NCC190062_NOI Application_20190417

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 4/17/2019 4:48:50 PM (NCG01 NOI Submission)
Approve by Morman, Alaina 4/18/2019 8:16:02 AM (Review- Construction NOI 10225)
The task was assigned to Morman, Alaina by round robin distribution 4/17/2019 4:49 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: April 19, 2019 5:00 PM.
The priority is: High 4/17/2019 4:49 PM
Submit by Morman, Alaina 4/18/2019 8:16:49 AM (Payment Verification - NCG01-2019-0062)
The task was assigned to Morman, Alaina. The due date is: April 19, 2019 5:00 PM. The priority is:
High 4/18/2019 8:16 AM

STME
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
! 1i1) irill 1-11 f_T11I a 10 10
Part A.
Project Location and Waterbody Inforrration
1. Project Name * River Dell East (POD 12) Phase 4 at Flowers Plantation
2. County* Johnston
3. Highway or Street E Neuse River Parkway
Address * Street narra only is acceptable if no address nurrber assigned yet
4. City or Township * Flowers Plantation
5. State * NC
6. Zip Code* 27527
7. Latitude * Enter the latitude in decirral degrees
35.6682
8. Longitude * Enter the longitude in decirral degrees (MJSTbe negative)
-78.3438
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. Date to End*
11. SIC (Primary)*
12. Acres to be
disturbed *
13. Total site area
(acres)*
14. Post -
construction
impervious area
(acres) *
05/15/2019
Estirrated Construction Project Start Date
05/15/2020
Estirrated Construction Project End Date
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial aassification for Developrrant
16.39
(including off -site borrow and waste areas)
5.65

NCC Project NCC-JOHNS-2019-River Dell East (POD 12) Phase 4 at Flowers
Tracking ID Plantation
Assigned autorratically
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. You may
enter up to 3 waterbodies.
15a. Receiving Buffalo Creek
Wate rbody* Narre of waterbody into which storrrwater runoff will discharge
15b. Waterbody 27-57-16-(3)
Index No. * NC Waterbody Index Ninber
Stormwater PF No
discharges will flow r Yes
to additional
wate rs *
16a. Is this project F Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B.
Perrrittee Information - Legally Responsible Entity and Individual
.....................................................................................................................................................................
h
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form should 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. Organization DWF Development, Inc.
Name *
2. First Name*
Rebecca
ff Corporation, enter Registered Agent First l\b e
3. Last Name *
Flowers
ff Corporation, enter Registered Agent Last Barre
4. Permitee E-mail
[e-mail]
Address*
5. Permittee 919-369-8332
Telephone No.*
6. Permittee Mailing Street Address
Address* 4880 NC-42 East
Address Line 2
City
State / Province / Region
Clayton
NC
Fbstal / Zip Code
Country
27527
us
Check box if the V Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 4880 NC-42 East
Address Line 2
City
State / Province / Region
Clayton
NC
Postal / Zip Code
Country
27527
us

C. Site Contact Information
Part C.
Roiect Site Contact hforrration
1. Type of Non -Government
Ownership*
2. Primary Site Kevin
Contact - First
Name *
3. Primary Site Varnell
Contact - Last
Name *
4. Title Project Manager
5. Site Contact E- [e-mail]
mail Address*
6. Site Contact 252-459-8196
Telephone No.*
7. Organization Stocks Engineering
Name
8. Site Contact Street Address
Mailing Address* PO Box 1108
Address Line 2
city
Nashville
Fbstal / Zip Code
27856
State / Province / Region
NORTH CAROLINA
Country
us

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 04/10/2019
Approved *
2. E&SC Plan Project JC# 19-011-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.
5. E&SC Plan 19-011 River Dell East POD 12 PH4 ESC Approval
Approval 126.52KB
4.10.19.pdf
letter/documentation
Mist be RDF forrrat
6. NOI Certification NCG01-eNOI-Certification-Form-RDE - Ph4.pdf 278.18KB
Form Mist be RDFforrrat
This is an Express f No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.6B (1) provides that:
Anyperson who knowinglymakes any false statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes 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 deice or method required to be operated or maintained under this Article or rules of the
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
rJ 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.
* V 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.
* I7 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* V 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.
* I7 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 Responsible Person named on this Notice of Intent
r Authorized Responsible Person*
Important: The person who signs this Certification above and signs the NOI Certification Form should be the same
person (or authorized responsible person within the same organization) as listed in Section B (Permittee Information)
of this form. *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* Rebecca Flowers
Date * 04/17/2019

F. Tracking and COC Info
NOI Tracking No. 10225
NC Reference No. NCG01-2019-0062
Uses 'count_nunber variable (increrrented by SP)
Certificate of NCC190062
Coverage (COC) Uses 'count _nunber'variable (increrrented bySP)
No. *
Count Number 62
Sequential nunber for subrrittal that is increrrented by Stored Procedure
COC Year 2019
Year of date reviewed, used to assign YY digits after "NOC' in OOC no.)