20201300 Ver 1_AA Form Walker_20211215

AGENT AUTHORIZATION FORM FOR WNCSI STREAM PROJECTS
PROPERTY LEGAL DESCRIPTION:
LOT NO. N/A PLAN NO. N/A PARCEL ID: 1972026504000;
1972112774000.1972210576000.1972233270000
STREET ADDRESS: 2483 Hwy 321 N/ 147 Howard Edmisten Rd
Property Owner:
Eugene B Walker Living Trust/ Eugene Walker
Property Owners Street Address (if different than above):
2483 Hwy 321 N, Sugar Grove, NC 28679
The property owners above have entered into a Memorandum of Understanding with Resource
Institute, Inc. that authorizes the activities proposed on the subject property (see attached). As
an authorized representative of Resource Institute, I do hereby authorize
Adam Williams , of Brushy Fork Environmental Consulting, Inc.
(Contractor/Agent) (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.
We hereby certify the above information submitted in this application is true and accurate to
the best of our knowledge.
Authorized Signature:
Date: 10 v ( - a,6