HomeMy WebLinkAboutNCC190405_NOI Application_20190528Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/28/2019 9:38:41 PM (NCG01 NOI Submission)
Approve by Clark, Paul 5/29/2019 4:24:23 PM (Review- Construction NOI 11454)
* 9. The date to begin 5/15/2019 is the date of the E&SC plan approval. This date should be later than
the application submittal date. The 5/15/2019 was likely accidentally entered?
15c should read Tar River and not include the word basin.
These are reasons NOT to reject eNO1.
• The task was assigned to Clark, Paul by round robin distribution 5/28/2019 9:39 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: May 30, 2019 5:00 PM.
The priority is: High 5/28/2019 9:39 PM
Submit by Clark, Paul 5/29/2019 4:25:20 PM (Payment Verification - NCG01-2019-0405)
• The task was assigned to Clark, Paul. The due date is: May 30, 2019 5:00 PM. The priority is: High
5/29/2019 4:24 PM
STME
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Inforrration
1. Project Name * IRONWOOD- MARQUART
2. County* Pitt
3. Highway or Street 4410 OAKSONG DRIVE
Address * Street name only is acceptable if no address nurrber assigned yet
4. City or Township* greenville
5. State * NC
1r-G)ff&T7G)MraIif_T1IIa10141
6. Zip Code* 27834
7. Latitude * Enter the latitude in decirral degrees
35.6460
8. Longitude * Enter the longitude in decirral degrees (MIST be negative)
-77.4480
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*
09/15/2019
Estimated Construction Project End Date
11. SIC (Primary)*
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial aassification for Development
12. Acres to be
0.25
disturbed*
(including off -site borrow and waste areas)
13. Total site area 1.17
(acres)*
14. Post- 0.15
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-PITT-2019-IRONWOOD-MARQUART
Tracking ID 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 SAMS BRANCH STREAM
Waterbody* Narreof waterbody into which stornvwater runoff will discharge
15b. Waterbody 28-29
Index No. * NCWaterbody Index Ninber
Stormwater r No
discharges will flow pr Yes
to additional
wate rs *
15c. Additional TAR RIVER BASIN
Receiving Waterbody nacre
Waterbody
15d. Waterbody 28-84
Index No. NCWaterbody Index Nanber
15e. Additional Waterbody narre
Receiving
Waterbody
15f. Waterbody svmarquart@gmail.co
Index No. m
NC Waterbody Index NAnber
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 MQ CONSTRUCTION INC
Name *
2. First Name* GREGORY
ff Corporation, enter Registered Agent First Nacre
3. Last Name * MARQUART
ff Corporation, enter Registered Agent Last Nbrre
3b. Title PRESIDENT
4. Permitee E-mail svmarquart@gmail.com
Address*
5. Permittee 1-252-341-1224
Telephone No.*
6. Permittee Mailing Street Address
Address* 2024 Stallings Road
Address Line 2
City
Macclesfield
Postal / Zip Code
27852
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
fJ Yes
Street Address
2024 Stallings Road
Address Line 2
City
Macclesfield
Rbstal / Zip Code
27852
State / Province / Region
NC
Country
US
State / Province / Region
NC
Country
US
C. Site Contact Information
Part C.
Roiect Site Contact Information
1. Type of Individual
Ownership*
2. Primary Site GREGORY
Contact - First
Name*
3. Primary Site MARQUART
Contact - Last
Name *
4. Title PRESIDENT
5. Site Contact E- svmarquart@gmail.com
mail Address*
6. Site Contact 252-341-1224
Telephone No.*
7. Organization
MQ CONSTRUCTION INC
Name
8. Site Contact
Street Address
Mailing Address*
2024 STALLINGS RD
Address Line 2
city
MACCLESFIELD
Fbstal / Zip Code
27852
State / Province / Region
NC
Country
United States
D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 05/15/2019
Approved *
2. E&SC Plan Project ESC[-2019-0013
Number/ID* Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by r Local Program
4. Local Program* City of Greenville
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 4410 Oak Song Drive EC Plan Approval (2).pdf 228.96KB
Approval Mist be R7Ffornat
letter/documentation
6. NOI Certification IRONWOOD 4410 OAK NCG01-eNO1-Certification-
Form 440.43KB
Form-20190507-DEMLR-SW. pdf
Mist be RDFforrrat
This is an Express r 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* Gregory J. Marquart
Title president
Organization MQ Construction, Inc
Date * 05/28/2019
F. Tracking and COC Info
NOI Tracking No. 11454
NC Reference No. NCG01-2019-0405
Uses 'count number variable (incremrented by SP)
Certificate of NCC190405
Coverage (COC) Uses 'count nunber variable (increrrentedbySP)
No. *
Count Number 405
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.)