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Variance Application Form - Grant County Government

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<strong>Grant</strong> <strong>County</strong><br />

Department of Community Development<br />

Planning Department<br />

P.O. Box 37 - 457 1 st Avenue Northwest<br />

Ephrata, WA 98823<br />

(509) 754-2011 Ext. 620 - FAX (509) 754-6097<br />

LAND USE ACTIVITY<br />

ACKNOWLEDGEMENT AND AUTHORIZATION FORM<br />

I, ___________________________________________________________, legal owner<br />

of Parcel (s) _______-_______-________, _______-_______-_______, hereby authorize<br />

____________________________________________________to act as my agent, in the<br />

_____________________________________________________application filed in the<br />

<strong>Grant</strong> <strong>County</strong> Planning Department.<br />

_________________________________<br />

Legal Owner Signature<br />

_________________________________<br />

Date<br />

__________________________________<br />

Legal Owner Signature<br />

__________________________________<br />

Date

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