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12 Digit parcel number for the property.
Parcel Number-This number can be obtained from Land Records/Mapping Department 2nd Floor, located at 1401 Fayetteville Road or Amy.email@example.com or 910-410-1139.
I, the owner of the property, give the applicant authorization to act as an agent on my behalf in applying for, signing, obtaining any of the documents below.
I agree to abide by all decisions and/or conditions between the legal representative acting on my behalf and the Richmond County Health Department, Environmental Health Section.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
I have read this application and certify that the information provided herein is true, complete, and correct. Authorized county and state officials are granted right of entry to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am solely responsible for the proper identification and labeling of all property lines and corners and making the site accessible so that a complete site evaluation can be performed.
This field is not part of the form submission.
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