20231321 Ver 1_Agent Authorization Form-Crenshaw_Signed_9.19.23_20230925

AGENT Al1THORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. Multiple PLAN NO. Multiole PARCEL ID NO. Multiple Properties
PROJECT NAME: Crenshaw Stormwater Improvements
STREET ADDRESS: Jones W nd and Clatter Ave Wake Forest NC
PROPERTY/ ROJE SIZE: Parcels: 2.69 ac LOD: 0.51 ac
PROPERTY ROJE OWNER: Town of Wake Forest
Property/Project Owner's Address (if different than property above):
301 Brooks St., Wake Forest NC 27587
Attention: Steve Meyer. CIP Manager
Telephone: [phone]
The undersigned, registered property/project owners or owner representatives of the above noted
property/project, do hereby authorize WS_ P USA to act on our behalf and take all actions necessary for
the processing, issuance and acceptance of this Jurisdictional Determination and/or Section 404 permit.
We hereby certify the above information submitted in this application is true and accurate to the best of
our knowledge.
Property/Project Owner Representative:
1A,- AL
Authorized Signatu e
Steve Meyer
Print Name
Date