20171252 Ver 1_Agent Authorization Letter_20170928

PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: 73957
STREET ADDRESS: Property adjacent 1519 Tull Road, Greenville, NC
Please print:
Property Owner:
Property Owner:
Catherine F Geyer
The undersigned, registered property owners of the above noted property, do hereby authorize
Igor Palyvoda
(Contractor / Agent)
of Baldwin Design Consultants, PA
(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):
1401 Warwick Circle, Winterville, NC 28590
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorize S' nature
Date: 9tZ6 / 2.ol 7
Authorized Signature
Date: qj -20 1, r-