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HomeMy WebLinkAboutNCC205958_NOI Application_20210202Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 12/22/2020 5:50:19 PM (NCG01 NOI Submission) Approve by Gamble, Aana C 12/24/2020 3:40:43 PM (Review- Construction NOI 39709) • The task was assigned to Gamble, Aana C by round robin distribution 12/22/2020 5:50 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 24, 2020 5:00 PM 12/22/2020 5:50 PM Submit by Selkane, Aziza 2/2/2021 11:33:01 AM (Payment Verification for NCC205958) * Lucas L Woodburn • Selkane, Aziza assigned the task to Selkane, Aziza 2/2/2021 11:31 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: February 4, 2021 5:00 PM 12/24/2020 3:40 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW Quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting r No an NOI that was r Yes rejected before? Previous Rejected 37992 NOI No. Prior Reviewer Paul Clark Name 1a. Project Name * Pennant Square 1 b. Specific Lot This field may be used to list specffc lot numbers. Numbers 1 c. Parcel ID List all R% associated w ith this project. Number(s) (PIN) 56135804110000 56135862580000 56135863270000 56135864850000 56135855710000 56135845850000 56135844550000 56135854100000 2. County* Cabarrus 3. Highway or Street 161 W. D. Street Address* Street name only is acceptable if no address number assigned yet 4. City or Township* Kannapolis 5. State * NC 6. Zip Code* 28081 7. Latitude* Enter the latitude in decimal degrees 35.4930 8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative) -80.6270 If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of North Carolina. Look for the coordinates in the bottom left corner. 9. Date to Begin* 12/31/2020 Estinated Construction Project Start Date 10. Date to End* 12/31/2024 Estinated Construction Project End late 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial aassification for Developrrent 12. Acres to be 14.56 disturbed* (including off -site borrow and waste areas) 13. Total site area 10.80 (acres) * 14. Post- 9.00 construction (Estimated) impervious area (acres) * NCC Project NCC-CABAR-2020- Pen na nt Square Tracking ID Assigned automatically Below you must enter waterbody information for surface waters affected by this project. Please consult DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You may enter up to 3 waterbodies if needed. 15a. Receiving Irish Buffalo Creek Waterbody* Plane of waterbody into which stormwater runoff will discharge 15b. Waterbody 13-17-9-(2) Index No. * NCWaterbody Index Narrber Stormwater V No discharges will flow r Yes to additional wate rs * 16a. Is this project r Yes subject to the NC r No, not subject to NC SPCA Sediment Pollution Control Act?* B. Permittee Information Part B. ^ Fbrnittee Inforrration - Legally Fbsponsible Entity and Individual Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same organization. That person must be a responsible corporate officer who owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. 1. Organization Legally Pesponsible Entity Name * Tri Pointe Homes, Inc. IF pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field. Note: The organization name must match the business entity name registered with the NC Secretary of State. You can verify the registration here. 2. First Name * Luke IF Corporation, enter Faegistered Agent First %rre 3. Last Name* Woodburn IF Corporation, enter F;bgistered Agent Last %rre 3b. Title Director of Land Development 4. Permitee E-mail luke.woodburn@tripointehomes.com Address* 5. Permittee 704-944-4434 Telephone No.* 6. Permittee Mailing Street Address Address* 3436 Toringdon Way, Suite 210 Address Line 2 City Charlotte Fbstal / Zip Code 28277-2450 Check box if the street address the same as mailing address 7. Permittee Street Address* F Yes Street Address 3436 Toringdon Way, Suite 210 Address Line 2 City Charlotte Fbstal / Zip Code 28277-2450 State / Frovince / Fbgion NC Country us State / Ftovince / Faegion NC Country us 8. Type of Ownership is only individual if an individual is naned in B.1. above. Ownership* Non -Government C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Luke Contact - First Name * 2. Primary Site Woodburn Contact - Last Name * 3. Title Director of Land Development 4. Site Contact E- luke.voodburn@tripointehomes.com mail Address* 5. Site Contact 704-944-4434 Telephone No. 6. Organization Tri Pointe Homes, Inc. Name 7. Site Contact Street Address Mailing Address* 3436 Toringdon Way, Suite 210 Address Line 2 City Charlotte Fbstal / Zip Code 28277-2450 8. Consultant Name (Optional) Andrew P. Grant, PE First and Last narre 9. Consultant E-mail agrant@bgeinc.com This person will be copied on all correspondence. 10. Consultant 980-5008961 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) Default is legally responsible person a-rrail 12. Billing (For Annual Fee correspondence) Telephone Default is legally responsible person telephone State / Rovince / Region NC Country us D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 09/09/2020 Approved * 2. E&SC Plan Project CABAR-2021-018 Number/ID * Assigned by agency or local program 3. E&SC Plan r State DEQ Office Approved by* r Local Program 4. State DEQ Office * Mooresville (MRO) Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a complete application. Please also upload a site map showing the overall extent of the project (for linear projects, can include the beginning point and end point coordinates in the "Notes" box below). 5. E&SC Plan 2020-0909 - NCDEQ Pennant Square EC Approval letter or 137.05KB Approval.pdf Grading Permit Mast be FDFfon-rat 6. Site Location Map Mist be RDFforrret (lint 201VB) Pennant Square Site Aerial.pdf 292.63KB Rease do not upload entire set of E&SC plans. 7. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded docurrents support the application. Include additional waterbodies if necessary. 8. NOI Certification NCG01-eNO1-Certification-Form-20190919-DEMLR- Form 698.68KB SW -Pennant Square.pdf Mast be FCFfon-rat This is an Express r No Review Project* r Yes E. Certification North Carolina General Statute 143-215.66 (1) provides that: Any person who knowingly makes anyfalse statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Artcle; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the Commission implementing this Artcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). Under penalty of law, I certify that: 17 I am the person responsible for the construction activities of this project, for satisfying the requirements of this permit, and for any civil or criminal penalties incurred due to violations of this permit. rJ The information submitted in this NOI is, to the best of my knowledge and belief, true, accurate, and complete based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information. * 17 I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control Plan. * rJ I hereby request coverage under the NCG010000 General Permit and understand that coverage under this permit will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an individual permit. Specify if you are:* IT The Legally Responsible Person named on this Notice of Intent f Authorized Responsible Person* (signing on behalf of Legally Responsible Person named in Part B) Important: The person who electronically signs this Certification above must be the same person who signs the NOI Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who owns or operates the construction activity, such as a president, secretary, treasurer, or vice president, or a manager that is authorized in accordance with Part IV, Section B, Item (6) of the NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. Signature l�r� I�rr�df Type Name* Luke Woodburn Title Director of Land Development Organization Legally Plesponsible Entity Tri Pointe Homes, Inc. Date * 12/22/2020 F. Tracking and COC Info NOI Tracking No. 39709 NC Reference No. NCG01-2020-5958 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC205958 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 5958 Sequential nurrber for subrrittal that is incremented by Stored Frocedure COC Year 2020 Year of date reviewed (used to assign YY digits after "NOC' in COCno.) Initial Invoice No. NCC205958-2020 Invoice Due Date 1/23/2021 Initial Fee $ 100.00 Invoice Status OPEN