HomeMy WebLinkAbout11-23 Power of AttorneyCOG Special Limited Power of Attorney
o �� County of Frederick, Virginia
w 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
All Men By The a 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 ultipl persons o _ the property or are applicants, an executed power of attorney from each owner will be needed.VA
Mailing Address of Property Owner/.
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 herebymake, constitute, and appoint:
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Name of Atto ey-In- act
Mailing Address of Attorney -In -Fact
VA-ZZ61 546-46Z-'�I�Z
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 application with Frederick County, Virginia for the following, for the above identified property:
Rezoning ❑ Subdivision
Conditional Use Permit F1 Site Plan
Master 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:
This appointment shall expire one year from the day that it is signed, or at such sooner time as I
otherwise rescind or modify it.
Signature
Title (if signing on behalf of an entity) .-e a r dsw.
State of ' (J( n I a , County/City of h � S , To wit:
I, V 0Gl rI � , a Notary Public in and for the jurisdiction aforesaid, certify that
the person wh6 signed the foregoing instrument personally appeared before me and has acknowledged the
same before me in the jurisdiction aforesaid this day of 4o k , 20 43
h My Commission Expires: (-) 3 3 4 26 Z 4
Notary &blic — 1� motion Number: '60 2!i 1,b 11"
Vicky O Painter
Commonwealth of Virginia
Notary Public
Commission No. 8025284
M- Commission Expires 0313112026