20190369 Ver 1_Agent Author Form Signed_20190322

: McGill
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AGENT AUTHORIZATION FORM
PROJECT NAME: Rowan County — Access Road from Julian Road
PROPERTY LEGAL DESCRIPTION: DB:231 PG:7
PARCEL ID. 402C003, 402090
STREEf- ADDRESS: Summit Park Drive and 1455 Julian Road
Salisbury, NC 28144
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Property Owner/Representative: Aaron Church, Rowan Countv
(If Representative) Title: Rowan County Manager
The undersigned, registered property owners of the above noted property, do hereby authorize
John C. Vilas , of McGill Associates P.A.
(Contractor / Agent) (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.
Properry Owner's/Representative's Address (if different than property above):
County Manaaer's OfFice
130 W Innes Street
Salisbury, NC 28144
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the best of our
knowledge. � �-�
Au�horiz�d Signature
Date: �/� � / � ///
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���rz�d Sign ture
Date: � . � `t' o�� � �
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1013 STATE FARM ROAD, BOONE, NORTH CAROLINA 28607 � 828.386.1920 � www.mcgillengineers.com