NCC190682_Annual Fee Invoice_20201027

North Carolina Department of Environmental Quality
Division of Energy, Mineral and Land Resources
Stormwater Program
NPDES Construction Stormwater Permit
F"p-;^lk^ ;°^^ Jal INVOICE
Annual Permit Fee
This Construction Stormwater annual fee is required by the North Carolina Administrative Code 143-
215.D(a). The fee covers the administrative costs associated with your permit. The fee is required of
any person holding a permit for any time during the annual fee period, regardless of the facility's
operating status. Failure to pay the fee by the due date will subject the permit to revocation.
Operating without a valid permit is a violation and is subject to a $10,000 per day fine. If the permit is
revoked and you later decide a permit is needed, you must reapply, with the understanding the permit
request may be denied due to changes in environmental, regulatory, or modeling conditions.
Invoice No: NCC190682-2020
Invoice Date: 10/27/2020
Certificate of Coverage No.: NCC190682
Due Date: 11/27/2020
Effective Date: 06/21/2019
Annual Fee Period: Oct 2020 to Jun 2021
Project Name: RFM and Gwaltney Farms,
LLC
Annual Fee: $100
Legally Responsible Person:
[e-mail]
William Wakeman
Telephone: [phone]
Site Contact: Michael Warnock
RFM and Gwaltney Farms, LLC
Site Contact E-mail:
Mich [e-mail]
306 East Main Street
Suite 200
Lakeland, FL 33801-5023
Electronic payment option is preferred. Type https://deg.nc.gov/SW-epaVments into your browser. If
you select eCheck, there is no convenience fee. The convenience fee for a credit card is 2.65% and
convenience fee for debit card is $3.95
If you must pay with paper check, please make your check payable to "DEMLR Stormwater Program"
and include the Certificate of Coverage No. in the memo field along with a copy of this invoice.
A $25.00 processing fee will be charged for returned check in accordance with North Carolina General
Statute 25-3-512.
Remit to: NCDEQ— Division of Energy, Mineral and Land Resources
Stormwater Program
1612 Mail Service Center
Raleigh NC 27699-1612