HomeMy WebLinkAbout2.PROJ-26-0029 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
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AGENT AUTHORIZATION
To Butte County, Department of Development Services:
Sannar Land Surveying (Adam Nako) (80§-382-7541
Print Name of Agent Phone Number
FORM NO
DPL-02
556 Little Avenue Gridley, CA 95948 ada m. nako@g mail .com
Mailing Address Email Address
is hereby authorized to process this application on my/our property, identified as Butte County Assessors
Parcel Number(s)
025-150-006, 025-050-017 & 025-050-018
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
(l;i,~Mdff
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 Si30i380-7212
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.