20200767 Ver 1_SEC Agent Authorization Form_20200626

Environmental Consultants,
8412 Falls of Neuse Road, Suite 104, Raleigh, NC 27615 • Phone; [phone]
s andec.com
PROPERTY OWNER CERTIFICATION / AGENT AUTHORIZATION
Project Name/Description: OLD HOLLAND ROAD SITE S&EC Project #13732
Date: 2020
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
69 Darlington Avenue
Wilmington, NC 28403
Attn: Bryan Roden -Reynolds (or assigned) Field Office: USACE Asheville/Charlotte Regulatory Field Office
I, the undersigned, a duly authorized owner of record of the property/properties identified herein, do
authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps) and Soil &
Environmental Consultants, PA (S&EC) staff (as my agent) to enter upon the property herein described
for the purpose of conducting on -site investigations and issuing a determination associated with Waters
of the U.S. subject to Federal jurisdiction under Section 404 of the Clean Water Act and/or Section 10 of
the Rivers and Harbors Act of 1899. This document also authorizes S&EC (as my agent) to act on my
behalf and take all actions necessary for the processing, issuance and acceptance of a permit or
certification and any and all associated standard and special conditions. This notification supersedes any
previous correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only for government
officials to enter the property when accompanied by S&EC staff. You should call S&EC to arrange a site
meeting prior to visiting the site.
PARCEL INFORMATION:
Old Holland Road Site, Concord, Cabbarus Co., NC
PINs (acres): 45898075560000 (20.509 acres), 45899006810000 (2.25 acres), 45899042310000 (1.06 acres), 45899050000000
(2.22 acres); total area = +/- 26.039 acres
Watershed: Rocky River, 13-17, "C", Yadkin Pee -Dee 03040105
PROPERTY OWNER INFORMATION:
Name: Addison Concord, LLC
Address: 237 S Westmonte Dr, Suite 140, Altamonte Springs, FL 32714
Phone No.: [phone] Fax No.: ( ) Mobile No.: ( )
Email: [e-mail]
_Alfred Rembowski
Property 0wi3or (plea
Signature
_6/ 16/2020
Date
We hereby certify the above information submitted in this application is true and accurate to
the best of our know/edge.