Full Text
1 CITY OF LEWISTON Annual Stormwater Management Facilities Certification (to be sent to Planning and Code Enforcement and Public Works as required by Appendix A Zoning and Land Use Code, Article XIII. Development Review and Standards, Section 15. Post-construction stormwater management standards) I, (print or type name), certify the following: 1. I am making this Annual Stormwater Management Facilities Certification for the following property: (print or type name of subdivision, condominium or other development) located at (print or type address), (the “Property”); 2. The owner, operator, tenant, lessee or homeowners’ association of the Property is: (name(s) of owner, operator, tenant, lessee, homeowners’ association or other party having control over the Property); 3. I am a Qualified Third-Party Inspector (as defined by the City of Lewiston Post-Construction Stormwater Management Ordinance, and) hired by the owner, operator, tenant, lessee or homeowners’ association of the Property (circle one); 5. On 20__, I inspected the Stormwater Management Facilities, including but not limited to parking areas, catch basins, drainage swales, detention basins and ponds, pipes and related structures required by the approved Post- Construction Stormwater Management Plan for the Property; 6. At the time of my inspection of the Stormwater Management Facilities on the Property, I identified the following need(s) for routine maintenance or deficiencies in the Stormwater Management Facilities: 7. On 20__, the owner, operator, tenant, lessee or homeowners’ association of the Property took or had taken the following routine maintenance or the following corrective action(s) to address the deficiencies in the Stormwater Management Facilities stated in 6. above: ---PAGE BREAK--- 2 8. As of the date of this certification, the Stormwater Management Facilities are functioning as intended by the approved Post-Construction Stormwater Management Plan for the Property. 20__. Signature Print Name STATE OF MAINE ss. 20__ Personally appeared the above-named the of and acknowledged the foregoing Annual Certification to be said person’s free act and deed in said capacity. Before me, Notary Public/Attorney at Law Print Name: Mail this certification to the City of Lewiston at the following address: Director of Planning & Code Enforcement Director of Public Works City Building 103 Adams Avenue 27 Pine Street Lewiston, ME 04240 Lewiston, ME 04240