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AGENCY AUTHORIZATION
(To be completed by landowners of subject property when landowners do not represent themselves. Instructions for
completing required information are in bold and brackets below lines. If applicant is a company, corporation,
partnership, joint venture, trustee, etc., please use the corporate signature block and have the notary fill in the
notarization section for corporations not individuals and cannot be submitted digitally)
TO: Pinal County Planning & Development Services
P.O. Box 2973
Florence, AZ 85132
[Insert Name -- If a Corporation, Partnership or Association, Include State of Incorporation]
hereinafter referred to as “Owner,” is/are the owner(s) of ______
acres located at
, and further identified
[Insert Address of Property]
as assessor parcel number and legally described as follows:
[Insert Parcel Number]
[Legal Description is attached hereto as Exhibit A]
Said property is hereinafter referred to as the “Property.”
Owner hereby appoints
[Insert Agent’s Name. If the Agent Is a Company, Insert Company Name Only]
hereinafter referred to as “Agent,” to act on Owner’s behalf in relation to the Property in obtaining approvals from
Pinal County for any necessary amendment to Pinal County’s Comprehensive Plan; zone changes; planned area
development overlay districts; platting of the subject property; special use permit or industrial use permit; and to file
applications and make the necessary submittals for such approvals.
Owner consents and agrees to be bound by all stipulations agreed to by this Agent in connection with any of above-
referenced processes.
[Individual PROPERTY OWNER signature block and acknowledgment. DO NOT SIGN HERE IF SIGNING AS AN
OFFICER OF A CORPORATION ON THE NEXT PAGE.]
[Signature] [Signature]
[Address] [Address]
Dated: _____________________ Dated:
_________________
STATE OF )
) ss.
COUNTY OF )
The foregoing instrument was acknowledged before me this day of , by _____________________
.
[Insert Name of Signor(s)]
My commission expires ______________________________
_________________________________
_____________________________________
Printed Name of Notary Signature of Notary Public