Loading...
HomeMy WebLinkAboutSWG040129_Application_20201105 S1NGo`t 0 12°I FOR AGENCY USE ONLY N.C. DIVISION OF WATER QUALITY Date Received J.Rilg Year Month Da SURFACE WATER PROTECTION SECTION � �;] << c!j Certificate of Covera.e STATE STORMWATER NOTICE OF INTENT (NOI) _MICAlfflo 1111, ''IMMLIWPIRU ED SWG040000 - GENERAL PERMIT TO CONSTRUCT A LINEAR UTILITY LINE Permit Assi.ned to AND ASSOCIATED INCIDENTAL BUILT-UPON AREA 1.1. 120 ')ri\,- State Stormwater Management Application Notice of Intent for coverage under the General Stormwater,l aria�y r rrf I?• Permit to construct a utility line and incidental built-upon area associated with a linear utility protecf inclutfitie` i {ih;4C sewer, gas, telephone, and electric. For the construction, operation and maintenance of incidental impervious areas associated with the construction of a linear utility line. Incidental built-upon area associated with the utility project includes small, single pump stations, access roads which minimize their built-upon area, concrete pads, manhole covers, etc. (Please print or type) 1. Mailing address of owner/developer: (The address to which all permit correspondence will be mailed.) Owner/Developer Name Leland Highway 17 Sewer Expansion II, Phase 2 Street Address 102 Town Hall Drive City Leland State NC ZIP Code 28451 Telephone No. (910)371-1249 Fax ( ) 2. Proposed Project Information: Project Name Leland Highway 17 Sewer Expansion II, Phase 2 Street Address of the Project City Town of Leland State NC ZIP Code 28451 County Contact Person Richard Rudin Mailing Address 219 Station Rd, Suite 101 City Wilmington State NC ZIP Code 28405 Telephone No. ( 919)535-5181 Fax ( ) 3. Physical Location Information: Please provide the street address of the project and describe how to get to the project, using street names, state road numbers, and the distance and direction from the nearest major intersection: Parallel forcemains located along US 17 and SR 1412 and SR 1619 with bore and jack under the intersection of SR 1622 and 1619. Pump station is located on south side of SR1412 approximately 1,970 If from the intersection of Tharp Ave NE and SR 1412. 4. What is the name of the receiving stream? Town Creek 5. River Basin Cape Fear River Basin Receiving Stream Classification C; SW 6. This Certificate of Coverage is being submitted as a result of: ® New or proposed project ❑ Modification to an existing project Existing COC or Permit Number: Date project is scheduled to begin construction N/A 2 7. What is the total project area above mean high water? ft 8. What is the total amount of built-upon area proposed at this site? 14,461 ft2 (Please include all manhole covers,pump stations,concrete pads,and gravel access roads) SWU-116-17FEB2010 Page 1 of 3 9. What type of utility project will be constructed? ❑ Water ® Sewer ❑ Gas ❑ Telephone ❑ Electric ❑ Other 10. Has the built-upon area been minimized to the extent practicable? ▪ YES ❑ NO 11. Is the runoff from the built-upon area outside the vegetative buffer directed away from surface waters,to the extent practicable? ® YES ❑ NO 12. Is the project within 575' of the Mean High Water line of class ORW waters? ❑ YES (Please show the 575' AEC line on plans) ® NO (If yes,total built-upon area must be less than or equal to 25%of the total project area within the AEC above mean high water.) 13. Are there any wetlands on the site? IX YES(please delineate on the plans) ❑ NO Name and affiliation of person making this determination: Troy Beasley-WithersRavenel 14. Please list all Best Management Practices employed at this site: Silt fence, straw wattle check dam, inlet protection 15. Certification: North Carolina General Statute 143-215.6B (i) provides that: Any person who knowingly makes any false statement, representation,or certification in any application, record, report, plan, or other document filed 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 under this 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 guilty of a Class 2 misdemeanor which may include a fine not to exceed$10,000. (18 U.S.C.Section 1001 provides a punishment by a fine of not more than $10,000 or imprisonment of not more than 5 years,or both,for a similar offense.) I hereby request coverage under the referenced General Permit. I understand that coverage under this permit will constitute the permit requirement for the project and is enforceable in the same manner as an individual permit. I certify that I am familiar with the information contained in the application and that to the best of my knowledge and belief such information is true, complete, and accurate. Printed name of person signing: Richard Rudin Title: Project Manager ,—DocuSigned by: 10/15/2020 (Signature of Applicant) `—F641C903CF18488. (Date signed) A check or money order must accompany this Notice of Intent for$505.00, made payable to:NCDENR. Your application will be returned unprocessed unless all of the following items are submitted: x❑ This completed form ❑x Two sets of site and grading plans X❑ A check for$505.00 A USGS map with the project clearly located on it. Mail the entire package to: NCDENR Division of Water Quality Surface Water Protection Section—Stormwater at the Appropriate Contact Address (see the following page) Note: The submission of this document does not guarantee the issuance of a Certificate of Coverage under the General Permit. SWU-116-17FEB2010 Page 2 of 3 For questions,please contact the DWQ Central Office or Regional Office for your area. lap r-Ail" li A lIF.W C=3111 111 ''t-\ ---J--r—C. --A •p - --• �F att Ile �- � , • 99 �.. <\, Wil ngton DWQ Regional Office Contact Information: ASHEVILLE REGIONAL OFFICE FAYETTEVILLE REGIONAL OFFICE MOORESVILLE REGIONAL OFFICE 2090 US Highway 70 225 Green Street 610 East Center Avenue/Suite 301 Swannanoa, NC 28778 Systel Building Suite 714 Mooresville, NC 28115 (828) 296-4500 Fayetteville, NC 28301-5043 (704) 663-1699 HOW&ORW Projects in Counties Above (910) 433-3300 HOW&ORW Projects in Counties Above HOW&ORW Projects in Counties Above RALEIGH REGIONAL OFFICE WASHINGTON REGIONAL OFFICE WILMINGTON REGIONAL OFFICE 3800 Barrett Drive 943 Washington Square Mall 127 Cardinal Drive Extension Raleigh, NC 27609 Washington, NC 27889 Wilmington, NC 28405-2845 (919) 791-4200 (252) 946-6481 (910) 796-7215 HOW&ORW Projects in Counties Above Coastal Stormwater,HQW&ORW Projects in Counties Coastal Stormwater,HOW&ORW Projects in Above Counties Above J WINSTON-SALEM REGIONAL CENTRAL OFFICE OFFICE 1617 Mail Service Center 585 Waughtown Street Raleigh, NC 27699 1617 "To preserve,protect Winston-Salem, NC 27107 (919) 807-6300and enhance ' North Carolina's water._." • (336) 771-5000 Phase 2 Post-Construction Projects not covered HOW&ORW Projcts in Counties Above by local government SWU-116-17FEB2010 Page 3 of 3