HomeMy WebLinkAboutMER22-0015 Agent AuthDocuSign Envelope ID: OC20EBAF-2C8D-448A-A7A1-5ABE829775E9
AGENT AUTHORIZATION
To Butte County, Department of Development Services:
Community Housing Improvement Program (Theresa Nantor)r 530-) 592-6557
Print Name of Agent Phone Number
1001 Willow Street Chico, CA 95928
Mailing Address
is hereby authorized to process this application on my/our property, identified as Butte County Assessors Parcel Number(s)
066-310-013, 066-320-001 to -005, and 066-340-001 to -003
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)
Norman and Else Madsen 1992 Revocable Trust
Print Name Print Name
OocuSigned by:DocuSIgned by:
AUi/sua.NttmiUA.
Signatl#ng(^2F6AE4F7423 SignatMe-47EA2F6AE4F7423...
Print Name Print Name
Signature Signature
Print Name of Applicant (if other than owner)Signature of Applicant (if other than owner)
NorthStar (Nicole Ledford)r530-) 893-1600
Phone NumberPrint Name of California Civil Engineer/Land Surveyor
111 Mission Ranch Blvd., Suite 100, Chico, CA 95926 nledford(^northstarae.com
Mailing Address Email Address
Please contact Planning Division Staff with any questions.