City of Washington
Department of Planning and Development
Application for a Subdivision Variance

Page 4: Owner Authorization for Non-Owner Application
NOTE:
IF THE PERSON WHO IS REQUESTING THE CITY COUNCIL TO TAKE ACTION ON A PARTICULAR PIECE OF PROPERTY IS NOT THE OWNER OF THE PROPERTY OR DOES NOT HAVE A BINDING OPTION TO PURCHASE THE PROPERTY, THEN THE ACTUAL OWNER OF THE LAND MUST COMPLETE THIS FORM.
IF THE PERSON WHO IS REQUESTING THE CITY COUNCIL TO TAKE ACTION ON A PARTICULAR PIECE OF PROPERTY IS THE OWNER OF THE PROPERTY OR HAS A BINDING OPTION TO PURCHASE THE PROPERTY, PLEASE DISREGARD THIS FORM.
 

Dear Sir or Madam,

I am the owner of the property located at:

I hereby authorize:
to appear with my consent before the City of Washington Planning Board and City Council in order to ask for a variance from:
 
at this location. I understand that the variance, if granted, is permanent and runs with the land. I authorize you to advertise and present this matter in my name as the owner of the property.
If there are any questions, you may contact me at my address:
 
or by telephone at:_________________________________.

Respectfully yours,

_______________________________________________
(Owner)

 

Sworn to and ascribed before me, this the________day of_________, 20___.

_______________________________________________
(Notary Public)

My commission expires:_____________________________

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