Annual Certification Form for the North Carolina Post-Construction Stormwater Program

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2.1 Permittee is no longer associated with the permit:

Please be aware of the following actions required prior to completing and submitting this Annual Certification Form. (Do not save a draft or the form will not revise with new information after changes made on our end.)

Per the conditions of the post-construction permit, if the Current Permittee is a different entity than the one that the permit was originally issued to, a complete Transfer Application must be submitted to the Division. This Transfer Application form is available on this website. Rules governing the transfer process can be found in 15A NCAC 02H .1045.

Permittee Updates: Completed update forms should be sent to the DEMLR office that issued the permit (Attn: Stormwater Program). For permits issued in coastal counties, Wilmington and Washington Regional Office address information is here. For non-coastal counties, Central Office address information is here.

2.2 Permittee Signing Official name or contact information is not correct:

Please be aware of the following actions required prior to completing and submitting this Annual Certification Form. (Do not save a draft or the form will not revise with new information after changes made on our end.)

Per the conditions of the post-construction permit, the Permittee must submit a complete Permittee Information Update Form to the Division for any changes to the Permittee name (for changes in name only, not for a change in the entity that is the Permittee) or Permittee contact information. That Update form is available on this website. The project name must be updated before this Annual Certification Form can be completed and submitted.

Permittee Updates: Completed update forms should be sent to the DEMLR office that issued the permit (Attn: Stormwater Program). For permits issued in coastal counties, Wilmington and Washington Regional Office address information is here. For non-coastal counties, Central Office address information is here.

Use 'Add' link above to add other Additional Permittee names

>>> 3 For guidance on what you need to do, answer the question below <<<

3.1 Additional Permittee is no longer associated with the permit:

Please be aware of the following actions required prior to completing and submitting this Annual Certification Form. (Do not save a draft or the form will not revise with new information after changes made on our end.)

Per the conditions of the post-construction permit, if the Current Permittee is a different entity than the one that the permit was originally issued to, a complete Transfer Application must be submitted to the Division. This Transfer Application form is available on this website. Rules governing the transfer process can be found in 15A NCAC 02H .1045.

Additional Permittee Updates: Completed update forms should be sent to the DEMLR office that issued the permit (Attn: Stormwater Program). For permits issued in coastal counties, Wilmington and Washington Regional Office address information is here. For non-coastal counties, Central Office address information is here.

3.2 Additional Permittee Signing Official name or contact information is not correct:

Please be aware of the following actions required prior to completing and submitting this Annual Certification Form. (Do not save a draft or the form will not revise with new information after changes made on our end.)

Per the conditions of the post-construction permit, the Permittee must submit a complete Permittee Information Update Form to the Division for any changes to the Permittee name (for changes in name only, not for a change in the entity that is the Permittee) or Permittee contact information. That Update form is available on this website. The project name must be updated before this Annual Certification Form can be completed and submitted.

Additional Permittee Updates: Completed update forms should be sent to the DEMLR office that issued the permit (Attn: Stormwater Program). For permits issued in coastal counties, Wilmington and Washington Regional Office address information is here. For non-coastal counties, Central Office address information is here.

It is not necessary to add each individual lot owner into this form unless that is how the permit is explicitly written (very rare). Please enter the Homeowners Association (HOA) information for the Property Owner information.

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4.1  Property was sold or transferred:

Please be aware of the following actions required prior to completing and submitting this Annual Certification Form. (Do not save a draft or the form will not revise with new information after changes made on our end.)

Per the conditions of the post-construction permit, if the Property Owner is a different entity than the one that the permit was originally issued to or included as a Co-permittee, a complete Transfer Application must be submitted to the Division. This Transfer Application form is available on this website. Rules governing the transfer process can be found in 15A NCAC 02H .1045.

Property Owner Updates: Completed update forms should be sent to the DEMLR office that issued the permit (Attn: Stormwater Program). For permits issued in coastal counties, Wilmington and Washington Regional Office address information is here. For non-coastal counties, Central Office address information is here.

4.2 Property Owner Signing Official name or contact information is not correct:

Please be aware of the following actions required prior to completing and submitting this Annual Certification Form. (Do not save a draft or the form will not revise with new information after changes made on our end.)

Per the conditions of the post-construction permit, the Permittee must submit a complete Permittee Information Update Form to the Division for any changes to the Property Owner Signing Official name (for changes in name only, not for a change in the entity that is the Permittee) or Property Owner contact information. That Update form is available on this website. The project name must be updated before this Annual Certification Form can be completed and submitted.

Property Owner Updates: Completed update forms should be sent to the DEMLR office that issued the permit (Attn: Stormwater Program). For permits issued in coastal counties, Wilmington and Washington Regional Office address information is here. For non-coastal counties, Central Office address information is here.

>>> 5 For guidance on what you need to do, answer the question below <<<

5.1  Additional Property Owner's Property was sold or transferred:

Please be aware of the following actions required prior to completing and submitting this Annual Certification Form. (Do not save a draft or the form will not revise with new information after changes made on our end.)

Per the conditions of the post-construction permit, if the Property Owner is a different entity than the one that the permit was originally issued to or included as a Co-permittee, a complete Transfer Application must be submitted to the Division. This Transfer Application form is available on this website. Rules governing the transfer process can be found in 15A NCAC 02H .1045.

Property Owner Updates: Completed update forms should be sent to the DEMLR office that issued the permit (Attn: Stormwater Program). For permits issued in coastal counties, Wilmington and Washington Regional Office address information is here. For non-coastal counties, Central Office address information is here.

5.2 Additional Property Owner Signing Official name or contact information is not correct:

Please be aware of the following actions required prior to completing and submitting this Annual Certification Form. (Do not save a draft or the form will not revise with new information after changes made on our end.)

Per the conditions of the post-construction permit, the Permittee must submit a complete Permittee Information Update Form to the Division for any changes to the Property Owner Signing Official name (for changes in name only, not for a change in the entity that is the Permittee) or Property Owner contact information. That Update form is available on this website. The project name must be updated before this Annual Certification Form can be completed and submitted.

Property Owner Updates: Completed update forms should be sent to the DEMLR office that issued the permit (Attn: Stormwater Program). For permits issued in coastal counties, Wilmington and Washington Regional Office address information is here. For non-coastal counties, Central Office address information is here.

I, , also certify that, since the project is not currently in conformance with all of the permitting conditions, the permittee, , will perform the corrective actions within the stipulated timeframes as outlined in Section E.