HomeMy WebLinkAboutNCC192486_Notice of Termination_20210102Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 1/2/2021 4:53:29 PM (NOT Submittal)
Approve by Georgoulias, Bethany 1/4/2021 8:08:49 AM (NOT Request Review- NCC192486)
p Date entered for close-out inspection approval sent was 71212020, but 7114 could reflect when it was
received by the permittee.
• The task was assigned to Georgoulias, Bethany. The due date is: January 7, 2021 5:00 PM
1 /2/2021 4:53 PM
1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC192486
Coverage (COC) Enter the Certificate of Coverage Nimber
No.*
2020 Annual Fee Status OPEN
2021 Annual Fee Status May be blank (if not yet billed)
Information associated with this permit:
Project Name
Cypress Lakes Village, Section 10 - Lot 330
Address
Amen Court, Grays Creek Township, NC
County
Cumberland
Latitude
34.9236
Longitude
-78.8933
Permittee Listed
Cates Building, Inc.
Legally Responsible
Christopher Cates
Individual
NC Reference No.
NCG01-2019-2486
E&SC Plan ID
CUMBE-2020-043
Original NOI
17587
Tracking No.
Date COC Issued
11/1/2019
Prior Rescission
Cate populates only if COCwas already rescinded at tirre of subrrittal.
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 *
O Mistake or Invalid Coverage
r Other
Ad d i o n a I Nbre information about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Dxurrentation if applicable.
Documentation Mist beFDFformat
Project Close-out Information:
Final Close-out 7/14/2020
Inspection Approval
Project Close-out CY330 closeout letter.pdf 532.68KB
Approval Mast be FDFforrrat
Documentation
North Carolina General Statute 143-215.66 (1) 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 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 deice or method required to be operated or maintained under this Article or rules ofthe
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
rJ 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
Type Name* Christopher E. Cates
Title * President
Organization* Cates Building Inc
Date * 01 /02/2021
Email for pam@cavinessandcates.com
Confirmation *
Contact Telephone* 9107787902
NOT Certification CY330 NOT.pdf
Form Mast be FDF Forrrst
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Erails
(Optional)
Original Permittee CCd on Wification Bmils
Email pam@cavinessandcates.com
Original Site Contact CCd on Notificaiton Errails
Email pam@cavinessandcates.com
733.46KB