HomeMy WebLinkAbout04-19 Power of AttorneySpecial Limited Power of Attorney
County of Frederick, Virginia
Frederick Planning Website: wwwofevams
Department of Planning & Development, County of Frederick, Virginia
107 forth Kent Street, Winchester, Virginia 22601
Phone (540) 665-5651 Facsimile (540) 665-6345
Know All Men By These Presents: That I (We)
(Name) (Phone) t ¢ �,• `�
5.
( Address) "` 1. ': r A' , �' } , -,► �, `T "�: ,, a,. --- - 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. ; �'tt y t -on Page , and is described as
Parcel: rLa Lot: Block: Section: Subdivision:
do hereby make, constitute and appoint:
(Name) ,i i �- .< ;,., l '� , i., f.:. „ (Phone) l o - (o ; •- u5 t i
(Address)1i1, L t4: i,+� ��? 11`"t� a .�• til= �1 �': [.:�t� !? 1
To act as my true and lawful attorney-in-fact for and in my (our) name, place and stead with full power and
authority 1 (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This authorization shall expire one year from the day it is signed, or until it is otherwise rescinded or modified.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 (we) have hereto set my (our) hand and seal this &J""' _ day of aa, 20J_9,
Signature(s)
State of Virginia, £ /County of I a k To -wit:
I,`dVef �A. � _, 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 &S4 day of.20 111 .
otary Public
JENNIFER R AMBROSE
NOTARY PUBLIC
REGISTRATION # 7511207
MY COMMISSION EXPIRES
DECEMBER 31. 2019
My Commission Expires: nni 31,2kIq