NCC190761_NOT Signed Certification_20210610

NCG01 Notice of Termination (NOT) Certification Form
Directions:
Print this form, complete, scan and upload to the electronic NOT (Rescission) form.
Then, mail the original signed form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 61h Floor
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAILTHIS FORM UNTIL YOUR NOT REQUEST HAS BEEN REVIEWED AND APPROVED.
THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE (NOT DIGITAL) [40 CFR 122.22]
General Permit Certificate of Coverage (COC) No.: NCC190761
Name of Project: Penncross
Per NC General Statute 143-215.6B (i), any person who knowingly makes any false statement, representation, or
certification in any application, record, report, plan, or other document filed or required to be maintained under this
Article or a rule implementing this Article ... shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
I, as an authorized representative, hereby request rescission of coverage under the NPDES Stormwater Permit for
the subject facility. I am familiar with the information contained in this request, and to the best of my knowledge
and belief, such information is true, complete, and accurate.
Legally Responsible Organizational Entity: Will Kuhn Homes LLC
*Legally Responsible Person: William Kuhn
Title of Legally Responsible Person:
*Signature: w IJJ b . a�-� Date:
Print Name and Title of Signed (only if authorized individual signing differs from Legally Responsible Person):
* IMPORTANT NOTE: This form must be signed by a responsible corporate officer that owns or operates the
construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is authorized in
accordance with Part IV, Section B, Item (6) of the NCGO10000 permit.
For more information on signatory requirements, see Part IV, Section B, Item (6) of the NCGO10000 permit.

wG reenvi I le
ENGINEERING
Engineering Department-Sedimentation/Erosion Control Program
June 7, 2021
Letter of Final Inspection
Will Kuhn Homes, LLC
2625 Charles Blvd.
Greenville, NC 27858
Re: Project Name: Meadow Woods -Will Kuhn Homes, LLC
Project Number: ESCP-2019-0030
County: Pitt
Disturbed Acreage: 1.76
Responsible Party: Will Kuhn Homes, LLC
Dear Mr. Kuhn,
At your request, this office has completed its final site inspection of the referenced project. We
find the site stable and in compliance with the approved Sedimentation. and Erosion Control
Plan.
Upon issuance of this letter, the referenced Sedimentation and Erosion Control Plan has been
closed for this project.
Please do not hesitate to call if you have any questions.
Respectfully,
John P. Harrell
Civil Engineer 1
Engineering Department
City of Greenville
JHarrell a greenvillenc.gov
www.greenvillene.gov
252-329-4887

Certificate of Coverage
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
GENERAL PERMIT NO. NCG010000
NC Reference No. N0004-2019-0761
Certificate of Coverage No, NCC190761
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and regulations
promulgated and adopted by the North Carolina Environmental Management Commission, and the Federal Water
Pollution Control Act, as amended,
Will Kuhn Homes, LLC
is hereby authorized authorized to discharge stormwater associated with CONSTRUCTION ACTIVITIES to surface waters
of North Carolina from a site located at;
Meadow Woods -Will Kuhn Homes, LLC
Penncross
Greenville
Pitt County
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in N.C. General Permit
No. NCG010000.
This Certificate of Coverage is affiliated with E&SC Plan Project No. ESCP-2019-0030
This Certificate of Coverage shall become effective 6/27/2049,
This Certificate of Coverage shall remain in effect for the duration of the General Permit or until rescinded.
for S. Daniel Smith
Interim Director, Division of Energy, Mineral, and Land Resources
By the Authority of the Environmental Management Commission