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HomeMy WebLinkAboutNCC193292_NOI Application_20191227Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 12/20/2019 8:31:05 AM (NCG01 NOI Submission) Approve by Garcia, Lauren V 12/20/2019 9:42:05 AM (Review- Construction NOI 19827) • The task was assigned to Garcia, Lauren V by round robin distribution 12/20/2019 8:31 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 24, 2019 5:00 PM 12/20/2019 8:31 AM Submit by McCoy, Suzanne 12/27/2019 7:23:49 AM (Payment Verification for NCC193292) * United Developers • McCoy, Suzanne assigned the task to McCoy, Suzanne 12/27/2019 7:23 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 31, 2020 5:00 PM 12/20/2019 9:42 AM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information 1. Project Name * Zebulon Green Apartments 2. County* Wake 3. Highway or Street 351 Pony Road Address * Street narre only is acceptable if no address number assigned yet 4. City or Township* Zebulon 5. State * NC 6. Zip Code * 27597 7. Latitude * Enter the latitude in decimal degrees 35.8175 8. Longitude* Enter the longitude in decimal degrees (M. ST be negative) -78.3309 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* 02/03/2020 Estimated Construction Project Start Date 10. Date to End* 12/30/2020 Estimated Construction Project End Cute 11. SIC (Primary) * Residential, Other than SFE (1522) Standard Industrial aassification for Ceveloprrent 12. Acres to be 7.50 disturbed* (including off -site borrow and waste areas) 13. Total site area 11.30 (acres) * 14. Post- 2.96 construction (Estimated) impervious area (acres) * NCC Project NCC-WAKE-2020-Zebulon Green Apartments Tracking ID 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 Little River Wate rbody* %rre of waterbody into which storrrwater runoff will discharge 15b. Waterbody 27-57-(8.5) Index No.* NCWaterbody Index Number Stormwater rJ 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. ^ Flarnittee 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 United Developers Name * 2. First Name* James If Corporation, enter Pegistered Agent First Barre 3. Last Name* Smith If Corporation, enter Faegistered Agent Last %rre 3b. Title President 4. Permitee E-mail shawna@dugginssmith.com Address * 5. Permittee 910-485-6600 Telephone No.* 6. Permittee Mailing Street Address Address* 2939 Breezewood Avenue Address Line 2 Suite 201 city Fayetteville Fbstal / Zip Code 28303-5497 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 2939 Breezewood Avenue Address Line 2 Suite 201 Cty Fayetteville Fbstal / Zip Code 28303-5497 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 Non -Government Ownership * 2. Primary Site James Contact - First Name * 3. Primary Site Smith Contact - Last Name * 4. Title President 5. Site Contact E- shawna@dugginssmith.com mail Address* 6. Site Contact 910-485-6600 Telephone No.* 7. Organization United Developers Name 8. Site Contact Street Address Mailing Address* 2939 Breezewood Avenue Address Line 2 Suite 201 aty Fayetteville Fbstal / Zip Code 28303-5497 9. Consultant Name (Optional) James Mercer First and Last narre 10. Consultant E- mmercer@mdgeng.com mail This person will be copied on all correspondence. 11.Consultant 828-645-7088 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 10/18/2019 Approved * 2. E&SC Plan Project SEC-022127-2019 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Wake 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 Zebulon Green Approval Apartments_MUNICIPALWatershedManagementAp... 312.21 KB letter/documentation 18-19.pdf Mist be RDFfornal 6. NOI Certification Zebulon Green NOI Cert.pdf 431.04KB 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 lwe� ff S-6 Type Name* James B SMith Title President Organization United Developers Date * 12/20/2019 F. Tracking and COC Info NOI Tracking No. 19827 NC Reference No. NCG01-2019-3292 Uses 'count number' variable (incremrented by SP) Certificate of NCC193292 Coverage (COC) Uses 'count number' variable (incremented by SP) No.* Count Number 3292 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.)