20230651 Ver 1_Agent Authorization_20230506

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO: Lot 6 PLAN NO: PARCEL ID: 378108798796
STREET ADDRESS:
2682 Canvasback Ln, Catawba, NC 28609
Please print:
Property Owner: Brent Parnell
Property Owner: —Angela Parnell
The undersigned, registered property owners of the above noted property, do herebyauthorize
Charlie Washburn ,of Marine Construction LLC
(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.
Property Owners Address(if different than property above):
(Mailing) Same as above
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Client Signature Charlie Washburn
Date Date