b'STORMWATERCATALOG ANNUAL PERMITTEE CERTIFICATION OF PROPER MAINTENANCE FOR PERMIT RENEWALI, ( Name ), acting as ( Position ) for ( Permittees Name ), Permittee, certify under penalty of law that the Storm Water Quality Management Plan in effect for __________________ ( Development ) under Harris County/City of Houston Storm Water Quality Permit number ___________, has been maintained according to the provisions contained therein.Signature:________________________________Date:______________ ( Printed Name ) ( Permittees Name ) ( Address ) ( Phone Number ) State of Texas County of __________ Before me, a notary public, on this day personally appeared ___________________ known to me (or proved to me on the oath of ________________) to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed. Given under my hand and seal of office this _______ day of _____________, ________._____________________ Notary Publics Signature 316 INFO@PARKUSA.COM|888-611-7275|WWW.PARKUSA.COM'