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HomeMy WebLinkAboutHDC2009-020 Certificate Of Approppriateness Authorization Of Representation Statement 11/10/2009G LITTLE ROCK HISTORIC DISTRICT COMMISSION 4�� y DEPARTMENT 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 C, C ©,t Q do hereby authorize Property owner (print) to represent me and my interests in an Agentlrepresentative 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: C32. c, S c E A k a��U� Gs�Q� \\ O S d Title Holder's Signature ate Agent's Signature Date Subscribed and sworn to me, a Notary Public on this day of , 20ly . Notary Public el ►*►'ar`N MICHELLE ANN BROWN Notary Public, State of Texas M Commission Expires: D O Z I '' My Commission Expires y pH« H;� September 05, 2012 Revised 7/2009