20240184 Ver 1_Goode Preserve Agent Authorization Form - signed_20240126

Agent Authorization Form
Date: 06/22/2022
Name of Property Owner(s) Applying for Permit:
Mills River Ventures LLC
Types of Permits Sought:
USACE Jurisdictional Determination, Nationwide Permitting, NC DWR
Permittina/Determination
By signature below, I do hereby certify that I have the authority and duly authorize
Quible & Associates, P.C. to act on my behalf for purposes of applying for and
obtaining any and all necessary permits for my property located at:
5674 Old Haywood Rd.
Mills River, NC 28759
PIN 9632695820
This certification is valid until: 12/31/2022
Sincerely,
Mills River Ventures, LLC
Mark Marshall (Jun 22, 202215:08 EDT)

Goode Preserve Agent Authorization Form
Final Audit Report 2022-06-22
Created:
2022-06-22
By:
Tyson Griswold ([e-mail])
Status:
Signed
Transaction ID:
CBJCHBCAABAAKtpteEQC11wYJ7sLYKJZ-8NbbnUA_52s
"Goode Preserve Agent Authorization Form" History
Document created by Tyson Griswold ([e-mail])
2022-06-22 - 7:03:00 PM GMT- IP address: 172.220.253.58
Document emailed to [e-mail] for signature
2022-06-22 - 7:03:17 PM GMT
Email viewed by [e-mail]
2022-06-22 - 7:03:20 PM GMT- IP address: 66.249.88.28
Document e-signed by Mark Marshall ([e-mail])
Signature Date: 2022-06-22 - 7:08:31 PM GMT - Time Source: server- IP address: 45.27.33.48
Agreement completed.
2022-06-22 - 7:08:31 PM GMT
0 Adobe Acrobat Sign