20141194 Ver 1_Agent Authorization Letter_20141201

AGENT AUTHORIZATION
This form authorizes PEI to act as our agent in stream /wetland matters including U.S. Army
Corps of Engineers and North Carolina Division of Water Resources field verification and
permitting.
Property Address: f /49VV9r IeOy SC< e. IS. ,Gals IAA.,i1 AVd-
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Owner Information:
Address: E/0., /y 6 XU
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Telephone Number: pGZ' J�oZ 7'
Fax Number:
E -mail Address: L =./.�� lq 6X'q Q<i C
JURISDICTIONAL DETERMINATION REQUEST
SECTION D- PROPERTY OWNER CERTIFICATION
I, the undersigned, a duly authorized owner of records of the property /properties identified
herein, do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers
(Corps) 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.
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Property Owner (please print)
Property Owno(Signature
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Date