20240367 Ver 1_agent authorization form_20240229

I, �,,_51u".(____________designate Glen Sullivan of Foggy Mountain
Nursery to act as my duly authorized agent concerning all US Army Corps of
Engineers and NC DENR permitting regarding the stream bank restoration project
on my property in A ___County, NC.
X(AV%A L�i �m Cow'
Name
s I-c • 11775 Ny 6B'
150 Dove-•%e_L,. Crr-. J �C Zr446 A/C ZfCfs
Address
3�c- M-5soi
Phone number Fax number
6LJCAM. S 1 --S % �tS COv�►IOV. (0— Gf aO ;n;ji7a�.�a��� Orsh 6001A
E-mail address
Signature Date
I'. Co"