NCC205959_NOI Application_20201229

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/24/2020 10:52:35 AM (NCG01 NOI Submission)
Approve by Gamble, Aana C 12/24/2020 3:44:50 PM (Review- Construction NOI 39778)
• The task was assigned to Gamble, Aana C by round robin distribution 12/24/2020 10:52 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 28, 2020 5:00
PM 12/24/2020 10:52 AM
Submit by McCoy, Suzanne 12/29/2020 9:17:38 AM (Payment Verification for NCC205959)
* Randy Secrest
• McCoy, Suzanne assigned the task to McCoy, Suzanne 12/29/2020 9:16 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: February 4, 2021 5:00 PM
12/24/2020 3:44 PM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
Are you submitting r No
an NOI that was r Yes
rejected before?
Previous Rejected 39719
NOI No.
Prior Reviewer Michael Meloy
Name
1a. Project Name * UNION COUNTY SHERRIFS OFFICE
1 b. Specific Lot This field rray be used to list specifc lot numbers.
Numbers
1 c. Parcel ID List all R% associated w ith this project.
Number(s) (PIN) 09057010
2. County* Union
3. Highway or Street PRESSON ROAD
Address* Street name only is acceptable if no address nunber assigned yet
4. City or Township* WINGATE
5. State * NC
6. Zip Code* 28112
7. Latitude* Enter the latitude in decimal degrees
34.9800
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-80.4660
If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of
North Carolina. Look for the coordinates in the bottom left corner.
9. Date to Begin* 12/21/2020
Estimated Construction Project Start Date
10. Date to End* 12/21/2022
Estimated Construction Project End Date

11. SIC (Primary)* Commercial (1542)
Standard Industrial Classification for Development
12. Acres to be 11.71
disturbed* (including off -site borrow and waste areas)
13. Total site area 12.00
(acres) *
14. Post- 4.71
construction (Estirreted)
impervious area
(acres) *
NCC Project NCC-UNION-2020-UNION COUNTY SHERRIFS OFFICE
Tracking ID Assignedautorratically
Below you must enter waterbody information for surface waters affected by this project. Please consult
DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please
enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You
may enter up to 3 waterbodies if needed.
15a. Receiving RAYS FORK
Wate rbody* t\brre of waterbody into which storrrwater runoff will discharge
15b. Waterbody 13-17-36-8
Index No. * NCWaterbodyIndex Nirrber
Stormwater V No
discharges will flow r Yes
to additional
wate rs *
16a. Is this project r Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B. ^
Fbrnittee Inforrration - Legally Fbsponsible Entity and Individual
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same
organization. That person must be a responsible corporate officer who 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.
1. Organization Legally Responsible Entity
Name * Turner Construction Company
It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field.
Note: The organization name must match the business entity name registered with the NC Secretary of State. You can
verify the registration here.
2. First Name * Jeffrey
If Corporation, enter Registered Agent First %rre
3. Last Name* Owens
It Corporation, enter F;bgistered Agent Last %rre
3b. Title Vice President Operations Manager
4. Permitee E-mail [e-mail]
Address*
5. Permittee 704-400-4081
Telephone No.*
6. Permittee Mailing Street Address
Address* 4601 Park Road
Address Line 2
Suite 601
Cty
Charlotte
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
Fbstal / Zip Code
28209
V Yes
Street Address
4601 Park Road
Address Line 2
Suite 601
city
Charlotte
Fbstal / Zip Code
28209
State / Ffovince / Fbgion
NC
Country
us
State / Ftovince / Region
NC
Country
us
8. Type of Ownership is only individual if an individual is naned in B.1. above.
Ownership* Non -Government

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
...........................................................................................................................................................................................................................................................................
1. Primary Site
Randy
Contact - First
Name *
2. Primary Site
Secrest
Contact - Last
Name *
3. Title
General Supt.
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
704-309-6473
Telephone No.*
6. Organization
Turner Construction
Name
7. Site Contact
Street Address
Mailing Address*
6907 Secrest Shortcut Road
Address Line 2
City
State / Rovince / Region
Indian Trail
NC
Fbstal / Zip Code
Country
28079
United States
8. Consultant Name
(Optional)
Mark Momsen
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
704 7247634
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
[e-mail]
Default is legally responsible person e-n-ail (older NOts rray not populate)
12. Billing
(For Annual Fee correspondence)
Telephone
704-400-4081
Default is legally responsible person telephone (older NOIs rray not populate)

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 11/10/2020
Approved *
2. E&SC Plan Project UNION-2021-013
Number/ID * Assigned by agency or local program
3. E&SC Plan r State DEQ Office
Approved by* r Local Program
4. State DEQ Office * Mooresville (MRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. For linear projects, please also upload a site map showing the overall extent of the project or
include the beginning point and end point coordinates in the "Notes" box below.
5. E&SC Plan Union County Sheriffs Office (UNION-2021-013)
Approval letter or 312.75KB
approval w mods.pdf
Grading Permit
Mast be FDFfon-rat
6. Site Location Map Mist be RDFforrret (lint 201VB)
[1) GO-00 COVER SHEET.pdf 396.21KB
Rease do not upload entire set of E&SC plans.
7. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded docurrents support
the application. Include additional waterbodies if necessary.
8. NOI Certification UCSO Stormwater Certification form.pdf 92.41 KB
Form Mist be RDFforrret
This is an Express r No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.66 (1) provides that:
Any person who knowingly makes anyfalse 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 Artcle; 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 Artcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
17 I am the person responsible for the construction activities of this project, for
satisfying the requirements of this permit, and for any civil or criminal penalties
incurred due to violations of this permit.
rJ The information submitted in this NOI is, to the best of my knowledge and belief,
true, accurate, and complete based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information.
* 17 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ I hereby request coverage under the NCG010000 General Permit and
understand that coverage under this permit will constitute the permit
requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
Specify if you are:* IT The Legally Responsible Person named on this Notice of Intent
f Authorized Responsible Person* (signing on behalf of Legally Responsible
Person named in Part B)
Important: The person who electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible
person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who
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 * Jeffrey H Owens
Title VP/Operations Manager
Organization Legally Responsible Entity
Turner Construction Company
Date * 12/24/2020

F. Tracking and COC Info
NOI Tracking No. 39778
NC Reference No.
NCG01-2020-5959
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC205959
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5959
Sequential nurrber for subrrittal that is incremented by Stored Frocedure
COC Year 2020
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)
Initial Invoice No. NCC205959-2020
Invoice Due Date 1/23/2021
Initial Fee $ 100.00
Invoice Status OPEN