HomeMy WebLinkAbout02-19 Power of Attorney��K cod Special Limited Power of Attorney
c County of Frederick, Virginia
Frederick Planning Website: w-,vw.feva.us
Department of Planning &llevelopment, County of Frederick, Virginia
107 North Kent Street, Winchester, Virginia 22601
Phone (540) 665-5651 Facsimile (540) 665-6395
All Men By These Presents That:
Am a t6y4ASOYi V k
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Name of Property Owner/Applicant
Please note: If the property owner/applicant is an entity, the name of the entity should appear above.
If multiple persons o n the roperty or are ap ants, execuI dpower of attorney from each owner will be nee`gd.
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Mailing Address of Property Owner/Applicant IF Telephone Number
as owner of, or applicant with respect to, the tract(s) or parcel(s) of land in Frederick County,
Virginia, identified by following property identification numbers:
do hereby make, constitute, and appoint:
Name of Attorney=ln-Fact '
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Mailing Address of Attorney -In -Fact Telephone Number
to act as my true and lawful attorney-in-fact for and in my name, place, and stead, with the same
full power and authority I would have if acting personally, to rile and act on my behalf with respect
to application with Frederick County, Virginia for the following, for the above identified property:
RezoningSubdivision
Conditional Use Permit ri Site Plan
WMaster Development Plan (prelim. or final) ❑ Variance or Zoning Appeal
and, further, my attorney-in-fact shall have the authority to offer proffered conditions and to make
amendments to previously approved proffered conditions except as follows:
R/A
This appointment shall expire one year from the day that it is signed, or at such sooner time as I
otherwise rescind or ify it.
Signature
Title (if signing on ehalf of ane I ) 12r &f L
State of U \&1VAlf-• ,County/City of RAV-' &4 To wit:
I, �,1►�� ��Yri+t \�V"�%rj" , a Notary Public in and for the jurisdiction aforesaid, certify that
the person whjo signed the foregoing instrument personally appea ed before me and has acknowledged the
e before me in the jurisdiction aforesaid this c')O day of
4.,.- My Commission Expires. �• ���
Notary Pu j Registration Number: