HomeMy WebLinkAbout2.PROJ-26-0030 Agent Authorizataion FormButte County Department of Development Services
PLANNING DIVISION
7 County Center Drive, Oroville, CA 95965
Planning Cenler Phone 530.552.3701 Fax 530.538.7785
dsplarming@buttecountv.net
AGENT AUTHORIZATION
To Butte County, Department of Development Services:
Sannar Land Surveying (Adam Nako) (80§-382-7 541
FORM NO
DPL-02
Print Name of Agent
556 Little Avenue Gridley, CA 95948
Phone Number
adam.nako@gmail.com
Mailing Address Email Address
is hereby authorized to process this application on my/our property, identified as Butte County Assessors
Parcel Number(s)
025-150-003 & 025-150-004
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)
Richard F. Sannar, PLS 4835 St30i380-7212
Print Name of California Civil Engineer/Land Surveyor Phone Number
556 Little Avenue Gridley, CA 95948 rfsannar@gmail.com
Mailing Address Email Address
Please contact Planning Division Staff with any questions.