Special Limited Power Of Attorney
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1Special Limited Power of Attorney
County of Henrico, Virginia
4301 E. Parham Road, Richmond, Virginia 23228
Henrico Planning Web Site:
Mailing Address: Planning Department, P.O. Box 90775, Henrico, VA 23273-0775
Phone (804) 501-4602
Facsimile (804) 501-4379
Know all men by these presents: That I (We)
(Name):
(Telephone):
(Address):
the owner(s) of all those tracts or parcels of land (“Property”) conveyed to me (us), by deed recorded in the
Clerk’s Office of the Circuit Court of the County of Henrico, Virginia, by
Instrument No.
, on Page
, and is described as
Parcel:
Lot:
Block:
Section:
Subdivision:
do hereby make, constitute and appoint:
(Name):
(Telephone):
(Address):
To act as my true and lawful attorney-in-fact and in my (our) name, place and stead with full power and
authority I (we) would have if acting personally to file planning applications for my (our) above described
Property, including:
Rezoning (including proffers)
Lighting Plan
Final Subdivision
Provisional Use Permits
Variance
Subdivision Construction Plans
Conditional Use by Special Exception
Landscape Plan
Building Permit(s)
Plan of Development
Alternative Fence Height
Transfer of Approval
Administrative Site Plan
Conditional Subdivision
My attorney-in-fact shall have the authority to offer proffered conditions and to make amendments to
previously approved proffered conditions except as follows:
This authorization shall expire one year from the day it is signed, or until it is otherwise rescinded or modified.
In witness thereof, I (we) have hereto set my (our) hand and seal this ______ day of ______________, 20____,
Signature(s)
State of Virginia, City/County of
, To-wit:
I,
, a Notary Public in and for the jurisdiction aforesaid, certify that the person(s) who
signed to the foregoing instrument and who is (are) known to me, personally appeared before me and has
acknowledged the same before me in the jurisdiction aforesaid this ______ day of _______________ 20____.
My commission expires:
Notary Public
POF-005 – 10/01/08
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