HomeMy WebLinkAboutNCC191417_Notice of Termination_20201112Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/12/2020 3:53:48 PM (NOT Submittal)
Approve by Georgoulias, Bethany 11/13/2020 8:03:23 AM (NOT Request Review- NCC191417)
• The task was assigned to Georgoulias, Bethany. The due date is: November 17, 2020 5:00 PM
11/12/2020 3:53 PM
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NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC191417
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
Information associated with this permit
Project Name
Meadow Ridge, Phase 2-Lot 64, Phase 4 Lots 97-99, 101, 102 &
115-117
Address
Irwin Drive, Sandhills Township, NC
County
Moore
Latitude
35.1440
Longitude
-79.4772
Permittee Listed
H&H Constructors, Inc.
Legally Responsible
Brian Walker
Individual
NC Reference No.
NCG01-2019-1417
E&SC Plan ID
MOORE-2020-010
Original NOI
14836
Tracking No.
Date COC Issued
8/21/2019
Prior Rescission
Date populates only if COCwas already rescinded at tirre of submttal.
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 *
r Mistake or Invalid Coverage
r Other
Add Tonal IVbre information about the basis of this request, if needed.
Explanation
Supporting Upload Supporting DDcunentation if applicable.
Documentation Mist beFDFformat
Project Close-out Information:
Final Close-out 7/24/2020
Inspection Approval
Project Close-out MOORE-2020-010-CO.pdf 58.32KB
Approval Mast be FDFforrrat
Documentation
North Carolina General Statute 143-215.613 (i) 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 Artide; 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 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 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
olhgw waewt
Type Name* Brian Walker
Title * Agent
Organization* H&HConstructors, Inc.
Date * 11 /12/2020
Email for brianwalker@hhhomes.com
Confirmation *
Contact Telephone* 910-486-4864
NOT Certification MDR064 NOT.pdf 352.32KB
Form Mist be RY Fbrrrat
Is this COCAlready Ensure this OOChas not been rescinded since subrrittal!
Rescinded?
Original Permittee CCd on Kbtification Bmils
Email brianwalker@hhhomes.com
Original Site Contact CCd on Notificaiton Errails
Email brianwalker@hhhomes.com