20161001 Ver 1_Agent Authorization Letter_20161018

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TIMMONS GROUP
YOUR VISION ACHIEVED THROUGH OURS.
AGENT AUTHORIZATION and
PROPERTY OWNER CERTIFICATION FORM
All Blanks to be Filled in byApplicant
(When Applicant has property/properties under contract to
purchase from duly authorized owner of record)
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The Department of the Army NCDENR-Division of Water Resources u
US Army Corps of Engineers 401 &Buffer Permitting Unit Z
Wilmington District 1650 Mail Service Center m
PO Box 1890 Raleigh,NC 27699-1650
Wilmington,NC 28402-1890
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To Whom It May Concern:
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1, the applicant, hereby designate and authorize representatives of Timmons Group, Inc., to act on my
behalf as my agent in the processing of permit applications, to furnish upon request supplemental U)
information in support of applications,etc.,from this day forward. o n
This the 1 day ofOWF, 20 lS � O'
(number) (Month) (Year)
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1, the undersigned applicant, with written authorization from a duly authorized owner of record of the 0
property/properties identified herein, do authorize representatives of the Wilmington District, U.S.Army w
Corps of Engineers (Corps)to enter upon the property herein described for the purpose of conducting on- `) ~
site investigations and issuing a determination associated with Waters of the U.S. subject to Federal
jurisdiction under Section 404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of
1899. E
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This notification supersedes any previous correspondence concerning the agent for this project. v o
Project Name:
C6v�.ICI L- 3 S/4lffN PeaPEv-;c/ Location:
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Property Applicant's Name(Print): ,UTAM P Y r)L)SKy - 13,4kFP- 9E5t D,-i ITI,dL 3
Property Applicant's Signature: '" F(/L-
Property
Applicant's Mailing Address: I( JAMES t)4ekScA/ A✓1 zc�
C�ey ,MG Z �13
Property Applicant's Telephone: Fax No.
Property Applicant's Email Address:-
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