NCC220693_ESC Approval Submitted_20220211

Planning and Development
Department
Blue Moon Five2, LLC
326 W. Villa Dunes Dr.
Nags Head, NC 27959
Town of Nags Head
Post Office Box 99
Nags Head, North Carolina 27959
www.townofhagshead.net
February 4, 2022
LETTER OF APPROVAL
RE: Project Name: Blue Moon Five2, LLC Acres Approved: 2.06 Ac
Project ID: 2022-01
County: Dare, Town of Nags Head,
Address: 4329 S. Croatan Highway
River Basin: Pasquotank
Submitted By: Ben Cahoon
Date Received: February 4, 2022
Plan Type: New - Commercial
Dear Sir:
Telephone [phone]
FAX [phone]
This office has reviewed the subject erosion and sedimentation control plan. We find the plan to be
acceptable and hereby issue this Letter of Approval under the Sedimentation Pollution Control Act
of 1973and Chapter 28 of the Town of Nags Head Unified Development Ordinance. This plan
approval shall expire three (3) years following the date of approval, if no land -disturbing activity
has been undertaken, as is required by Title 15A NCAC 4B .0129.
As of April 1, 2019, all new construction activities are required to complete and submit an
electronic Notice of Intent (NOI) form requesting a Certificate of Coverage (COC) under the
NCGO10000 Construction Stormwater General Permit. After the form is reviewed and found to be
complete, you will receive a link with payment instructions for the $100 annual permit fee. After
the fee is processed, you will receive the COC via email. As the Financially Responsible Party
shown on the FRO form submitted for this project, you MUST obtain COC prior to
commencement of any land disturbing activity. The NOI form may be accessed at
deq.nc.gov/NCGOI. Please direct questions about the NOI form to Alama Morman at
Alaina.mormangncdenr.gov or Paul Clark at Paul.clarkgncdenr.gov. If the owner/operator of this
project changes in the future, the responsible party must obtain a new COC.

Title 15A NCAC 4B .0118(a) and the NCGO1 permit require that the following documentation be
kept on file at the job site:
1. The approved E&SC plan as well as any approved deviation.
2. The NCGO1 permit and the COC, once it is received.
3. Records of inspections made during the previous 12 months.
Also, this letter gives the notice required by G.S. 113A-61.1(a) of our right of periodic inspection to
insure compliance with the approved plan.
North Carolina's Sedimentation Pollution Control Program is performance -oriented, requiring
protection of existing natural resources and adjoining properties. If, following the commencement
of this project, it is determined that the erosion and sedimentation control plan is inadequate to meet
the requirements of the Sedimentation Pollution Control Act of 1973 (North Carolina General
Statute 113A-51 through 66), this office may require revisions to the plan and implementation of
the revisions to ensure compliance with the Act.
Acceptance and approval of this plan is conditioned upon your compliance with Federal and State
water quality laws, regulations, and rules. In addition, local city or county ordinances or rules may
also apply to this land -disturbing activity. This approval does not supersede any other permit or
approval.
Please note that this approval is based in part on the accuracy of the information provided in the
Financial Responsibility Form, which you provided. This permit allows for a land -disturbance, as
called for on the application plan, not to exceed the approved acres. Exceeding the acreage will be a
violation of this permit and would require a revised plan and additional application fee. You are
requested to file an amended form if there is any change in the information included on the form. In
addition, it would be helpful if you notify this office of the proposed starting date for this project.
Please notify us if you plan to have a preconstruction conference.
Your cooperation is appreciated.
Sincerely,
David Ryan, P.E.
Town Engineer
Enclosures: NPDES NCGO1 Fact Sheet
Financial Responsibility/ Ownership Form
cc: Michael Robinson, P.E.
Ben Cahoon, Cahoon + Kasten Architects
Tommy Twiddy, Ocean Builders

