79241A_Schmieler, Albert C_20210430

r
•i

Authorized Agent Consent Agreement
1 Chuck Schmieler
(Property Owner)
hereby authorize Stewart M Davenport
(Authorized Agent)
to act on
my behalf in obtaining CAMA permits for the location listed below. This agency authorization
is limited to the specific activities described above.
Property Address:
Chuck Schmieler
238 Gov Eden House Road
Merry Hill, NC 27957
Property Owner's Mailing Address:
Chuck Schmieler
238 Gov Eden House Road
Merry Hill, NC 27957
Property Owner's Signature:
Authorized Agent Signature:
Date: April 14th, 2021
Form: Authorized Agent Agreement as developed by NCDCM revised 9/25/06

Authorized Agent Consent Agreement
Chuck Schrnieier hereby authorize Stewart M Davenport to act on
(Pn)PCM, Owmer I (Authanted Agcm)
my behalf in obtaining LAMA permits for the location listed below. This agency authorization
is limited to the specific acti% itics described abo%,c.
Properly Addre-,-.:
Chuck Schmieler
238 Gov Eden House Road
Merry Hill, NC 27957
PmpcTly Owner's Mailing Address:
Chuck Schmierer
238 Gov Eder House Road
Merry H41, NC 2-1957
Propaty Owner's sipamm:
Authorized Agcnt Sigaarure:
Date: April 14th, 2021
form, Ataborurd Agent Agreement as do.-clopod by NCDCM m%iscd 9 25 06