NCC233238_MODIFICATION Supporting Doc (LEG RESP CHANGE)_20240418

NCG01 Legally Responsible Individual Change Form
use this form when:
The person who is legally responsible for the permit has changed, but there is NO CHANGE in the project name
or ownership.
**If the project name has changed, or if the ownership of the project has changed, do NOT use this form.**
Instead,you must submit a new NCG01 electronic Notice of Intent(eNOI).
Directions:
Print this form,complete,scan and upload to the Construction Stormwater Permit MODIFICATION Form.
Then, mail the original form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral& Land Resources Stormwater Program
512 N.Salisbury Street,6th Floor(Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS FORM UNTIL YOUR MODIFICATION HAS BEEN REVIEWED AND ACCEPTED AS COMPLETE.
THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE(NOT DIGITAL) [40 CFR 122.22]
Certificate of Coverage(COC) Number: NCC233238
Name of Project: Hidden Creek Subdivision
Legally Responsible Organizational Entity: Taylor Morrison of Carolinas, Inc.
PREVIOUS Legally Responsible Individual. Christian Sheppard
NEW Legally Responsible Individual: Christopher Ferraguto
The following section is to be completed and signed by the NEW Legally Responsible Individual,
Per NC General Statute 143-215.6B(i), 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. . . shall be guilty of a Class 2 misdemeanor which may
include a fine not to exceed ten thousand dollars($10,000).
Page 1 of 2

NCG01 Legally Responsible Individual Change Form
THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE(NOT DIGITAL) [40 CFR 122.22]
Under penalty of law, I certify that (check all boxes to indicate your agreement).
77 1 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.
77 1 will abide by all conditions of the NCGO10000 General Permit and the approved Erosion and
Sediment Control Plan.
If the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution
Prevention Plan)of the NCGO10000 General Permit, I will nonetheless ensure that all conditions of
Part II of the permit are met on the project at all times.
I 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.
This form has been reviewed and is accurate and complete to the best of my knowledge.
*Signatur Date: yIleliq
Print Name of Signed: Christopher Ferraguto
Title:Vice President
Mailing Address: 15501 Weston Parkway, Suite 100, Cary, NC 27513
street Address: 15501 Weston Parkway, Suite 100, Cary, NC 27513
Email Address: [e-mail]
Phone Number: 919-355-0834
*IMPORTANT NOTE: This form must be signed by a responsible corporate officer that 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 permit.
For more information on signatory requirements,see Part IV,Section B, Item(6)of the NCGO10000 permit.
Page 2 of 2

MODIFICATION FORM • er
Permit for Construction Activities NCGO10000
or 1111
Certificate of NCC233239
Coverage(COC)No.* Enter the Certificate of Coverage Number(Use capital letters)
2020 Annual Fee Status 2021 Annual Fee Status 2022 Annual Fee Status
May be blank if N/A May be blank if N/A May be blank if N/A
2023 Annual Fee Status 2024 Annual Fee Status
May be blank if N/A May be blank if N/A
Information associated with this permit:
Project Name Hidden Creek Subdivision
Address 1135 YATES STORE RD, Cary, NC
County Chatham
Latitude 35.8090
Longitude -78.9230
Permittee Listed Taylor Morrison of Carolinas, Inc.
Legally Responsible Christian Sheppard
Individual
NC Reference No. NCG01-2023-3238
E&SC Plan ID 22-DP-4277
Original NOI Tracking 165773
No.*
Date COC Issued* 04/01/2024
Prior Rescission Date This field will populate only if COC has already been rescinded.
Modification Information:
Reason for Modification*
Closed-Out Lots/Outparcels in E&SC Plan
Additional Lots/Outparcels Approved-E&SC Revised
Other Revision(s)to E&SC Plan
Legally Responsible Individual and/or Site Contact Has Changed
Multiple Reasons(List)
Addional Explanation
More information(e.g—new Site Contact details)..If lots are being added please include specific lot numbers.
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance,etc. (only upload

applicable sheets).
For changes to the legally responsible individual, you must upload this form.
Supporting Documentation*
Upload Supporting Documentation(Revised E&SC Approval,Close-Out Doc,etc.)
NCG01-Legal ly-Responsible-Change-Form-Christopher Ferraguto
697.75K6
NCC233238 Hidden Creek Subdivision.pdf
Must be PDF format
Is this project funded with ARPA(American Rescue Plan Act)grant funds?*
No
Yes
North Carolina General Statute 143-215.66(1)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(S10,000),
* I hereby request modification to coverage under the NPDES Stormwater Permit for the
subject project site. I am familiar with the information contained in this request and to
the best of my knowledge and belief such information is true,complete and accurate.
Specify if you are:* The Legally Responsible Individual
Authorized Responsible Person*
*This form must be signed by a responsible corporate officer that 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.
Reminder: This Modification request must be submitted by the Permittee or someone within the Permittee
organization who is authorized to do so.
Signature* ��,
"kb f"o
Type Name* Christopher Ferraguto
Title* Vice President
Organization* Taylor Morrison of Carolinas,Inc
Date* 04/18/2024
Email Address* [e-mail]
Email for confirmation
Telephone Number* 919-355-0834
Contact number if we need to reach you
Note:Original permittee and site contact are copied on modification correspondence.
Additional Email [e-mail]
(Optional) Additional email for confirmation