HomeMy WebLinkAboutNCC193070_Modification Review_20201207Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 12/2/2020 12:23:42 PM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 12/7/2020 7:28:56 AM (Construction COC ADD TO FILE Review- NCC193070)
Deeds for both lots included with submittal. E&SC approval documents provided via e-mail on 1215.
• The task was assigned to Georgoulias, Bethany. The due date is: December 7, 2020 5:00 PM
12/2/2020 12:23 PM
Y. ,
NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of NCC193070
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
Information associated with this permit
Project Name East College Park - Evergreen - All SF Lots
Address Maple St, Hill St, N Carver St, N Fisher St, Pender St, Boyer St, Raleigh, NC
County Wake
Latitude 35.7824
Longitude-78.6157
Permittee Listed Evergreen Construction Co, Inc
Legally Responsible Timothy Morgan
Individual
NC Reference No. NCG01-2019-3070
E&SC Plan ID
Original NOI
Tracking No.
Wake-2018-027
19177
Date COC Issued* 12/09/2019
Prior Rescission This field will populate only if COChas already been rescinded.
Date
Modification Information:
Reason for r Closed -Out Lots/Outparcels in E&SC Plan
Modification * F Additional Lots/Outparcels Approved - E&SC Revised
r Other Revision(s) to E&SC Plan
r Legally Responsible Individual and/or Site Contact Has Changed
r Multiple Reasons (List)
Addional Nbre information if needed (e.g., new Site Contact details can be included here)
Explanation Adding 2 additional lots
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets).
For changes to the legally responsible individual, you must upload this form
Supporting Upload Supporting Docurrentation (%vised EBSC Approval, (lose -Out Doc, etc.)
Documentation 1509 Pender St Deed.pdf 98.1KB
1511 Pender Street Deed.pdf 98.95KB
Mist be FDFforrrat
North Carolina General Statute 143-215.6113 (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 Artide 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 device or method required to be operated or maintained under this Artide 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).
� I hereby request modification to coverage under the NPDES Stormwater Permit
for the subject project site. 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.
Specify if you are:* r The Legally Responsible Individual
r Authorized Responsible Person*
*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* Rod Miller
Title * Project Manager
Organization* Evergreen Construction Company
Date * 12/02/2020
Email Address* Rod@eccmgt.com
Brrail for confin-ration
Telephone Number* 919-427-4010
Contact nunber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email Additional errailfor confirrration
(Optional)
Original Permittee tim@eccmgt.com
Email
Original Site Contact rod@eccmgt.com
Email
Review Date 12/07/2020
Rescinded Since
Submitted?
Request Date 20201202
Formatted
Review Date 20201207
Formatted