HomeMy WebLinkAboutLLA23-0010 AGENT AUTHORIZATIONButte County Department of Development Services
PLANNING DIVISION
7 County Center Drive,Oroville,CA 95965
Planning Center Phone 530.552.3701 Fax 530.538.7785
dsplanning?@buttecountv.net
AGENT AUTHORIZATION
To Butte County,Department of Development Services:
Jim Brainard Ut -AYO-3784
Print Name of Agent Phone Number
ailing Addre |&||alan Ad |Ic ?TOD.Com
ili SS CA 4 a b 78 mai ress
is hereby authorized to process this application on my/our property,identified as Butte County Assessors
Parcel Number(s)
AYN 017-100 -03 And Ol7-lon-033
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)
Kay Simenc Quave MTwWwES
Print Name Pp.
Signature
Print Name
Signature Signature
Print Name of Applicant (if other than owner)Signature of Applicant (if other than owner)
Jim Brana,TA Surve us LLC Alle -A'to-3784PrintNameofCalifogniaCivilEngineer/and Surveyor Phone Number
903 Camelia Ave,Roseville \bs urveys Ile @ovtlook.com
Mailing Address CA 95 G 78 Mail Address
Please contact Planning Division Staff with any questions.