The Entity below hereby serves its Notice of Intent to the Michigan Department of Environment, Great Lakes, and Energy, Materials Management Division, to accept or decline the role of County Approval Agency and the responsibility to prepare and implement a Materials Management Plan as provided by Part 115, Solid Waste Management, of the Natural Resources and Environmental Protection Act, 1994 PA 451, as amended, and its administrative rules.

This form cannot be saved or reopened, and should be completed and submitted in a single session. Please contact EGLE-MMP@Michigan.gov with any questions.

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* 1. County Name:

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* 2. Entity Name:
*County BOC; Regional Planning Agency; or Authorized Municipality

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* 3. Name of Authorized Signer:
*Name of highest official representative such as the BOC chairperson, Regional Executive Director, appointed entity acting on behalf of municipalities, or an authorized representative.

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* 4. Title of Authorized Signer:

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* 5. Accept or Decline County Approval Agency (CAA) responsibilities?

T