HomeMy WebLinkAboutNCC190444_NOI Application_20190601Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/1/2019 2:57:46 PM (NCG01 NOI Submission)
Approve by Lucas, Annette 6/3/2019 11:52:59 AM (Review- Construction NOI 11622)
In Good luck with your project.
• The task was assigned to Lucas, Annette by round robin distribution 6/1/2019 2:58 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: June 5, 2019 5:00 PM
6/1 /2019 2:58 PM
Submit by Lucas, Annette 6/3/2019 11:57:48 AM (Payment Verification - NCG01-2019-0444)
• The task was assigned to Lucas, Annette. The due date is: June 4, 2019 5:00 PM 6/3/2019 11:53 AM
STME
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Inforrration
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1. Project Name * JOAN P. H. MYERS RESIDENCE AKPAR 60198 3037 MT. VIEW
CHURCH ROAD
2. County* Chatham
3. Highway or Street 3037 MOUNT VIEW CHURCH ROAD
Address* Street narre only is acceptable if no address nun-ber assigned yet
4. City or Township* HAW RIVER
5. State * NC
6. Zip Code * 27559
7. Latitude* Enter the latitude in decimal degrees
35.6489
8. Longitude * Enter the longitude in decirral degrees (MJST be negative)
-79.1291
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*
05/28/2019
Estirrated Construction Project Start Date
10. Date to End*
05/20/2020
Estirrated Construction Project End Date
11. SIC (Primary)*
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial Classification for Developrrent
12. Acres to be
1.57
disturbed*
(including off -site borrow and waste areas)
13. Total site area 8.98
(acres) *
14. Post- 0.95
construction (Estirrated)
impervious area
(acres) *
NCC Project NCC-CHATH-2019-JOAN P. H. MYERS RESIDENCE AKPAR 60198
Tracking ID 3037 MT. VIEW CHURCH ROAD
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 ROCKY BRANCH
Waterbody* Narre of waterbody into which storrrwater runoff will discharge
15b. Waterbody 17-44-(1)
Index No. * NCWaterbody Index Ninber
Stormwater r No
discharges will flow pr Yes
to additional
wate rs *
15c. Additional DEEP RIVER
Receiving Waterbody nacre
Waterbody
15d. Waterbody NCWaterbody Index Ninber
Index No.
15e. Additional 17-(43.5)
Receiving Waterbody nacre
Waterbody
15f. Waterbody NCWaterbody Index Ninber
Index No.
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 T.C. Property Solutions, Inc.
Name *
2. First Name* Martin
ff Corporation, enter Registered Agent First l\b e
3. Last Name * Galardi
ff Corporation, enter Registered Agent Last Barre
3b. Title president
4. Permitee E-mail pointemg@aol.com
Address*
5. Permittee 9194278314
Telephone No.*
6. Permittee Mailing Street Address
Address* T.C. Property Solutions, Inc.
Address Line 2
140 Muirfield Drive
City
Youngsville
Postal / Zip Code
27596-2015
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
T.C. Property Solutions, Inc.
Address Line 2
140 Muirfield Drive
City
Youngsville
Postal / Zip Code
27596-2015
State / Province / Region
NC
Country
USA
State / Province / Region
NC
Country
USA
C. Site Contact Information
Part C.
Roiect Site Contact Information
1. Type of Individual
Ownership*
2. Primary Site Martin
Contact - First
Name *
3. Primary Site Galardi
Contact - Last
Name *
4. Title President
5. Site Contact E- pointemg@aol.com
mail Address*
6. Site Contact 9194278314
Telephone No.*
7. Organization
T.C. Property Solutions, Inc.
Name
8. Site Contact
Street Address
Mailing Address*
140 Muirfield Dr
Address Line 2
city
Youngsville
Rbstal / Zip Code
27596-2015
State / Province / Region
NC
Country
USA
D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 05/22/2019
Approved *
2. E&SC Plan Project 2019-03942
Number/ID* Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by r Local Program
4. Local Program* Chatham 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 Letter of Approval - Performance Reservations. pdf 809.83KB
Approval Mist be PCFfornat
letter/documentation
6. NOI Certification NCG01-eNO1-Certification-Form-20190507-DEMLR-
Form SW.pdf 380.28KB
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
�arr.��ir �+�r2lr�fcr'r.
Type Name* Martin J Galardi
Title president
Organization T.C. Property Solutions, Inc.
Date * 06/01 /2019
F. Tracking and COC Info
NOI Tracking No. 11622
NC Reference No. NCG01-2019-0444
Uses 'count number variable (incremrented by SP)
Certificate of NCC190444
Coverage (COC) Uses'countnunber'variable (incremrented by SF)
No. *
Count Number 444
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.)