HomeMy WebLinkAbout20240598 Ver 1_Site Plan_20240425I Pond/ Normal Water Level
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15170 Cove
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Norwood, NC
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SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. 4 PLAN NO. 656401475812 PARCEL ID: 656401475812
STREET ADDRESS: 15170 Cove Point Ln, Norwood, NC 28128
Please print:
Property Owner: Shannon Wise
Property Owner: Bishop Creek Properties
The undersigned, registered property owners of the above noted property, do hereby authorize
Brooke Whetzel , of Bishop Creek Properties LLC
(Contractor / Agent) (Name of consulting firm)
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):
5321 Lantana Ave, Charlotte, NC 28205
Telephone: (704)241-8253
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
F�'�
Authorized Signature Authorized Signature
Date: 4-19-2024 Date: