20160108 Ver 1_Agent Authorization Letter_20160204

Montalvo, Sheri A
From: Montalvo, Sheri A
Sent: Wednesday, February 03, 2016 2:35 PM
To: [e-mail]
Subject: Murphy Hill Terminal
Attachments: Agent Authorization Form.pdf
Importance: High
Matthew,
We have received the PCN and fee for the above project. Page 10 of 10 has your signature on it so we will require an
agent authorization form to be completed. I have attached one for your use. You can email it back to me once
completed at [e-mail] and I can take the project off hold and forward it through for review.
Thanks
sherC m wtaLvo
401 & Buffer Permitting Unit - Administrative Assistant
Department of Water Resources
Division of Environmental Quality
919-807-6303 (office)
[e-mail]
512 N. Salisbury St., Ste 942-G1, Raleigh, NC 27604
1617 Mail Serive Center
Raleigh, NC 27699-1617
-"---Notf ling Compares
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

SAMPLE AGENT ALJTHOR1ZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. _ PARCEL ID: #9743-48-9492
STREET ADDRESS,, _. 20 Murphy Hili Rd,, Weaverville, NC 28787
Please print:
Property Owner: DaVd H. Hightower
Property 0'vvner;
The undersigned, registered PmPerry owners Of the above noted property, do hereby authorize
Jim Garrard
of Murphy Hill Terminal, LLC
(Contractor /Agent)
(Name of consulting firm)
to act on my loahalf and take all actions necessary for the processing, Issuance and acceptance of
this permit or certification and any and all standard and special conditions attachea.
Property Owner's Address (if Cifferent than property above):
49 Pegg Road, Weaverville, NC 28787
Telephone: [phone]
We hereby certify the above information submitted in this @ppiication Is true and accurate to the
best of our knowledge.
10/10 19vd MV-IIIQCIN0N 9999e99e2e 9T:01 9T0Z/0T/ZT