SW6201202_O&M Agreement Form_20210222

Project Name:
Project Location:
Faithwill Farms Subdivision
Stedman, Cumberland County, North Carolina
Maintenance records shall be kept on the following BMP(s). This maintenance record shall be kept in a log in a known set
location. Any deficient BMP elements noted in the inspection will be corrected, repaired, or replaced immediately. These
deficiencies can affect the integrity of structures, safety of the public, and the pollutant removal efficiency of the BMP(s).
The BMP(s) on this project include (check all that apply & cc
Bioretention Cell Quantity:
Dry Detention Basin
Grassed Swale
Green Roof
Infiltration Basin
Infiltration Trench
Level Spreader/VFS
Permeable Pavement
Proprietary System
Rainwater Harvesting
Sand Filter
Stormwater Wetland
Wet Detention Basin
Disconnected Impervious Area
User Defined BMP
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Quantity:
Present:
Present:
nding O&M tables will
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
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(West Side of Wade -Stedman Rd I
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed
for each BMP above, and attached O&M tables. I agree to notify NCDENR of any problems with the system or prior to any
changes to the system or responsible party.
* Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Email:
Signature:
County of
personally appeared before me this
Ben Stout
Registered Agent - Stout Land Development, LLC
409 Chicago Drive - Suite 103
Fayetteville, NC 28306
910-779-0019
[e-mail]
, a Notary Public for the State of
, do hearby certify that
day of
acknowledge the due execution of the Operations and Maintenance Agreement .
Witness my hand and official seal,
Date:
:Tit:
STOSZ
Version 1.4
My commission expires
2/22/2021
Page 1 of 3

Witness my hand and official seal,
STO$Z My commission expires
Version 1.4 O&M Manual
aur�� iuvvicuyc a is uuc cncuuuu11 vI a is vNci auu110 aI iu iviau ncI IUI Ia.
Witness my hand and official seal,
STO$Z My commission expires
Version 1.4 O&M Manual
aur�� iuvvicuyc a is uuc cncuuuu11 vI a is vNci auu110 aI iu iviau ncI IUI Ia.
Witness my hand and official seal,
STO$Z My commission expires
Version 1.4 O&M Manual
aur�� iuvvicuyc a is uuc cncuuuu11 vI a is vNci auu110 aI iu iviau ncI IUI Ia.
Witness my hand and official seal,
STO$Z My commission expires
Version 1.4 O&M Manual
aur�� iuvvicuyc a is uuc cncuuuu11 vI a is vNci auu110 aI iu iviau ncI IUI Ia.
Witness my hand and official seal,
2/22/2021
Page 1 of 3
2/22/2021
Page 1 of 3
2/22/2021
Page 1 of 3
2/22/2021
Page 1 of 3
STO$Z
Version 1.4
My commission expires
2/22/2021
Page 1 of 3

Witness my hand and official seal,
STO$Z My commission expires
Version 1.4 O&M Manual
aur�� iuvvicuyc a is uuc cncuuuu11 vI a is vNci auu110 aI iu iviau ncI IUI Ia.
Witness my hand and official seal,
STO$Z My commission expires
Version 1.4 O&M Manual
aur�� iuvvicuyc a is uuc cncuuuu11 vI a is vNci auu110 aI iu iviau ncI IUI Ia.
Witness my hand and official seal,
STO$Z My commission expires
Version 1.4 O&M Manual
aur�� iuvvicuyc a is uuc cncuuuu11 vI a is vNci auu110 aI iu iviau ncI IUI Ia.
Witness my hand and official seal,
STO$Z My commission expires
Version 1.4 O&M Manual
aur�� iuvvicuyc a is uuc cncuuuu11 vI a is vNci auu110 aI iu iviau ncI IUI Ia.
Witness my hand and official seal,
2/22/2021
Page 1 of 3
2/22/2021
Page 1 of 3
2/22/2021
Page 1 of 3
2/22/2021
Page 1 of 3
STO$Z
Version 1.4
My commission expires
2/22/2021
Page 1 of 3