20191748 Ver 2_Signed Twin Rivers POA AA_20200331

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. N/A PLAN NO. N/A PARCEL ID: 1889-50-9291-000
See attached Declaration of Restrictions Document. This AA is valid for all parcels included in project.
STREET ADDRESS: Rivers Edge Dr, Boone, NC 28607
Property Owner:
Twin Rivers Property Owners' Association
The undersigned, registered property owners of the above noted property, do hereby authorize
Adam Williams of Brushy Fork Environmental Consulting. Inc.
(Contractor/Agent) (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.
Property Owner's Address of different than property above):
PO Box 1598, Boone, NC 28607
Telephone:
Email: -Aaiy e 1qL0 00 M r Ca W
We hereby certify the above information submitted in this application is true and accurate to
the best of our Uowlede,,!A
Authoriz d S� nature: t
� estcleI" -Wt �i' �p�f� ���r.�, S CE�i
Date: �%