HomeMy WebLinkAbout42-16 Power of AttorneySpeciai Limited Power of Attorney
County of Frederick, Virginia
Frederie'R. Planning Website: www.co.frederjck.va.tv
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)
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(Name)
(Address) -vi P c?,
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the owner(s) of all those tracts or parcels of land ("Prope rty") convey ed to rn e (us), by deed recorded in thie.
Clerk's Office of the Circuit Court of the Count-,,, of Frederick, Virginia. by
InstrumentNo. on Page-nd is dmribcd as M
a
Parcel: Lot: Block: Section: Subdivision.
do hereby make,. constitute and appoint:
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Name) 7) e,, L
k , I c, ??.f '` " v i f (Phone)
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(Address)
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To act as my true and lawful attorney -in-fact for and in my (our) nam, e, p lace and ste ad with full power and
authority I (wc) would have if acting personall y to file planning applications for in y (our} a bove describe d
Property, including:
_=Rezoning (including proffers)
_=Conditional Use Permit
Miaster Development Plan (Preliminary ant; Finai)
Site Plan
Variance or Appeal
My attorney-in-fact shall have die authority to offer proffered conditions and to snake amendments to previously
approved proffcred conditions except as follows:
This authorization shall expire one year from the day it is signed, or until it is otherwise4escinded or modified,
In witness thereof, I (w e hereto set my (our) hand and seat this he day ofAA It// 201k,
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signature(s) lltl� S11
OF 0!:�
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State of 4LV
City/Coun of K%1x T, -,It:
TENNES
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NOTARY
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Simason a ot ary Public in and fat] 'jiONAltien aforesiid,
certify that thekerson(s) who sij! nedtothe foregoing instrurn entpWonally a bafore**q --,-afid has
acknowledged the sante befi 'e in the jurisdiction aforesaid this 'day of
My Commission Expires-