600 Loring Ave - Sousa Signs - POA signed •
225 East Industrial Park Dr. Manchester, NH 03109
603-622-5067 FAX 603-624-6188
PROPERTY OWNER AUTHORIZATION
FOR PERMITS, VARIANCES & HEARINGS
THIS DOCUMENT MUST BE SIGNED BY PROPERTY OWNER OR PROPERTY
OWNER'S REPRESENTATIVE WHERE PROPOSED SIGNAGE IS TO BE INSTALLED
THIS DOCUMENT VERIFIES THAT YOU, THE OWNER OR OWNER'S REPRESENTATIVE, AUTHORIZE
SOUSA SIGNS TO SUBMIT APPLICATIONS FOR PERMITS, VARIANCES, AND I OR HEARINGS ON
BEHALF OF THE PROPERTY OWNER
SOUSA SIGNS CANNOT APPLY FOR PERMITS, VARIANCES OR HEARINGS UNTIL WE
RECEIVE THE PROPERTY OWNER'S AUTHORIZATION TO DO SO.
ADDRESS OF PROPOSED SIGNAGE: 600 Loring Avenue, Salem, MA 01970
I HEARBY AUTHORIZE AN AUTHORIZED REPRESENTATIVE OF SOUSA SIGNS OF MANCHESTER, NH
TO APPLY FOR SIGN PERMITS FOR THIS SITE.
FV I HEARBY AUTHORIZE AN AUTHORIZED REPRESENTATIVE OF SOUSA SIGNS OF MANCH STER, NH
TO APPEAR BEFORE THE PLANNING BOARD,SIGN REVIEW BOARD,AND/OR ZBA FOR THIS SITE.
• IF YOU ARE THE PROPERTY OWNER, PLEASE SIGN AND COMPLETE THE INFORMATION BELOW
• IF YOU ARE THE OWNER'S AUTHORIZED REPRESENTATIVE, PLEASE INCLUDE JOB TITLE
IN ADDITION TO LANDLORD'S CONTACT INFO.
J
SIGNATURE OF PROPERTY OWNER/OWNER'S REP: - —--�/
PRINTED NAME(AND JOB TITLE IF OWNER'S REP): 7�rr) L �_ I a S
MAILING ADDRESS: .600 Loring Avenue V
Salem, MA 01970
PHONE NUMBER: 978-741-4740
Electronic Signature Agreement, By typing your name you are signing this Agreement electronically.
You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.
applySousa Signs cannot