Owner Authorization Statement 001AUTHORIZATION STATEMENT
h .~1~d~1'Y~. ~~" ~- ~ ~ ~~~~~~~~1Y-~~ ,hereby certify that l am
(check one)
the Owner of the property
^ Property Manager of ,corporation which is
the Owner and/or authorized to represent the property
at the following address: 991 0 SE oura^t Street
Yelm. WA 9A5n7
I certify that BASELINE Enaineerino Inc is authorized to act as the Owner's sole agent
regarding the property at the above address for the purpose of filing applications for decisions,
permits or review under applicable city/county/state codes and has full power and authority to
perform on behalf of the Owner all acts required to enable said agencies to process and review
such applications. ,/ ,~/"
CN/
Signature of Owner or Pro erty Manager Signature of Owner or Property Manager
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Print or Typ Name Print or type name
~~~ ~0~~
Date ~ nafA
STATE OF WASHINGTON )
ss.
County of P~~R(~ )
I certify that I know or have satisfactory evidence that SVSaN k• g01ItY ~/are the
person(s) who appeared before me, and acknowledged that hel®'they signed this
instrument and acknowledged it to be his/~e their free and voluntary act for the uses
and purposes mentioned in the instrument.
DATED this ~~ day of , zp~~p
~.. -a Signature ~ ~~~
Ymarv u71ic
Smtewu4esnin~~`~n Notary Name
sAarw M eo~E, r+
~ MM COMMISSION FT n S
tum 27 zn;s~ Residing at ~~~ ~!A
My Appointment Expires a~7~e~.0~