HomeMy WebLinkAbout20150621 Ver 2_Agent Authorization Letter_20160908Agent Authorization Form
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: 1j I) f
STREET ADDRESS: I T�� 0 t,Q —LD
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Hunter Terrell
(Contractor / Agent)
of
Equinox Environmental
Conultation and Desiqn, Inc.
(Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Telephone: 5 M3 A-3
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Authorized Signature
Date: Date:
r
Agent Authorization Form
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: 9 (4 q q " q3 - 11 i ?) - 0 o cx�td
r
1:11:14:1V61111.4 • -
Please print:
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Equinox Environmental
Hunter Terrell , of Conultation and Design, Inc.
(Contactor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
2 4 w L W-Ccftl
Telephone: L
fiep
We hereby certify the above Information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Sig tune Authorized Signature
101 -
Date: Date: