Appointment of Agent - Signed09/14
Please note that for quasi-judicial proceedings, either the land owner or an attorney must be present for
the case at the public hearing.
The undersigned owner does hereby appoint an authorized the agent described herein as their exclusive agent
for the purpose of petitioning New Hanover County for a variance, special use permit, rezoning request, and/or
an appeal of Staff decisions applicable to the property described in the attached petition. The Agent is hereby
authorized to, on behalf of the property owner:
1. Submit a proper petition and the required supplemental information and materials
2. Appeal at public meetings to give representation and commitments on behalf of the property owner
3. Act on the property owner’s behalf without limitations with regard to any and all things directly or
indirectly connected with or arising out of any petition applicable to the New Hanover County Zoning
Ordinance.
Agent Information Property Owner(s) Subject Property
Name Owner Name Address
Company Owner Name 2 City, State, Zip
Address Address Parcel ID
City, State, Zip City, State, Zip
Phone Phone
Email Email
Application Tracking Information (Staff Only)
Case Number Reference: Date/Time received: Received by:
This document was willfully executed on the __________ day of ___________________ , 20__________.
_______________________________________ __________________________________________
Owner 1 Signature Owner 2 Signature
NEW HANOVER COUNTY
PLANNING & LAND USE
AUTHORITY FOR
APPOINTMENT OF AGENT
230 Government Center Drive
Suite 110
Wilmington, NC 28403
910-798-7165 phone
910-798-7053 fax
www.nhcgov.com
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Print FormDocuSign Envelope ID: 6A9A8366-798D-4FFC-9B05-9BF816BBACEE
5/2/2022 | 3:47 PM ADT