HomeMy WebLinkAboutNCC192728_NOI Application_20191210Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/7/2019 12:47:31 PM (NCG01 NOI Submission)
Approve by Georgoulias, Bethany 11/11/2019 11:24:53 AM (Review- Construction NOI 18248)
• Georgoulias, Bethany reassigned the task to Georgoulias, Bethany 11/11/2019 11:19 AM
• The task was assigned to Morman, Alaina by round robin distribution 11/7/2019 12:48 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 11, 2019 5:00
PM 11/7/2019 12:48 PM
Submit by McCoy, Suzanne 12/10/2019 1:41:51 PM (Payment Verification for NCC192728)
* EH Blount Construction
• McCoy, Suzanne assigned the task to McCoy, Suzanne 12/10/2019 1:41 PM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 23, 2019 5:00
PM 11/11/2019 11:24 AM
.• SThF� ';
1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name *
Vancroft Lots 78, 79, 87, 88, 89, 98, 99, 100, and 101
2. County*
Pitt
3. Highway or Street
1217 Fellowes Court
Address *
Street narre only is acceptable if no address number assigned yet
4. City or Township* Winterville
5. State * NC
6. Zip Code * 28590
7. Latitude * Enter the latitude in decimal degrees
35.5590
8. Longitude* Enter the longitude in decimal degrees (M. ST be negative)
-77.4140
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*
11/08/2019
Estimated Construction Project Start Date
10. Date to End*
05/31/2020
Estimated Construction Project End Cute
11. SIC (Primary) *
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial aassification for Developrrent
12. Acres to be
2.34
disturbed*
(including off -site borrow and waste areas)
13. Total site area 2.34
(acres) *
14. Post- 0.75
construction (Estimated)
impervious area
(acres)*
NCC Project NCC-PITT-2019-Vancroft Lots 78, 79, 87, 88, 89, 98, 99, 100, and
Tracking ID 101
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 Swift Creek
Waterbody* Narreof waterbody into which stormwater runoff will discharge
15b. Waterbody 27-97-(0.5)
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. ^
Fternittee 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 E H Blount Construction LLC
Name *
2. First Name* Hunter
IF Corporation, enter Fbgistered Agent First Barre
3. Last Name* Blount
If Corporation, enter F3egistered Agent Last %rre
3b. Title President
4. Permitee E-mail Hunterblount@Gmail.com
Address *
5. Permittee 2525313532
Telephone No.*
6. Permittee Mailing Street Address
Address* 2045 Eastgate Drive
Address Line 2
Suite D
city
Greenville
Fbstal / Zip Code
27858-4153
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
2045 Eastgate Drive
Address Line 2
Suite D
aty
Greenville
Fbstal / Zip Code
27858-4153
State / Ftovince / Faegion
NC
Country
us
State / Frovince / Fbgion
NC
Country
us
C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Type of
Individual
Ownership *
2. Primary Site
Hunter
Contact - First
Name *
3. Primary Site
Blount
Contact - Last
Name *
4. Title
President
5. Site Contact E-
HunterBlount@Gmail.com
mail Address*
6. Site Contact
2525313532
Telephone No.*
7. Organization
E H Blount Construction
Name
8. Site Contact
Street Address
Mailing Address*
2045 Eastgate Drive
Address Line 2
Suite D
aty
Greenville
Fbstal / Zip Code
27858-4153
9. Consultant Name
(Optional)
First and Last narre
10. Consultant E-
This person will be copied on all correspondence.
mail
11. Consultant
Telephone No.
State / Rovince / Fbgion
NC
Country
us
D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 11/06/2019
Approved *
2. E&SC Plan Project ESCP-2019-0065
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* City of Greenville
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 ESCP-2019-0065-Vancroft Lots 78, 79, 87, 88, 89,
Approval 208.81 KB
98, 99, 100, and 101 Approval.pdf
letter/documentation
Mist be R7Ffon-rat
6. NOI Certification Copier_ 20191107_120906.pdf 44.76KB
Form Mist be R7Ffon-rat
This is an Express F 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 Atide; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Atcle; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Atide or rules of the
Commission implementing this Atcle 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
72f�e,/t t r�IYli�
Type Name* Hunter Blount
Title President
Organization EH Blount Construction
Date * 11 /07/2019
F. Tracking and COC Info
NOI Tracking No. 18248
NC Reference No. NCG01-2019-2728
Uses 'count number' variable (incremrented by SP)
Certificate of NCC192728
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 2728
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.)