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<br />-8- <br /> <br />Attachment B <br />CABARRUS COUNTY <br />Application for Approval of Tier II Registration for Non-Licensed Professional <br />And Others to Obtain and Use Sensitive Infrastructure Data <br /> <br />This is a request by NON-LICENSED PROFESSIONALS to obtain sensitive maps, plans, data, and <br />other engineering information pertaining to the County's public infrastructure systems as per the County's <br />Infrastructure Confidentiality and Security Policy, Section 3.3. Partial GIS Data Sets from jurisdictional <br />Data Sets can be included as needed. <br /> <br />Briefly describe the information requested and the intended use of the information:. <br /> <br />Category of Information Requested (Select Only One Per Form): <br /> <br />_ Public Buildings <br />_ Telecommunication and Data Network Systems <br /> <br />_ Public Security Plans <br /> <br />List the individuals with your firm/organization/group that you authorize to make requests for <br />information as described above. As a condition of this approval, you will immediately notifY <br />County, in writing, if any of the individuals are no longer a member of your firm/organization/ <br />group or otherwise not authorized to obtain information under this agreement <br />Authorized Individuals (Please Print): <br /> <br />I hereby agree that any material furnished to me will not be copied for transmittal to any other <br />company or individual. Approval of this request is conditional upon reading and accepting the <br />terms of the County's Infrastructure Confidentiality and Security Policy, Including contract <br />termination, limits upon future work and payment of damages, if any. I understand and agree that <br />the County provides no warranties of any kind about the data provided. <br /> <br />REQUIRED FOR APPROVAL: <br /> <br />NAME OF FIRMlORGANIZA nON/GROUP: <br /> <br />, <br /> <br />ADDRESS: <br /> <br />(Date Approved) <br /> <br />(Printed Name) <br /> <br />(Signature) <br /> <br />COUNTY ApPROVED BY: <br />(Name) <br /> <br />(Date Approved) <br /> <br />(Title) <br /> <br />I:--/~ <br />