HomeMy WebLinkAbout11. PROJ-25-0010 DPL-02_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
PO BOX 2493 PARADISE CA BEAU@TOWNSURVEYS.COM
073-290-010 & 073-290-011
Leonard Rammel
Town Surveys Inc
TOWN SURVEYS INC 530 433-4324