Letter of Authorization Effective 1/1/2020
Teton County Planning and Building Department
200 S. Willow, P.O. Box 1727
Jackson, WY 83001
Phone (307)733-7030
LETTER OF AUTHORIZATION BY OWNER
THE LETTER OF AUTHORIZATION IS TO BE SUBMITTED ONLY IF THE
APPLICANT/AGENT IS NOT THE RECORDED OWNER OF THE PROPERTY. THE
RECORDED OWNER MUST SIGN THE LETTER OF AUTHORIZATION AND HAVE IT
NOTARIZED.
OWNER, CO-OWNER, OR CORPORATE OWNER:
Name:
Physical Address of Property:
Mailing Address:
Zip code: Phone:
Email:
AGENT OR CONTRACTOR: (If authorizing Agent and Contractor, fill out a form for each)
Name:
Mailing Address:
Zip code: Phone:
Email:
Owner, Co-Owner, or Corporate Owner, (“Owner”) which property is specifically described
as
hereby authorizes Agent or Contractor, as stated above, to represent and/or act for Owner
in making application for, receiving, and accepting on Owner’s behalf, any permits or other
action by the Teton County Commissioners, Planning and Development, Building, and/or
Engineering Departments relating to Owner’s Property in Teton County, and the
modification, development, planning, platting, replatting, improvements, use or occupancy
of land, or energy mitigation in Teton County. Owner acknowledges and agrees to be bound
and must abide by the written terms or conditions of issuance of any such named Agent or
Contractor, whether actually delivered to Owner or not. Owner agrees that no modification,
development, planning, platting or replatting, improvements, use or occupancy of land, or
energy mitigation involved in any application, as it relates to Owner’s Property, shall take
place until approved by the appropriate official(s) of Teton County, in accordance with all
applicable codes and regulations. Owner agrees to pay any fines and/or mitigation fees to
Teton County and will be liable for any other penalties arising out of the failure to comply
with the terms of any permit or arising out of any violation of the applicable laws, codes,
and/or reg
ulations applicable to the action sought to be permitted by the application
authorized herein. Owner agrees and authorizes Agent or Contractor to pay any fines
and/or mitigation fees to Teton County and for the Agent or Contractor to accept and
receive any reimbursement or fee payments due to Owner from Teton County, including but
not limited to energy mitigation fees.
