20211478 Ver 1_03 - 2-signed AGENT AUTHORIZATION FORM for 2018.27 (1)_20211008

SAGE
ECOLOGICAL
SERVICES
EST. 2016
AGENT AUTHORIZATION FORM
All Blanks to Be Filled in By the Current Landowner or Legal Representative
Name: Holly Springs Foursquare Church dba 'Oasis Church' - Agent: Todd Davis
Address: 1828 Ralph Stephens Road Holly Springs, NC 27540
Phone: [phone]
Email: todd.davis(iioasischurchnc.com
Project Name/Description: 1828 Ralph Stephens Road Property
Sage Project 4 2018.27
Date:
The Department of the Army
U.S. Army Corps of Engineers,
P.O. Box 1890
Wilmington, NC 28402
Attn:
Field Office:
Wilmington District
Re: Wetlands and Streams Related Consulting and Permitting
To Whom It May Concern:
I, the undersigned, the owner or a duly authorized representative of record of the property/properties identified
herein, do authorize representatives of the U.S. Army Corps of Engineers (Corps) 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. I also hereby designate and authorize Sage Ecological Services to act on my behalf as my
agent in the processing of permit applications, to furnish upon request supplemental information in support of
applications, etc. from this day forward.
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 Sage staff. Please contact Sage to arrange a meeting
prior to visiting the site.
BY: Todd Davis
Print Name of Landowner or
Legal Representative
BY:
Signature of Landowner or
Legal Representative