HomeMy WebLinkAboutHDC2015-024 Certificate Of Appropriateness 01/13/2015DEPARTMENT 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
1,
1.26 /L - i S /' ��d i !v .� do hereby authorize
� Property owner (print)
�STWe to represent me and my interests in an
Agent1representative 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:
31 cv . CAMP 1 -ro Lr A;,\j5 L�-1Tsmv go c
L Ll 3
Title Holder's Signature Date
4"t, - _I -_ 12 -1 �
Agent's Signature Date
Subscribed and sworn to me, a Notary Public on this 13 clay of 1yL , 2a i 5
�- - EMILY H. MADDEN
PULASKI CQUNN
NOTARY 13UBLIC -• ARKANSAS
My cammission EXi+�olre8 July 31, 2022
C,arnrrsfsslon .1 a3$�474
My Commission Expires:
Notary Public
Revised 8/2012