Weymouth Woods Signed Auth_20230726

SEGi
AGENT AUTHORIZATION FORM

PROPERTY LEGAL DESCRIPTION:

LOT NO. PLAN NO. PARCEL I.D.

STREET ADDRESS:

Property Owner (please print):

The undersigned, registered property owner of the above noted property, does hereby authorize
Southern Environmental Group, Inc. (SEGi) to act on their behalf in matters regarding areas of
environmental concern.

Property Owner's Address (if different than property above):

Telephone:

We hereby certify the above information submitted in this application is true and accurate to the best of
our knowledge.

Property Owner Authorized Signature SEGi Authorized Signature

David Scibetta
Print Name Print Name

06/30/2023
Date Date

Weymouth Woods State Park
00992142
1024 N Fort Bragg Rd
NORTH CAROLINA STATE OF NORTH CAROLINA
DEPT OF ADMN
116 W Jones St

Raleigh NC 27603-8003
Email:
Jody Reavis
07/05/2023
l I f
D Potential Wetland Waters of the US
C Project Area
- • Stream
0 ft 250 ft 500 ft 750 ft
Map Source: ESRI Street Map
All lines are approximate and should be used for
planning purposes only.
Vicinity Map
Weymouth Woods
Southern Pines, Moore Co., N.C.
06/30/2023 023-093.01
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N
I/ .(
; i
1 I
D Potential Wetland Waters of the US
C Project Area
- • Stream
0 ft 250 ft 500 ft 750 ft
Map Source: Topo Map
All lines are approximate and should be used for
planning purposes only.
Topo Map
Weymouth Woods
Southern Pines, Moore Co., N.C.
06/30/2023 023-093.01
N