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SWM Permit Notice of Termination 1 Note: This permit is separate from any permits required by the Montana Department of Environmental Quality. A State Stormwater Construction Permit is required for all land disturbance activities equal to or greater than one acre or for land disturbance activities less than one acre that are part of a larger common plan of development or sale that would disturb one acre or more. Contact Information: Project Owner Contact Person: Company: Mail Address: City: State: Zip: Phone: Email: Fax: Mobile: Other: Stormwater Management Notice of Termination Permit Number Public Works Department 201 1st Ave East Kalispell, Montana 59901 (406) 758-7720 Project Information Project Address: Stabilization Activity: Termination Date: Acknowledgement Certificate: I certify that I am the Owner or Owner’s authorized agent. If acting as an authorized agent, I further certify that I am authorized to act as the Owners agent regarding the property at the above-referenced address for the purpose of filing applications for decisions, permits or review under the City of Kalispell Ordinance 1600 and have full power and authority to perform on behalf of the Owner all acts required to enable the City to process and review such applications I certify that the information on this application is true and correct and I shall comply with the laws of the State of Montana and the ordinances of the City of Kalispell. Signature of Legally Responsible Person (Submission must include original signature) Date Signed Name (printed) Title