20220405 Ver 2_5a - NC ECS Agent Authorization_owner_20220720

DocuSign Envelope ID: 1 F5421AC-OBD2-4885-9E8F-95154B19E3D9
.Ts
Property/Site:
ECS SOUTHEAST, LLP "Setting the Standard for Service"
Geotechnical • Construction Materials • Environmental • Facilities
Agent Authorization
McConnell Road Industrial
NC Registered Engineering Firm F-1078
NC Registered Geologists Firm C-406
SC Registered Engineering Firm 3239
Address of Site: 3617 & 3635 McConnell Road
Greensboro, NC 27405
Parcel Identification Number (PIN): 7894226778 & 7894222546
Owner Information:
William Causey
Name:
Address: 2734 River Forks
RoadSanford, NC 27330
Telephone Number:
Fax Number:
E-mail Address:
Property Owner Certification:
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 (USACE)
and/ or the North Carolina Division of Water Resources (NCDWR) 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/State jurisdiction under
Section 404 and 401 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of
1899. I also authorize ECS to act in my behalf in the processing of this request and to furnish
supplemental information in support of this request, including stream/wetland matters in
coordination with the USACE and thgb, 1Q R field verification and permit application:
TSPA'
Property Owner Signature:
Date:
�— 99D0BD03132F431...
6/22/2022
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