Agent Authorization Form

/Agent Authorization Form
Agent Authorization Form 2016-12-01T16:10:13+00:00

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Agent Authorization Form
Application Title
Tax Map Number(s)
The above named property owner hereby appoints
as its agent, and authorizes said agent to apply for and process the above mentioned development plan on his/her behalf. Agent is further authorized to sign all necessary documentation for such purposes, including acceptance of conditions imposed by Council upon approval of the plan. This authorization shall remain in force and effect until written notice of revocation is delivered to the Municipality of Murrysville’s Director of Community Development.
Signed & sealed, intending to be legally bound on this date of
By checking "Yes," you are electronically signing this document.
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