HomeMy WebLinkAbout01-20 Power of Attorney4��x coG� Special Limited Power of Attorney
q County of Frederick, Virginia
Frederick Planning Website: www.feva.us
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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:
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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 own the property or are applicants, an executed power of attorney from each owner will be needed.
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Mailing Address of Property Owner/Applicant 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-}rr6per a tification numbers:
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do hereby make, constitute, and appoint:
Name of Attorney -In -Fact S
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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 file and act on my behalf with respect
to appli mtion with Frederick County, Virginia for the following, for the above identified property:
Rezoning F1Subdivision
Conditional Use Permit ❑ Site Plan
Master Development Plan (prelim. or final) b 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:
This appointment shall ex -P.1 -re -on e ar fro)n the day that it is signed, or at such sooner time as I
otherwise rescind or odify it. �•��"�"'C°°°°,
Signature -- ) •NOTARY • ��
Title (if signing o behalf of e - r pi ''' ;
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State of \/%rcuoo- C; oun /City of Ft erie_�i C,K wlt: r RF)
1, _ s t A Q -i A IL , a Nota Public in and for the urisdiction aforesaid 0",
IY J ,gyp 4 %b�the person who signed the regoing instrument personally appeared before me and has ackn�a•``
s e before mein the jurisdiction aforesaid this 1 5' day of JAl ucl W--) 20 L-0
)Z_ l EMy Commission Expires:.. C �J� �S Z
Notary Public Registration Number: � C-� -7 t