NCC223098_FRO Submitted (2)_20220901

Provide a Notarized Item B for each landowner listed in Item 4.
Land Owner Consent. As a landowner, I provide my consent for land -disturbing activities to occur on the property listed in
Item 2 by the person or entity listed in Item S.
R I,f 1+WW8
Date TyV or Print Name
1 I C! - M 141.1.4 1 i .r A
Telephone Fax 'title a A on /
\ 1 .tat S
Email Signature
.......................... ......................................... ......... •......................................................
Business Landowner (Provide coCDgrate resolution on sikLnyloiy ittahority
a Notary Public of the County of
State of , hereby certify that
personally came before me this day and acknowledged that he is
of and acknowledged, on behalf of
Witness my hand and ofFcial seal, this
the due execution of the foregoing instrument.
day of 120
Notary Public
My commission expires 120
........•.•........................................y..•up•pubNy........•..•.•................................•.......•..
Ind!4dual jandownu�-+, �� Fl,
I, )� SC . / ICi"iteAry Public of the County
rof /�Un ,�� p 1�
State of hereby certify that k,(..�/� I(.t./ [t. L42 ]K
personally appeared before me this date and under oath acknowledged that the above form was executed by them.
Witness my hand and official seal, this day f
Laic
My commission expires TJ 20
SE-W
ALICIA K SCHAUTTEET
NOTARY PUBLIC
Wake County
North Caroline
My Commission Expires Aug. 14, 2023
Rev.Vft
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