HomeMy WebLinkAbout04-17 Power of AttorneySpecial Limited Power of Attorney
County of Frederick, Virginia
Frederick Planning Website: www.fcva.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) Y'� !tom \- (Phone) 'i -` - x
(Address) rIcq�. . ai b "�c $ � _ L"� >s"�\•- �< � �, c� ; F•� �. � i the
owner(s) of all those tracts or parcels of land ("Property") conveyed to me (us), by deed recorded in the Clerk's
Office of the Circuit Court 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 )C Z.f���- -!�._. �: �.. _ (Phone)a% - /li
(Address)
To act as my true and lawful attorney-in-fact for and in my (our') name, place and stead with full power and
authority I (we) would have if acting personally to file planning applications for my (our) above described
Property, including:
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This authorization shall expire one year from the day it is signed, or until it is otherwise rescinded or modified.
In witness thereof, I} ave reto set�ny ( a d and seal this �-,) day of 1,r c",-" , 20 l'
Signature(s)
State of Virginia, City/County of To -wit:
K 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 mein the jurisdiction aforesaid this '4 day of 20 C .
�b-1, �A My Commission Expires:
Notary Public