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HomeMy WebLinkAboutNCC210084_Modification Review_20210412Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 4/12/2021 3:22:03 PM (ADD TO FILE Submittal) Approve by Georgoulias, Bethany 4/12/2021 4:31:26 PM (Construction COC ADD TO FILE Review- NCC210084) * Different organization is listed under signature, but same legally responsible individual for permittee (A. Sydes Construction, Inc.) • The task was assigned to Georgoulias, Bethany. The due date is: April 15, 2021 5:00 PM 4/12/2021 3:22 PM Y . Ta4M1 NORTH CAPOLINA EnYlrenmemf& Qualay Certificate of NCC210084 Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters) No.* Information associated with this permit: Project Name Bennett Place V, Somerset Place V, and Roanoke Bay IV Address Wood House Drive, Jacksonville, NC County Onslow Latitude 34.8697 Longitude-77.4842 Permittee Listed A. Sydes Construction, Inc. Legally Responsible Anthony Sydes Individual NC Reference No. NCG01-2021-0084 E&SC Plan ID Original NOI Tracking No. ONSLO-2021-029 40517 Date COC Issued* 01/12/2021 Prior Rescission This field will populate only if CCChas already been rescinded. Date Modification Information: Reason for r Closed -Out Lots/Outparcels in E&SC Plan Modification * r Additional Lots/Outparcels Approved - E&SC Revised F Other Revision(s) to E&SC Plan r Legally Responsible Individual and/or Site Contact Has Changed r Multiple Reasons (List) Addional Ivbre inforrration (e.g., new Site Contact details). If lots are being added, please include specific lot nunbers. Explanation E&SC Plan was modified to show design for the first phase of the subdivision. Previously, this was only showing clearing. 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 Dxurrentation (Pevised E&SCApproval, nose -Out Doc, etc.) Documentation ONSLO-2021-029 Approval Revised 4-9-2021-1.pdf 234.94KB Mist be FDFfornat 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 Artide; 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 f 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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. Signature Type Name* Anthony W. Sydes Title * President Organization* Clearly Development, Inc. Date * 04/12/2021 Email Address* leahquinn@sydescommunities.com En -ail for confirnation Telephone Number* 9104556956 Contact nunber ff we need to reach you Note: Original permittee and site contact are copied on modification correspondence. Additional Email office@parkerjacksonville.com (Optional) Additional en -ail for confirnation Original Permittee leahquinn@sydescommunities.com Email Original Site Contact leahquinn@ysydescommunities.com Email Review Date 04/12/2021 Rescinded Since Submitted? Request Date 20210412 Formatted Review Date 20210412 Formatted