HomeMy WebLinkAbout2.Agent Authorization FormAGENT AUTHORIZATION
To Butte County, Department of Development Services:
LACO Associates (Mike Nelson)
Print Name of Agent
(530) 801-6170
Phone Number
LACO Chico Office: 932 B W. Eighth Ave, Chico, CA 95926 Email: nelsonm@lacoassociates.com
Mailing Address
is hereby authorized to process this application on my/our property, identified as Butte County Assessors Parcel Number(s)
040-520-104 through -111
This authorization allows representation for all applications, hearings, appeals, etc. and to sign all documents necessary for said processing, including mitigation and conditions of approval, but not including documents(s) relating to title interest.
Owner(s) of Record (sign and print name)
Tuscan Ridge Associates, LLC
Print Name
Signature
Print Name of Applicant (if other than owner)
Chad Mosier
Print Name of California Civil Engineer/Land Surveyor
Print Name
Signature
Print Name
Signature
Signature of Applicant (if other than owner)
(707) 525-1222Phone Number
Same as above mosierc@lacoassociates.com
Mailing Address Email Address
Please contact Planning Division Staff with any questions.