SW7160803_Change of Permittee Information_20240709

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Date Received Fee Paid Permit Number
STATE STORMWATER:
PERMIT INFORMATION UPDATE APPLICATION FORM
There is NO FEE for updating project name or permittee information.
This form is to only to be used by the current permittee to notify the Division of:
1) changes to the Point of Contact(signing official) for the current permittee (LLC, Corporation, HOA or POA);
2) changes to the mailing address, phone number or email address of the current permittee;
3) changes to the name of the project; and
4) changes to the legal corporate name as documented by a Name Change or Merger filed with the NCSOS.
A. NEW PERMIT INFORMATION
State Stormwater Permit Number: SW7160803
Are you updating
(check all that apply): If so, please provide the updated information:
❑ Project name
❑Corporation Name'
® Permit Contact Name2,3 JESSIE HEDRICK
® Permit Contact Title SVP BRANCH FACILITY MANAGEMENT
Mailing Address3 PO BOX 26807, RALEIGH NC, 27611
® Phone number 919-856-3340
® Email address FACILITIESMANAGEMENTCa)NCSECU.ORG
' Provide documentation such as a Name Change/Merger filed with the NCSOS.
2 Provide supporting documentation such as NCSOS filing. The permit contact's position must be in accordance
with 15A NCAC 02H .1040(1).
3 If more than one point of contact or mailing address is being changed, please attach a separate sheet.
B. CERTIFICATION OF PERMITTEE
I, JONATHAN CRANE , the current permittee, hereby notify
DEMLR that I am making the changes as listed in Section A above. I further attest that this application for an update to the
permit information curtly on file is accurate and complete to the best of my knowledge.
Signature: Wei Date: -7 !81 Le)Ly
I, Joseph Bradley , a Notary Public for the State of North Carolina
County of Wake , do hereby certify that j 0,., a rrlq,J C.-rziwc
personally appeared before me this the 61-" day of J u Y , 20 2H , and acknowledge the due
execution of the forgoing instrument. Witness my hand and official seal,
(Notary Seal) �.•. QN B
•
Notary Signature ;...,y
My commission expires al i 6 Ito ze qA-,CO IAA .‘`��`
Stormwater Permit Information Update Form Pane 1 of 1 nnn., „ •)n17

State Employees' Credit Union
Facilities Services
May 13,2024
Jim Farkas, PE
North Carolina Department of Environmental Quality
512 North Salisbury Street
1612 Mail Service Center
Raleigh, NC 27699-1612
Dear Mr. Farkas,
Please allow this letter to serve as confirmation of Jessie Hedrick's position as the Senior Vice
President of Facilities Management at State Employees'Credit Union.As part of her
responsibilities as they relate to this position, Jessie has the authority to sign stormwater
retention permits and renewals on behalf of State Employees'Credit Union.
Sincerely,
onathan Crane
Associate EVP, Property Management
State Employees'Credit Union
Billing Address: • P.O.26807 • Attn:Facilities Services• Raleigh,NC 27611
Street Address: 4401 Creedmoor Road • Attn: Facilities Services • Raleigh,NC 27612 • 919-856-3340
www.ncsecu.org
Equal Opportunity Employer—vets, disability