HomeMy WebLinkAboutNCC192423_NOI Application_20191023Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/17/2019 11:45:17 AM (NCG01 NOI Submission)
Approve by Morman, Alaina 10/18/2019 11:28:10 AM (Review- Construction NOI 17302)
• The task was assigned to Morman, Alaina by round robin distribution 10/17/2019 11:45 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 21, 2019 5:00
PM 10/17/2019 11:45 AM
Submit by McCoy, Suzanne 10/23/2019 11:00:21 AM (Payment Verification for NCC192423)
* Alejandro Barroso
• McCoy, Suzanne assigned the task to McCoy, Suzanne 10/23/2019 10:59 AM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 29, 2019 5:00
PM 10/18/2019 11:28 AM
STME
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name * Ryan's Crossing
2. County* Chatham
3. Highway or Street 2064 Manns Chapel Road
Address * Street name only is acceptable if no address number assigned yet
4. City or Township* Pittsboro
5. State * NC
1 r-i) iTiT 7i) M fiIi f_TiI a 10141
6. Zip Code* 27312
7. Latitude * Enter the latitude in decimal degrees
35.8320
8. Longitude * Enter the longitude in decimal degrees (MIST be negative)
-79.1400
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*
10/25/2019
Estimated Construction Project Start Date
10. Date to End*
10/25/2021
Estimated Construction Project End Date
11. SIC (Primary)*
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial aassification for Development
12. Acres to be
17.51
disturbed*
(including off -site borrow and waste areas)
13. Total site area 114.11
(acres)*
14. Post- 13.32
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-CHATH-2019-Ryan's Crossing
Tracking ID Assigned autorratically
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 Wilkinson Creek
Waterbody* Narre of waterbody into which stornwater runoff will discharge
15b. Waterbody 16-35
Index No. * NCWaterbody Index N.arrber
Stormwater fJ No
discharges will flow r Yes
to additional
wate rs *
16a. Is this project F Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*
B. Permittee Information
Part B.
Perrrittee Information - Legally Responsible Entity and Individual
.....................................................................................................................................................................
h
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 Manns Chapel Subdivision LLC
Name *
2. First Name* Alejandro
ff Corporation, enter Registered Agent First l\b e
3. Last Name * Barroso
ff Corporation, enter Registered Agent Last Barre
3b. Title Member
4. Permitee E-mail abarroso@bainbridgere.com
Address*
5. Permittee 9196983175
Telephone No.*
6. Permittee Mailing Street Address
Address* 2611 Churchill Road
Address Line 2
City
Raleigh
Postal / Zip Code
27608-1905
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
fJ Yes
Street Address
2611 Churchill Road
Address Line 2
City
Raleigh
Fbstal / Zip Code
27608-1905
State / Province / Region
NC
Country
us
State / Province / Region
NC
Country
us
C. Site Contact Information
Part C.
Roiect Site Contact Information
1. Type of Non -Government
Ownership*
2. Primary Site Alejandro
Contact - First
Name *
3. Primary Site Barroso
Contact - Last
Name *
4. Title Member
5. Site Contact E- abarroso@sealidevelopment.com
mail Address*
6. Site Contact 9196983175
Telephone No.*
7. Organization
Manns Chapel Subdivision LLC
Name
8. Site Contact
Street Address
Mailing Address*
2611 Churchill Road
Address Line 2
aty
Raleigh
Fbstal / Zip Code
27608-1905
9. Consultant Name (optional)
McKim and Creed
First and Last narre
10. Consultant E- cseamster@mckimcreed.com
mail This person will be copied on all correspondence.
11. Consultant 9195395464
Telephone No.
State / Province / Region
NC
Country
us
D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 10/02/2019
Approved *
2. E&SC Plan Project 2018-05874
Number/ID* Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by r Local Program
4. Local Program* Chatham County
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application.
5. E&SC Plan RC - Soil Erosion & Sedimentation Control Permit
Approval (10-2-19).pdf 99.19KB
letter/documentation
Mist be RJF format
6. NOI Certification RC - NCG01 NOI Certification Form.pdf 483.73KB
Form Mist be RJFformat
This is an Express r No
Review Project* r Yes
E. Certification
North Carolina General Statute 143-215.6B (1) provides that:
Anyperson who knowinglymakes any false statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes 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 deice or method required to be operated or maintained under this Article or rules of the
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
rJ 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.
* V 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.
* I7 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* V If the Erosion and Sediment Control Plan approved by the delegated program is
not compliant with Part II (Stormwater Pollution Prevention Plan) of the
NCG010000 General Permit, I will nonetheless ensure that all conditions of Part
II of the permit are met on the project at all times.
* I7 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:* r The Responsible Person named on this Notice of Intent
r Authorized Responsible Person'
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
e�llr -t-- 0r.�"�"/c
Type Name* Alejandro Barroso
Title Member
Organization Manns Chapel Subdivision LLC
Date * 10/17/2019
F. Tracking and COC Info
NOI Tracking No. 17302
NC Reference No. NCG01-2019-2423
Uses 'count number variable (incremrented by SP)
Certificate of NCC192423
Coverage (COC) Uses'count_nunber'variable (incremrented by SF)
No. *
Count Number 2423
Sequential nunber for subrrittal that is incremented by Stored Procedure
COC Year 2019
Year of date reviewed (used to assign YY digits after "NGC' in OOCno.)