20191385 Ver 1_Signed_AgentAuth_W_WilsonAve_TownofMooresville_20191009

AGENT AUTHORIZATION FORM
TOWN OF MOORESVILLE, NORTH CAROLINA
Project Name:
Project Location:
Date:
TOWN OF
MOORESV1 LLE NORTH CAROLINA
W. Wilson Ave. Improvements
W. Wilson Ave. from U5 Hwy 21 to NC Hwy 115
June 2015
The undersigned does hereby authorize:
The Professional Engineers and Scientists Ecological Engineering, LLP
of
(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.
Mailing Address:
Town of Mooresville
413 North Main Street
Mooresville, NC 28115
I hereby certify the above information submitted in this application is true and accurate to the best of
my knowledge.
Ryan Rase Date
Deputy Town Manager, Town of Mooresville