Agent Authorization

7 Samuel Ashe Drive, Asheville, NC 28805 1 919-600-4790 1 [e-mail]
AGENT AUTHORIZATION FORM
Project Name: Besancon Property Pleasant Grove Floodalain Restoration
Project Address/Location: North of intersection of Pleasant Grove Road
& Justus View Drive SPIN 9528-13-9941)
The undersigned is the
aProperty Owner Assigned Easement Right -Of- Lease Holder
11 Representative E Holder 11 Way Holder 11
and will be the applicant on the request for permit(s) and/or jurisdictional determination. I
hereby authorize Jennings Environmental PLLC to act on my behalf and take all actions
necessary for the processing, issuance, and acceptance of the permit or certification and any
and all standard and special conditions attached. Additionally, I authorize the representative(s)
of the permitting agency(s) to enter the property for the purpose of conducting activities
associated with verification of the request for permit(s) and/or jurisdictional determination. I
hereby certify that the information submitted in this document is true and accurate to the best
of our knowledge.
Name: Kieran Roe
Company Name
(if applicable): Conserving Carolina
Mailing Address: 847 Case Street
Phone Number: 828-697-5777
Email Address: kieran&cjlaarrolifna org
Signature: If -
Date: 7)
Check if applicable
The property owner has executed a binding agreement with the Natural Resources Conservation
Service (NRCS) for this stream/wetland restoration project. The above is the assigned representative
for the NRCS and is authorized to act on behalf of the NRCS and the property owner through a signed
mutual agreement for the stream sabilization/restoration project.
Jennings Environmental PLLC is licensed with the North Carolina Board of Examiners for Engineers and Surveyors and is
authorized to practice engineering under the provisions of Chapter 89C and 55B of the General Statutes of North Carolina.
License Number P-1932.