20180250 Ver 1_More Info Received_20180327

Q'('C I "J
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT No: 260 —,PLAN No..
PARCEL ID: 1713386324
STREET ADDRESS: 1417 Battery Drive, Raleigh, INC27610
.Please 0drit:
Prope'rty'.0wher: CJ Properties and Investments LLC
Property .0wher: Patrick Teen, member of Cj'Propprties and- Investments LLC
The undersigned, registered propertyproperty, do hereby authorize
owners of. the above noted..
Tony PattersonOf Patterson Custom Builders LLC.
(Contractor / Age I nt) (Name of consulting firm)
to -act on my behalf:and take all actions,mecessary for the processing, issuance and acceptance of
this permit or certification and, any and all."standard, and special coMi.bohsattached.
Property'Owner's Address (If:different than property above),
,208 W Wilbrook Road, Raleigh, NC 27609
919-740-8722
DileWehere�yCertify the above information submitted in this��6t)plication is true andaccurate to the
i
best,of our knowledge.
Ap(horiz6d Sigriature