Fillable Printable Authorization Letter Template For Signature

Authorization Letter Template For Signature

LETTER OF AUTHORIZATION FOR SIGNATURE

APPLICATION FOR:

Certificate of Assured Water Supply

Assignment of a Type A Certificate of Assured Water Supply

Assignment of a Type B Certificate of Assured Water Supply

Classification of a Type A Certificate of Assured Water Supply

Water Adequacy Report

Analysis of Assured Water Supply

Analysis of Adequate Water Supply

Physical Availability Determination

PLEASE COMPLETE ONE FORM PER OWNER OR BUYER!

The Assured and Adequate Water Supply Rules, A.A.C. R12-15-701 et seq., allow a

representative to sign an application for assured or adequate water supply on behalf of an

applicant if the applicant submits a letter, signed by the applicant and dated within 90

days of the date the application is submitted, authorizing a representative to submit

applications for permits regarding the land to be included in the application. This form,

when completed correctly, fulfills this purpose.

The applicant listed below hereby authorizes ___________________________________,

Name of Representative

of ____________________________________________________________________,

Representative’s Company, if

applicable

as its representative to submit applications for permits regarding the land to be included

in the application for______________________________________________________,

Name of subdivision, master plan, or area included in the application

and to sign the application on behalf of the applicant.

________________________________________________________________________

Applicant’s printed name

_________________________________ ____________________________________

Applicant’s title Date

________________________________________________________________________

Additional copies of this page may be made as necessary.

Letter of Authorization for Signature REV 10-26-07

Applicant’s company name or entity name as it appears on the title report or deed

Additional copies of this page may be made as necessary.

Letter of Authorization for Signature REV 10-26-07