COUNTY OF YUBA
DEPARTMENT OF PUBLIC WORKS
915 8TH Street, Suite 125
Marysville, CA 95901
AGREEMENT TO PAY FORM
In addition to the initial Base Fee, fees for services are billed to the applicant at an hourly rate for
“Time Based Fees” pursuant to Yuba County Resolution 13.00.062. This form must be signed and
original signatures submitted to the Yuba County Public Works Department along with the fee in
order for services to begin. Applicant hereby grants Yuba County Public Works authority to utilize
outside consultants and to bill the applicant/owner for the services provided by outside consultants
as determined by their rates.
Any person acting on behalf of the property owner for the work referenced below may be
requested to present documentation demonstrating themselves as representatives. This may
include Power of Attorney, a notarized statement from the property owner or a copy of a
The herein fees are intended to compensate the Yuba County Public Works Department for staff
time and consultant time spent on the applicant’s project.
I/We understand that the Yuba Public Works Department will bill as services are rendered, and
I/We agree to pay such billing within thirty (30) days of the mailing of such billing for the project.
I/We understand that until the Yuba County Public Works Department receives written notification
of a change in property ownership I/We am/are responsible to pay such billing. I/We further
understand that if billing is not paid prior to the expiration as specified in the “15 Day Notice” that all
services by the Yuba County Public Works Department will cease for this project.
Property Owner/Business Name:
I declare under penalty of perjury that I am the property owner or that I am authorized to enter into this fee
agreement on his/her behalf. I have r