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HomeMy WebLinkAboutNCC215105_NOI Application_20210910Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 9/9/2021 10:25:22 AM (NCG01 NOI Submission) Approve by Broussard, Brooklyn C 9/9/2021 10:30:02 AM (Review- Construction NOI 64460) • The task was assigned to Broussard, Brooklyn C by round robin distribution 9/9/2021 10:25 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 13, 2021 5:00 PM 9/9/2021 10:25 AM Submit by Selkane, Aziza 9/10/2021 10:35:52 AM (Payment Verification for NCC215105) * Robert M. Green • Selkane, Aziza assigned the task to Selkane, Aziza 9/10/2021 10:34 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 21, 2021 5:00 PM 9/9/2021 10:30 AM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting IT No an NOI that was r Yes rejected before? 1a. Project Name * CDIA- Ta)away F Ext, South Crossfield Ta)away, Yorkmont Realign - Pkg 3 1 b. Specific Lot This field rray be used to list specffc lot numbers. Numbers 1 c. Parcel ID List all Rios associated w ith this project. Number(s) (PIN) 11521103A, 14119204, 14119203, 14119202, 11521109, 11521105, 14119206, 14119103, 14119101, 14102318 2. County* Mecklenburg 3. Highway or Street Yorkmont Road Address* Street name only is acceptable if no address nunber assigned yet 4.CityorTownship* Charlotte 5. State * NC 6. Zip Code* 28202 7. Latitude* Enter the latitude in decimal degrees 35.2040 8. Longitude * Enter the longitude in decinal degrees (MJST be negative) -80.9470 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* 11/01/2021 Estirrated Construction Project Start Date 10. Date to End* 10/31/2023 Estinated Construction Project End Date 11. SIC (Primary) * Other (9999) Standard Industrial C]assification for Developrrent 12. Acres to be 43.00 d istu rbe d * (including off -site borrow and waste areas) 13. Total site area 43.00 (acres) * 14. Post- 40.00 construction (Estimated) impervious area (acres) * Project Tracking ID NCC-MECKL-2021-CDIA - Taxiway F Ext, South Crossfield Taxiway, Yorkmont Realign - Pkg 3 Assigned automatically (not used) 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 Coffey Creek Waterbody* Name of waterbody into which stormwater runoff will discharge 15b. Waterbody 11-137-4 Index No. * NCWaterbody Index Number 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 must 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. Permittee * Legally Pesponsible Entity City of Charlotte - Aviation IF pernittee is an individual, enter first and last narre in this field. otherwise, enter organization/business narre. Note: If the permittee is a business, the business must be registered with the NC Secretary of State. You can verify the registration here. 2. First Name * Jeff IF Corporation, enter Faegistered Agent First %rre 3. Last Name* McSwain IF Corporation, enter F;bgistered Agent Last %rre 3b. Title Airport Development Manager 4. Permitee E-mail leslie.hurwitz@cltairport.com Address* 5. Permittee 704-564-7919 Telephone No.* 6. Permittee Mailing Street Address Address* 600 East 4th Street Address Line 2 City Charlotte Fbstal / Zip Code 28202-2816 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 600 East 4th Street Address Line 2 City Charlotte Fbstal / Zip Code 28202-2816 State / Ffovince / Pegion NC Country us State / Ftovince / Region NC Country us 8. Type of Ownership is only individual if an individual is naned in B.1. above. Ownership* Government- Municipal C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Leslie Jo Contact - First Name * 2. Primary Site Hurwitz Contact - Last Name * 3. Title Engineering Project Manager 4. Site Contact E- leslie.hurwitz@cltairport.com mail Address* 5. Site Contact 704-564-7919 Telephone No. 6. Organization City of Charlotte - Aviation Name 7. Site Contact Street Address Mailing Address* 600 East 4th Street Address Line 2 City Charlotte Fbstal / Zip Code 28202-2816 8. Consultant Name (Optional) Rob Green First and Last narre 9. Consultant E-mail robert.green2@wsp.com This person will be copied on all correspondence. 10. Consultant 980-365-2322 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) leslie.hur\&4tz@cltairport.com Default is legally responsible person e-rrail 12. Billing (For Annual Fee correspondence) Telephone 704-564-7919 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 06/09/2021 Approved * 2. E&SC Plan Project MECKL-2021-073 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 MECKL-2021-073 CDIA-06092021.pdf 1.6MB Approval letter or Mast beRDFformal Grading Permit 6. Signed FRO Financial Pesponsibility/Ownership Form Mast be FDFfornat 7. Site Location Map Wst be RDFforrret (lint 201VB) SurfacewaterMap(V1.1).pdf 432.08KB Rease do not upload entire set of E&SC plans. 8. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded docurrents support the application. Include additional waterbodies if necessary. 9. NOI Certification CamScanner 08-24-2021 13.58_1.pdf 785.11KB Form Mist be RDFforrret 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 Type Name * Jeff McSwain Title Airport Development Manager Organization Legally Responsible Entity City of Charlotte - Aviation Date * 09/09/2021 F. Tracking and COC Info NOI Tracking No. 64460 NC Reference No. NCG01-2021-5105 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC215105 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 5105 Sequential nurrber for subrrittal that is incremented by Stored Frocedure COC Year 2021 Year of date reviewed (used to assign YY digits after "NOC' in COCno.) Initial Invoice No. NCC215105-2021 Invoice Due Date 10/9/2021 Initial Fee $ 100.00 Invoice Status OPEN