HomeMy WebLinkAbout04-15 Power of Attorney0
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Special Limited Power of Attorney
County of Frederick, Virginia
Frederick Planning Website: www.co.frederick.va.us
Department of Planning & Development, County of Frederick, Virginia
107 North Kent Street, Winchester, Virginia 22601
Phone (540) 665-5651 Facsimile (540) 665-6395
Know All Men By These Presents: That I (We)
(Name) r -f (Phone) �%1 S� �
_.N q1 /' 1 i e
(Address) Kjlkid10 4
the owner(s of all those tracts or parcel of land ("Property" conveyed
Clerk's Office of the Circuit Court of the County of Frederick, Virginia, by
Instrument No. I n Page
Parcel: Lot: Block: Section
do hereby make, constitute and appoint:
to me (us), by deed recorded in the
and is described as
Subdivision:
(Name) %C�� i .i (Phone)
(Address) (J 114t
To act as my true and lawf i
authority I (we) would have
Property, including:
-7c,�2 732 q K'/-6
attorn y -in -fact for and m my (our) name, place and stead with full power and
if acting personally to file planning applications for my (our) above described
Rezoning (including proffers)
Conditional Use Permit
Master Development Plan (Preliminary and Final)
Subdivision
Site Plan
Variance or Appeal
My attorney-in-fact shall have the authority to offer proffered conditions and to make amendments to previously
approved proffered conditions except as follows:
This authorization shall expire
In witness thereof, I (we) have
Signature(s)
ar from the day it is signed, or unfl it is otherw* e scmded or moditied.
set n>iyl (kur) hand and seal this day of C 0 _, 20LII
PUBLIC
�1 MY COMMISSION EXPIRES SEPT. 30.2016
State of Virginia, City/County of C'0� \iU�i�l lJDt, To -wit. COMMISSION ><752B194
1,��5wt19Q'1011CIVIA01 a Notary Public in and for the jurisdiction aforesaid,
certify that the person(s) who signed to the foregoing instrume t ersonall eared before me and has
acknowle ged the s e before mein the jurisdiction aforesaid this day o� 20�.
�.Q My Commission Expires: d
Notary Public