HomeMy WebLinkAboutNCC223728_NOI Application_20221103Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 11/1/2022 10:04:10 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 11/1/2022 1:49:22 PM (Review - NOI 111531 Amber Ridge Subdivision)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 11/1/2022 10:04 AM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 4, 2022 5:00
PM. The priority is: High 11/1/2022 10:04 AM
by Workflow 11/1/2022 1:49:39 PM (Workflow Start Event)
Submit by Holloman, Tevye L 11/3/2022 1:22:53 PM (Payment Verification for NCC223728)
F Katherine Lusk
• Holloman, Tevye L assigned the task to Holloman, Tevye L 11/3/2022 1:22 PM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 13, 2022 5:00 PM.
The priority is: High 11/1/2022 1:49 PM
a
NORTH CAROLINA,
Enri--tn! C2-1;ly
A. Project Information
Part A.
Project Location and Waterbody Information
................................................................................................................... .
Are you submitting No
an NOI that was • Yes
rejected before?
Previous Rejected 110262
NOI No.
Prior Reviewer Name Brooklyn Broussard
la. Project Name* Amber Ridge Subdivision
1 b. Specific Lot This field may be used to list specifc lot numbers.
Numbers 1-21, 23,24,25
1 c. Parcel ID
List all PINs associated with this project.
Number(s) (PIN)
1763354747
1763354833
1763354828
1763354915
1763362024
1763351979
1763351936
1763350993
1763350951
1763350818
1763259865
1763259812
1763257773
1763257730
1763256678
1763255695
1763255640
1763255571
1763257561
1763258544
1763258596
1763352864
1763352752
1763352646
2. County*
Wake
3. Highway or Street 5913 LANGPORT DR,5908 LANGPORT DR 5905 LANGPORT DR
Address* 5901 LANGPORT DR 5853 LANGPORT DR 5849 LANGPORT DR
5845 LANGPORT DR 5841 LANGPOR
Street name only is acceptable if no address number assigned yet
4. City or Township* Mark's Creek
5. State* NC
6. Zip Code* 27545
7. Latitude* Enter the latitude in decimal degrees
35.7707
8. Longitude* Enter the longitude in decimal degrees (MUST be negative)
-78.4506
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*
10/26/2022
Estimated Construction Project Start Date
10. Date to End*
10/01/2025
Estimated Construction Project End Date
11. SIC (Primary)*
Residential, Single Family Houses (SFE) (1521)
Standard Industrial Classification for Development
12. Acres to be
4.85
disturbed*
(including off -site borrow and waste areas)
13. Total site area 6.40
(acres)*
14. Post -construction 1.21
impervious area (Estimated)
(acres) *
Project Tracking ID NCC-WAKE-2022-Amber Ridge Subdivision
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 Marks Creek (Lake Myra)
Waterbody * Name of waterbody into which stormwater runoff will discharge
15b. Waterbody Index 27-38
No, * NC Waterbody Index Number
Stormwater No
discharges will flow Yes
to additional waters*
16a. Is this project Yes
subject to the NC No, not subject to INC SPCA
Sediment Pollution
Control Act?*
B. Permittee Information
Part B.
Permittee Information - Legally Responsible 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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
1. Permittee* Legally Responsible Entity
Clayton Properties Group Inc.
If permittee is an individual, enter first and last name in this field. Otherwise, enter organization/business name.
Note: If the permittee is a business, the business must be registered with the NC Secretary of State. You can verify the
registration here. Permittee must be the same entity that is responsible for the land -disturbing activity as listed on the NC
SPCA Financial Responsibility/Ownership (FRO) Form.
2. First Name* Chris
If Corporation, enter Registered Agent First Name
3. Last Name* Simmering
If Corporation, enter Registered Agent Last Name
3b. Title VP Land Acquisition and Development
4. Permitee E-mail csimmering@mungo.com
Address*
5. Permittee 919-390-5299
Telephone No.*
6. Permittee Mailing Street Address
Address* 2521 Schieffelin Rd suite #116
Address Line 2
City State / Province / Region
Apex NC
Postal / Zip Code Country
27502-4400 us
Check box if the Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
2521 Schieffelin Rd suite #116
Address Line 2
City
State / Province / Region
Apex
NC
Postal / Zip Code
Country
27502-4400
us
8. Type of
Ownership is only individual if an individual is
named in B.1. above.
Ownership*
Non -Government
C. Site Contact Information
Part C.
Project Site Contact Information
1. Primary Site Ed
Contact - First
Name*
2. Primary Site Lynch
Contact - Last Name*
3. Title Entitlement and Engineering Manager
4. Site Contact E-mail elynch@mungo.com
Address*
5. Site Contact 919-609-0054
Telephone No.*
6. Organization Name Mungo Homes
7. Site Contact
Mailing Address*
8. Consultant Name
Street Address
2521 Schieffelin Road
Address Line 2
City
Apex
Postal / Zip Code
27502-4400
(Optional)
First and Last name
9. Consultant E-mail
This person will be copied on all correspondence.
10. Consultant
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
elynch@mungo.com
Default is legally responsible person e-mail
12. Billing Telephone
(For Annual Fee correspondence)
919-609-0054
Default is legally responsible person telephone
State / Province / Region
NC
Country
us
D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Plan Approval Information
1. Date E&SC Plan 07/05/2022
Approved *
2. E&SC Plan Project SEC-082628-2022
Number/ID* Assigned by agency or local program
3. E&SC Plan State DEQ Office
Approved by* Local Program
4. Local Program* Wake 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 SEC-082628-2022_Approval-
Approval letter or 277.36KB
S&EConstructionPlanReviewChecklist.pdf
Grading Permit
Must be PDF format
6. Signed FRO Financial Responsibility/Ownership Form
Signed FRO Amber Ridge 20220628.pdf 97.67KB
Must be PDF format
7. Site Location Map Must be PDF format (limit 20 MB)
Amber ridge Topo and Soils.pdf 2.28MB
Please do not upload entire set of E&SC plans.
8. Notes (Optional) Provide any additional information that might help the reviewer better understand how uploaded documents
support the application. Include additional waterbodies if necessary.
9. NOI Certification Amber Ridge NCG01 NOI signed.pdf 62.92KB
Form Must be PDF format
This is an Express No
Review Project* Yes
E. Certification
North Carolina General Statute 143-215.613 (i) provides that:
Any person who knowingly makes any false 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 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 Article or rules of the Commission implementing this Article shall
be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
* 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.
* 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.
* I will abide by all conditions of the NCG010000 General Permit and the approved
Erosion and Sediment Control Plan.
* 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.
* 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:* The Legally Responsible Person named on this Notice of Intent
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* Chris Simmering
Title VP Land Acquisition and Development
Organization Legally Responsible Entity
Clayton Properties Group, Inc.
Date * 11 /01 /2022
F. Tracking and COC Info
NOI Tracking No. 111531
NC Reference No. NCG01-2022-3728
Indicates NCG01 or NCG25. Uses NOI number until approved, then uses NUMBER incremented by SP (passed
from workflow if eNOI approved)
Certificate of NCC223728
Coverage (COC) No.* Uses NOI number until approved, then uses NUMBER incremented by SIP (formatted and passed from workflow if
eNOI approved)
Initial Invoice No. NCC223728-2022
Invoice Due Date 12/1/2022
Initial Fee $ 100.00
Invoice Status OPEN