20151102 Ver 1_Agent Authorization Letter_20151023

AGENT AUTHORIZATION
This form authorizes PEI to act as our agent in stream /wetland matters including U,S. Army
Corps of Engineers field verification and permitting.
Property Address: /h 91 A) ,
Lo 6no✓�P n/G >arsl
Owner Information: �7 )
Name: C,,�. &ArrYP21n
Address: 07319 NH
Lq 6P-40�e, ,vim
Telephone Number: 1g14
L 9Z�— /75i3�
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Fax Number: I / II--
E -mail Address: A-ee rIS Mi 44 r01 h C. V' >f • C'or�
Signature: Date: .S",aO ✓/, ZD /J`i