NCC190283_NOI Application_20190514

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/14/2019 3:58:10 PM (NCG01 NOI Submission)
Approve by Lucas, Annette 5/15/2019 2:53:10 PM (Review- Construction NOI 11002)
In Good luck with your project.
• The task was assigned to Lucas, Annette by round robin distribution 5/14/2019 3:58 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: May 16, 2019 5:00 PM
5/14/2019 3:58 PM
Submit by Lucas, Annette 5/15/2019 3:00:41 PM (Payment Verification - NCG01-2019-0283)
• The task was assigned to Lucas, Annette. The due date is: May 16, 2019 5:00 PM 5/15/2019 2:53 PM

STME
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Inforrration
1. Project Name * UNC Kenan Stadium and Off -Site Stormwater Site
2. County* Orange
3. Highway or Street Stadium Drive
Address * Street name only is acceptable if no address nurrtrer assigned yet
4. City or Township* Chapel Hill
5. State * NC
1r-i)iTiT7i)ilf1Iif_T1IIa10141
6. Zip Code* 27514
7. Latitude * Enter the latitude in decirral degrees
35.9070
8. Longitude * Enter the longitude in decirral degrees (MIST be negative)
-79.0479
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*
05/15/2019
Estimated Construction Project Start Date
10. Date to End*
06/30/2019
Estimated Construction Project End Date
11. SIC (Primary)*
Other (0000)
Standard Industrial aassification for Development
12. Acres to be
2.60
disturbed*
(including off -site borrow and waste areas)
13. Total site area
2.60
(acres)*
14. Post-
2.60
construction
(Estimated)
impervious area
(acres) *
NCC Project
NCC-ORANG-2019-UNC Kenan Stadium and Off -Site Stormwater
Tracking ID
Site
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 Chapel Creek
Waterbody* %rre of waterbody into which stormuater runoff will discharge
15b. Waterbody 16-41-2-8
Index No.* NC Waterbody Index Nunter
Stormwater V No
discharges will flow r- Yes
to additional
wate rs *
16a. Is this project r Yes
subject to the NC f 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
The University of North Carolina at Chapel Hill
Name *
2. First Name*
Jonathan
ff Corporation, enter Registered Agent First %rre
3. Last Name *
Pruitt
ff Corporation, enter Registered Agent Last Barre
3b. Title
Vice Chancellor for Finance and Operations
4. Permitee E-mail [e-mail]
Address*
5. Permittee 919-962-3795
Telephone No.*
6. Permittee Mailing Street Address
Address* Campus Box 1000
Address Line 2
City State / Province / Region
Chapel Hill NC
Postal / Zip Code Country
27599 USA
Check box if the r Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 300 South Building - 200 E. Cameron Ave.
Address Line 2
City State / Province / Region
Chapel Hill NC
Pastal / Zip Code Country
27514 USA

C. Site Contact Information
Part C.
Roiect Site Contact Information
1. Type of Government - State
Ownership*
2. Primary Site Janet
Contact - First
Name *
3. Primary Site Clarke
Contact - Last
Name *
4. Title Stormwater Specialist
5. Site Contact E- [e-mail]
mail Address*
6. Site Contact 919-843-0475
Telephone No.*
7.Organization UNC-CH
Name
8. Site Contact Street Address
Mailing Address* 1120 Estes Drive Extension
Address Line 2
city
Chapel Hill
Rbstal / Zip Code
27599
State / Province / Region
NC
Country
US

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 05/06/2019
Approved *
2. E&SC Plan Project ORANG-2019-013
Number/ID* Assigned by agency or local program
3. E&SC Plan f• State DEQ Office
Approved by r Local Program
4. State DEQ Office * Raleigh (RRO)
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 ORANG-2019-013 LOA MOD 20190506.pdf 209.19KB
Approval Mast be PCFfornat
letter/documentation
6. NOI Certification Kenan Stadium Notice of Intent Certification
Form 40.17KB
Form.pdf
Mast be ROF format
This is an Express f• No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.613 (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.
* rJ 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.
* rJ 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
O v�W'1&I?r
Type Name * Jonathan Pruitt
Title Vice Chancellor for Finance and Operations
Organization The University of North Carolina - Chapel Hill
Date * 05/14/2019

F. Tracking and COC Info
NOI Tracking No. 11002
NC Reference No. NCG01-2019-0283
Uses 'count number variable (incremrented by SP)
Certificate of NCC190283
Coverage (COC) Uses 'count nunber variable (increrrentedbySP)
No. *
Count Number 283
Sequential nunber for subrrittal that is incremented by Stored Procedure
COC Year 2019
Year of date reviewed (used to assign YY digits after "NGC' in OOCno.)