HomeMy WebLinkAbout02_LU2021-19-01_authorizationWapp.doc 3
04/18/06
AUTHORIZATION OF REPRESENTATION STATEMENT
TIA"4 No 143
Il
L IGe!►` &I FlCaAOI' Q �Q R h!0q%WtR6MaQeL do hereby authorize
Property owner (print)
—s Ee � Aij D bei, -ro l: , 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.
Legal Description.- %IW ?
Street Address: 1 7_&5- ea- m)W I 1
t fa J.-C I X ll
Owner's _ signature date
%101-
Agent's signature
Subscribed and sworn to me, a Notary Public on this day of
My Commission Expires: 0.q 7
date
pGF=7TE �•�l Public
.
COINPA E]iP
3 tt.30.202
No, 123,50639 e
� •'• FAULKNER
: '9 ' COUNTY r�
h,
pV�l IC
••<<Il 1111 1111411114i 1'
LUa".doc 3 04AW6
AUTHORIZATION OF REPRESENTATION STATEMENT
rp"4 IVo i !3
L. Ve x►0i F/e AOP 8ZO J,3 C "It 1'4p maMje .. do hereby authorize
Property owner (print)
--lot W ii e_ � Au oqd4.&� mat— . 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.
LegalOcscripunw � � A � 4P '
Street Address: / ? /3' eaJyll
Owner's signature �-
Agent's signature
. aeaf
date
date
Subscribed and sworn to me, a Notary Public on tins clay of IArAL CXI•) 1
lMy Commission Expires: kA I DU a116
q' Va . �_)�
Notary Public
.;�`�,,•�S�LLfir`• •`afj���i
• 5-14-2028
* : No.123B1230:'*
PULASKI
A!s