Designation_of_Agent_202203Designation_of_Agent_202203.docx
DESIGNATION OF AGENT CITY OF PRATTVILLE
I, _____________________________________________, being owner of the property which is the subject of
this application (________________________________________________________________), hereby
authorize _____________________________________________________ to act as my representative with the
City of Prattville’s staff, and/or Planning Commission, and/or Board of Zoning Adjustment, and/or Historic
Preservation Commission, and/or City Council, as required by the type of request listed hereon.
Such representation shall be for all purposes concerning any manner, right, or obligation relating to this petition.
This designation authorizes my agent to make verbal or written representations and/or declarations on my
behalf and I shall be legally bound by said verbal or written representations and/or declarations relating to this
petition.
The petitioner understands and acknowledges that the City will rely upon the agent’s representations in
approval or denial of said petition.
Property owner’s or owners’ signature(s): _______________________________________ Date: __________
_______________________________________ Date: __________
STATE OF ALABAMA
COUNTY OF _____________________________
I, ___________________________________________, a Notary Public in and for said State at Large, hereby certify that
_____________________________________________, whose name is signed to the foregoing document, and
______ Who is known to me, or
______ Whose identity I proved on the basis of ___________________________________________________________
and that being informed of the contents of the document, he/she, as such officer and with full authority, executed the same
voluntarily on the day the same bears date.
Given under my hand and official seal this the _________ day of _______________________________, 20______.
_____________________________________________
Notary Public
My Commission Expires: __________________________