SW6220703_Annual Certification Summary (2024)_20240129

Section A-Project Information
Permit Number: SW6220703 Project Town/City: Cameron
Project Name: Magnolia Hills Subdivision Project County: Harnett
Permit issued: 1/30/2023 Project Status: underway
Section B-Permittee Information
Name: Galt Land Development Street Address: Mailing Address:
Signing Official: Shaun Gardner 256 Brian Hill Rd 256 Brian Hill Rd
Title: Managing Member
Phone Number: 910-988-8172 Ext. Raeford,NC 28376 Raeford,NC 28376
Email Address: [e-mail]
Section C-Property Owner Information
Name: Galt Land Development Street Address: Mailing Address:
Signing Official: Shaun Gardner 256 Brian Hill Rd 256 Brian Hill Rd
Title: Managing Member
Phone Number: 910-988-8172 Ext. Raeford,NC 28376 Raeford,NC 28376
Email Address: [e-mail]
Section D-Site Conformance with Permitting Conditions
Max BUA not exceeded? Yes Veg.setbacks per plans? Yes Site is as shown on plans? Yes
SCM BUA not exceeded? NA Easements recorded? NA Designer Cart.submitted? NA
Lot BUA not exceeded? Yes O&M Agreemt recorded? NA O&M being performed? NA
BUA as shown on plans? Yes O&M Agreemt on plats? NA No maintenance issues? NA
SCM/LD area per plans? Yes Deed Restrict.recorded? NA Maint.records being kept? NA
SCM/LD area accessible? Yes O&M done per E&SC? NA Permit is active? Yes
Stormwater outlets stable? Yes SCMs fixed when done? NA Other conditions met? Yes
See Attachment A for a list of all N/A explanations to the above items.
Section E-Plan to Bring the Project info Conformance
Project is in conformance with all permit conditions.
Section F-Project Certifier Information
Certifier Signing: Scott Brown,PE Street Address: Mailing Address:
Title: Project Engineer 409 Chicago Drive 409 Chicago Drive
Phone Number: 910-426-6777 Suite 112 Suite 112
Email Address: [e-mail] Fayetteville,NC 28306 Fayetteville,NC 28306
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 Scott Brown,PE on January 29,2024.

ATTACHMENT A
Explanation about why"NIA"items above are not applicable to this project.
Max BUA not exceeded N/a:
SCM BUA not exceeded N/a: This is a low density project
Lot BUA not exceeded N/a:
BUA as shown on plans N/a:
SCM/LD area per plans N/a:
SCM/LD area accessible N/a:
Stormwater outlets stable N/a:
Veg.setbacks per plans N/a:
Easements recorded N/a: Project still under construction
O&M Agreemt recorded N/a: Project still under construction
O&M Agreemt on plats N/a: Project still under construction
Deed Restrict.recorded N/a: Project still under construction
O&M done per E&SC N/a: Project still under construction
SCMs fixed when done N/a: Project still under construction
Site is as shown on plans N/a:
Designer Cert.submitted N/a: Project still under construction
O&M being performed N/a: Project still under construction
No maintenance issues N/a: Project still under construction
Maint.records being kept N/a: Project still under construction
Permit is active N/a:
Other conditions met N/a: