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HomeMy WebLinkAboutNCC190740_NOI Application_20190626Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 6/26/2019 10:19:45 AM (NCG01 NOI Submission) Approve by McCoy, Suzanne 6/26/2019 10:31:11 AM (Review- Construction NOI 12807) • The task was assigned to McCoy, Suzanne by round robin distribution 6/26/2019 10:19 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: June 28, 2019 5:00 PM 6/26/2019 10:19 AM Submit by McCoy, Suzanne 6/26/2019 10:32:32 AM (Payment Verification - NCG01-2019-0740) • The task was assigned to McCoy, Suzanne. The due date is: June 27, 2019 5:00 PM 6/26/2019 10:31 AM 1r-i)iTiT7G)MF11if_T1IIa10141 NORTH CAROLINA Ernvlronmentol qualily A. Project Information Part A. Project Location and Waterbody Inforrration 1. Project Name * Sanctuary At Yates Mill Lot 6 2. County* Wake 3. Highway or Street 2128 Gardenbrook Address * Street name only is acceptable if no address nurrtrer assigned yet 4. City or Township* Raleigh 5. State * NC 6. Zip Code* 27606 7. Latitude * Enter the latitude in decirral degrees 35.7180 8. Longitude * Enter the longitude in decirral degrees (MJSTbe negative) -78.7330 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* 06/26/2019 Estimated Construction Project Start Date 10. Date to End* 06/25/2020 Estimated Construction Project End Date 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial aassification for Development 12. Acres to be 0.40 disturbed* (including off -site borrow and waste areas) 13. Total site area 0.74 (acres)* 14. Post- 0.12 construction (Estimated) impervious area (acres) * NCC Project NCC-WAKE-2019-Sanctuary At Yates Mill Lot 6 Tracking ID Assigned autor atically 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 Woodys Lake Waterbody* Nbrreof waterbody into which stornwater runoff will discharge 15b. Waterbody 27-43-4 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 Fbsponsible 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 Upright Builders, Inc. Name * 2. First Name* SANDRA ff Corporation, enter Registered Agent First l\bma 3. Last Name * LINNEY ff Corporation, enter Registered Agent Last Barre 3b. Title Controller 4. Permitee E-mail SLINNEY@UPRIGHTBUILDERS.COM Address* 5. Permittee 9198588383 Telephone No.* 6. Permittee Mailing Street Address Address* 590 New Waverly Place Address Line 2 Ste. 140 City CARY Postal / Zip Code 27518 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 590 New Waverly Place Address Line 2 Ste. 140 City CARY Rastal / Zip Code 27518 State / Province / Region NORTH CAROLINA Country United States State / Province / Region NORTH CAROLINA Country United States C. Site Contact Information Part C. Roiect Site Contact Information 1. Type of Non -Government Ownership* 2. Primary Site SANDRA Contact - First Name * 3. Primary Site LINNEY Contact - Last Name * 4. Title Controller 5. Site Contact E- SLINNEY@UPRIGHTBUILDERS.COM mail Address* 6. Site Contact 9198588383 Telephone No.* 7. Organization Upright Builders, Inc. Name 8. Site Contact Street Address Mailing Address* 590 New Waverly Place Address Line 2 Ste. 140 City CARY Rbstal / Zip Code 27518 State / Province / Region NORTH CAROLINA Country United States D. E&SC Plan Part D. Erosion & Sediment Control (E&SC) Ran Approval Information ....................................................................................................................................................................................................................................... 1. Date E&SC Plan 06/24/2019 Approved * 2. E&SC Plan Project SEC-019919-2019 Number/ID* Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by r Local Program 4. Local Program* Wake 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 SYM6 Land Dist Permit.pdf Approval Mist be RDFforrrat letter/documentation 6. NOI Certification SYM6 NOI Signed 6 26 19.pdf Form Mist be RJFforrrat This is an Express r No Review Project* r Yes 275.37KB 1.86MB 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. * 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* Sandra Linney Title Controller Organization Upright Builders, Inc. Date * 06/26/2019 F. Tracking and COC Info NOI Tracking No. 12807 NC Reference No. NCG01-2019-0740 Uses 'count number variable (incremrented by SP) Certificate of NCC190740 Coverage (COC) Uses'count_nunber'variable (incremrented by SF) No. * Count Number 740 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.)