Fact Sheet on the New NCG01 Permit DE_`
April 2019 �° `
omanmem m E�.��me�ri o�iQ�
�
The NC Construction General Permit (also known as "NCG01") was renewed on April 1, 2019. The updated permit
does not significantly change the measures that are required to be implemented on construction sites. However,
there are some organizational and technical updates to the permit as described below. Most notably, there is a new
process in which construction sites will obtain official coverage under an NCG01 permit through an electronic
process. DEMLR worked with a broad team of stakeholders to make all of these updates. If you have questions,
contact Annette Lucas at [e-mail] or [phone].
Organizational Updates
The new permit:
• Repeats state requirements for E&SC
Plans and organizes them with federal
construction activity requirements;
• Is clearly organized by topic; and
• Has less text and more tables.
Technical Updates
The new permit:
• Requires that the E&SC Plan meet
SWPPP requirements (p. 2);
• Provides a list of items that must be
included in the SWPPP, such as the
construction sequence, plans,
calculations, etc. (p. 2-4);'
• Has updated language on bypasses and
upsets that is tailored to construction
activities (p. 10);
• Puts all timeframes for inspections,
record -keeping and reporting in
"calendar days" for clarity and
consistency (p. 11-14);2
• Changes the inspection frequency
(during business hours) to at least
once per 7 calendar days and after
every storm > 1.0 inch (previously 0.5
inch);' and
• Excludes weekends, state and federal
holidays from normal business hours
unless construction activities take
place (p. 23).
1 This list is based on website guidance
by the DEMLR Sediment Program.
2 The number of calendar days was
selected to be as equivalent as
possible with the previous permit.
' The intent is to provide predictability
to the inspection schedule.
Acronyms to Know
COC: Certificate of Coverage, proof of coverage under an NCG01 permit
DEMLR: NC Division of Energy, Mineral, and Land Resources
E&SC: Erosion & Sedimentation Control
e-NOI: Notice of Intent, application form for the NCG01 permit
e-NOT: Notice of Termination, form for closing out the NCG01 permit
SWPPP: Stormwater Pollution Prevention Plan, required by the NCG01
The NCG01 Process
The new NCG01 applies to permits approved on or after April 1, 2019.
Permittees will no longer receive a copy of the NCG01 permit in the mail
with their E&SC Plan approvals and be considered as covered under the
permit. Federal rules require that DEMLR receive an NOI on each
construction project and issue each construction project its own COC.
Under the new NCG01 process, construction sites will continue to
receive approval for E&SC Plans from either DEMLR or the delegated
local E&SC program just like before. After receiving E&SC Plan approval,
permittees will officially obtain coverage under the NCG01 by
completing an a-NOI (available at deq.nc.gov/NCG01). The e-NOI will
only take about 20 minutes to fill out and submit on-line.
Initially, there will be no charge associated with applying for an NCG01
permit but on or around June 1, 2019, DEMLR will begin charging a $100
annual general permit fee as required per §143-215.3D.
DEMLR is working on creating a single application form that will allow an
applicant to simultaneously apply for an E&SC permit and an NCG01
COC. That effort is part of a larger Permit Transformation project at
DEMLR.

Q&A About the New NCG01 Permit
Why do construction sites have to do this extra application step?
DEMLR is required by the EPA to issue a specific COC to every construction
site that disturbs one acre or more. DEMLR is working to create a form
that combines the E&SC plan approval and e-NOI processes, but that will
take more time. For now, DEMLR has created an efficient e-NOI process.
If an E&SC Plan is approved before April 1, which permit applies?
Projects with already approved E&SC Plans will automatically follow the
new NCG01 permit, but will not need to fill out an a-NOI or pay an annual
permit fee. However, the permittees should print the new permit and the
two standard detail sheets and have them on site.
Will DEMLR offer tools to help permittees comply with the new NCG01?
Yes, DEMLR will provide two sample plan sheets at deg.nc.eov/NCG01 that
can be placed into the E&SC plan set. The first covers the site stabilization
and materials handling portions of the permit. The second sheet covers
the inspection, record -keeping and reporting portions of the permit.
How will the new a-NOI submittal and COC process work?
Permittees will apply for E&SC Plan approvals from DEMLR or the local
E&SC program like before. The E&SC approval letter will instruct the
permittee to visit deg.nc.gov/NCG01 to submit an e-NOI form to DEMLR.
The permittee may begin the construction activity after receipt of the COC
(within three days*). The permittee must print and retain a copy of the
permit and the COC on site. Initially, the COC will be issued for free but on
or around June 1, 2019, a $100 annual general permit fee will be charged.
Who is allowed to submit an a-NOI form?
Submittal must be by a responsible corporate officer that owns or
operates the activity, such as a president, secretary, treasurer, or vice
president or a manager that is authorized in accordance with IV.I3.6 of the
NCG01 permit. Additional signatory options are set forth in IV.I3.6 of the
permit. It is possible for consultant to prepare the e-NOI, save it as a draft,
and email it to the responsible entity for signature & submittal.
What happens to the COC when the construction activity is complete?
When a project is complete, the permittees will contact DEMLR or the local
delegated program to close out the E&SC Plan. After DEMLR or the local
E&SC program inform the permittee of the project close out via inspection
report, the permittee will visit deg.nc.eov/NCG01 to submit an e-NOT.
Will there be a grace period for adherence to the new process?
DEMLR does not have the authority to grant a grace period from a
federally mandated permit. Permittees will be informed of the new
process via web site, E&SC Plan approval letters and list servs. If a
construction activity disturbs one acre or more (or is part of common plan
of development that disturbs one acre or more) fails to submit an a-NOI
after approval of its E&SC Plan, this is a violation of federal permitting
requirements and the permittee could be subject to a penalty assessment.
How does the new NCG01 affect the
delegated local E&SC Programs?
Local programs will continue to review
and approve E&SC plans. However,
they will no longer send copies of the
NCG01 with E&SC Plan approvals.
DEMLR will provide sample language to
use in local E&SC Plan approvals to
advise permittees that they must
submit an a-NOI to DEMLR.
Local programs are not required to
check if permittees have submitted e-
NOls to DEMLR. However, if they wish
to do this voluntarily, there will be a
tool available on DEMLR's web site for
them to view a list of construction
projects that have submitted a-NOIs.
When local programs close out an E&SC
Plan, the close-out letter will advise
permittees that they must submit an e-
NOT. DEMLR will provide sample
language.
Local programs may approve E&SC
plans that meet state sediment laws
and rules even if those plans are not
compliant with all of the NCG01
requirements. However, their
permittees will be required to add two
plan sheets (which will be provided by
DEMLR) to their E&SC Plans to ensure
that they fully comply with the ground
stabilization, materials handling, and
inspection, record -keeping and
reporting portion of the NCG01 permit.
*Or 24 business hours for a project
approved under the DEMLR Express
review program.

