HomeMy WebLinkAboutAuthorization of Representation AffidavitCity of Little Rock
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Department of Planning and Development
723 West Markham Street
little Rock, Arkansas 72201-1334
Phone: (501) 371-4790 Fax: (501) 371-4546
Prew:TNn:NT01
www.littlerock.gov
PLANNING &
DEVELOPMENT
CERTIFICATE OF APPROPRIATENESS AUTHORIZATION OF REPRESENTATION
AFFIDAVIT
do hereby authorize
Property Owner pri t)
ufMLo represent me and my interests in an
Agent/ epresentative's name and business (print)
Application for a Certificate of Appropriateness for the property described below. I have reviewed the
application and I have indicated that I have done this by initialing a copy of the submittals which are
attached.
Street Address: I k-jU I�UL,T
M C+rt.L I +X44L
Property Owner's Si nature
Agent/Representative's Signature
Date
3 , 20
Date
Subscribed and sworn to me, a Notary Public on this —[!4day of m&K 1, ! Z5
7ZWL
;.jg7T44'•.,
RHONDAKAUCHER
MY COMMISSION # 12375195
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EXPIRE& February 10, 2030
Same County
Notary Public
My Commission Expires: () 2- 1 ( 0 k2DSC)
Historic District.docx Page 7 of 7 Revised 02/06/2025