WQ0004115_Signature Authority_20220322

DATE
Division of Water Resources
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
To Whom It May Concern:
Subject: Permit No. WQ00#####
Signature Authority Designation
FACILITY
PERMIT TYPE System
COUNTY County
As an appropriate signing official for Champion Hills
(city/town or business name) as designated by 15A NCAC 2T .0106, I hereby delegate authority to sign
and certify all permit applications, reports or other permit related documents to the following staff for the
following permit types (sewer, spray, land application) and/or permit numbers:
Position
Assistant
Superintendent
Person
Currently in
Position
Karl Griffiths
Permit Type
or Permit
Number
WQ0004115
If you have any questions, please contact me at the following:
Permittee/Applicant name (please print): Karl Griffiths, Champion Hills Club_
Title: Assistant Superintendent
Complete mailing address: 5 Pine Shadow Drive
City: Hendersonville
State: N.C. Zip: 28739
Telephone number: ( 828 6961962_) Facsimile number: (
signature