NCC200782_NOI Application_20200227

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 2/25/2020 4:59:26 PM (NCG01 NOI Submission)
Approve by Morman, Alaina 2/26/2020 12:05:34 PM (Review- Construction NOI 22432)
• The task was assigned to Morman, Alaina by round robin distribution 2/25/2020 4:59 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: February 27, 2020 5:00
PM 2/25/2020 4:59 PM
Submit by McCoy, Suzanne 2/27/2020 7:01:14 AM (Payment Verification for NCC200782)
* Taylor Withers
• McCoy, Suzanne assigned the task to McCoy, Suzanne 2/27/2020 7:00 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: April 8, 2020 5:00 PM
2/26/2020 12:05 PM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
la. Project Name * Little Sugar Creek Tributary to the Central Business District SS
Repl.
1 b. Specific Lot This field may be used to list specffc lot numbers.
Numbers
2. County* Mecklenburg
3. Highway or Street 1200 Baxter St
Address * Street narre only is acceptable if no address number assigned yet
4. City or Township* Charlotte
5. State * NC
6. Zip Code * 28202
7. Latitude * Enter the latitude in decimal degrees
35.2110
8. Longitude* Enter the longitude in decimal degrees (WISTbe negative)
-80.8370
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*
03/02/2020
Estimated Construction Project Start Rate
10. Date to End*
08/27/2021
Estinated Construction Project End Date
11. SIC (Primary) *
Other (0000)
Standard Industrial aassification for Developrrent
12. Acres to be
2.49
disturbed*
(including off -site borrow and waste areas)
13. Total site area 2.49
(acres) *
14. Post- 2.49
construction (Estimated)
impervious area
(acres) *

NCC Project NCC-MECKL-2020-Little Sugar Creek Tributary to the Central
Tracking ID Business District SS Repl.
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 Sugar Creek Tributary
Wate rbodY * Wre of waterbody into which stormwater runoff will discharge
15b. Waterbody 11-137-8
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. ^
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 Sanders Utility Construction Co., Inc
Name *
2. First Name* Freddie
IF Corporation, enter Fbgistered Agent First Barre
3. Last Name* Young
IF Corporation, enter Pegistered Agent Last %rre
3b. Title Vice President
4. Permitee E-mail [e-mail]
Address *
5. Permittee 7044005694
Telephone No.*
6. Permittee Mailing Street Address
Address* 6801 Brookshire Boulevard
Address Line 2
City State / Frovince / Region
Charlotte NC
Fbstal / Zip Code Country
28216-0308 us
Check box if the rJ Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
6801 Brookshire Boulevard
Address Line 2
City
State / Frovince / Plegion
Charlotte
NC
Fbstal / Zip Code
Country
28216-0308
us
8. Type of
Non -Government
Ownership*

C. Site Contact Information
Part C.
Roject Site Contact Information
..............................................................................................................................................................................................................................................................................................................................................................................................
1. Primary Site Billy
Contact - First
Name *
2. Primary Site Gould
Contact - Last
Name *
3. Title
4. Site Contact E- [e-mail]
mail Address*
5. Site Contact 7049997708
Telephone No.*
6. Organization
Name
7. Site Contact Street Address
Mailing Address* 6801 Brookshire Blvd
Address Line 2
city
Charlotte
Fbstal/ Zip Code
28216
8. Consultant Name (Optional)
First and Last nave
9. Consultant E-mail This person will be copied on all correspondence.
10. Consultant
Telephone No.
State / Frovince / Pegion
NC
Country
United States

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 01/03/2020
Approved *
2. E&SC Plan Project MECKL-2020-051
Number/ID * Assigned by agency or local program
3. E&SC Plan r State DEQ Office
Approved by* r Local Program
4. State DEQ Office * Mooresville (MRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. For linear projects, please also upload a site map showing the overall extent of the project.
5. E&SC Plan EC Permit.pdf 969.25KB
Approval Wst be FDFfornat
letter/documentation
Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application.
6. NOI Certification NOI.pdf 94.15KB
Form Mast be RDFfon-rat
This is an Express F No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.6E (i) 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 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
��fr�ltrrre# �frrrrr� � •� .
Type Name * Frederick M Young Jr.
Title Executive Vice President
Organization Sanders Utility Construction Co., Inc.
Date * 02/25/2020

F. Tracking and COC Info
NOI Tracking No. 22432
NC Reference No. NCG01-2020-0782
Uses 'count number' variable (incremrented by SP)
Certificate of NCC200782
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 782
Sequential number for submittal that is incremented by Stored Frocedure
COC Year 2020
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)