Limited Power Of Attorney Instructions Sheet printable pdf download

Limited Power Of Attorney Instructions Sheet

City of Livonia

Inspection Department

33000 Civic Center Drive - Livonia, Michigan 48154

(734) 466-2580 – Fax (734) 466-2095

LIMITED POWER OF ATTORNEY INSTRUCTIONS SHEET

CONTRACTOR:

If you are not personally coming into the City of Livonia Building Inspection Department

office to register and pull permits, or if you wish to designate a representative whom you

authorize to act on your behalf to obtain permits in your name, we require a notarized

Limited Power Of Attorney form.

1. List the name(s) of the person (people) whom you are giving this limited power of

attorney on your behalf on the line after the wording “do hereby appoint” and also on

the line just before the wording “will sign my name, etc”. If you do not wish to

designate a representative and no one other than yourself, the license holder, will be

signing applications and you wish to register by mail and pull permits by mail, you

must list yourself, the license holder, on the lines described above and please note

somewhere on the form that you will be the only one signing the permit application(s)

and will be sending the application(s) by mail.

2. List the date you wish for this Limited Power Of Attorney to expire not to exceed the

date of your current registration. You must notify the City of any changes or

revocation done prior to the expiration date.

3. Sign form in the presence of a Notary Public and have the form notarized. A Notary

Public is available in the Inspection Department free of charge for departmental

business. Call ahead to ensure they are on duty. Out of state Notaries will require a

notary seal.

4. A Limited Power Of Attorney form authorizes the person (people) you designate to

have said power to do anything you may do. They will sign your name and then their

name as attorney in fact. This binds you as any contract does and you will be held

responsible. Careful consideration should go into the decision to grant any Power Of

Attorney. You may wish to consult an attorney prior to executing said document.

I:\Dept\Inspection\FORMS\LIMITED POWER OF ATTORNEY INSTRUCTIONS SHEET.doc 4/18/05

Limited Power Of Attorney Instructions Sheet