WQ0039181_Signature Authority_20230807

Division of Water Resources
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
August 7, 2023
Subject: Signature Authority Designation
To Whom It May Concern:
As an appropriate signing official for � L O) ICI- �C' ii U S %1tJ'/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
Currentiv in
Position
Permit TYve
or Permit
Number
PS a c/ c11111rA
If you have any questions, please contact me at the
e following:
Permittee/Applicant name (please print):
Title:T�
s
Complete mailing address:
Cit}: za'j State: _A& Zip: �z
Telephone number: (10 y�� — ! ib Z Email: � � r�� C1 l' C1�' �j
Sincerely,
signature