20231250 Ver 1_Agent Authorization_20230914

CYPRESS CREEK C
AGENT AUTHORIZATION
This form authorizes state employees, federal employees, and all entities under contract with Cypress Creek
Renewables (CCR) to perform site assessments, site verifications; and permitting exercises on the purchase or lease
site. Cypress Creek Renewables is not responsible for damages resulting from assessment; verification, and permitting
activities. This form must be completed in full.
A list of CCR's third party contractors is available upon request.
Property Address: 'G`�
Pane; Tax ID Number{`s-
Owner Names, /
Address:
Telephone Number:
E-mail
Fax (optional)
Date Signed