NC0070289_Change in Responsbile Official_20170802

1. CURRENT PERMIT INFORMATION:
N
Permit Number NCO070128/9 or NCGD T T I T
1 Facility Narre RicicewooLd Farm; s Subdivision
11. NEW OWNER/NAME INFORMATION:
1 This request for a na,ne change is a resi:`,t of
a Crlange In ownership cr proper°y1co:npany
Narne change only
X c Omer ,olease expla,n) Change In resonsible o sisal
2 New owner s name �narne to oe put cr, Kermit)
✓ :�i �; V,'i.'r..''r 7�ti
RECEIVEMCDEWWR
AUG - 2 2017
Water Quality
Permitting Section
3 New owners or signung offictal's name and title Wavne Hundev
(Person leually responsible for oeilrnit)
Presi ;ent Stones prow Hor,�teo,dvneis Asso4iation
4_ Mailing address _P 0 Box 69 725 --C Ity Charlotte
Stale-- NC _ Zip Code 25227 Phone (704) .155-5463 _
rriarl adcress (Mr Hurtlev s assistant ,J rlene Hoffecker) verderef Pled) tetzero, net
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION UNLESS ALL OF THE
APPLICABLE ITEMS LISTED BELOW ARE INCLUDED WITH THE SUBMITTAL,
REQUIRED ITEMS
1 This completed application form
2 legal documentation of the transfer of ownership (such as a property deed articles of
incorporation, or sales agreement)
[see r everse side of this page for signature requirements]
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WDES Name & Ownefsnio Change
Page 2 of 2
Applicant's Certification:
1. Wayne Hund attest that this application
for a narne/ownersh[p change has been reviewed and is accurate and complete to the best of
my knowledge. I understand that if all required parts of this application are not completed and
that if all required supporiing information and attachments are not included, this application
package will be returned as incomplete
Signature Date 07/13/2017
President
Stones Throw Homeowners Association
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION & MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDDRESS:
NC DEQ I DWR I NPDES
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Version 712016

Certified List of Officials/Officers/Directors
NAME OF BORROWER:
Stones Throw Homeowners Association of Cabarrus County
MAILING ADDRESS: P 0 BOX 690725 Charlotte NC 28227
PROJECT LOCATION/ADDRESS: Stones Throw HOA
CONTACT PERSON: F W Huntley President
PHONE NUMBER: 704-455-5463
E-MAIL ADDRESS Contacts. Tracy alley222(a@Pmail com or [e-mail]
1. OFFICERS AND DIRECTORS OF GOVERNING BODY
NAME
TITLE
ADDRESS
PHONE NUMBER
TERM
EXPI RATIOI
F.W. Huntley
No email address
President
PO BOX 690725
I Charlotte NC 28227
704-455-5463
2017-2019
Tracy Alley
trac aIle 222 mail com
Vice -President
9748 Knightsbridge Drive
Concord, NC 28025
704-607-3739
2018
Verlene Hoffecker
[e-mail]
Secretary-
Treasurer
PO BOX 690725
Charlotte NC 28227
704-455-5463
2019
CERTIFIED CORRECT BY: rac 111f, , Vice Presiden S o e Throw HOA
SIGNATURE OF OFFICER:
DATE: January 19, 2017 %

Date: t -
Wastewater Branch
Water Quality Permitting Section
Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Delegation of'Signature l�-
Authority ',��--- �{ p
Facility Name: P—� d G�,.�.�Cc �� C' -CA -L S fit-
NPDES Permit Number: _N I C 101 o 1-7 1 "
To Whom It May Concern:
By notice of this letter. I hereby delegate signatory authority to each of the following individuals for all
permit applications, discharge monitoring reports, and other information relating to the operations at
the subject facility as required by all applicable federal, state, and local environmental agencies
specifically with the requirements for signatory authority as specified in 15A NCAC 213.0506.
Individual #I Individual '42 (ifappltcable)
If you have any questions regarding this letter, please feel free to contact me at either the phone
number or email address below.
Sincerely.
Authorized Signi Official's Signature t
Author' Signing Offieial'sN me ttypeorprmt) Title
S 0 t t c, L ( .1 Ck r)--7 n L, (' 11,-, r-1 — -an A t r '-1
Mailing Address
Email Address
Office Phone
Mobile Plione
cc: 1A o Q,r-e Stit t C. Regional Office. hater Quality Permitting Section
(Enter t egion name)
Title:;r-
Mailing Address:
fK, Fck-iI s fir,
Physical Address:
(ifcliffet ent)
Email Address:
Office Phone:
Mobile Phone:
-7 Olt -_(o of _ r1 I �-
If you have any questions regarding this letter, please feel free to contact me at either the phone
number or email address below.
Sincerely.
Authorized Signi Official's Signature t
Author' Signing Offieial'sN me ttypeorprmt) Title
S 0 t t c, L ( .1 Ck r)--7 n L, (' 11,-, r-1 — -an A t r '-1
Mailing Address
Email Address
Office Phone
Mobile Plione
cc: 1A o Q,r-e Stit t C. Regional Office. hater Quality Permitting Section
(Enter t egion name)