NCC190582_Modification Review_20200422

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 4/20/2020 11:46:42 AM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 4/22/2020 10:46:11 AM (Construction COC ADD TO FILE Review- NCC190582)
• The task was assigned to Georgoulias, Bethany. The due date is: April 23, 2020 5:00 PM
4/20/2020 11:46 AM

Y. ,
NORTH CAPCLINA
Emlremmentel Quality
Certificate of NCC190582
Coverage (COC) Enter the Certificate of Coverage N nber (Use capital letters)
No.*
Information associated with this permit
Project Name
Seaforth Landing - Cotton Custom Homes
Address
203 Seaforth Landing Drive, Pittsboro, NC
County
Chatham
Latitude
35.7137
Longitude
-79.0666
Permittee Listed
cotton custom homes
Legally Responsible
Bill Cotton
Individual
NC Reference No.
NCG01-2019-0582
E&SC Plan ID
2019-04816
Original NOI
11959
Tracking No.*
Date COC Issued*
06/11/2019
Prior Rescission
This field will populate only ff ODChas already been rescinded.
Date
Modification Information:
Reason for r Closed -Out Lots/Outparcels in E&SC Plan
Modification* F Additional Lots/Outparcels Approved - E&SC Revised
r Other Revision(s) to E&SC Plan
r Multiple Reasons (List)
Addional ivbre information if necessary
Explanation lot 13 Seaforth Landing was permitted for Land Disturbing by Chatham County
today 4.20.20
1 am working from home. Please email [e-mail] with
questions
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets).

Supporting Upload Supporting Ibcurrentation (Fevised E&SCApproval, nose -Out Doc, etc.)
Documentation Letter of Approval-1.pdf- land dist - 13 SFL.pdf 288.76KB
Mist be FDFfornat
North Carolina General Statute 143-215.613 (i) provides that:
Anyperson who knowinglymakes anyfalse 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 underthis Article; orwho 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 Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine notto exceed ten thousand
dollars ($10,000).
17 I, as an authorized representative, hereby request modification to coverage
under the NPDES Stormwater Permit for the subject project site. I am familiar
with the information contained in this request and to the best of my knowledge
and belief such information is true, complete and accurate.
'This form must be signed by a responsible corporate officer that 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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
Signature
Type Name* Anita Becker
Title * Office Manager
Organization* Cotton Custom HOmes
Date * 04/20/2020
Email Address* [e-mail]
Bmil for Confirmation
Telephone Number* 919-280-8931
Contact r1unber if we need to reach you
Review Date 04/22/2020
Request Date 20200420
Formatted
Review Date 20200422
Formatted