20151024 Ver 4_george jordan owner cert signed_20220203

Environmental Consultants,
8412 Falls of \ruse Rood, 5uitc 104, Ralcigt, NC 27613 • Phone: ()19) 846-SM) • [:as: [phone]
sandec.cam
PROPERTY OWNER CERTIFICATION / AGENT AUTHORIZATION
Project Name/Description:
Date:
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
S&EC Project # 12613
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): 016 Y&( A 0 176 Y4 &/7 l f L l 1Y 7
Site Address: -�1 3 k d3 F. T� o q
City, County, State:
Mailing Address:
Email: v ¢ (dq A ,G�,, Phone:
Property Owner Name (please )4nt)�:: Dated
Property Owner gnatu
We hereby certify the above information submitted in this application is true and accurate to
the best of our knowledge.

Environmental Consultants,
8412 Calls of Neuse Road, Suite 104, %dc* NC 27615 - Phone: {)19) 84&59OU • Fax: [phone]
sandec.unn
PROPERTY OWNER CERTIFICATION / AGENT AUTHORIZATION
Project Name/Description:
Date:
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
S&EC Project # 12613
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): 074 Y6 a-1fd$ X /0q 6 &J 6 Y 6 /,S7 "] 6
= Site Address: 3y Sr36 LF C3- 3 5 E, T,
City, County, State: L ,
PROPERTY OWNER INFORMATION(mailing address, email and ohone
Mailing Address: V o, A,, j q
Email. eor 7 �Cf e &kcRhone: L
14,
Property wy�ame (please prjrlt� Dat
� i
Property
We hereby certify the above information submitted in this application is true and accurate to
the best of our knowledge.