20151024 Ver 4_B3 II, LLC - Wetlands Authorization Form_20220203

Soil & Environmental Consultants, PA
8412 Falls of Neuse Road, Suite 104, Ideigh, NC 27615 • Phone: [phone] • Fax: [phone]
sandec.com
PROPERTY OWNER CERTIFICATION / AGENT AUTHORIZATION
Project Name/Description: �Vk�.ker $k" e.k' - Cary, AA_
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
69 Darlington Avenue
Wilmington, NC 28403
Attn: James Lastinger Field Office:
Raleigh
I, the undersigned, a duly authorized owner of record of the property/properties identified
herein, do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers
(Corps) and Soil & Environmental Consultants, PA (S&EC) staff, as my agent, to enter upon the
property herein described for the purpose of conducting on -site investigations and issuing a
determination associated with Waters of the U.S. subject to Federal jurisdiction under Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. This
document also authorizes S&EC, as my agent, to act on my behalf and take all actions
necessary for the processing, issuance and acceptance of a permit or certification and any and
all associated standard and special conditions. This notification supersedes any previous
correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only for
government officials to enter the property when accompanied by S&EC staff. You should call
S&EC to arrange a site meeting prior to visiting the site.
PARCEL INFORMATION:
Parcel Index Number(s) (PIN):
Site Address:
City, County, State:
PROPERTY OWNER INFORP
Mailing Address: (I l�t7y S
Email:
Property Own am ple e
Property wner atyCe.
o7(04(910aa1 +- 07c,4co\�0q;.0
3101w" os , Gln a S��ee
[ATION (mailing address, email and phone)
t �o fKS 9 eao\ Aa\t%x_ _ Al L a i to
Phone:
Date
We hereby certify the above information submitted in this application is true and accurate to
the best of our knowledge.