20221460 Ver 1_Agent Auth Form_20221020

Environmental Consultants,
9412 Falls of Neuse Road, Suite 104, Raleigh, NC 27615 • Phone; [phone]
sandec.com
APPLICANT / AGENT AUTHORIZATION
Project Name/Description: 501 N. WEST STREET (RALEIGH)
Date: 2022
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
69 Darlington Avenue
Wilmington, NC 28403
Attn: Lyle Phillips (or assigned)
S&EC Project 4
USACE Regulatory Field Office: Raleigh
I, the undersigned, a duly authorized applicant of the property/properties identified herein, do authorize
representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps), NC Division of Water
Resources (DWR) and Soil & Environmental Consultants, PA (S&EC) staff (as my agent) 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 jurisdiction under Section 404 of the
Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899, and Neuse Buffer rules (15A
NCAC 02B .0714). This document also authorizes S&EC (as my agent) to act on my behalf and take all
actions necessary for the processing, issuance and acceptance of a permit or certification and any and all
associated standard and special conditions. This notification supersedes any previous correspondence
concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only for government
officials to enter the property when accompanied by S&EC staff. You should call S&EC to arrange a site
meeting prior to visiting the site.
PARCEL INFORMATION:
501 N. West Street, Raleigh, Wake County, NC (physical location)
Area: +/- 0.24 acres PIN No.: 1704510336 Lat/Long: 35.786737/-78.645842
Watershed: Pigeon House Branch, 27-33-18, C;NSW, Neuse 03020201-0804
APPLICANT INFORMATION:
Name: Vision Hospitality Group, Inc.
Address: 411 Broad Street, Suite 401, Chattanooga, TN 37402
Phone No.: [phone]
Email: bparker _,vhghotels.com
Brian Parker, Sr. VP of Development & Construction 9/19/2022
Property Owner (please print) Date
Property Owner Signature
We hereby certify the above information submitted in this application is true and accurate to
the best of our knowledge,