20151231 Ver 1_More Info Received_20151207

Montalvo, Sheri A
From: Derek Goddard <derek@brec biz>
Sent: Monday, December 07, 2015 10:09 AM
To: Montalvo, Sheri A
Cc: Tasha Alexander (Tasha L [e-mail])
Subject: Re Eastern Band of the Cherokee Indians Stream Bank Stabilization
Attachments: Agent Authorization Form Piney Grove #2 and #3.pdf
Hi Sheri,
Attached is the Agent Authorization that was left out of the Documents. Tasha, I think this was left out of yours
as well.
Thanks
On Tue, Dec 1, 2015 at 11:42 AM, Montalvo, Sheri A <sheri.montalvo(a-),ncdenr.�4ov> wrote:
Derek,
We have received the PCN and fee for the above project. With your name signed to the signature page 10 of
10 we will require an agent authorization to be completed. I have attached one for your use. After it has been
completed you can email it back to me at sheri.montalvo(a,ncdenr.zov and I can take the project of hold and
forward it through the review process.
Thanks
i
sher� MowtaLvo
I
401 & Buffer Permitting Unit - Administrative Assistant
Department of Water Resources
Division of Environmental Quality
919-807-6303 (office)
sheri montalvo a,ncdenr gov
1

AGENT AUTHORIZATION FORM
Property Legal Description
PIN: f'(,Al�j
Address:
Property Owner
Client
The undersigned, registered property owners of the above noted property, do hereby authorize
0
Derek Goddard
(Agent)
,of BREL, A
(Name of consulting firm)
to act on my behalf and take all actions necessary for the processing , issuance and acceptance
of this permit or cer-tification and all standard and special conditions attached.
Property Street Address (if different than property above):
We hereby certify the above information submitted in this application IS true and accurate to
the best Of Our knowledge.
�7
Authorized Signature- Print and Sign
D a t e.