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HomeMy WebLinkAboutNCC192493_NOI Application_20191028Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 10/23/2019 5:28:42 PM (NCG01 NOI Submission) Approve by Clark, Paul 10/24/2019 9:33:20 AM (Review- Construction NOI 17607) • The task was assigned to Clark, Paul by round robin distribution 10/23/2019 5:29 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 25, 2019 5:00 PM 10/23/2019 5:29 PM Submit by McCoy, Suzanne 10/28/2019 7:53:19 AM (Payment Verification for NCC192493) * Jessica Meyer • McCoy, Suzanne assigned the task to McCoy, Suzanne 10/28/2019 7:52 AM • The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 5, 2019 5:00 PM 10/24/2019 9:33 AM !1i)iTII�T2,G)M Fill f_T1IIa1010 NORTH CAROLINA Ernvlronmentol qualily A. Project Information Part A. Project Location and Waterbody Inforrration 1. Project Name * Fletcher's Mill 2. County* Durham 3. Highway or Street 2018 Fletchers Chapel Road Address * Street name only is acceptable if no address nurrtrer assigned yet 4. City or Township* Durham 5. State * NC 6. Zip Code* 27703 7. Latitude * Enter the latitude in decirral degrees 36.0157 8. Longitude * Enter the longitude in decirral degrees (MJSTbe negative) -78.7989 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* 10/31/2019 Estimated Construction Project Start Date 10. Date to End* 10/01 /2021 Estimated Construction Project End Date 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial aassification for Development 12. Acres to be 25.81 disturbed* (including off -site borrow and waste areas) 13. Total site area 34.75 (acres)* 14. Post- 8.01 construction (Estimated) impervious area (acres) * NCC Project NCC-DURHA-2019-Fletcher's Mill 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 Little Lick Creek Waterbody* Nsrreof waterbody into which stornwater runoff will discharge 15b. Waterbody 27-9-(2) Index No. * NCWaterbody Index Nurrber 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 SFTEN, LLC Name * 2. First Name* Jessica ff Corporation, enter Registered Agent First l\b e 3. Last Name * Meyer ff Corporation, enter Registered Agent Last Barre 3b. Title NPDES Technical Compliance Administrator 4. Permitee E-mail jameyer@drhorton.com Address* 5. Permittee 919-215-6561 Telephone No.* 6. Permittee Mailing Street Address Address* 2000 Aerial Center Parkway Address Line 2 Suite 110A City Morrisville Postal / Zip Code 27560-9294 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 2000 Aerial Center Parkway Address Line 2 Suite 110A City Morrisville Postal / Zip Code 27560-9294 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 Jessica Contact - First Name * 3. Primary Site Meyer Contact - Last Name * 4. Title NPDES Technical Compliance Administrator 5. Site Contact E- jameyer@drhorton.com mail Address* 6. Site Contact 919-215-6561 Telephone No.* 7. Organization SFTEN, LLC Name 8. Site Contact Street Address Mailing Address* 2000 Aerial Center Parkway Address Line 2 Suite 110A city Morrisville Fbstal / Zip Code 27560-9294 9. Consultant Name (optional) Kristi Anspach, Eco Turf, Inc. First and Last narre 10. Consultant E- kanspach@ecoturf.net mail This person will be copied on all correspondence. 11.Consultant 919-883-8211 Telephone No. State / Province / Plegion NC Country us D. E&SC Plan Part D. Erosion & Sediment Control (E&SC) Ran Approval Information ....................................................................................................................................................................................................................................... 1. Date E&SC Plan 06/03/2019 Approved * 2. E&SC Plan Project 5237-08 Number/ID* Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by r Local Program 4. Local Program* Durham City/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 Fletchers Mill Letter of Approval.pdf 143.62KB Approval Mast be FDFfornat letter/documentation 6. NOI Certification Fletcher's Mill NOI Certification Form.pdf 952.03KB Form Mist be RJFfornat 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 Type Name* Jessica Meyer Title NPDES Technical Compliance Administrator Organization SFTEN, LLC Date * 10/23/2019 F. Tracking and COC Info NOI Tracking No. 17607 NC Reference No. NCG01-2019-2493 Uses 'count number variable (incremrented by SP) Certificate of NCC192493 Coverage (COC) Uses 'count _nunber'variable (increrrented bySP) No. * Count Number 2493 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.)