NCC230264_FRO Submitted_20230130

activity under a common plan of development of this size as covered by the NCG01 permit, betore this Corm
and an acceptable erosion and sedimentation control plan have been completed and approved by the Land
Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the appropriate
Regional Office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place NIA in the blank.)
Part A.
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E
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Project NameParmenter Lake house
'If this project involves American Rescue Plan Act (ARPA) funds. list the Project Name below
under which you applied for funding through the Division of Water Infrastructure (DWI).
Location of land -disturbing activity: CountyBurke City or Township Connelly Springs
2234 snowmass DR 35,776370-81.451917
Highway/Street Latitude(decimal degrees) Longitude(decimal degrees)
Approximate date land -disturbing activity will commence: 1 /1 412023
Purpose of development (residential, commercial, industrial, institutional, etc.): residential
Total acreage disturbed or uncovered (including off -site borrow and waste areas): ' 85
Amount of fee enclosed: $1 00 . The application fee of $100.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee is $900).
Checks should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed m No ❑
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Brian Parmenter E-mail Address [e-mail]
Phone: Office # na Mobile # [phone]
i
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Brian Parmenter Chair Mayo na 704-787-4996
Name
4773 turnridge ct nw
Current Mailing Address
Concord NC 28027
City State
10. Deed Book No.2638
Phone: Office # Mobile #
4773 Turnridge ct nw
Current Street Address
Concord NC 28027
Zip City
Page No.200
State
Zip
Provide a copy of the most current deed.