20191656 Ver 1_EE_AgentAuthorizationForm_Signed_20191205

AGENT AUTHORIZATION FORM
Town of Chapel Hill
Project Name: Estes Dr.
Project Location: Intersection Martin Luther King Blvd and Estes Dr. Chapel Hill
Date: July 2015
Town of Chapel Hill, 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 fort he processing, issuance and acceptance of this
permit or certification and any and all standard and special conditions attached.
Town of Chapel Hill
405 Martin Luther King Jr. Blvd
Chapel Hill, NC 27514
[phone]
[e-mail]
I hereby certify the above information submitted in this application is true and accurate to the
best of my knowledge.
David Bonk
Long Range and Transportation Planning Manager
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Date