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application for side walk use permit - City of Melbourne, Florida

application for side walk use permit - City of Melbourne, Florida

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AUTHORIZATION TO REPRESENT<br />

I, , owner <strong>of</strong> the following described property:<br />

PROPERTY ADDRESS:<br />

, hereby authorize the following<br />

named individual to apply on my behalf <strong>for</strong> an Outdoor Display and/or Outdoor Seating Permit as provided<br />

<strong>for</strong> in Appendix B, Article VII, <strong>of</strong> the <strong>City</strong> Code <strong>of</strong> <strong>Melbourne</strong>, <strong>Florida</strong>.<br />

AUTHORIZED REPRESENTATIVE:<br />

BY:<br />

PROPERTY OWNER<br />

STATE OF FLORIDA<br />

COUNTY OF BREVARD<br />

The <strong>for</strong>egoing instrument was acknowledged be<strong>for</strong>e me this day <strong>of</strong> , 20 , by<br />

who is personally known to me, or who<br />

has produced<br />

as identification and who did (did not) take an oath.<br />

Notary Public<br />

My Commission Expires:

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