20181097 Ver 1_LandownerAuthorizationForm_20191223

ID#* 20181097 Version* 1
Select Reviewer:*
Mac Haupt
Initial Review Completed Date 12/23/2019
Mitigation Project Submittal - 12/23/2019
Is this a Prospectus, Technical Proposal or a New Site?* r Yes r No
Type of Mitigation Project:*
V Stream r Wetlands W Buffer r- Nutrient Offset
(Select all that apply)
Project Contact Information
Contact Name:*
Katie Webber
Project Information
..................................................................................................................................................................................
ID#:* 20181097
Existing IDY
Project Type: r DMS r Mitigation Bank
Project Name: Dogtown Stream Mitigation Bank
County: Catawba
Document Information
Email Address:*
[e-mail]
Version:
*1
Existing Version
Mitigation Document Type:*
Mitigation Bank Information
File Upload: La ndownerAuthorization Form. pdf 56.35KB
Rease upload only one RDF of the conplete file that needs to be subnitted...
Signature
Print Name:* Kathleen Webber
Signature:*

Dogtown Stream Mitigation Project
4328 C & B Farm Rd Conover, NC 28613
375309060630 & 375305291678
Colonel Land, LLC
Environmental Banc & Exchange LLC
302 Jefferson Street, Suite 110 Raleigh NC 27605
3337 1168 Catawba
3397 1430 Catawba
*Please note both parcels are owned by the same parent company