Date ______________________ 

I hereby give Video Station Superstore the permission to install a satellite system at the property

Located below.

I certify I am the owner of such property and authorized to give such permission

Also I give permission for Video Station Superstore to do a roof and wall penetrations.  While Video Station Superstore will silicone all holes made, it is the owners responsibility to maintain in order to prevent leaks.  Video Station Superstore shall not be responsible for any damage done by such installation.

Authorized by    __________________________________________________________________