20191453 Ver 1_USACE Agent Auth Final_20191021

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ENGINEERS
m I AGENT AUTHORIZATION FORM
00 All Blanks to Be Filled in By the Current Landowner or Municipal Official
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Name: NCDOT — Division 2. Michael Aman. PE, Division Bridge Program Mana er
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m Address: 103.7 W.H. Smith Blvd.. Greenville. NC 27834
Phone: [phone]
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coProject Name/Description: State Project 17BP.2.R.95 — Replace Bridge # 14 on SR 1971
(Durham Creek Rd.) over Branch of Durham Creek Beaufort County
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m I Date: 10/16/2019
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US Army Corps of Engineers, Washington Regulatory Field Office
2407 West Fifth St.
Washington, NC 27889
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Attn: Tom Steffens
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Re: Stream and Wetland Delineation and Penn itting Consultation
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To Whom It May Concern:
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1, the current landowner or municipal official, hereby designate and authorize TGS Engineers to
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act in my behalf as my agent in the processing of permit applications, to furnish upon request
supplemental information in support of applications, etc. from this day forward.
This notification supersedes any previous correspondence concerning the agent for this project.
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Notice: This authorization, for liability and professional courtesy reasons, is valid only for
government officials to enter the property when accompanied by TGS staff. You should
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call TGS a site meeting prior to visiting the site.
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BY: �n+�C/ BY:
Print Name of Applicant Sigfiature ofAj5plicant