:;: DISCLOSURE OF CAMPAIGN CONTRIBUTIO(.f:>\c,o/ ;1'/J,,,OUNt'<,,,,,,, 11111 ""'""''' H ave you, Wit. h' 1n t h e two years 1mme. d' Jat e I y prece d. mg t h e f'l 1 mg o f t h. IS app 1 Jcat1on, maae campaign contributions aggregat ing $250.00 or more t o a member of the Board of Commissioners or a member of the Gwinnett County Planning Commission? :J YES. NO Jacqueli ne Huley YOUR NAME If the answer is yes, please complete the following section: NAME AND OFFICAL POSITION OF GOVERNMENT OFFICIAL CONTRIBUTIONS (List all which aggregate to $250 or More) DATE CONTRIBUTION WAS MADE (Within last two years) SE P 1 5 2017 SUP '17 03 0 7

Gwinnett County Planning Division Special Use Permit Application Last Updated 12/20 I 5 CONFLICT OF INTEREST CERTIFICATION FOR SPECIAL USE PERMIT The undersigned below, making application for a Special Use Permit, has complied with the Official Code of Georgia Section 36-67 A - I, et. seq, Conflict of Interest in Zoning Actions, and has submitted or attached the required information on the forms provided. SIGNATURE OF APPLI CANT DATE TYPE OR PRINT NAME AND TITLE Melody A. Glouton, Esq. of Andersen Tate & Carr, P C ATTORNEY OR REPRESENTATIVE DATE DATE,,,,,..,,,, TYPE OR PRINT NAME AND TITLE,,, KO 11...... '' \e:....... l. '',,,,.:- NO -:..:...,.'1S_.. ft. :;4 """' - '. D. -IJ.,,... :\ 'c 1-t! : : ; A = ':, ct1,,. I - r ' :rc.,',,,,,,,,,.,,,,, 0 \\\ D ISCLOSU RE O F CAMPAIGN CO N TR I B UTivJi c u,,,'' Have you, within the two years immediately preceding the filing of t his application, made campaign contributions aggregating $250.00 or more to a member of the Board of Commissioners or a member of the Gwinnett County Planning Commission? [I] YES D NO Melody A. Glouton, Esq. of Andersen Tate & Ca rr, P.C. If the answer is yes, please complete the following section: YOUR NAME NAME AND OFFICAL POSITION OF GOVERNMENT OFFICIAL CONTRIBUTIO N S (List all which aggregate to $250 or More) SEE ATTACHED EXHIBIT B DAT E CONTRIBUTION WAS MADE (W ithin last two years) Attach additional sheets if necessary all contributions. SEP 1 5 2017 Ianning & Development

EXHIBIT BAND DISCLOSURE OF CAMPAIGN CONTRIBUTIONS BY ANDERSEN, TATE & CARR, P.C., ATTORNEY FOR APPLICANT NAME ANO OFFICIAL POSITION OF GOVERNMENT OFFICIAL Charlotte Nash Commission Chairman Jace Brooks District 1 Commissioner John Heard District 4 Commissioner Lynette Howard District 2 Commissioner Tommy Hunter, District 3 Commissioner -contributions DATE CONTRIBUTION WAS MADE $1,000 March 2016 $500 October 20, 2016 $578.10 October 20, 2016 $80.69 April 2, 2015 $750 May 2015 $500 March 2016 $1,000 January 9, 2014 $150 May 5, 2015 $200 March 26, 2014 $1,000 March 19, 2014 $750 March 5, 2015 $500 January 27, 2016 2973876_1 RECEIVED BY SE P 1 5 2017 SUP '17 0 3 0

Gwinnett County Planning Division Special Use Permit Application Last Updated 12/20 IS VERIFICATION OF CURRENT PAID PROPERTY TAXES FOR SPECIAL USE PERMIT THE UNDERSIGNED BELOW IS AUTHORIZED TO MAKE THIS APPLICATION. THE UNDERSIGNED CERTIFIES THAT ALL GWINNETT COUNTY PROPERTY TAXES BILLED TO DATE FOR THE PARCEL LISTED BELOW HAVE BEEN PAID IN FULL TO THE TAX COMMISSIONER OF GWINNETT COUNTY, GEORGIA. IN NO CASE SHALL AN APPLICATION OR REAPPLICATION FOR REZONING BE PROCESSED WITHOUT SUCH PROPERTY VERIFICATION. *Note: A SEPARATE VERIFICATION FORM MUST BE COMPLETED FOR EACH TAX PARCEL INCLUDED IN THE SPECIAL USE PERMIT REQUEST. PARCEL I.D. NUMBER: (Map Reference Number) 5 District 42 12 Land Lot Parcel ol{-"2 ol"'2- ***PLEASE TAKE THIS FORM TO THE TAX COMMISSIONERS OFFICE AT THE GWINNETT JUSTICE AND ADMINISTRATION CENTER, 75 LANGLEY DRIVE, FOR THEIR APPROVAL BELOW.*** TAX COMMISSIONERS USE ONLY (PAYMENT OF ALL PROPERTY TAXES BILLED TO DATE FOR THE ABOVE REFERENCED PARCEb HAVE BEEN VERIFIED AS PAID CURRENT AND CONFIRMED BY THE SIGNAT R BELO l I TITLE 4-4--+u pca --\'hf1n-jl... J41<.. 1 ------+=-o.-1...-...0r-------- 2,.0\1 p. LV,\\<. 1 (._ \..\Af \ (tt;/., DATE RECEIVED BY 8 SEP 1 5 2017 SUP '17 0 3 0 Planning & Oeve\opment