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HomeMy WebLinkAbout20211518 Ver 1_1-5-2022 Agent Authorization_20211207SAMPLE AGENT AUTHORIZATION FORM PROPERTY LEGAL DESCRIPTION: LOT NO. 6586 PLAN NO. PARCEL ID: 8615-17-6586 STREET ADDRESS. Richland Street, Waynesville, NC 28786 Please print: Property Owner: Property Owner: Richland Estates LLC The undersigned, registered property owners of the above noted property, do hereby authorize Daniel Hyatt of Wade Trim Inc. (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): 4365 Arnold Avenue, Naples, Florida 34104 Telephone: 239-777-4160 We hereby certify the above information submitted in this application is true and accurate to the best of our knowledge. Authorized ignature Date: % f Date:.