HomeMy WebLinkAboutHDC2016-002 COA Authorization Of Representation Statenet 02/04/2016DEPARTMENT OF PLANNING AND DEVELOPMENT
723 West Markham Street
Little Rock, Arkansas 72201-1334
Phone: (501) 371-4790 Fax: (501) 399-3435
CERTIFICATE OF APPROPRIATENESS
AUTHORIZATION OF REPRESENTATION STATEMENT
I, l Jvdc WLA Dwl do hereby authorize
pp Property owner (print)
name and business (print)
to represent me and my interests in an
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:
T old r s Signature
Agent's Signature
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Date
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Subscribed and sworn to me, a Notary Public on this 1 day of g ,4 0_ I , ;—, 0 1(o
EMILY H. MADDEN
PIiU: " "O11N1Y
N07ARYPp,: ;RKANSAS
My Commiss' 31,022
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My Commission Expires: JNL-( -31 Zo_2.Z
Notary Public
Revised 8/2012