HomeMy WebLinkAboutNCC190949_Notice of Termination_20201105Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/5/2020 10:21:52 AM (NOT Submittal)
Approve by Georgoulias, Bethany 11/5/2020 2:18:20 PM (NOT Request Review- NCC190949)
• The task was assigned to Georgoulias, Bethany. The due date is: November 10, 2020 5:00 PM
11/5/2020 10:21 AM
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NORTH CAROLINA
Enrlronmenral Quallly
Certificate of
NCC190949
Coverage (COC)
Enter the Certificate of Coverage Nmber
No.*
Information associated
with this permit:
Project Name
Swans Creek Phase One Lot 11
Address
6348 Creekbend Drive, Grays Creek, NC
County
Cumberland
Latitude
34.8643
Longitude
-78.8525
Permittee Listed
Hornaday Homes, LLC
Legally Responsible
John Hornaday
Individual
NC Reference No.
NCG01-2019-0949
E&SC Plan ID
CUMBE-2019-166
Original NOI
13397
Tracking No.
Date COC Issued
7/12/2019
Prior Rescission
Cate populates only if COCwas already rescinded at tirre of subrrittal.
Date
Reason for Rescission/Termination Request:
Reason for F Project Closed -Out
Termination of r Sale (Another Owner/Operator will apply for a new COC)
Coverage * O Mistake or Invalid Coverage
r Other
Addional We inforrration about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Docurrentation if applicable.
Documentation Mist beFDFforrrat
Project Close-out Information:
Final Close-out 4/23/2020
Inspection Approval
Project Close-out 20201105102400scan.pdf 214.26KB
Approval Mast be FDFforrrat
Documentation
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes any false 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 knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring deice or method required to be operated or maintained under this Article or rules ofthe
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
17 I, as an authorized representative, hereby request rescission of coverage under
the NPDES Stormwater Permit for the subject facility. 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 NCG010000 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
Signature
Type Name * JOHN D HORNADAY
Title * MANAGER
Organization* Hornaday Homes, LLC
Date * 11 /05/2020
Email for hornadaycc@aol.com
Confirmation *
Contact Telephone* 9104839715
NOT Certification 20201105102822scan.pdf 272.77KB
Form Mast be FDF Forrrat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Original Permittee CCd on Wification Errails
Email hornadaycc@aol.com
Original Site Contact CCd on Notificaiton Bmils
Email hornadaycc@aol.com