HomeMy WebLinkAbout2.MUP25-0001 Agent Authorization Form 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
Matt McDougall (Feb 1, 2024 09:02 PST)
Matt McDougall
Ian@nexgeneng.com (cc: Katie@nexgeneng.com)
Ian@nexgeneng.com (cc: Katie@nexgeneng.com)
1043 Nichols Ct. Ste 200, Rocklin, CA 95765
1043 Nichols Ct. Ste 200. Rocklin, CA 95765
030-200-099
Ian Cole, NexGen Engineering 916 345-3454
Ian Cole, NexGen Engineering and Consulting 916 345-3454
Matt McDougall
DPL-02_Agent Authorization Form - Sundown
Estates
Final Audit Report 2024-02-01
Created:2024-01-11
By:Katie Haase (katie@nexgeneng.com)
Status:Signed
Transaction ID:CBJCHBCAABAAuV5Nk7TMWGPPENlntG7bubSuqLye36cO
"DPL-02_Agent Authorization Form - Sundown Estates" History
Document created by Katie Haase (katie@nexgeneng.com)
2024-01-11 - 4:27:00 PM GMT- IP address: 104.220.95.144
Document emailed to Matt McDougall (matt@casaparkhomes.com) for signature
2024-01-11 - 4:27:04 PM GMT
Email viewed by Matt McDougall (matt@casaparkhomes.com)
2024-01-11 - 4:27:30 PM GMT- IP address: 174.208.169.10
Email viewed by Matt McDougall (matt@casaparkhomes.com)
2024-01-18 - 4:31:51 PM GMT- IP address: 174.208.162.28
Email viewed by Matt McDougall (matt@casaparkhomes.com)
2024-01-25 - 4:31:48 PM GMT- IP address: 174.236.226.46
Email viewed by Matt McDougall (matt@casaparkhomes.com)
2024-02-01 - 4:36:12 PM GMT- IP address: 174.208.99.214
Document e-signed by Matt McDougall (matt@casaparkhomes.com)
Signature Date: 2024-02-01 - 5:02:51 PM GMT - Time Source: server- IP address: 98.97.117.32
Agreement completed.
2024-02-01 - 5:02:51 PM GMT