NCC204134_NOT Closeout Documents_20240506

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6100 Fox Road
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PERMIT# LD- 115968
CERTIFICATE
OF
COMPLETION PLAN# T# 579377
City of Raleigh
Stormwater Management Division
[phone] Stephen Leischner
DATE 01/18/24
THIS CERTIFICATE OF COMPLETION CERTIFIES THAT:
® Final Inspection is Approved
The project has been inspected by a City stormwater inspector. Under the referenced
permit(s), the site is found to be in compliance with the approved plans and City Code. All
required stormwater certifications, surveys and approvals have been received and approved.
All temporary measures have been removed and permanent ground cover sufficient to restrain
erosion has been established.
VI City Permit(s) Closed
The referenced permit(s) have been closed.
N Coverage Under NCG010000
Proceed to deq.nc.gov/NCG01 to submit a Notice of Termination (NOT) request to terminate
NCGO1 permit coverage. Please note that this Certificate must be uploaded as part of completing
the NOT process. Once the NOT is approved, continued self-monitoring of the project for
NCG01 compliance will no longer be required.
® All Below Ground Stormwater Conveyance is Unobstructed
Photographs and other assurances that all pipe systems, inlets, and junction boxes have been
cleared of sediment and any other construction related debris.
® All Applicable Temporary Erosion Control Measures Removed
Insure appropriate removal of all temporary measures inclusive of inlet protection, silt fence,
silt fence outlets, etc. Extenuating circumstances could be detailed in comments below.
Stormwater Inspections Form 504
V3.3/2022
Page 1 of 2

COMMENTS:
1. Please note that permanent stormwater SCMs require periodic maintenance in order to
function properly.
2. Annual SCM inspection certifications must be submitted to the City utilizing official forms,
which may be downloaded from the City web site.
3. The annual due date for stormwater SCM inspection certifications associated with the
referenced permit(s) is: 01-17-25
Stormwater Inspections Form 504
V2.14.2019
Page 2 of 2