WQ0018992_Signature Authority_20230530

DocuSign Envelope ID: 6EA89FF6-AACD-4800-92EE-1126308AFA03
DATE
Division of Water Resources 5�6 kv-3
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Signature Authority Designation
To Whom It May Concern:
As an appropriate signing official for 55UUMIA1406 40A (city/town/
county 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
Person
Currently in
Position
Permit Type
or Permit
Number
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If you have any questions, please contact me at the following:
Permittee/Applicant name (please print):
Title: SSaGi �F'ri�� 10,0 i4 L64
Complete mailing address:
City: ,ATL.A.Alt State: N L Zip: Z13 TrL
Telephone number: (252j '� 0VLL Email: b Q"`�'`'• c'M
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SW HOA President
signature