NCC215563_NOI Application_20211007

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/5/2021 1:23:03 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/6/2021 7:52:53 AM (Review- Construction NOI 67942)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/5/2021 1:24 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 7, 2021 5:00
PM 10/5/2021 1:24 PM
Submit by Evans, Shaundra M 10/7/2021 8:16:43 AM (Payment Verification for NCC215563)
* Raymond G Rinker
• Evans, Shaundra M assigned the task to Evans, Shaundra M 10/7/2021 8:16 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 17, 2021 5:00
PM 10/6/2021 7:53 AM

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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 67826
NOI No.
Prior Reviewer Brooklyn Broussard
Name
1a. Project Name* Wilson's Walk
1 b. Specific Lot
This field may be used to list specifc lot numbers.
Numbers
1-350
1 c. Parcel ID
List all R% associated w ith this project.
Number(s) (PIN)
05106025
05106025a
05106025b
2. County*
Johnston
3. Highway or Street 1492 Cole Road
Address* Street name only is acceptable if no address number assigned yet
4. City or Township* Wilson Mill
5. State * NC
6. Zip Code* 27520
7. Latitude* Enter the latitude in decimal degrees
35.5882
8. Longitude * Enter the longitude in decimal degrees (UBTbe negative)
-78.4222
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* 10/15/2021
Estimated Construction Project Start Date
10. Date to End * 04/30/2026
Estimated Construction Project End Cate

11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521)
Standard Industrial aassification for Development
12. Acres to be 62.00
disturbed* (including off -site borrow and waste areas)
13. Total site area 78.43
(acres) *
14. Post- 30.00
construction (Estimated)
impervious area
(acres) *
Project Tracking ID NCC-JOHNS-2021-Wilson's Walk
Assigned automatically (not used)
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 Cooper Branch
Waterbody* %rreof waterbody into which stormwater runoff will discharge
15b. Waterbody 27-43-13
Index No. * NCWaterbody Index Number
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 must 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. Permittee * Legally %sponsible Entity
Starlight Homes North Carolina LLC
It pernittee is an individual, enter first and last narre in this field. Otherwise, enter organization/business narre.
Note: If the permittee is a business, the business must be registered with the NC Secretary of State. You can verify the
registration here.
2. First Name * Raymond
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Rinker
It Corporation, enter F;bgistered Agent Last %rre
3b. Title VP of Land Development
4. Permitee E-mail [e-mail]
Address*
5. Permittee 919-229-3238
Telephone No.*
6. Permittee Mailing Street Address
Address* 5711 Six Fork Road
Address Line 2
suite 300
Cty
Raleigh
Fbstal / Zip Code
27612
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
5711 Six Fork Road
Address Line 2
suite 300
city
Raleigh
Fbstal / Zip Code
27612
State / Ffovince / Fbgion
North Carolina
Country
USA
State / Frovince / Region
North Carolina
Country
USA
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
Raymond
Contact - First
Name *
2. Primary Site
Rinker
Contact - Last
Name*
3. Title
VP of Land Development
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
919-229-3238
Telephone No.
6. Organization
Starlight Homes North Carolina LLC
Name
7. Site Contact
Street Address
Mailing Address*
5711 Six Forks Road
Address Line 2
suite 300
city
Raleigh
Fbstal / Zip Code
27609
8. Consultant Name
(Optional)
Steven Carson
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
919-577-1080
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
[e-mail]
Default is legally responsible person a-rrail
12. Billing
(For Annual Fee correspondence)
Telephone
919-229-3238
Default is legally responsible person telephone
State / Rovince / Region
North Carolina
Country
USA

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 10/13/2020
Approved *
2. E&SC Plan Project JC#20-0035-P
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Johnston County
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
20-003 wilsons walk mass grading ESC appr
Approval letter or
189.75KB
10.13.2020.pdf
Grading Permit
Mast be RDFfon-rat
6. Signed FRO
Financial Pesponsibility/Ojvnership Form
FRO 10.5.2021.pdf 1.43MB
Mast be RDFfornat
7. Site Location Map
Mast be R7Ffon-rat (lirrit 20IVB)
Site Plan.pdf 3.92MB
Rease do not upload entire set of E&SC plans.
8. Notes (Optional)
Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional w aterbodies if necessary.
9. NOI Certification revised NOI cert 10.5.2021.pdf 1.31VIB
Form 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 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* Raymond Rinker
Title VP of Land Development
Organization Legally Ibsponsible Entity
Starlight Homes North Carolina LLC
Date * 10/05/2021

F. Tracking and COC Info
NOI Tracking No. 67942
NC Reference No.
NCG01-2021-5563
Uses 'count_nunber' variable (increrrented by SP)
Certificate of
NCC215563
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5563
Sequential nunber for subnittal 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. NCC215563-2021
Invoice Due Date 11/5/2021
Initial Fee $ 100.00
Invoice Status OPEN