20190211 Ver 1_Agent Authorization_20190215

AGENT AUTHORIZATI4N FORM
nat� 9/7/2018
NCDOT Project #:
U-5S75 AIlen Road Widening, Greenville, Pitt County
Name of Property Owner Applying for Permit:
NCDOT Hi�hwav Division 2
Mailing Address:
1037 W.H. Smith Blvd, Greenville NC 27835
[phone]
I certify that I have authorized (agent) SEPI En ineerin — Susan Westbe to act on my
behalf and take a�! actions necessary for the processing, issnance a�d acceptance of this
permit or certifcation and any and all standard and special conditions attached.
This cer�ifca�ia� is valid �hru {date) 9/7/2019
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Owner Sign�#ure
Date