HomeMy WebLinkAboutADM24-0011 Agent Authorization Butte 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@buttecounty.net
To Butte County, Department of Development Services:
( )
Print Name of Agent Phone Number
_______________________________________________________________________________________________________________________ Mailing Address Email Address
is hereby authorized to process this application on my/our property, identified as Butte County Assessors
Parcel Number(s)
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)
_________________________ _________________________
Print Name Print Name
_________________________ _________________________
Signature Signature
_________________________ _________________________
Print Name Print Name
_________________________ _________________________
Signature Signature
_____________________________________________ ___________________________________________ Print Name of Applicant (if other than owner) Signature of Applicant (if other than owner)
( ) Print Name of California Civil Engineer/Land Surveyor Phone Number
Mailing Address Email Address
Please contact Planning Division Staff with any questions.
AGENT AUTHORIZATION
FORM NO
DPL-02
This authorization only gives Renewable Solar Agent Authorization pertaining to the solar electric project to be installed (Permit No. B23-3219). This can also be applied to
an Administrative Permit should one be required. The system is behind the meter for 1.1 MW and will be ground mounted.
601 W Grangeville Blvd permits@rsi.solar
047-540-002
Janet Gonzalez
Renewable Solar Inc- Janet Gonzalez 559-410-8640
DocuSign Envelope ID: 7389F5E6-E785-4848-9C3F-F7F8321DA730
James Strong