NCC192065_NOT Signed Certification_20230815

NCGO1 Notice of Termination (NOT) Certification Form
Directions:
Print this form, complete, scan and upload to the electronic NOT(Rescission)form.
Then, mail the original signed form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral& Land Resources Stormwater Program
512 N.Salisbury Street, 6th Floor
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS FORM UNTIL YOUR NOT REQUEST HAS BEEN REVIEWED AND APPROVED_
THEFORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE[NOT DIGITAL) [40 CFR 122.221
General Permit Certificate of Coverage (COC) No.: G C , `A 4-0{o S
Name of Project: 0c Z 'S rtR__Ar\ a ; , s , o —
Per NC General Statute 143-215.68(i), any person who knowingly makes any false statement, representation, or
certification in any application, record, report, plan, or other document filed or required to be maintained under this
Article or a rule implementing this Article. . . shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars($10,000).
Under penalty of law, I certify that:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for
the subject facility. 1 am familiar with the information contained in this request, and to the best of my knowledge
and belief, such information is true, complete, and accurate.
Legally Responsible Organizational Entity: `JJ \� f L—�--�--
*Legally Responsible Person -PNt \'l 0CA
Title of Legally Re onsible Person: u t i i t St 6:4-e An+
*Signature: Date:
Print Name and Title of Signe only if authorized individual signing differs from Legally Responsible Person):
P164L1.) T42 L„is,9,1 0- -
* IMPORTANT NOTE: This form must be signed by a responsible corporate officer flfat owns or operates the
construction activity,such as a president,secretary, treasurer, or vice president, or a manager that is authorized in
accordance with Part IV, Section B, Item(6)of the NCG010000 permit.
For more information on signatory requirements, see Part IV, Section B, item (6)of the NCG010000 permit.

DowSign Envelope ID; 8717260E-A412-4F48-AAC7-DE3982060D5F
CONSENT RESOLUTION APPOINTING AUTHORIZED SIGNATORY
WJH LLC
Effective Date—January 1, 2023
The undersigned, on behalf of the Designated Officer (the "Officer") of WJH LLC, a
Delaware limited liability company (the "Company"), pursuant to the provisions of the
Delaware Limited Liability Company Act, hereby adopts and approves, by unanimous written
consent, the following resolution and each and every action effected thereby:
APPOINTMENT OF AUTHORIZED SIGNATORY
WHEREAS, the Officer has the authority to act on behalf of the Company; and
WHEREAS, the Officer desires to appoint persons authorized to sign documents on
behalf of the Company.
NOW, THEREFORE BE IT:
RESOLVED, that the following person is hereby appointed as an authorized signatory
for the Company ("Authorized Signatory"):
Matt Johnson,Division Manager,Mid-Atlantic Region
RESOLVED, that such Authorized Signatory is hereby authorized to sign, without the
need for other signatures,any Building Documents("Documents"), including but not
limited to HUD 92541 Builders certifications,HUD 92544 Warranty of Completions,
HUD NPMA 99A Termite Protection Builder's Guarantees and CABO Safe Drinking
Water Certifications, including any associated,ancillary or incidental Documents;
RESOLVED, that such Authorized Signatory is hereby authorized to sign, without the
need for other signatures, any contract amendments not exceeding $5,000.00 in the
sales price or concessions;
RESOLVED, that such Authorized Signatory is hereby authorized to designate or
delegate such tasks and duties, which are included within the scope of Signatory's
employment responsibilities, to Employees of Company as he deems necessary and
proper to effectuate and handle the affairs and business of the Company, pursuant to
terms of this Resolution;
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DocuSign Envelope ID: 8717260E-A412-4F48-AAC7-DE3882060D5F
RESOLVED,that the execution of any Document on behalf of the Company by such an
Authorized Signatory shall conclusively establish the approval by the Company and
the Officer of the terms, conditions, execution, delivery and performance of such
executed document; and
RESOLVED, that all such related Documents signed by Authorized Signatory prior to the
Effective Date are hereby retroactively approved;
RESOLVED, that this Consent may be executed in counterparts and each such
counterpart shall be deemed to be an original, but all such counterparts together
constitute but one and the same agreement. Delivery of the executed signature pages
by facsimile transmission or in "portable document format" via electronic mail shall
constitute effective and binding execution and delivery of each such signature page.
IN WITNESS WHEREOF, the undersigned has executed this Consent Resolution effective
as of the Effective Date set forth above.
COMPANY: WJH LLC,
a Delaware limited liability company
,—DocuSIgncd by:
By: nuff
Gregory W. Hutt
Title: President
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