20201375 Ver 2_Agent Authorization_20211011

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. Half Moon Condominium Common Area PLAN NO. Tract 2
PARCEL. ID: 00104C99
STREET ADDRESS: 17810 Half Moon Lane, Cornelius NC 28031
Please print:
Property Owner: Christopher Sheehy, President HOA Half Moon Bay
The undersigned, registered property owners of the above noted property, do hereby authorize
Beth Mosteller of Dale & Beth's Lake Use Permit Service
(Contractor / Agent) (Name of 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 (if different than property above):
Christopher Sheehy, c/o Main Street Managers, 1811S West Catawba Ave., Cornelius NC 28031
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized ignature
Date: