COMPANY LETTERHEAD/LOGO Current Date …

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COMPANY letterhead /LOGOCurrent date ( valid for ONE YEAR)To Whom It May Concern:By my signature on this statement, I, __________________, _________________ authorize the Name (please print) Titlefollowing employees to represent, and sign building permit applications on my behalf, in Montgomery County, as the applicant, until this authorization is rescinded by me (in writing). Sincerely, _______________________________ Original SignatureList of Authorized Representatives:________________________ _______________ ____________________________Authorized Representative s Original Signature Print Name____________________________________ ___ ____________________________Authorized Representative s Original Signature Print Name____________________________________ ___ ____________________________Authorized Repres

COMPANY LETTERHEAD/LOGO Current Date (Valid for ONE YEAR) To Whom It May Concern: By my signature on this statement, I, _____, _____ authorize the

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