HomeMy WebLinkAboutauthorization of representationDEPARTMENT OF PLANNING AND DEVELOPMENT
723 West Markham Street
Little Rock, Arkansas 72201-1334
Phone: (501) 371-4790 Fax:(501) 399-3435
www.littlerock.gov
CERTIFICATE OF APPROPRIATENESS
AUTHORIZATION OF REPRESENTATION STATEMENT
I, 1 do hereby authorize
Property owner (print)
V)q-JAe!2 AC ,Q to represent me and my interests in an
Agent/representative name and business (print)
Application for a Certificate of Appropriateness on the following property described below. I
have reviewed the proposed application and I have indicated so by initialing a copy of the
submittals that are attached.
Street Address:
/4I
'/7
Title Holder' ;--Sure
agent's Signature
Date
Date
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Subscribed and sworn to me, a Notary Public on this day of
My Commission Expires
Notary Public
JANE VALBNZuELA ----
PU_ASKi MAT,
N07ARv PUBLIC ARKANSAS
r'y C_�mmission KxpireS A'2,st -.b 2--
'�;owm,ssior N-, P 6
Page 5 of 5 Revised 03/06/2020