20200988 Ver 1_More Info Received_20200813

TIMMONS GROUP
YOUR VISION ACHIEVED THROUGH OURS.
AGENT AUTHORIZATION and
PROPERTY OWNER CERTIFICATION FORM
All Blanks to be Filled in by Current Landowner
The Department of the Army NCDEQ — Division of Water Resources
US Army Corps of Fngineers
Wilmington District 461 &Buffer Permitting Unit
PO Box 1890 1650 Mail Service Center
Wilmington, NC 28402-1890 Raleigh, NC 27699-1650
To Whom It May Concern:
1, the undersigned, current property owner designate and authorize representatives of Timmons Group to
act on my behalf as my agent in the processing of permit applications, to furnish upon request
supplemental information in uppolt of applications, etc., from this day forward.
This the _ f day of 20�
(number) Month) (Year)
1, 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 NCDEQ
Division of Water Resources (DWR) to enter upon the property herein described for the purpose of
conducting on -site investigations and issuing a determination associated with Waters of (lie U.S. subject
to Federal jurisdiction under Section 401 and 404 of the Clean Water Act, and/or Section 10 of the Rivers
and Harbors Act of 1899.
This notification supersedes any previous correspondence concerning the agent for this project.
Project Flame: Meadow View
Parcel ID: 165907-69-2203, 165907-78-1039
Site Address: 1294 Shotwell Rd, Clayton, NC 27520
Property Owner's Name (Print): E -Lee, LLC
Property Owner's Signature:
Property Owner's Mailing Address: S/,6 C0912IV C_
a-7�a9
Property Owner's Telephone:
J S - eD &_
—6-53 9 Fax No.
914
Property Owner's Email Address:
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