20231004 Ver 1_Agent Authorization_20230718

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO: 128
STREET ADDRESS:
178 Greens Rd
PLAN NO: Riprap PARCEL ID: 08145 3128
Granite Falls, NC 28630
Please print:
Property Owner: Jeffrey Stroven
Property Owner: Karen Stroven
The undersigned, registered property owners of the above noted property, do herebyauthorize
Yvette Huffman , of Lake Permit Services, LLC
(Permit Agent) (Name of consulting firm)
to act on my behalf for the processing and submission of this permit or certification.
Property Owners Address (if different than property above):
(Mailing) 2900 Rocky Road
Lenoir NC 28645
Telephone: [phone] or 828-600-5253
We hereby certify the above information submitted in this application is true and accurate to the
best of o r ow ge.
c
I nt ignature Lake "a - it Services Ld.
Date Date