20211333 Ver 1_Wetlands - Agent Form - 140227 140228 140229 140230 140231 140232_20210908

Soil &Environmental ConsuYtants, PA
8412 1,a& of heat. R.nd, &.i_ 1[}S, Rnieigb, NC 27615 . phone;(919) 89( 59(kl -
&Mdec.com Pax: (1 846.9467
PROPERTY OWNER CERTIFICATION 1 AGENT AUTHORIZATION
Project Name/Description:��C
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
69 Darlington Avenue
Wilmington, NC 28463
Attu: Apr 'l No Field Office:
Raleigh
1, the undersigned, a duly azlthorized owner of record of the property/properties identified herein, do
authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps) and Soii &
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 deof scribed
RivU.Sers
subject to Federal jurisdiction under Section 404 of the Clean Water Act and/or Section 16 of the
Rivers and Harbors Ace of tyfo 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 any and all associated standard and special conditions. This notification supersedes any previous and
correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, officials to enter the property when accompanied by S&EC stis valid only for government
aff You should call S&EC to arrange a site
meeting prior to visiting the site,
PARCEL 11VFpRMaT pN-
tc4ozz7 +- lL10-4 If- 146C>Z3CD
Parcel Index Number(s) (Pity): t?Z'Z-S '
Site Address: ct, L
City, County, State: Durham, Durham, NC 1�—
�,uuics yMCZ I
Email;
Phone: c7l Z
L L
Pro a er a {please print)
Date
Property Owner Signature
We hereby certify the above information submitted in this application is true and accurate to the best of
our knowledge.

Environmental Consultants,
8412 lulls of Neu u Road, Suite 104. Raleigh, KC, 276IS • Phme: {919} ".59M • Fax: �)]'sj 846-9467
seadec.C=
PROPERTY OWNER CERTIFICATION 1 AGENT AUTHORIZATION
Project Name/Description: AA L 0 C
The Department of the Army
U.S. Army Corps of Engineers. Wilmington District
69 Darlington Avenue
Wilmington, NC 28403
Attn: AadLNorton Field Office; Raleigh
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 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 tail S&EC to arrange a site
meeting prior to visiting the site.
PAR EL INFORMA ION:
Parcel Index Number(s) (PIN):
Site Address; �t
City, County, State: _Durham, Durham, NC
Mailing Address: L'Z; III
Email: pC pp 01Ce [pAt Phone:
' g TIC
Pr Name (please print)
Property Owner Signmure
Date
We hereby certify the above information submitted in this application is true and accurate to the best of
our knowIedge.