20211765 Ver 1_03-Signed Agent Authorization Form for 2021.018_20211203

AGENT AUTHORIZATION FORM
All Blanks to Be Filled in By the Current Landowner or Legal Representative
Name:���c
Address: ?S'70a�,�,rk
Phone:
Email:
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Project Name/Description: Blanchard Properly
Sage Project # ?fm ns8
Date:
The Department of tite Army
U.S. Army Corps of Engineers, Wilmington District
P.O. Box 1890
Wilmington, NC 28402
Attn:
Field Office:
Re: Wetlands and Streams Related Consulting and Permitting
To Whom it May Concern:
1, the undersigned, the owner or a duly authorized representative of record of the property/properties identifiers
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 tite U.S. subject to Federal jurisdiction under Section 404 of the Clean Water Act and/or Section 10 of the Rivers
and 1-iarbors Act of 1899. 1 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. front this day forward.
This notification supersedes any previous correspondence concerning the agent for this project.
Notice: This authorization, for livability and professional courtesy reasons, is valid only for government
officials to enter the property when accompanied by Sage staaff. Release contact Sage to arrange a meeting
prior to visiting the site.
BY: i3
Print Name of Landowner or Sign tore of Landowner or
Legal Representative Legal Representative