Loading...
HomeMy WebLinkAbout20230175 Ver 1_Clayton_Pond_Project_Signed_Authorization_Signed_Form_Jan_2023_20230130DocuSign Envelope ID: 9A5944F6-89FF-4FF6-BE98-BD252C8C5AB0 ,aL Shaping Communities Together meg ill AGENT AUTHORIZATION FORM PROJECT NAME: Finch Dam (JOHNS-009 Breach Evaluation PROPERTY LEGAL DESCRIPTION: DB: 06281 PG: 0960; DB: 0126 PG: 0051 PARCEL ID. 05I05001C; 05I04002A STREET ADDRESS: Grifols Therapeutics, LLC Caterpillar, Inc. 8368 US 70 Business West Clayton, North Carolina 27520 Caterpillar, Inc. 954 NC Highway 42 East Cla)ton, North Carolina 27527 Representative: Grifols Therapeutics, LLC; Caterpillar, Inc. (If Representative) Titles: Mr. David D. Auge, Grifols Therapeutics, LLC - Manager, Environmental Affairs; Dave Emonson The undersigned do hereby authorize: Jon Swaim McGill Associates P.A. (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. Representative's Address (if different than property above): Telephone: Grifols - (919) 553-5011 Caterpillar - (9191550-1100 We hereby certify the above information submitted in this application is true and accurate to the best of our knowl f DocuSigned by: f E09155915AE920467 61&S6vu ... Authorized Signature Authorized Signature Date: J ✓%,-J 4 Date: 1/27/2023 MCGILL ASSOCIATES 1240 19- Street La ie N Hicko Nu 28601 828 328 20 4 , AACGILLASSOC IATE S (,'ON1