20140532 Ver 2_Agent Authorization Letter_20150818

Strickland, Bev
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Matt Bare <MBare @mckimcreed.com>
Tuesday, August 18, 2015 9:21 AM
Strickland, Bev
Troy Karski
RE: DWR# 140532 V2 - The Peninsual Club - #18
Agent Authorization Form SIGNED.pdf
Per our phone conversation and the email below, you should be receiving a link that will allow you to download the full
set of plans. I attached the agent authorization form.
Thanks,
Matt Bare, PE, SI, LEED AP I Project Engineer
Tel [phone] Direct 704.945.3357 1 Cell 336.408.0571
8020 Tower Point Drive I Charlotte, NC 28227
MBareCa)mckimcreed.com I littp://www.mckimcreed.com
From: Strickland, Bev rmai Ito: bev.strickland(d)ncdenr.govJ
Sent: Tuesday, August 18, 2015 9:13 AM
To: Matt Bare
Subject: DWR# 140532 V2 - The Peninsual Club - #18
Mr. Bare,
Could you please send me a pdf copy of the large map submitted with the above project?
Thanks
Bev
Jc3we4 I sHa"
B veidy Stu ^IClldand, Laserfldhe Adnihnustrator
NCDENR - Division of Water Resources
Physical: Suite 1219, 512 N Salisbury, NC
Mailing: Mail Service Center 1617, Raleigh, NC 27699 -1617
Phone# 919 - 707 -8789
Email Address: Bev.Strickland @ncdenr.gov
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SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION: 00164166, 00161132,
LOT NO. PLAN NO. PARCEL ID: &00159153
STREET ADDRESS: 19101 Peninsula Club Drive
Cornelius, NC 28031
Please print:
Property owner: The Peninsula Club, Inc., Attn: Jared Nemitz
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Matthew D. Bare of McKim & Creed, Inc.
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
,! ) -.-
Au ized ignatur�
Dt:
Authorized Signature
Date: