HomeMy WebLinkAboutLLA24-0012 7. Agent AuthorizationBuUe Couniy Deparlmenl orDevclopmcnl Services l-ORM NOPLANNINGDIVISION
7 County Center Drive.Orovillc.CA 95965
Planning Center Phone 5.i()..^52.370!Fa.\5’V).53.S.77K5
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DPL-02ButteCounty
u C A U F O R N I A
AGENT AUTHORIZATION
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)
-/yc -(PH2--QO 0
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)
7J.
Print Name Print Name
Sign Signature"e
Prin Print Name
Signature Signature
Print Name of Applicant (ifotherthan owner)Signature of Applicant (if other than owner)
Name of California CiviitngineeiVi
Ml CI\^5^9 Mmian/Mailing Address '0 ErViail Address J ^
Print and Surveyor Phone Number
Please contact Planning Division Staff with any questions.