HomeMy WebLinkAboutNCC190621_NOI Application_20190617Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/17/2019 8:55:36 AM (NCG01 NOI Submission)
Approve by Georgoulias, Bethany 6/17/2019 9:45:24 AM (Review- Construction NOI 12402)
• The task was assigned to Georgoulias, Bethany by round robin distribution 6/17/2019 8:56 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: June 19, 2019 5:00 PM
6/17/2019 8:56 AM
Submit by Georgoulias, Bethany 6/17/2019 9:45:45 AM (Payment Verification - NCG01-2019-0621)
• The task was assigned to Georgoulias, Bethany. The due date is: June 18, 2019 5:00 PM
6/17/2019 9:45 AM
STME
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Inforrration
1. Project Name * Park Place -Phase Two (Lot 42)
2. County* Cumberland
3. Highway or Street Owland Court
Address * Street name only is acceptable if no address nurrtrer assigned yet
4. City or Township * Seventy First Township
5. State * NC
1r-i)iTOT:2,G)MF11f_T1IIa10141
6. Zip Code* 28304
7. Latitude * Enter the latitude in decirral degrees
35.0093
8. Longitude * Enter the longitude in decirral degrees (MIST be negative)
-78.9804
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*
04/04/2019
Estimated Construction Project Start Date
10. Date to End*
06/01 /2020
Estimated Construction Project End Date
11. SIC (Primary)*
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial aassification for Development
12. Acres to be
0.28
disturbed*
(including off -site borrow and waste areas)
13. Total site area 0.31
(acres)*
14. Post- 0.07
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-CUMBE-2019-Park Place -Phase Two (Lot 42)
Tracking ID Assigned automatically
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 Beaver Creek
Wate rbody* Barre of waterbody into which stormvwater runoff will discharge
15b. Waterbody 18-31-24-5
Index No. * NCWaterbody Index Ninber
Stormwater fJ 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 Caviness & Cates Building and Development Co.
Name *
2. First Name* Christopher
ff Corporation, enter Registered Agent First kbrre
3. Last Name * Cates
ff Corporation, enter Registered Agent Last Barre
3b. Title Vice President
4. Permitee E-mail pam@cavinessandcates.com
Address*
5. Permittee (910) 778-7902
Telephone No.*
6. Permittee Mailing Street Address
Address* 639 Executive Place, Suite 400
Address Line 2
City State / Province / Region
Fayetteville NC
Pastal / Zip Code Country
28305 USA
Check box if the r% Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 639 Executive Place, Suite 400
Address Line 2
City
State / Province / Region
Fayetteville
NC
Pastal / Zip Code
Country
28305
USA
C. Site Contact Information
Part C.
Roiect Site Contact Information
1. Type of Non -Government
Ownership*
2. Primary Site Pamela
Contact - First
Name *
3. Primary Site Geddie
Contact - Last
Name *
4. Title Start Coordinator
5. Site Contact E- pam@cavinessandcates.com
mail Address*
6. Site Contact (910) 778-7902
Telephone No.*
7. Organization Caviness & Cates Building and Development
Name Co.
8. Site Contact Street Address
Mailing Address* 639 Executive Place, Suite 400
Address Line 2
Cty State / Province / Region
Fayetteville NC
Fbstal / Zip Code Country
28305 United States
D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 04/04/2019
Approved *
2. E&SC Plan Project CUMBE-2019-130
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 * Fayetteville (FRO)
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 APPROVAL CUMBE-2019-130 CAVCATES.pdf 71.25KB
Approval Mist be PCFfornat
letter/documentation
6. NOI Certification PL42 NOI.pdf 1.68MB
Form Mist be RJFfornat
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
Type Name * Christopher E. Cates
Title Vice President
Organization Caviness & Cates Building and Development Company
Date * 06/17/2019
F. Tracking and COC Info
NOI Tracking No. 12402
NC Reference No. NCG01-2019-0621
Uses 'count_nunber variable (increrrented by SP)
Certificate of NCC190621
Coverage (COC) Uses'count_nunber'variable (incremented by SF)
No. *
Count Number 621
Sequential nunber for subrrittal that is increrrented by Stored Procedure
COC Year 2019
Year of date reviewed (used to assign YY digits after "NGC' in OOCno.)