NCC213051_NOI Application_20210524

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 5/18/2021 1:51:26 PM (NCG01 NOI Submission)
Approve by Clark, Paul B 5/20/2021 12:19:21 PM (Review- Construction NOI 53067)
• The task was assigned to Clark, Paul B by round robin distribution 5/18/2021 1:53 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: May 20, 2021 5:00 PM
5/18/2021 1:53 PM
Submit by McCoy, Suzanne 5/24/2021 12:58:06 PM (Payment Verification for NCC213051)
* Seamon Whitesides & Associates Inc
• McCoy, Suzanne assigned the task to McCoy, Suzanne 5/24/2021 12:57 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: July 1, 2021 5:00 PM
5/20/2021 12:19 PM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
Are you submitting
IT No
an NOI that was
r Yes
rejected before?
1a. Project Name *
Stonebridge Subdivision Parcels 3, 7, 9 (Phases 1-4)
1 b. Specific Lot
This field may be used to list specifc lot numbers.
Numbers
Lots 1-230
1 c. Parcel ID List all RW associated w ith this project.
Number(s) (PIN) 09417001F
2. County* Union
3. Highway or Street Stone Marker Drive
Address* Street name only is acceptable if no address number assigned yet
4. City or Township* N/A
5. State * NC
6. Zip Code* 28112
7. Latitude* Enter the latitude in decimal degrees
34.9400
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-80.6300
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*
07/01/2021
Estimated Construction Project Start Rate
10. Date to End *
07/01 /2023
Estinated Construction Project End Cate
11. SIC (Primary)*
Residential, Single Family Houses (SFE) (1521)
Standard Industrial C]assification for Development
12. Acres to be
137.60
disturbed*
(including off -site borrow and waste areas)

13. Total site area 137.60
(acres) *
14. Post- 31.61
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-UNION-2021-Stonebridge Subdivision Parcels 3, 7, 9 (Phases
Tracking ID 1-4)
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 Little Twelvemile Creek
Waterbody* %rreof waterbody into which stormwater runoff will discharge
15b. Waterbody 11-138-2-3
Index No. * NCWaterbody Index Number
Stormwater F No
discharges will flow 17 Yes
to additional
wate rs *
15c. Additional Beaverdam Creek
Receiving Waterbody narre
Waterbody
15d. Waterbody 13-17-36-3
Index No. NCWaterbody Index Number
15e. Additional Waterbody name
Receiving
Waterbody
15f. Waterbody NCWaterbody Index Number
Index No.
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. ^
Fternittee 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 * Stonebridge Land Holdings, 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 * Johnathan
If Corporation, enter Faegistered Agent First %rre
3. Last Name* McCall
It Corporation, enter Pbegistered Agent Last %rre
3b. Title Owner
4. Permitee E-mail [e-mail]
Address*
5. Permittee 704-774-1964
Telephone No.*
6. Permittee Mailing Street Address
Address* 2627 Brekonridge Centre Drive
Address Line 2
City
Monroe
Fbstal / Zip Code
28110-5629
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
2627 Brekonridge Centre Drive
Address Line 2
City
Monroe
Fbstal / Zip Code
28110-5629
State / Frovince / Pegion
NC
Country
us
State / Frovince / 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
Keith
Contact - First
Name *
2. Primary Site
Fenn
Contact - Last
Name *
3. Title
Market Partner -Land Development
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
980-269-6609
Telephone No.
6. Organization
True Homes
Name
7. Site Contact
Street Address
Mailing Address*
2649 Brekonridge Centre Drive
Address Line 2
City
Monroe
Fbstal / Zip Code
28110-5629
8. Consultant Name
(Optional)
Frances Yarbrough
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
980-312-5450
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
[e-mail]
Default is legally responsible person e-rrail
12. Billing
(For Annual Fee correspondence)
Telephone
704-774-1964
Default is legally responsible person telephone
State / Rovince / Region
NC
Country
us

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 04/29/2021
Approved *
2. E&SC Plan Project UNION-2021-031
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. 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 STONEBRIDGE-04282021.pdf 3.99MB
Approval letter or Mast beRDFformat
Grading Permit
6. Site Location Map Wst be RDFformat (lint 20 NB)
C1.2 PERMITTING PHASING PLAN.pdf 1.49MB
Rease do not upload entire set of E&SC plans.
7. Notes (Optional) Rovide any additional information that night help the reviewer better understand how uploaded docurrents support
the application. Include additional waterbodies if necessary.
8. NOI Certification NCG01-eNO1-Certification-Form-20210212-DEMLR-
Form 89.04KB
SW-Signed.pdf
Mast be R7Ffon-rat
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
��1z�rlrtfrlsr �}i��!=�r1/I
Type Name * Johnathan McCall
Title Owner
Organization Legally Plesponsible Entity
Stonebridge Land Holdings, LLC
Date * 05/18/2021

F. Tracking and COC Info
NOI Tracking No. 53067
NC Reference No. NCG01-2021-3051
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of NCC213051
Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 3051
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. NCC213051-2021
Invoice Due Date 6/19/2021
Initial Fee $ 100.00
Invoice Status OPEN