APPLICATION FOR ZONING CERTIFICATION

November 5, 2020
Date

THE ZONING ADMINISTRATOR/OFFICER

Sir/Madam:

In accordance with Executive Order (EO) No. 648 as strengthened by LOI 729, EO 90, EO 72, I
am applying for Zoning Certification of property situated in __________Purok 4, Tabo-o,_____________
Barangay
_________________________________Jimenez, Misamis Occidental____________________________
Municipality and Province

with OCT/TCT/TD No/s.- 07-0023-00786, 07-0023-00665, 07-0023-00839, 07-0023-00841,07-0023-

00842-07-0023-00843 & 07-0023-00955 and with an area of 41,929 square meters.

The undersigned attest that the documents submitted are in accordance with the pertinent laws,
decree, rules and regulations, standards and guidelines and that assume full responsibility from any non-
compliance or violation thereof.

Attached hereto are:

1. Vicinity Map indicating clearly and specifically the exact location of the proposed site and
existing land uses within 500 meter radius;
2. Lot Plan as described by the Title orTax Declaration which is duly signed and sealed by a
Geodetic Engineer;
3. Photo copy of Title and/or latest Tax Declaration and Right Over the Property if the applicant is
not the registered owner; and
4. Proposed use of the lot(s) Third Millennium Oil Mills, Inc’s Oil Mill, Solvent and Refinery Plants
5. Filing Fee ______________________(PhP720.00 per hectare+PhP 30.00 documentary stamp)
6. File/fastened in a long folder.

Very truly yours,

Engr. Elviro S. Andoy Jr.

Applicant/Owner / Authorized Representative

Address ______Purok 4, Taboo,___________

___Jimenez Misamis Occidental____

Tel. No. ____ __(088) 272 -3734__________

TIN ______101421226________________

Republic of the Philippines)

_____________________) S.S.

SUBSCRIBED AND SWORN TO before me this ____ day of ________________________, in

the Municipality of Jimenez, Province of Misamis Occidental, affiant exhibiting to me his/her
Community Tax Certificate No._________________________ , issued at ________________________
on ________________________ .

Doc. No. ______

Page No. ______
Book No.______
Series of ______ NOTARY PUBLIC