HomeMy WebLinkAbout04-18 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) (p� !� �ru�ai m�ncs� v gwslsvrc �Nol.pan� L (Phone) 70-3—
(Address)
03'
(Address) 3 '6 V3 (f c Ac, v;-- D 3 o v Ck, V;kvV4 zo 15 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. 13 k)10 9? 5 on Page
Parcel: Lot: 103 Block: Section
do hereby make, constitute and appoint:
and is described as
Subdivision:
(Name) i t1 (20-4 i (Phone) 7�3) 5 b �, 2
(Address) i 4 1
To act as my true and I
authority I (we) would
Property, including:
V�, 2c t 5�
wftA attorney-in-fact for and in my (our) name, place and stead with full power and
have 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This authorization shall expire one year from the day it is signed, or until it is otherwise rescinded or modified.
In witness thereof, I e) h "reto set my (our) hand and seal this _ day of , 20_,
0// //
Signature(s)
State of Virginia, City/County of Va',C- Q2�1 , To -wit:
I, _asctLl >n % e -'C- , 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
a sa e before me in the jurisdiction aforesaid this � day of , 20�.
M
Commission Expires: f 0 bon
tary Pub C SUSAN L [ANI KH
NOTARY PUBLIC
HEGISTRATION B 73y5724
MY COMMISSION EXPIRES
OCTOBER 31. 2019