20240421 Ver 1_More Info Received_20240509 (2)

Osprey Point
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT N0.
1-5 PLAN NO. PARCEL ID: Osprey Point 02558700
STREET ADDRESS: 501 Highway 64/264, Manteo, NC, 27954
Please print: 501 Highway Manteo Holdings, LLC
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Michael J. Morway of Albemarle & Associates, Ltd
(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):
419 Wood Landing Rd, Fredericksburg, VA, 22405
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature
Date: