SW6211003_Annual Certification Summary (2024)_20240301

Section A-Project Information
Permit Number: SW6211003 Project Town/City: Red Springs
Project Name: Dollar General-Red Springs Project County: Hoke
Permit issued: 1/14/2022 Project Status: underway
Section B-Permittee Information
Name: Rhetson Companies Inc Street Address: Mailing Address:
Signing Official: Jamie Encinosa 2075 Juniper Lake Rd 2075 Juniper Lake Rd
Title: EVP of Operations
Phone Number: 910-944-0881 Ext. West End,NC 27376 West End,NC 27376
Email Address: [e-mail]
Section C-Property Owner Information
Name: Wills P.Rodgers,Jr. Street Address: Mailing Address:
Signing Official: Wills Rodgers 8205 Belgium Drive 8205 Belgium Drive
Title: Property Owner
Phone Number: 9192185784 Raleigh,North Carolina 27606 Raleigh,North Carolina 27606
Email Address: [e-mail]
Section D-Site Conformance with Permitting Conditions
Max BUA not exceeded? NA Veg.setbacks per plans? NA Site is as shown on plans? NA
SCM BUA not exceeded? NA Easements recorded? NA Designer Cart.submitted? NA
Lot BUA not exceeded? NA O&M Agreemt recorded? NA O&M being performed? NA
BUA as shown on plans? NA O&M Agreemt on plats? NA No maintenance issues? Yes
SCM/LD area per plans? NA Deed Restrict.recorded? NA Maint.records being kept? Yes
SCM/LD area accessible? NA O&M done per E&SC? Yes Permit is active? Yes
Stormwater outlets stable? NA 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: Carlo Pardo Street Address: Mailing Address:
Title: Professional Engineer 4006 Barrett Drive 4006 Barrett Drive
Phone Number: 9195536570 Suite 104 Suite 104
Email Address: [e-mail] Raleigh,NC 27609 Raleigh,NC 27609
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 Carlo Pardo on March 1,2024.

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