SW3220302_As-Built - Certification_20240403 (3)

Post-Construction Stormwater Management
Permit No. SW3220302
AS-BUILT PERMITTEE CERTIFICATION
I hereby state that I am the current permittee for the project named above, and I certify by my
signature below, that the project meets the below listed Final Submittal Requirements found in NCAC
02H.1042(4) and the terms, conditions and provisions listed in the permit documents, plans and
specifications on file with or provided to the Division.
_ Check here if this is a partial certification. Section/phase/SCM #?
_ Check here if this is part of a Fast Track As-built Package Submittal. _
•
Printed Name Julian Wilson Signature
I, 6 • �d rid� , a Notary Public in the State of SCUM Caro/0 a
County of IZl GA!Znd . do hereby certify that 1.nt/1 an Wi/Sar►
personally appeared before me this 3151 day of Sa.n u47 , 20 02 4
and acknowledge the due execution of this as-built certification. ,,��••.•`,',P,B E,,ppkA""L)
Witness hynd a d officials al ra' G�o1�RY pG.;9�'z.,
,, ) 1 i
My commission expires 7/ia/e053 _ j •
Permittee's Certification NCAC .1042(4) '•,, ,• ' ` mpleted/ N/A
4,, „••cA•p Na,„ Provided
A. DEED RESTRICTIONS/ BUA RECORDS
1. The deed restrictions and protective covenants have been recorded Y or N ��
and contain the necessary language to ensure that the project is
maintained consistent with the stormwater regulations and with the
permit conditions.
2. A copy of the recorded deed restrictions and protective covenants Y or N Wfil
has been provided to the Division.
3. Records which track the BUA on each lot are being kept. (See Note Y or N �
1) /
B. MAINTENANCE ACCESS
1. The SCMs are accessible for inspection, maintenance and repair. or N
2. The access is a minimum of 10 feet wide. Y or N
3. The access extends to the nearest public right-of-way. or N
C. EASEMENTS
1. The SCMs and the components of the runoff collection /conveyance Y or N
system are located in recorded drainage easements.
�1/I�
2. A copy of the recorded plat(s) is provided. Y or N AJ)-A
D. SINGLE FAMILY RESIDENTIAL LOTS- Plats for residential lots that Y or N
have an SCM include the following:
1. The specific location of the SCM on the lot. Y or N %
2. A typical detail for the SCM. Y or N WM
3. A note that the SCM is required to meet stormwater regulations and
that the lot owner is subject to enforcement action as set forth in Y or N ���
NCGS 143 Article 21 if the SCM is removed, relocated or altered
without prior approval.
E. OPERATION AND MAINTENANCE AGREEMENT Y or N
1. The O&M Agreement is referenced on the final recorded plat. (?)or N
2. The O&M Agreement is recorded with the Register of Deeds and Y®or N
a•pears in the chain of title.
F. OPERATION AND MAINTENANCE PLAN—maintenance records are
being kept in a known set location for each SCM and are available for Y®or N
review.
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Post-Construction Stormwater Management
Permit No. SW3220302
G. DESIGNER'S CERTIFICATION FORM— has been provided to the y�or N
Division.
Note 1- Acceptable records include ARC approvals, as-built surveys, and county tax records.
Provide an explanation for every requirement that was not met, and for every "N/A" below. Attach
additional sheets as needed.
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