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HomeMy WebLinkAboutNCC231124_Modification Review (LEG RESP CHANGE)_20240501 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by Anonymous User 4/30/2024 11:45:09 AM (ADD TO FILE Submittal) Approve by bethany.georgoulias 5/1/2024 10:11:50 AM(Construction COC ADD TO FILE Review-NCC231124) •Legally responsible person updated 5/1/2024. • The task was assigned to bethany.georgoulias.The due date is: May 3,2024 5:00 PM 4/30/2024 11:45:11 AM Ago Permit for DEQMODIFICATION Construction0i00 0000 Certificate of NCC231124 Coverage(COC)No.* Enter the Certificate of Coverage Number(Use capital letters) 2020 Annual Fee Status 2021 Annual Fee Status 2022 Annual Fee Status May be blank if N/A May be blank if N/A May be blank if N/A 2023 Annual Fee Status 2024 Annual Fee Status May be blank if N/A PAID May be blank if N/A Information associated with this permit: Project Name Goldsboro Collection System Improvements-Phase III Address S US 117 By-Pass HWY,Goldsboro, NC County Wayne Latitude 35.3712 Longitude -78.0145 Permittee Listed Wayne County Development Alliance Legally Responsible Mark Pope Individual At the time of Modification Request(not looked up again at review) NC Reference No. NCG01-2023-1124 E&SC Plan ID Wayne-2023-030 Original NOI Tracking 136763 No.* Date COC Issued* Effective Date at Submittal 04/01/2024 Prior Rescission Date This field will populate only if COC has already been rescinded. Modification Information: Reason for Modification* Closed-Out Lots/Outparcels in E&SC Plan Additional Lots/Outparcels Approved-E&SC Revised Other Revision(s)to E&SC Plan Legally Responsible Individual and/or Site Contact Has Changed Multiple Reasons(List) Addional Explanation More information(e.g.,new Site Contact details).If lots are being added,please include specific lot numbers. The new president of the Wayne County Development Alliance is Mr.Craig Foucht. You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable sheets). For changes to the legally responsible individual, you must upload this form. Supporting Documentation Upload Supporting Documentation(Revised E&SC Approval,Close-Out Doc,etc.) NCG01-Legally-Responsible-Change-Form-Phase III-Signed.pdf 619.14KB Must be PDF format Is this project funded with ARPA(American Rescue Plan Act)grant funds? No Yes This question was added to the eNOl on 2/3/2023 and will not be answered in applications submitted prior to that date. North Carolina General Statute 143-215.6B(i)provides that: Any person who knowingly makes any false 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 Article;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 Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars($10,000). * I hereby request modification to coverage under the NPDES Stormwater Permit for the subject project site. I am familiar with the information contained in this request and to the best of my knowledge and belief such information is true,complete and accurate. Specify if you are:* The Legally Responsible Individual Authorized Responsible Person' This form must be signed by a responsible corporate officer that 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 Yw� fi"�. Type Name* Craig Foucht Title* President Organization* Wayne County Development Alliance Date* 04/30/2024 Email Address* craig.foucht@ncgtpedr.com Email for confirmation Telephone Number* 919-288-5148 Contact number if we need to reach you Note:Original permittee and site contact are copied on modification correspondence. Additional Email craig.foucht@waynealliance.org (Optional) Additional email for confirmation Original Permittee mark.pope@ncgtpedr.com Email Original Site Contact Ismith@taloving.com Email Review Date 05/01/2024 Rescinded Since Submitted? Current Effective Date Current Expiration Date Permit Version 4/1/2024 3/31/2029 2.00