NCC231345_NOT Signed Certification_20240529

NCGO1 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, 6th Floor
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS 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.: NCC231345
Name of Project: Grier Road Project
Per NC General Statute 143-215.66(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(must match eNOT): Campbells Properties
*Legally Responsible Person (must match eNOT): Larry Campbell
*Title of Legally Responsible Person: Owner
Print Name&Title of Signed if Authorized Individual Differs from Legally Responsible Person:
*Signature: 44.E Date: ,7 1 `f G L/�
7
* 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 NCG010000 permit.
For more information on signatory requirements,see Part IV, Section B, Item (6)of the NCG010000 permit.

Crio
CHARLOTTE.
.
Storm Water Services
Land Development
May 20, 2024
Grading Permit Notice of Termination
Campbells Properties Lic
7327 OLD STATESVILLE RD
CHARLOTTE, NC 28269
Reference: 7320 Grier Rd
Permit Number: LDGP-2023-00065
You or your firm are on record as the owner or financially responsible party for land-disturbing activity at the
subject site covered under the above referenced grading permit number.
Per the completion of your project or your request,the City of Charlotte is closing the grading permit. Any
further land-disturbing activity of one or more acres will require an application for a new grading permit.
If you have any questions or feel the grading permit should remain open, please contact the Erosion Control
Coordinator assigned to your project.
Issued by,
•
James Wilson,CPESC
Erosion Control Administrator