HomeMy WebLinkAboutNCC192634_NOI Application_20191112Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/31/2019 2:01:42 PM (NCG01 NOI Submission)
Approve by Morman, Alaina 11/1/2019 10:18:18 AM (Review- Construction NOI 17971)
* Applicant entered wrong city in Part C mailing address, but the correct city was entered in Part 8 if vve
need it.
• The task was assigned to Morman, Alaina by round robin distribution 10/31/2019 2:01 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 4, 2019 5:00
PM 10/31/2019 2:01 PM
Submit by McCoy, Suzanne 11/12/2019 9:23:50 AM (Payment Verification for NCC192634)
* Caviness and Cates
• McCoy, Suzanne assigned the task to McCoy, Suzanne 11/12/2019 9:23 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 13, 2019 5:00
PM 11/1/2019 10:18 AM
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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name * Riverwood Athletic Club Alpine Valley P61D-3 Lots
6079, 6080, 6123, 6125, 6129, &6135
2. County* Johnston
3. Highway or Street Landry Court and Bradshaw Way
Address* Street narre only is acceptable if no address nunber assigned yet
4. City or Township* Wilders -rownship
5. State * NC
6. Zip Code* 27577
7. Latitude* Enter the latitude in decinal degrees
35.6970
8. Longitude * Enter the longitude in decinal degrees (MJST be negative)
-78.4240
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*
10/28/2019
Estirrated Construction Project Start Date
10. Date to End *
10/28/2020
Estinated Construction Project End Cate
11. SIC (Primary) *
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial Classification for Development
12. Acres to be
2.58
disturbed*
(including off -site borrow and waste areas)
13. Total site area 3.09
(acres) *
14. Post- 0.54
construction (Estirrated)
impervious area
(acres) *
NCC Project NCC-JOHNS-2019-Riverwood Athletic Club Alpine Valley P61D-3
Tracking ID Lots 6079,6080,6123,6125,6129,&6135
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 Marks Creek
Wate rbody* %ram of waterbody into which storrrwater runoff will discharge
15b. Waterbody 27-38
Index No.* NCWaterbody Index Minter
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. ^
F2rnittee 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 Caviness & Cates Building and Development Company
Name *
2. First Name* Christopher
If Corporation, enter Registered Agent First f brre
3. Last Name* Cates
If Corporation, enter Faegistered Agent Last %rre
3b. Title Vice President
4. Permitee E-mail pam@cavinessandcates.com
Address *
5. Permittee 910-778-7902
Telephone No.*
6. Permittee Mailing Street Address
Address* 639 Executive Place , Suite 400
Address Line 2
city State / Province / Region
Fayetteville N.C.
Postal / Zip Code Country
28305 us
Check box if the rJ Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 639 Executive Place , Suite 400
Address Line 2
City
State / Province / Pegion
Fayetteville
N.C.
Fostal / Zip Code
Country
28305
us
C. Site Contact Information
Part C.
Roject Site Contact Inforrration
...........................................................................................................................................................................................................................................................................
1. Type of
Non -Government
Ownership *
2. Primary Site
Pamela
Contact - First
Name *
3. Primary Site
Geddie
Contact - Last
Name *
4. Title
Starts Coordinator
5. Site Contact E-
pam@cavinessandcates.com
mail Address*
6. Site Contact
910-778-7902
Telephone No.*
7. Organization
Caviness & Cates Building and Development
Name
Company
8. Site Contact
Street Address
Mailing Address*
639 Executive Place, Suite 400
Address Line 2
City
State / Rovince / Region
Salemburg
N.C.
Fbstal / Zip Code
Country
28385
us
9. Consultant Name
(Optional)
Johnny Glenn Tew
First and Last narre
10. Consultant E-
JohnnyT@eclsglobalinc.com
mail
This person will be copied on all correspondence.
11. Consultant
9108973257
Telephone No.
D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 10/28/2019
Approved *
2. E&SC Plan Project JC#18-058-P
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Johnston 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 Alpine Valey P6D-3 ( Lots #
Approval 6079,6080,6123,6125,etc. Erosion Plan 119.22KB
letter/documentation
Approval.pdf
Mist be RDFfornat
6. NOI Certification AV6079,6080,6123,6125,6129 & 6135 NOI.pdf 620.58KB
Form Mist be RDFfornat
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 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.
* 17 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
f 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
Cf - �lffrr-e'eafAI , � 6., C, rr� -r f
Type Name* Christopher E. Cates
Title Vice President
Organization Caviness & Cates Building and Development Company
Date * 10/31 /2019
F. Tracking and COC Info
NOI Tracking No. 17971
NC Reference No. NCG01-2019-2634
Uses 'count number' variable (incremrented by SP)
Certificate of NCC192634
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 2634
Sequential number for submittal that is incremented by Stored Frocedure
COC Year 2019
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)