20220223 Ver 1_RichlandCreekToWFAgentAuth_20220207

Environmental Consultants,
8412 Falls of Neuse Road, suite 104, Raleigh, NC 27615 • Phone: [phone] • Fax: [phone]
sandmcom
PROPERTY OWNER CERTIFICATION / AGENT AUTHORIZATION
Project Name/Description: Richland Creek Outfall Extension Offsite Sewer
S&EC Project 413461
Date: 2021
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
69 Darlington Avenue
Wilmington, NC 28403
Attn: April Norton USACE Regulatory 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): 1842601365, 1842604470
Site Address: 0 and 0 Coram Fields Road, Wake Forest, NC 27587
PROPERTY OWNER INFORMATION:
Name: Town of Wake Forest
Address: 301 S. Brooks Street, Wake Forest, NC 27587
Phone No.: ( l Fax No.: ( ) Mobile No.: ri Iq IS -4LI f,
E,,m,, .ail: a
Propel Owner (please print) Date
Property Owner %2piatt(re
We hereby certify the above information submitted in this application is true and accurate to
the best of our knowledge.