20220523 Ver 1_agent authorization_20220401

Proposal for Jurisdictional Delineation Services
Chapel Hill — Carrboro YMCA Site
980 Martin Luther King Jr. Boulevard, Chapel Hill, North Carolina
II Z S&ME Proposal No. 219578
AGENT AUTHORIZATION AND RIGHT OF ENTRY FORM
Date: 14 OCT 21
Project Information
S&ME Project Name: Chapel Hill — Carrboro YMCA
Type of Project: Commercial / Institutional
Location: 980 MLK Jr. Boulevard, Chapel Hill, Orange County, North Carolina
Property Owner/Representative Information
Business Name:
Mailing Address:
City, State, Zip Code:
Telephone No.
Contact:
Agent Information
Business Name:
Street Address:
City, State, Zip Code:
Telephone No.
Contact:
YMCA of the Triangle Area, Inc.
801 Corporate Center Drive, Suite 200
Raleigh, NC 27607
919-719-9628
Tim Carr
S&ME, Inc.
3201 Spring Forest Road
Raleigh, NC 27616
919-872-2660
Mr. Walter Cole
-T-4�
Authorization: I
(Contact Signature)
Tim Carr
(Name of Landowner or Representative)
, on behalf of
a duly authorized owner of record of the property/ properties identified herein, hereby authorize S&ME to
act as agent with the USCAE in connection with the above -mentioned project. By signing above, I also
authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps) to enter upon
the property herein described for the purposes of conducting on -site investigations, if necessary, and
issuing a jurisdictional determination pursuant to Section 404 of the Clean Water Act and/or Section 10 of
the River and Harbors Act of 1889. I, the above signed, am either a duly authorized owner of record of the
property identified herein, or acting as the duly authorized agent of the owner of record of the property.