20211621 Ver 1_Toni Neal Agent Authorization_20211208

AGENT AUTHORLLA, O
PROPERTY LEGAL MSC ION:
tOT NO: 1
STREET ADDRESS:
4916 Rio De Luna
Hickory NC 28601
Please print:
Property Owner: Toni Neal
Property Owner:
PLAN NO: PARCEL ID: 08120
The undersigned, registered property owners of the above noted property, do herebyauthorize
Charlie Washburn
(Contractor/Agent)
, of Marine Construction LLC
(Name of consulting firm)
to act on my behalf and take all actions necessary fo1 the processing, issuance and acceptance of this
permit or certification and any and ail standard and special conditions attached.
Property Owners Address (if different than property above):
_(Mailing) 112 S Mulberry Ct
Mt. Holly NC 28120.__
Telephone: 347 . t2884
We hereby certify the a
best of our knowledge.
Authorized Signature
1L al /2QJ_...
Date
ve information subrr fitted in this application is tru
Authorized gnature
Date
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and accurate tothe