20211684 Ver 1_Yadkin - Cheek - Agent Authorization Form - UT Swan Creek_20211115

7 Samuel Ashe Drive, Asheville, PJC 2880S I 919-i- G-4 !,K❑ I gre&@jennlnpenv@bgMa1l,00rn
AGENT AUTHORIZATION FORM
Project Location: UT Swan Creek, Yadkin County, Mark Cheek Property
The undersigned, registered ,property owners) of the above noted property, do hereby
authorize Jennings Environmental PLLC to act on the property owner's behalf and take all
actions necessary for the processing, issuance, and acceptance of the permit or certification
and any and all standard and special conditions .attached.
The property owner(s) hereby certify that the information submitted in this application is true
and accurate to the best of our knowledge,
Property Owner(s):
Owners) Address: X;; 3 D b til8 e c
Owner(s) Phone:
Owner(s) Email:
1 le rebel
Authorized Signature(s)
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Dance
Jennings Environmental PLLC is licensed with the North Carolina 'Board of Examiners for Engineers and Surveyors and is
aiuthoriied to practice engineering under the provisions of Chapter 89C and 55B of the General Statutes of North Caroilna.
License Number P-1932.