20201044 Ver 1_Agent Authorization Form_20200908

AGENT AUTHORIZATION AND RIGHT OF ENTRY FORM
Date: August 4, 2020
Project Information
S&ME Project Name: Hawbridge School Permitting Activities
Type of Project: Institutional
Location: Saxapahaw Bethlehem Church Road, Saxapahaw, NC
Property Owner/Representative Information
Business Name: The Association for the Advancement of Education (dba The Hawbridge
Mailing Address:
PO Box 40
City, State, Zip Code: Saxapahaw, NC 27340
Telephone No. 336-376-1122
Email Address:
mciccotti (a)hawbridaesc
Contact:
Agent Information
Business Name
Street Address:
City, State, Zip Code:
Telephone No.
Contact:
S&ME, Inc.
3201 Spring Forest Road
Raleigh, NC 27616
919-872-2660
Ashley Bentz
Authorization: I, -op- "p— cAt f , on behalf of
The Hawbridge School
(Name of Landowner or Duly Authorized Agent)
a duly authorized owner of record of the property/ properties identified herein, hereby authorize S&ME,
Inc. to submit information to the US Army Corps of Engineers (USACE)/NC Division of Water
Resources (DWR), pursuant to obtaining necessary environmental permits for the project referenced
above. If applicable, this also authorizes the USACE/DWR to access the project area with prior
notification for the purposes of confirming the accuracy of the delineated boundaries.