HomeMy WebLinkAboutNCC191332_Notice of Termination_20201113Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/13/2020 11:10:08 AM (NOT Submittal)
Approve by Georgoulias, Bethany 11/16/2020 7:23:04 AM (NOT Request Review- NCC191332)
• The task was assigned to Georgoulias, Bethany. The due date is: November 18, 2020 5:00 PM
11/13/2020 11:10 AM
1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC191332
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
Information associated with this permit
Project Name
Cypress Lakes Village,Section 10-Lot327 & Gardens at Cypress Lakes
Village,phase
Address
Seattle Slew Lane, Grays Creek Township, NC
County
Cumberland
Latitude
34.9217
Longitude
-78.8971
Permittee Listed
Cates Building, Inc.
Legally Responsible
Christopher Cates
Individual
NC Reference No.
NCG01-2019-1332
E&SC Plan ID
CUMBE-2020-007
Original NOI
14706
Tracking No.
Date COC Issued
8/22/2019
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Date populates only if COCwas already rescinded at tirre of submttal.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 inforr ation about the basis of this request, if needed.
Explanation
Supporting Upload Supporting DDcunentation if applicable.
Documentation Mist beFDFfornat
Project Close-out Information:
Final Close-out 6/23/2020
Inspection Approval
Project Close-out GC327 Closeout letter.pdf 165.59KB
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
C4ttJr "g 'r3" C';�"xr
Type Name* Christopher E. Cates
Title * President
Organization* Cates Building Inc
Date * 11 /13/2020
Email for pam@cavinessandcates.com
Confirmation *
Contact Telephone* 9107787902
NOT Certification GC327 NOT.pdf 384.32KB
Form Mist be PM Fbrrrat
Is this COCAlready Ensure this OOChas not been rescinded since subrrittal!
Rescinded?
Original Permittee CCdonNotificationBmils
Email pam@cavinessandcates.com
Original Site Contact CCd on Notificaiton Errails
Email pam@cavinessandcates.com