20231188 Ver 1_Agent Authorization Letter_20230825

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
PARCEL ID: 04P13197N or 255900-26-7111 Deed Bk/Pg: DB 6151 / 0678
LOT NO.
PLAN NO.
STREET ADDRESS: Buckleberry Rd, Princeton, NC 27569
Owner(s) Please print: Timothy M. Baumclartner, Jeffrey A. Baumgartner, Karen Hartley, Barbara VViillou hb
Property Owner (signatu
Property Owner (signature): ff
Property Owner (signature): aAA—� /�►
Property Owner (signature): 4Z2
The undersigned, registered property owners of the above noted property, do hereby authorize
Jonathan Raeder , of Water & Land Solutions, L.L.C.__
(Employee Name) (MIFF Company Name)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of this
permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Timothy M. Baumgartner -2580 Steel Bridge Road, Clayton, NC 27520
Jeffrey -A. Baumgartner - 4048 Massey Holt Road. Princeton—NQ. 27569
Karen Hartley - 3962 Massey Holt Road, Princeton. NQ. 27569
Rarhara VAMInughhy - 197n Old Smithfield, Road, Princeton, N . '?756Q _
Telephone: [phone] (Tim)
We hereby certify the above information submitted in this application is true and accurate to the best of
Authorized Signature
Date: