§ 153.117 SAMPLE PERMISSION TO RECORD CERTIFICATE.

DATE:

PLAT:

I, _______________, an Illinois Professional Land Surveyor No. _____ do hereby designate

____________________________

as my representative to record the above listed plat.

_______________________________________

Professional Land Surveyor

#________________________

(Prior Code, § 153.117) (Ord. 06-01-01, passed 1-9-2006)