Status 403: The request is not authorized to perform this operation using this permission
Here is a sample of code that might throw this error in which the startsOn value is set to the current time:
Before you start double checking all of the user permissions in Azure and going through all the Access Control and Role Assignments in Blob Storage (assuming you do have them configured correctly), this might be a red herring for a different issue with the startsOn value for the call to GetUserDelegationKeyAsync(). The problem is likely with clock skew and differences in times from the server and client.
It is documented in SAS best practices from the Azure docs (found here), the following issue with clock skew and how to remedy the issue:
Be careful with SAS start time. If you set the start time for a SAS to the current time, failures might occur intermittently for the first few minutes. This is due to different machines having slightly different current times (known as clock skew). In general, set the start time to be at least 15 minutes in the past. Or, don't set it at all, which will make it valid immediately in all cases. The same generally applies to expiry time as well--remember that you may observe up to 15 minutes of clock skew in either direction on any request. For clients using a REST version prior to 2012-02-12, the maximum duration for a SAS that does not reference a stored access policy is 1 hour. Any policies that specify a longer term than 1 hour will fail.
There is a simple fix for this as instructed to modify the startsOn value to be either not set or 15 minutes (or greater) in the past. With this updated code, the 403 error is fixed and will proceed as expected.