20231729 Ver 2_Agent Authorization_20241024

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT No. 67 PLAN NO. PARCEL ID: 471001061458
STREET ADDRESS: 1396 Ron Whicker Drive Catawba, NC 28609
Please print: m
Property Owner: Chief Financial LLC, JeffreySwackhamer CEO
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Donna P. Hrko of Lancaster Custom Dock and Lift Systems, Inc.
(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):
811 Washington Ave. Carnegie, PA 15106
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature
F. -.
Date: 9/13/24 Date: 9/13/24