SW6221102_Annual Certification Summary (2024)_20240112

Section A-Project Information
Permit Number: SW6221102 Project Town/City: Aberdeen
Project Name: Utility Improvements to Serve Ashley Heights Project County: Hoke
Permit issued: 7/6/2023 Project Status: not started
Section B-Permittee Information
Name: Ashley Heights LLC Street Address: Mailing Address:
Signing Official: David Upchurch 150 S.Page Street 150 S Page St
Title: Engineer/Managing partner
Phone Number: 910-684-8646 Ext. Southern Pines,NC 28387 Southern Pnes,NC 28387
Email Address: [e-mail]
Section C-Property Owner Information
Name: Ashley Heights LLC Street Address: Mailing Address:
Signing Official: David Upchurch 150 S.Page Street 150 S Page St
Title: Engineer/Managing partner
Phone Number: 910-684-8646 Ext. Southern Pines,NC 28387 Southern Pnes,NC 28387
Email Address: [e-mail]
Section D-Site Conformance with Permitting Conditions
Section D not applicable.
Section E-Plan to Bring the Project info Conformance
Project is in conformance with all permit conditions.
Section F-Project Certifier Information
Certifier Signing: David Upchurch Street Address: Mailing Address:
Title: Engineer/Managing partner 150 S.Page Street 150 S Page St
Phone Number: 910-684-8646 Ext.
Email Address: [e-mail] Southern Pines,NC 28387 Southern Pnes,NC 28387
Section G-Certification
The information in this form is true,accurate,and complete? Yes
The project is in conformance with all permit conditions? Yes
Electronically signed by David Upchurch on January 12,2024.