HomeMy WebLinkAboutzba vpc owner authorizationfillable
Town of Lexington
Board of Appeals
Phone: (781) 698 4534
1625 MASSACHUSETTS AVENUE • LEXINGTON, MASSACHUSETTS 02420
Owner Authorization
(Must be signed by owner of Record)
I, _____________________, as the owner or authorized agent of ______________________,
Property Owner’s Name Street Address
hereby give permission to the following: ________________________________ to act on my Individual Name / Company Name
behalf in all matters relative to this application.
________________________________ ____________________
Print Name Date
________________________________
Signature
Mailing Address:
__________________________________
__________________________________
__________________________________