20230839 Ver 1_Agent Authorization_20230613

AGENT AM RIZAT1 N FOAM
PROPERTY LEGAL. DE CRIMO
T NO, 36 �� � UAN NO. ._ � PARCEL.. .
STREETADDRESS;
e4aF riot,
ph i Owner.
,1roperty Owner:
The , registered proms owners, of the above noted ompefry, do hefeby authorize
+GY1C 0- (5TU Yl e 2C C)I rI L
Agent (Name do aC on my behalf and take a# adiom wiry for the r nd acce tanm of
this permit or certficaticn aW any and all standard and special cmd0timm attached.
rp rtj %vneii Address (if Cufferent than prcperty above):
S84- 5a�- IU88
'we hereby oertify to aW, mfo. sibmAted in this appkA-*on is tnR and accurate to the
best of our kmwi j;o.
k'f �
A Sigma Authorized Siqrzwe
Date: Gate: