20201125 Ver 2_Agent Author Form_20220303

AGENT AUTHORIZATION FORM
PROJECT NAME: Cashiers Community–Wastewater Treatment & Collection System Improvements
PROPERTY LEGAL DESCRIPTION: DB:2065 PG:337
PARCEL ID.7582-46-3638
STREET ADDRESS: US 64 East, Cashiers, NC 28717
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Property Owner/Representative: Dan Harbaugh
(If Representative) Title:Executive Director
The undersigned, registered property owners of the above noted property, do hereby authorize
John C. Vilas, of McGill Associates P.A.
(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/Representative’sAddress (if different than property above):
_________________________________________________________________
_________________________________________________________________
Telephone: [phone]
We herebycertify the above information submitted in this application is true and accurate to the best of our
knowledge.
__________________ __________________ _________________ __________________
Authorized Signature Authorized Signature
Date: _______________________________ Date: _______________________________
1013 STATE FARM ROAD, BOONE, NORTH CAROLINA 28607 | 828.386.1920 | www.mcgillengineers.com