East West Connector (EWC) - STIP U-6239 - Signed Agent Authorization

PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: Multiple
STREET ADDRESS: East West Connector Project
Southeast corner of Interstate 77 and Langtree Road
Please print: Randall W. Hernann, Town of Mooresville, NC
Property Owner: 1 "'
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Nancy Oberle of Three Oaks Engineering, Inc.
(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 Address (if different than property above):
413 North Main Street, Mooresville, NC 28115
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
kt-,-
Authorized Signature
Date: 3/�— /2 2-0
DgWIV g-d by
Nancy N."., OW.
Oberle Da . 2022 03,24
10 39 U 44 DO'
Authorized Signature
Date: 03/24/2022
Authorized Signature
Date: