20160406 Ver 2_Agent Authorization Letter_20180228

Strickland, Bev
From:
Chris Roessler <[e-mail]>
Sent:
Wednesday, February 28, 2018 2:18 PM
To:
Haupt, Mac
Cc:
Xu, Lin; [e-mail]
Subject:
[External] RE: Landowner Authorization forms
Attachments:
Buckwater_landowner_authorization_signed.pdf
External email. Do not click links or open attachments unless verified. Send all suspicious email as an attachment to
Report Spam.
Those are attached, Mac.
Chris Roessler I Senior Scientist/ProjectManager
0: 919.851.9986, x 111 M: 919.624.0905
Wildlands Engineering, Inc.
312 West Millbrook Road, Suite 225
Raleigh, NC 27609
From: Haupt, Mac [mailto:[e-mail]]
Sent: Wednesday, February 28, 2018 2:07 PM
To: Chris Roessler <[e-mail]>
Cc: Xu, Lin <[e-mail]>; [e-mail]
Subject: Landowner Authorization forms
Chris,
I am not seeing any Landowner Authorization forms. Have checked a couple of times. We will need those to proceed
with the Certification.
Thanks,
Mac Haupt, LSS
Stream & Wetland Mitigation Coordinator
401 & Buffer Permitting Branch
Division of Water Resources
Department of Environmental Quality
Office: 919 807-6476
Mobile: [phone]
mac.haupt(a)ncdenr.gov
512 N. Salisbury Street, Suite 942-K, Raleigh, NC 27604
1617 Mail Service Center
Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the

North Carolina Public Records Law and may be disclosed to third parties

EXHIBIT C: Landowner Authorization Form
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF
MITIGATION SERVICES
LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: 1536 Page: 133 County: Orange
Parcel ID Number: 9895099042
Street Address: St. Mary's Road, Eno, North Carolina
Property Owner (please print): Bacon Family Limited Partnership
The undersigned, registered property owners) of the above property, do hereby authorize Wildlands
Engineering, Inc., the NC Department of Environment and Natural Resources, and the US Army Corps
of Engineers, their employees, agents or assigns to have reasonable access to the above referenced
property for the evaluation of the property as a potential stream, wetland and/or riparian buffer
mitigation project, including conducting stream and/or wetland determinations and delineations, as
well as issuance and acceptance of any required permit(s) or certification(s).
Property Owners(s) Address:
if different from above)
Property Owner Telephone Number: [phone]
I/We hereby certify the above information to be true and accurate to the best of my/our knowledge.
(Property Owner Authorized Signature) 'ate
(D)
(ProperiyriOwner Authorized Si ture) (Date)

NORTH CAROLINA ECOSYSTEM ENHANCEMENT PROGRAM
LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: 2034
Page: 527
County:
Orange
Parcel ID Number:
9895269592
Street Address: Off St. Mary's Road, Hillsborough, NC
Property Owner (please print): Douglas and Pat Crabtree
Property Owner (please print):
The undersigned, registered property owners) of the above property, do hereby authorize
Wildlands Engineering, Inc., Full Delivery Provider', the NC Department of Environment and
Natural Resources, and the US Army Corps of Engineers, their employees, agents or assigns to
have reasonable access to the above referenced property for the evaluation of the property as a
potential stream, wetland and/or riparian buffer mitigation project, including, conducting stream
and/or wetland determinations and delineations, as well as issuance and acceptance of any required
permit(s) or certification(s).
Property Owners(s) Address: 4211 St. Mary's Rd., Hillsborough, NC 27278
if different from above)
Property Owner Telephone Number: Doug Crabtree - 919-732-3932
Property Owner Telephone Number:
I/We hereby certify the above information to be true and accurate to the best of my/our knowledge.
(Property Owner Authorized Signature) ` � (Date)
(Property Owner uthoriieed'Signature) (Date)
Name of full delivery company

NORTH CAROLINA ECOSYSTEM ENHANCEMENT PROGRAM
LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: 3599 Page: 546 County: Orange
Parcel H) Number: 9895256668
Street Address: Off St. Mary's Road, Hillsborough, NC
Property Owner (please print): Crabtree Farm LLC (Doug Crabtree, manager)
Property Owner (please print):
The undersigned, registered property owners) of the above property, do hereby authorize
Wildlands Engineering, Inc., Full Delivery Providers, the NC Department of Environment and
Natural Resources, and the US Army Corps of Engineers, their employees, agents or assigns to
have reasonable access to the above referenced property for the evaluation of the property as a
potential stream, wetland and/or riparian buffer mitigation project, including conducting stream
and/or wetland determinations and delineations, as well as issuance and acceptance of any required
permit(s) or certification(s).
Property Owners(s) Address: Doug Crabtree (manager), 4211 St. Mary's Rd., Hillsborough, NC
27278
if different from above)
Property Owner Telephone Number: Doug Crabtree (manager) 919-732-3932
Property Owner Telephone Number:
I/We hereby certify the above information to be true and accurate to the best of my/our knowledge.
(Property Owner Authorized Signature) ' (Date)
/property Owner Adithorized ignature) (Date)
Name of full delivery company

NORTH CAROLINA ECOSYSTEM ENHANCEMENT PROGRAM
LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: 4151
Page: 211
County:
Orange
Parcel ID Number:
9895258436
Street Address: 1111 Walnut Hill Dr., Hillsborough, NC 27275
Property Owner (please print: Kandace K. Gotwals
Property Owner (please
The undersigned, registered property owners) of the above property, do hereby authorize
Wildlands Engineering, Inc., Full Delivery Providers, the NC Department of Environment and
Natural Resources, and the US Army Corps of Engineers, their employees, agents or assigns to
have reasonable access to the above referenced property for the evaluation of the property as a
potential stream, wetland and/or riparian buffer mitigation project, including conducting stream
and/or wetland determinations and delineations, as well as issuance and acceptance of any required
permit(s) or certification(s).
Property Owners(s) Address:
(if different from above)
Property Owner Telephone Number: 919-604-2705
Property Owner Telephone Number:
I/We hereby certify the above informafion to be true and accurate to the best of my/our knowledge.
(Property Owner Authorized Signature)
(Property Owner Authorized Signature)
Name of full delivery company
(Date)
(Date)

01TOLOMMNA] •9
LANDOWNERO ' • FORM
PROPERTY LEGAL DESCRITION: %f
Deed Book: �..�CG f ? Page: �2County. C1:
Parcel ID Number:
0
Street Address: C f Ll. /C G
Property Owner (please print):
Property Owner (please print):
The undersigned, registered property owners) of the above property, do hereby authorize
A'z S
Full Delivery Provideri, the NC Departme f Environment and Natural Resources, and the US
Army Corps of Engineers, their employees, agents or assigns to have reasonable access to the above
referenced property for the evaluation of the property as a potential stream, wetland and/or
riparian buffer mitigation project, including conducting stream and/or wetland determinations and
delineations, as well as issuance and acceptance of any required permit(s) or certification(s).
Property Owners(s) Address:
(if different from above)
Property Owner Telephone Number: ! � 7�� � Property Owner Owner Telephone Number: i2 yj`
I/We hereby certi
fy the above information to be true and accurate to the best of my/our knowledge.
iName of fidl delivery company

NORTH CAROLINA ECOSYSTEM ENHANCEMENT PROGRAM
LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: 1587 Page: 34 County: Orange
Parcel ID Number: 9895381829
Street Address: 4416 St. Mary's Road, Hillsborough, NC
Property Owner (please print): Pelham T. and Mary B. Jacobs
The undersigned, registered property owners) of the above property, do hereby authorize
Wildlands Engineering, Inc., Full Delivery Provider, the NC Department of Environment and
Natural Resources, and the US Army Corps of Engineers, their employees, agents or assigns to
have reasonable access to the above referenced property for the evaluation of the property as a
potential stream, wetland and/or riparian buffer mitigation project, including conducting stream
and/or wetland determinations and delineations, as well as issuance and acceptance of any required
permit(s) or certification(s).
Property Owners(s) Address:
if different from above)
Property Owner Telephone Number: 919-619-8105
I/We hereby certify the above information to be true and accurate to the best of my/our knowledge.
(Property OwnerOttrfkorized Signature) (Date)
(Property (Jwner Authorized Signature)
'Name of full delivery company

LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITZON:
Deed Door: 5798
Page: 191
Parcel ID Number: 9895079332
Street Address: St. Mary's Road, Eno, SIC
County: Orange
Property Owner (please print): Bacon Family Farmlands, LLC (Benjamin Johnson, manager)
Property Owner (please print):
The undersigned, registered property owner(s) of the above property, do hereby authorize
Wildlands Engineering, Inc., Full Delivery Provider', the NC Department of Environment and
Natural Resources, and the US Army Corps of Engineers, their employees, agents or assigns to
have reasonable access to the above referenced property for the evaluation of the property as a
potential stream, wetland and/or riparian buffer mitigation project, including conducting stream
and/or wetland determinations and delineations, as well as issuance and acceptance of any required
permit(s) or certification(s).
Property Owners(s) Address: Benjamin Johnson, manager, 24 Saint Andrews Court, Durham, NC
27707
(if different from above)
Property Owner Telephone number: 919-619-2359 (Benjamin Johnson, manager)
Property Owner Telephone Number:
1AVe hereby certify the above information to be true and accurate to the best of mylour knowledge.
ro/z6/JS
(Prope6y Owne Authorized Signature)
(Property Owner Authorized Signature)
'Name of full delivery company
(Date)
(Date)

,. 1IM131101 l
Wildlands Engineering, Inc., Full Delivery Providers, the NC Department of Environment and
Natural Resources, and the US Army Corps of Engineers, their employees, agents or assigns to
have reasonable access to the above referenced property for the evaluation of the property as a
potential stream, wetland and/or riparian buffer mitigation project, including conducting stream
and/or wetland determinations and delineations, as well as issuance and acceptance of any required
permits) or certification(s).
Property Owners(s) Address:
(if different from above)
I/We hereby certify the above information to be true and accurate to the best of y/our knowledge.
'Name of full delivery company
1®'

NORTH CAROLINA ECOSYSTEM ENHANCEMENT PROGRAM
LANDOWNER AUTHORIZATION FORM
PROPERTY LEGAL DESCRITION:
Deed Book: 4798 Page: 258 and 256 County: Orange
Parcel ID Number: 9895476632 and 9895282714
Street Address: St. Mary's Road, Hillsborough, NC
Property Owner (please print): David L. Sheets and Christa A. Riker -Sheets
Property Owner (please print): Donna S. Mayfield and Andrew M. Mayfield
The undersigned, registered property owner(s) of the above property, do hereby authorize
Wildlands Engineering, Inc., Full Delivery Provider', the NC Department of Environment and
Natural Resources, and the US Army Corps of Engineers, their employees, agents or assigns to
have reasonable access to the above referenced property for the evaluation of the property as a
potential stream, wetland and/or riparian buffer mitigation project, including conducting stream
and/or wetland determinations and delineations, as well as issuance and acceptance of any required
permit(s) or certification(s).
Property Owners(s) Address: 5032 Westhaven Lane, Trinity, NC 27370
(if different from above)
104 Summit Wood Ct., Holly Springs, NC 27540
Property Owner Telephone Number: 3364074570
Property Owner Telephone Number: 919-605-0248
re)
'Name of full delivery company
to be true and accurate to the best o m /our knowledge.
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