WQ0000731_Signature Authority_20220808

DATE CJ5? v
Division of Water Resources
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Permit No. WQ00####g
Signature Authority Designation ea
FACILITt 5iCie— 1
PERMIT TYPE System rr�
COUNTY Count_yrltAt l(ry I VA7�Lg
To Whom It May Concern: / ,A
As an appropriate signing official for �-�7 �� r �' � ("� (cityltown o �,({';ify
business name) as designated by 15A NCAC 2T .0106, I hereby dele ate authority to sign and certify allAr
permit applications, reports or other permit related documents to the following staff for the following C:49LCL!
permit types (sewer, spray, land application) and/or permit numbers: e4
Position
Person
Currently in
Position
Permit Tyke
or Permit
Number
If you have any questions, please contact me at the following: l
Permittee/Applicant name (pl se print):
Title: L Sit bt7-7 rE - C a rI -or
Complqe1nailinR address: &-cT -7 4t-
City: State: /�/ �_ Zip:
Telephone number: ( } , - D Facsimile number: ( )
ely,
signature