20231116 Ver 1_Site Plan_20230814

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Name: MILL SPRING Location: 035.333635' N, 082.188217' W
Date: 08/09/23 940 HAWK RIDGE DRIVE MILL SPRING NC
Scale: 1 inch = 600 ft. SITE VICINITY/PROJECT LOCA77ON MAP
C Copyright 2016, Trimble Navigation Limited

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DocuSign Envelope ID: 399429EE-BEC9-437D-BCF1 -BC7AF591 DB49
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 3 Db/Pg-PC. 468/1424-D/718 PARCEL ID: P55-240
STREET ADDRESS: 940 Hawk Ridge Dr. Mill Spring NC 28756
Please print:
Property Owner: Sidney and Patricia Jay
The undersigned, registered property owners of the above noted property, do herebyauthorize
WARREN EADUS , of OUIBLE & ASSOCIATES, P.C.
(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 Owner's Address (if different than property above):
940 Hawk Ridae Dr. Mill SDrina NC 28756
Telephone/email: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Cu3,g-d by.
is �1�
Authorized Signature
7/18/2023
Date:
DocuSigned by:
E byg _
Authorize idF..9�5G4[�$1ED495 Lp
ocuSigned by:
7/18/2023 Date: F�,�rnng_tEDj ss