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TOWN OF NAGS HEAD
Part A. FINANCIAL RESPONSISILITYIOWNERSHIP FORM
1. Project Name 1J� SIB MOM Vi"Ve, I L4,-C
2. Location of land -disturbing activity: County City or Township- -So flgad
HighwaylStreeLatitude_ � ,°j� (Q _ Longitude 15 . ipWn(p
3. Approximate date land -disturbing activity will commence:
4. Purpose of development (residential, commercial, industrial, institutional, etc.):_GQ�(Y11fY1P_I
5. Total acreage disturbed or uncovered (including off -site borrow O� s ( � and waste areas): �{
6. Amount of fee enclosed Commercial Projects Only): $ 2,( 1 Y)=) �iL(). ... ,. The application fee is
$50.00/up to 1 acre + $401additional acre & revisions).
7. Has an erosion and sediment control plan been filed? Yes�No Enclosed
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name_omCYIV "r1[Vl�j d.-1 E-mail Address "I
Telephone 2,�Z 44 M. I Wo— CelCell # _ Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
LG
Name Telephone Fax Number
_Zc-v W. \`I I is ot
Current Mailing Address Current Street Address
K G
City State Zip City State Zip
10. Deed Book No. �'A (p Page No,—, T Provide a copy of the most current deed.
Part B.
1. Person(s) or firm(s) who is financially responsible for the land -disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet):
L. r—
Name E-mail Address
' p VU' Vi ka Pr. $@ e
Current Mailing Address Current Street Address
Hays, 17C, 2:1 95) same.
City State Zip City State zip
Telephone�Q{p — Fax Number
M%) l0er .mend . w 111$h VC143 s'Woc% met 516:6

2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name
Current Mailing Address
City State Zip
Telephone
E-mail Address
Current Street Address
City State Zip
Fax Number
(b) If the Financially Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name. If the Financially Responsible
Party is a Corporation, give name and street address of the Registered Agent:
00 it
Name of Registered Agent E-mail Address
{ Chsne� fir.
32.(n_ V 1 a..._,. -e
Current Mailing Address Current Street Address
6 7115 Same
City State Zip City State Zip
Telephone y w 1 Fax Number n0VW_
The above information is true and correct to the best of my knowledge and belief and was provided by me
under oath (This form must be signed by the Financially Responsible Person if an individual or his attorney -in -
fact, or if not an individual, by an officer, director, partner, or registered agent with the authority to execute
instruments for the Financially Responsible Person). I agree to provide corrected information should there be
any change in the information provided herein.
Type or print name e g Title or Authority
CLA
nature
Notary Public
Date
(— — .
I. L , a Notary Public of the County of }
personally before met hereby certify that _ L appeared
State of
his day and being duly sworn acknowledged that the above form was executed by him,
Witness m hand al seal, this day of , 20 � .
Notary
� ' My commission expires
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