20090136 Ver 10_02b_Dunn Creek Agent Auth Signed_20230825

AGENT AUTHORIZATION FORM
Name: Jason Hartsorn, PE, Kimley-Horn and Associates, Inc.
Address: 421 Fayetteville Street, Suite 600, Raleigh, NC 27601
Phone: Direct: 919-678-4155, Mobile: [phone]
Project Name/Description: Dunn Creek Greenwa
Date: 3/14/17, work to begin in the Fall/Winter 2017
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
Attention: James Lastinp-er
Field Office: Ralei h REaulatory Field Office
Re: Wetland Related Consulting and Permitting
To Whom It May Concern:
The Town of Wake Forest hereby designates and authorizes Kimley-Horn and Associates, Inc. to act in
my/our behalf as my/our agent solely for the purpose of processing Jurisdictional Determinations,
Section 404 permits/Section 401 Water Quality Certifications applications, and Neuse River Basin
Riparian Buffer Determinations, and to furnish upon request supplemental information in support of
applications, etc. from this day forward until successful completion of the permitting process or
revocation by the owner.
In addition, I, the undersigned, a duly authorized owner of record of the property/properties identified
herein, do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps)
to enter upon the property herein described for the purpose of conducting on -site investigations and
issuing a determination associated with Waters of the U.S. subject to Federal jurisdiction under Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899.
Authorized this the 14th day of March , 2017
Kip Padgett, Town Manager
Town of Wake Forest
Print Property Owner's Name
Cc: Karen Higgins
NC Division of Water Resources
401 & Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
'ro erty Owner's Signature