HomeMy WebLinkAboutNCC191000_NOI Application_20190718 Action History (UTC-05:00) Eastern Time(US&Canada)
Submit by Anonymous User 7/18/2019 9:59:26 AM(NCG01 NOI Submission)
Approve by Clark, Paul 7/18/2019 10:50:12 AM(Review-Construction NOI 13611)
In Please note the estimated start date 0710512019 and E&SC approval plan letter date 0711512019. Did
not reject because this was either a typo or poor estimate. this was the only problem with the application.
• The task was assigned to Clark, Paul by round robin distribution 7/18/2019 9:59 AM
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:July 22,2019 5:00 PM
7/18/2019 9:59 AM
Submit by Clark, Paul 7/18/2019 10:59:34 AM(Payment Verification- NCG01-2019-1000)
• The task was assigned to Clark, Paul.The due date is: July 19, 2019 5:00 PM 7/18/2019 10:50 AM
1 sees �' � ••. -• i •• i i• i
IY sell
NORTH CAROLINA
Environmental QUII
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name* Greystone Farms Section Five, Part Two- Lot 197
2. County* Cumberland
3. Highway or Street Touchstone Drive
Address* Street narra only is acceptable if no address nurrber assigned yet
4. City or Township* Carvers Creek
5. State* INC
6.Zip Code* 28311
7. Latitude* Enter the latitude in decirral degrees
35.1626
8. Longitude* Enter the longitude in decirral degrees(MIST be negative)
-78.8586
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* 07/05/2019
Estimated Construction Project Start Date
10. Date to End* 01/10/2020
Estimated Construction Project End Date
11. SIC(Primary)* Residential, Other
than SFE(1522)
Standard Industrial Gassification for Developrrent
12.Acres to be 0.53
disturbed* (including off-site borrow and waste areas)
13.Total site area 0.60
(acres)*
14. Post- 0.08
construction (Estimated)
impervious area
(acres)*
NCC Project NCC-CUMBE-2019-Greystone Farms Section Five, Part Two- Lot
Tracking ID 197
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 Carvers Creek
Waterbody* Narre of waterbody into which storrrwater runoff will discharge
15b.Waterbody 18-24
Index No.* NC Waterbody Index Ninber
Stormwater r No
discharges will flow pr Yes
to additional
wate rs*
15c.Additional Cape Fear River
Receiving Waterbody nacre
Waterbody
15d.Waterbody 18-(23.5)
Index No. NCWaterbody Index Pbnber
15e.Additional Waterbody nacre
Receiving
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
.....................................................................................................................................................................
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 Hornaday Homes, LLC
Name*
2. First Name* John
ff Corporation,enter Registered Agent First l\brre
3. Last Name* Hornaday
ff Corporation,enter Registered Agent Last Barre
3b.Title Owner/Manager
4. Permitee E-mail hornadaycc@aol.com
Address*
5. Permittee 910-483-9715
Telephone No.*
6. Permittee Mailing Street Address
Address* 581 Executive Place, Suite 700
Address Line 2
City State/Province/Region
Fayetteville NC
Pastal/Zip Code Country
28305 us
Check box if the rJ Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 581 Executive Place, Suite 700
Address Line 2
City State/Province/Region
Fayetteville NC
Pastal/Zip Code Country
28305 US
C. Site Contact Information
Part C.
Project Site Contact Information
....................................................................................................................
1.Type of Non-Government
Ownership*
2. Primary Site John
Contact-First
Name*
3.Primary Site Hornaday
Contact-Last
Name*
4.Title Owner/Manager
5.Site Contact E- hornadaycc@aol.com
mail Address*
6.Site Contact 910-483-9715
Telephone No.*
7.Organization Hornaday Homes, LLC
Name
8.Site Contact Street Address
Mailing Address* 581 Executive Place, Suite 700
Address Line 2
City State/Province/Region
Fayetteville NC
Fbstal/Zip Code Country
28305 us
D. E&SC Plan
Part D.
Erosion&Sediment Control(E&SC)Ran Approval Information
....................................................................................................................................................................................................................................... .............................................................................................
1. Date E&SC Plan 07/15/2019
Approved*
2. E&SC Plan Project CUMBE-2019-185
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 185 HORNADAY.pdf 72.19KB
Approval Mist be PCFfornat
letter/documentation
6. NOI Certification SIGNED NOI.pdf 345.92KB
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* John Hornaday
Title Owner/Manager
Organization Hornaday Homes, LLC
Date* 07/18/2019
F. Tracking and COC Info
NOI Tracking No. 13611
NC Reference No. NCG01-2019-1000
Uses'count number variable(incremented by SP)
Certificate of NCC191000
Coverage (COC) Uses'count_nunber'variable(increrrented bySP)
No.*
Count Number 1000
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.)