HomeMy WebLinkAbout01-07 Power of AttorneySpecial Limited Power of Attorney
County of Frederick, Virginia
Frederick Planning Web Site: www.co.frederick.va.us
Department 61f 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 Those Present: That I (We)
(Name) �l Vc�. acts `.�.;_ (Phone)
(Address) 0 �: c� % i y1C � 11A
the owner(s) of all those tracts or arcels of land ("Property") conveyed to me (us), by deed recorded in the
Clerk's Office of the CircuitI i I rt of the County of Frederick, Virginia, by
Instrument No. on Page and is described as
Parcel: Lot: Block: Section: Subdivision:
do hereby make, constitute and appoint:
(Name) Ct l�5 l t�t 1��:{rl�`i (Phone) :E�VG 75�--
(Address) P,�_� - 11,'-7
tne,
�>To act as my true and lawful alto y -in- act for and in my (our)p ace, and stead with fu11 power and
authority I (we) would have if acting personally to file planningations for my (our) above described
Property, including:
❑ Rezoning (including proffers)
E�- Conditional Use Permits
❑ Master Development Plan (Preliminary and Final)
❑ Subdivision
❑ Site Plan
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This authorization shall expire one year from the day' is signed, or until it is otherwise rescinded or modified.
In witness thereof, I (we) have hereto set my (our) hand and seal this day of 200
Signature(s)
State of Virginia, City/County of
To -wit:
I, a Notary Public in and for the jurisdiction aforesaid,
certify that the person(s) who signed to the foregoing instrument personally appeared before me and has
acknowledged the same before me in the jurisdiction aforesaid this _ day of , 200
Notary Public
My Commission Expires: