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Conditional Use Permit Application Form - Grant County Government

Conditional Use Permit Application Form - Grant County Government

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<strong>Grant</strong> <strong>County</strong>Department of Community DevelopmentPlanning DepartmentP.O. Box 37 - 457 1 st Avenue NorthwestEphrata, WA 98823(509) 754-2011 Ext. 620 - FAX (509) 754-6097LAND USE ACTIVITYACKNOWLEDGEMENT AND AUTHORIZATION FORMI, ___________________________________________________________, legal ownerof Parcel (s) _______-_______-________, _______-_______-_______, hereby authorize____________________________________________________to act as my agent, in the_____________________________________________________application filed in the<strong>Grant</strong> <strong>County</strong> Planning Department._________________________________Legal Owner Signature_________________________________Date__________________________________Legal Owner Signature__________________________________Date

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