NCC201777_NOT Closeout Documents_20210809

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`'.z kson County Office of Permitting & Code Enforcement
' www jacksonnc.org/code-en orcement.httnl
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- - Sylva Office:538 Scotts Creek Road Suite 205,-Phone [phone]/Fax [phone]
Cashiers Orce: 357 FrankAllen Road,Suite 145,Phone:[phone]Fax [phone]
CERTIFICATE OF COMPLIANCE
FOR SOIL EROSION AND SEDIMENT CONTROL
Project: WRGC 540 Radio Tower 19-117
Location: 928 Rufus Robinson Road
Person Financially Responsible: Roy Burnette
Mailing Address: 928 Rufus Robinson Raad
City/State/Zip: Sylva, NC 28779
On the above referenced project, this letter certifies that the land disturbing
activity on the approved plan has been completed and the temporary
and/or permanent erosion control measures shown on the approved plan
have been constructed and the site has been satisfactorily stabilized except
for routine maintenance requirements. With this compliance statement, K
Jackson County is hereby released from monitoring the enforcement of the
Sediment Control Ordinance on the above referenced project. 7"Spoj ect
clel= re u%re>_a surer r `orcl;' Date: 3/2021
Dann Lewis
Land Development Administrator,Jackson County, NC
F

g°"cQiyh� Jackson County Office of Permitting& Code Enforcement�4G
Tony Elders, Director/Phone: [phone]/ton elders ,,lacksonna or g
y Sylva Office:538 Scotts Creek Road,Phone. [phone]/Fax: [phone]
o Gppo`�� Cashiers Office: 357 Frank Allen Road,Phone: [phone]/Fax: [phone]
Project: WRGC 540-AM TOWER River basin. Little Tennessee
Project Number: 19-1,1.7 Parcel Identification Number: _7632-44-1567-
Person Financially Responsible: I_BURNETTE.ROY -
Address:1 928 RUFUS ROBINSON RD SvIvaNC 28779
1. Project Location:)_928 RUFUS ROBINSON RD
Pictures: No® Yes❑ Prints: ❑ Slides: ❑ Digital: ❑ Video: ❑
2. Weather&Soil Conditions:_Cold/Damn
3. Is there a stream on the property? No® Yes❑ Stream Classification: � �
4. Is the site currently under notice of violation? No® Yes❑
5. Is the site in compliance with the S.P.C.A.and the rules? YesN No❑ If no,check violations below:
6. VIOLATIONS:Violations of applicable sections of Chapter 10:Jackson County Code of Ordinances-
Environmental;Article VI-Erosion and Sediment Control,(herein,"the Ordinance")and North Carolina rules
and regulations. An"X"will be placed in front of the violations existinn on your site.
❑ a. No approved plan,Sec.5.3.4,h(i)of the Ordinance ❑ g. Inadequate buffer zone,Sec.5.3.7,a(i)of the
and G.S. I I3A-57(4)and 15A NCAC 413.0107(c) Ordinance and G.S. 113A-57(1)
❑ b. Failure to follow approved plan, Sec. 5.3.4,h(i)of the ❑ h. Graded slopes and fills too steep,Sec.5.3.7,a(ii)of
Ordinance and G.S. 113A-57(5) the Ordinance and G.S. 113A-57(2)or 15A NCAC
4B.0124(d)
❑ c. Failure to submit revised plan,Sec.5.3.4,f,i(1)of the ❑ i. Unprotected exposed slopes,Sec.5.3.7,a(ii)of the
Ordinance and G.S. I I3A-54.1(b)and 15A NCAC Ordinance and G.S. 113A-57(2)
4B.0118(a)
❑ d. Failure to provide adequate groundcover,Sec. 5.3.7,a ❑ j. Failure to maintain erosion control measures,Sec.
(iii)of the Ordinance and G.S. 113A-57(3)and 15A 5.3.10 of the Ordinance and 15A NCAC 4B.0113
NCAC 4B.0107 or 15A NCAC 4B.0I24(e)
❑ e. Insufficient measures to retain sediment on site,Sec. ❑ k. Failure to self-inspect G.S. 113A-54.1(e)and 15A
5.3.8 of the Ordinance and G.S. I I3A-57(3) NCAC 413.0131
❑ f. Failure to take all reasonable measures,Sec. 5.3.4(m) ❑ 1. Other(describe) _.
of the Ordinance and 15A NCAC 4B.0105
7. NPDES Permit Violation? Yes:❑ No:N Describe.
8. Has sedimentation damage occurred since last inspection?Yes:❑ No:N First Inspection:❑
If yes,mark all that apply:
Lake/natural watercourse on the tract:❑ Lake/natural watercourse off tract:❑ Other property:❑
Description:...- _
Degree of damage: Slight:❑ Moderate:❑ Severe:❑
-._..rv.. _ _.._._.. _,----- .._H. ,. -- __. ,_ - _u_-,_-.
Contact made with:�
No one on site _ _ Title:
Inspection report given:❑ or sent❑ to person financially responsible. Date given/sent: 2/2/2021
9. Corrective actions needed: There are no erosion control issues on site.
10. Comments: Work has been completed according to the approved plan and the site has been satisfactorily stabilized
except for routine maintenance requirements. A Certificate of Compliance(COC)for the project is attached and,
with this compliance statement,our office is hereby released from monitoring the property for compliance with the
Sediment Control Ordinance.
Report by.1 Danny Lewis Others present:
Date of Inspection:2/3/2021 Time of inspection: 1:30pm
Cc:928 RUFUS ROBINSON RD

NUT Request Form - Construction Stormwater
NCG01 or NCG25
NORTH CAROLINA This form is to request Notice of Termination(NOT)for a existing coverage under the NC NPDES Stormwater
EnvtronmeatalQuality General Permit for Construction Activities
Certificate of NCC201777
Coverage(COC) No.* Enter the Certificate of Coverage Number(Use capital letters)
Information associated with this permit:
Project Name WRGC 540 AM New Tower
Address 928 Rufus Robinson Road, Sylva, NC
County Jackson
Latitude 35.3916
Longitude -83.2484
Permittee Listed Five Forty Broadcasting Company LLC
Legally Responsible Roy Burnette
Individual
NC Reference No. NCG01-2020-1777
E&SC Plan ID 19-117
Original NOI Tracking 24890
No.*
Date COC Issued* 05/01/2020
Prior Rescission Date This field will populate only if COC has already been rescinded.
Reason for Rescission/Termination Request:
Reason for Project Closed-Out
Termination of Sale(Another Owner/Operator obtained new COC)
Coverage* Mistake or Invalid Coverage
Other
Addional Explanation More information about the basis of this request,if needed.

For Project Close-out, you must provide documentation below. Please note, a Certificate of Occupancy
is not sufficient close-out documentation. You must provide a final inspection report or correspondence
from the authority that approved the E&SC Plan.
Final Close-out 2/3/2021
Inspection Approval*
Project Close-out EROSION CONTROL01792520210805092659.pdf 78.5KB
Approval Must be PDF format
Documentation*
North Carolina General Statute 143-215.613 (i) provides that:
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;or who knowingly makes a false statement of a material
fact in a rulemaking proceeding or contested case under this Article;or who falsifies,tampers with,or knowingly renders inaccurate any recording
or monitoring device or method required to be operated or maintained under this Article or rules of the Commission implementing this Article shall
be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars($10,000).
* 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.
*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 General Permit. For more information on signatory requirements, see Part IV, Section B, Item
(6)of that permit.
Signature*
Type Name* Roy Burnette
Title* Managing Member
Organization* Five Forty Broadcasting Company LLC
Date* 08/05/2021
Email for [e-mail]
Confirmation*
Contact Telephone* 8285862221
NOT Certification EROSION CONTROL01792520210805092659.pdf 78.5KB
Form* Must be PDF Format
YOU MUST MAIL THE ORIGINAL SIGNED NOT CERTIFICATION FORM to The Stormwater Program at the address on
the form for the application to fulfill federal requirements.