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HomeMy WebLinkAboutNCC210477_NOI Application_20210127Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 1/26/2021 10:28:03 AM (NCG01 NOI Submission) Approve by Meloy, Michael 1/26/2021 1:53:33 PM (Review- Construction NOI 41789) • The task was assigned to Meloy, Michael by round robin distribution 1/26/2021 10:28 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 28, 2021 5:00 PM 1/26/2021 10:28 AM Submit by Selkane, Aziza 1/27/2021 9:53:47 AM (Payment Verification for NCC210477) * Jeffrey C Guernier • Selkane, Aziza assigned the task to Selkane, Aziza 1/27/2021 9:52 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 9, 2021 5:00 PM 1/26/2021 1:54 PM .• SThF� '; 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 41449 NOI No. Prior Reviewer Michael Meloy Name 1a. Project Name* Boulding Branch Subdivision 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) 230852-230858 230860-230871 227091 2. County* Guilford 3. Highway or Street 2517-2550 William Joseph Lane, 3202-3210 Derby Circle Address* Street name only is acceptable if no address number assigned yet 4. City or Township* High Point 5. State * NC 6. Zip Code* 27265 7. Latitude* Enter the latitude in decimal degrees 35.9960 8. Longitude * Enter the longitude in decimal degrees (UBTbe negative) -79.9770 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* 01/22/2021 Estimated Construction Project Start Date 10. Date to End * 12/30/2022 Estinated Construction Project End Cate 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial aassification for Development 12. Acres to be 5.30 disturbed* (including off -site borrow and waste areas) 13. Total site area 5.50 (acres) * 14. Post- 1.30 construction (Estimated) impervious area (acres) * NCC Project NCC-GUILF-2021-Boulding Branch Subdivision Tracking ID Assigned automatically 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 Boulding Branch Waterbody* Narreof waterbody into which stormwater runoff will discharge 15b. Waterbody 17-3-2 Index No. * NCWaterbody Index Namber 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 Pesponsible Entity Name * True Homes, LLC 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 Faegistered Agent First %rre 3. Last Name* Guernier It Corporation, enter Pbegistered Agent Last %rre 3b. Title Operations Partner - Triad Land 4. Permitee E-mail jguernier@truehomesusa.com Address* 5. Permittee 336-451-6682 Telephone No.* 6. Permittee Mailing Street Address Address* 121 Shields Park Drive Address Line 2 City Kernersville Fbstal / Zip Code 27284 Check box if the street address the same as mailing address 7. Permittee Street Address* F Yes Street Address 121 Shields Park Drive Address Line 2 city Kernersville Fbstal / Zip Code 27284 State / Frovince / Fbgion NC Country us State / Ftovince / Faegion 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 Jeffrey Contact - First Name * 2. Primary Site Guernier Contact - Last Name * 3. Title Operations Partner- Triad Land 4. Site Contact E- jguernier@truehomesusa.com mail Address* 5. Site Contact 336-451-6682 Telephone No.* 6. Organization True Homes, LLC Name 7. Site Contact Street Address Mailing Address* 121 Shields Park Drive Address Line 2 City State / Rovince / Region Kernersville NC Fbstal / Zip Code Country 27284 us 8. Consultant Name (Optional) Rich Glover First and Last narre 9. Consultant E-mail rglover@jamestownengineering.com This person will be copied on all correspondence. 10. Consultant 336-886-5523 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) jguernier@truehomesusa.com Default is legally responsible person a-rrail (older NOIs rray not populate) 12. Billing (For Annual Fee correspondence) Telephone 336-451-6682 Default is legally responsible person telephone (older NCls rray not populate) D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 01/14/2021 Approved * 2. E&SC Plan Project EN 21 0013 2334 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* City of High Point Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a complete application. Please also upload a site map showing the overall extent of the project (for linear projects, can include the beginning point and end point coordinates in the "Notes" box below). 5. E&SC Plan LOA EN 21 0013 2334 Boulding Branch True Homes Approval letter or 2.99MB 1-14-2021.pdf Grading Permit Mist be FDFfon-rat 6. Site Location Map Mist be RDFforrret (lint 201VB) sca n01648. pdf 100.44KB 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 NOI-cert-BB.pdf 391.82KB 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 Atide; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Atcle; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Amide or rules of the Commission implementing this Atcle 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 If the Erosion and Sediment Control Plan approved by the delegated program is not compliant with Part II (Stormwater Pollution Prevention Plan) of the NCG010000 General Permit. I will nonetheless ensure that all conditions of Part II of the permit are met on the project at all times. * 17 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:* r 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 C. Guernier Title Operations Partner - Triad Land Organization Legally Ibsponsible Entity True Homes. LLC Date * 01 /26/2021 F. Tracking and COC Info NOI Tracking No. 41789 NC Reference No. NCG01-2021-0477 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC210477 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 477 Sequential nurrber for subrrittal that is incremented by Stored Frocedure COC Year 2021 Year of date reviewed (used to assign YY digits after "NOC' in COCno.) Initial Invoice No. NCC210477-2021 Invoice Due Date 2/25/2021 Initial Fee $ 100.00 Invoice Status OPEN