20231390 Ver 1_Agent Authorization Headwaters Trout Farm_20231011

7 Samuel Ashe Drive, Asheville, NC 28805 1 919-600-4790 1 [e-mail]
AGENT AUTHORIZATION FORM
Project Name: Headwaters Trout Farm EWP Stream Bank Stabilization
Project Address/Location: 71 Headwaters Farm Road
Balsam Grove, NC 28708
The undersigned is the
Assigned Easement Right -Of -
Property Owner �/ a � Lease Holder
P Representative Holder Way Holder
and will be the applicant on the request for permit(s) and/or jurisdictional determination. I
hereby authorize Jennings Environmental PLLC to act on my behalf and take all actions
necessary for the processing, issuance, and acceptance of the permit or certification and any
and all standard and special conditions attached. Additionally, I authorize the representative(s)
of the permitting agency(s) to enter the property for the purpose of conducting activities
associated with verification of the request for permit(s) and/or jurisdictional determination. I
hereby certify that the information submitted in this document is true and accurate to the best
of our knowledge.
Name: Jeff Parker
Company Name
(if applicable): Transylvania County Soil & Water Conservation District
Mailing Address: 106 Fact Morgan Street, Suite 103
Phone Number: 828-884-3230
Email Address: aeff.ap rkeratconc org
Signature:
Date:
Check if applicable
0 The property owner has executed a binding agreement with the Natural Resources Conservation
Service (NRCS) for this stream/wetland restoration project. The above is the assigned representative
for the NRCS and is authorized to act on behalf of the NRCS and the property owner through a signed
mutual agreement for the stream sabilization/restoration project.
Jennings Environmental PLLC is licensed with the North Carolina Board of Examiners for Engineers and Surveyors and is
authorized to practice engineering under the provisions of Chapter 89C and 55B of the General Statutes of North Carolina.
License Number P-1932.