20191315 Ver 1_2019-09-12 SIGNED - Agent Authorization Form_20190927

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO.
PLAN NO. PARCEL ID: 0721-00-5973
STREET ADDRESS: Greybeard Trail, Montreat, NC
Please print:
Property Owner:
Property Owner:
Town of Montreat
The undersigned, registered property owners of the above noted property, do hereby authorize
Michael J. Cain. P.E. of Civil Design Concepts, PA
(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.
Property Owner's Address (if different than property above):
PO Box 423, Montreat. NC 28757. Attn: Alex Carmichael. Town Administrator
Telephone: _ 828-669-8002, e
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Date: -A/ /L/ Z!7-6 I C(
Authorized Signature
Date: