20231204 Ver 1_Robert Ventures KS OBX LLC Agent Authorization_20230831

AUTHORIZATION TO ACT AS REPRESENTATIVE FORM
Property Legal Description:
DEED BOOK: 233 PAGE NO: 824
PARCEL ID: 065709074041
STREET ADRESS: 26219 Rampart Street, Salvo, NC 27972
Please Print:
Property Owner: KS OBX LLC
Property Owner:
The undersigned property owners of the above noted property, so hereby authorize
Doug Dorman of Atlantic Environmental Consultants, LLC to,
(Contractor/Agent) (Name of consulting firm)
1. Act on my behalf and take all actions necessary for the processing, issuance and
acceptance of permits and/or certifications and any all standard and special
conditions attached.
2. Enter the property to obtain site information including inspections with regulatory
agencies (Dare County, North Carolina Department of Environmental Quality,
U.S. Army Corps of Engineers, etc.) for the purpose of obtaining permits and/or
certifications.
Property Owners Address (if different than property above):
2810 N Church Street 928283, Wilmington, DE 19802
Property Owners Telephone Number: 215-693-1414
We hereby certify that the above information submitted in this application is true and
accurate to the best of our knowledge.
ManagVof the Manager, Robert Ventures LLC
Authorized Signature and Title Authorized Signature and Title
Date: August 28, 2023