HomeMy WebLinkAboutAGENT AUTHORIZATION FORMO&V— 01P( 7
SCANNED
BY
St Lucie County
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: 4502-610-0091-000-0
STREET ADDRESS: 9650 South Ocean Drive, Jensen Beach , FL 34957
Please print: .
Property Owner: Princess Condominium
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Julie Andrews, Hiram Matos-Pacheco , of Dewberry Engineers Inc.
(Contractor /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):
9650 .South Ocean Drive, Jensen Beach, FL 34957
Telephone: &
We hereby certify the above information submitted in this application is true and accurate to the
best_of:our knowledge. • .
u rized Si nature
Date: Wei
Authorized Signature
Date:
RECEIVED
AGENT AUTHORIZATION FORM APR 3 0 2018
5T. ��ci® 6®NnSy, Permitting
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: 4502-610-0091-000-0
STREET ADDRESS: 9650 South Ocean Drivel, Jensen Beach, FL 34957
Please print:
Property Owner: Princess Condominium
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Julie Andrews, Hiram Matos-Pacheco , of Dewberry Engineers Inc.
(Contractor / 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):
9650 South Ocean Drive, Jensen Beach,; FL 34957
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Aut ized/ S'i Ignatu
Date: Date: I Y � l