Loading...
HomeMy WebLinkAboutNCC191004_NOI Application_20190717 Action History (UTC-05:00) Eastern Time(US&Canada) Submit by Anonymous User 7/17/2019 3:07:36 PM(NCG01 NOI Submission) Approve by Morman,Alaina 7/18/2019 3:47:52 PM(Review-Construction NOI 13580) • The task was assigned to Morman,Alaina by round robin distribution 7/17/2019 3:07 PM • The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:July 19,2019 5:00 PM 7/17/2019 3:07 PM Submit by Morman,Alaina 7/18/2019 4:02:30 PM(Payment Verification-NCG01-2019-1004) • The task was assigned to Morman,Alaina.The due date is:July 19,2019 5:00 PM 7/18/2019 3:48 PM 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* Wendell Valley Blvd. 2. County* Wake 3. Highway or Street Knightdale Eagle Rock Road Address* Street narra only is acceptable if no address nurrber assigned yet 4. City or Township* Town of Wendell 5. State* NC 6.Zip Code* 27591 7. Latitude* Enter the latitude in decirral degrees 35.7919 8. Longitude* Enter the longitude in decirral degrees(MIST be negative) -78.4265 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* 09/02/2019 Estimated Construction Project Start Date 10. Date to End* 09/04/2020 Estimated Construction Project End Date 11. SIC(Primary)* Highway(1611) Standard Industrial aassification for Developrrent 12.Acres to be 11.73 disturbed* (including off-site borrow and waste areas) 13.Total site area 12.13 (acres)* 14. Post- 5.05 construction (Estimated) impervious area (acres)* NCC Project NCC-WAKE-2019-Wendell Valley Blvd. 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 Marks Creek Wate rbody* Narre of waterbody into which stormuater runoff will discharge 15b.Waterbody 27-38 Index No.* NCWaterbody Index Nunber Stormwater rJ No discharges will flow r Yes to additional wate rs* 16a.Is this project r 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 NASH Wendell Falls, LLC Name* 2. First Name* Garretson ff Corporation,enter Registered Agent First l\b e 3. Last Name* Browne ff Corporation,enter Registered Agent Last Barre 3b.Title Construction Manager 4. Permitee E-mail gbrowne@newlandco.com Address* 5. Permittee 919-819-9427 Telephone No.* 6. Permittee Mailing Street Address Address* 4020 Westchase Boulevard Address Line 2 Suite 150 City State/Province/Region Raleigh NC Rastal/Zip Code Country 27607 us Check box if the rJ Yes street address the same as mailing address 7. Permittee Street Street Address Address* 4020 Westchase Boulevard Address Line 2 Suite 150 City State/Province/Region Raleigh NC Rastal/Zip Code Country 27607 US C. Site Contact Information Part C. Project Site Contact Information .................................................................................................................... 1.Type of Non-Government Ownership* 2. Primary Site Garretson Contact-First Name* 3.Primary Site Browne Contact-Last Name* 4.Title Construction Manager 5.Site Contact E- gbrowne@newlandco.com mail Address* 6.Site Contact 919-819-9427 Telephone No.* 7.Organization NASH Wendell Falls, LLC Name 8.Site Contact Street Address Mailing Address* 4020 Westchase Boulevard Address Line 2 Suite 150 City State/Province/Fbgion Raleigh NC Fbstal/Zip Code Country 27607 us D. E&SC Plan Part D. Erosion&Sediment Control(E&SC)Ran Approval Information ....................................................................................................................................................................................................................................... .................................................................... 1. Date E&SC Plan 06/14/2019 Approved* 2. E&SC Plan Project SEC-008941-2018 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 Wendell Valley Approval Blvd_MUNICIPALWatershedManagementApproval_... 320.89KB letter/documentation 14-19.pdf Wendell Valley Blvd FRP form.pdf 136.56KB Wendell Valley Blvd. Erosion Control Plans.pdf 11.1 MB Mast be RCF format 6. NOI Certification Wendell Valley Blvd_NOI-signed.pdf 277.84KB Form NLst be PCFfornat This is an Express r No Review Project* f 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. * 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 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 6a/n✓}t.�5a Type Name* Garretson Browne Title Construction Manager Organization Newland Date* 07/17/2019 F. Tracking and COC Info NOI Tracking No. 13580 NC Reference No. NCG01-2019-1004 Uses'count number variable(incremented by SP) Certificate of NCC191004 Coverage (COC) Uses'count number variable(increrrentedbySP) No.* Count Number 1004 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.)