20220253 Ver 1_03 - 20220210 Agent Authorization Form_20220214

AGE',,'
ECOLOGICAL
SERVICES
EST, 2016
AGENT AUTHORIZATION FORM
All Blanks to Be Filled in By the Current Landowner or Legal Representative
Name: Cornwallis NC CPDC, LLC
Address: 450 Main Street
Baton Rouge, LA 70801
Phone: [phone]
Email: [e-mail]
Project Name/Description:
Sage Project #
Date: 2/10/22
The Department of the Army
U.S. Army Corps of Engineers,
P.O. Box 1890
Wilmington, NC 28402
Attn:
Field Office:
2022.009
Wilmington District
Re: Wetlands and Streams Related Consulting and Permitting
To Whom It May Concern:
I, the undersigned, the owner or a duly authorized representative of record of the property/properties identified
herein, do authorize representatives of the U.S. Army Corps of Engineers (Corps) to enter upon the property herein
described for the put -pose 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. I also hereby designate and authorize Sage Ecological Services to act on my behalf as my
agent in the processing of permit applications, to furnish upon request supplemental information in support of
applications, etc. from this day forward.
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 Sage staff. Please contact Sage to arrange a meeting
prior to visiting the site.
BY: w
Print Name of Landowner or
Legal Representative
BY:� -
Signature of Landowner or
Legal Representative