HomeMy WebLinkAboutAuthorization_LU19-19-01Wapp doc 3
AUTHORIZATION OF REPRESENTATION STATEMENT
041 1 81116
I • � [�Gy v du hereby authorize
Prop �wncr (pant)
to represent me and my interests in an
Agent/representative (print)
Application For a Land Use Amendment on the following property described below -- include both
legal description and street address.
(5wrter's slgnatu date — - — - -
Subscribed and sworn to me, a Notary Public on this —S— day ol' _� OV Z d V3
Q�
Notary P blic
My Commission Exp"r oa a
BEITYGAMMILL
SALINE COUNTY
COMMISSION M 123/5794
NOTARY PUBLIC -ARKANSAS
MY COMMiSS10N EXPUM FEBRUARY 22,2M2: