WQ0022725_Signature Authority_20220902

FOXV-4 5
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 _-5`t� .& (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:
Persoa Permit Tvw
Position I CnUM& in I or Permft
NL
If you have any questions, please contact me at the following:
Permittee/Appli•ant name (please print): leu tee _
Title:
Complete mWizrp address: tkc!vL L�
City. 4J State: &i, Zip:
Telephone er: () - Facsimile number.
Sincerely,
signature