HomeMy WebLinkAboutNCC191073_NOI Application_20190725Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/25/2019 3:06:45 PM (NCG01 NOI Submission)
Approve by Clark, Paul 7/26/2019 9:57:39 AM (Review- Construction NOI 13967)
• The task was assigned to Clark, Paul by round robin distribution 7/25/2019 3:06 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: July 29, 2019 5:00 PM
7/25/2019 3:06 PM
Submit by Clark, Paul 7/26/2019 9:58:39 AM (Payment Verification - NCG01-2019-1073)
• The task was assigned to Clark, Paul. The due date is: July 29, 2019 5:00 PM 7/26/2019 9:57 AM
STME
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Inforrration
1. Project Name * Hyde Park
2. County* Buncombe
3. Highway or Street Hyde Park Place
Address * Street name only is acceptable if no address nurrtrer assigned yet
4. City or Township* Fletcher
5. State * NC
1r-i)iTII1T7G)MF11if_T1IIa10141
6. Zip Code* 28732
7. Latitude * Enter the latitude in decirral degrees
35.4540
8. Longitude * Enter the longitude in decirral degrees (MIST be negative)
-82.5028
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 *
08/01 /2019
Estimated Construction Project Start Date
10. Date to End*
08/01 /2020
Estimated Construction Project End Date
11. SIC (Primary)*
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial aassification for Development
12. Acres to be
6.94
disturbed*
(including off -site borrow and waste areas)
13. Total site area 10.08
(acres)*
14. Post- 2.19
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-BUNCO-2019-Hyde Park
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 Pinner Creek (Morgan Lake)
Waterbody* I\bme of waterbody into which stormvdater runoff will discharge
15b. Waterbody 6-57-18
Index No. * NCWaterbody Index Ninber
Stormwater r No
discharges will flow pr Yes
to additional
wate rs *
15c. Additional Cane Creek
Receiving Waterbody narre
Waterbody
15d. Waterbody 6-57-(9)
Index No. NCWaterbody Index PJunber
15e. Additional French Broad River
Receiving Waterbody narre
Waterbody
15f. Waterbody 6.-54.75
Index No. NC Waterbody Index N irrber
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 Windsor Built Homes, Inc
Name *
2. First Name* Scott
ff Corporation, enter Registered Agent First l\b e
3. Last Name * Street
Y Corporation, enter Registered Agent Last Barre
3b. Title President
4. Permitee E-mail sstreet@windsorbuilt.com
Address*
5. Permittee 864.430.2995
Telephone No.*
6. Permittee Mailing Street Address
Address* P.O. Box 1598
Address Line 2
City
Fletcher
Postal / Zip Code
28732
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
r Yes
Street Address
236 Water Leaf Drive
Address Line 2
City
Weaverville
Fbstal / Zip Code
28787
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 Non -Government
Ownership*
2. Primary Site Scott
Contact - First
Name *
3. Primary Site Street
Contact - Last
Name *
4. Title President
5. Site Contact E- sstreet@Wndsorbuilt.com
mail Address*
6. Site Contact 864.430.2995
Telephone No.*
7. Organization Windsor Built Homes, Inc.
Name
8. Site Contact Street Address
Mailing Address* P.O.Box 1598
Address Line 2
city
Fletcher
Rbstal / Zip Code
28732
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 07/25/2019
Approved *
2. E&SC Plan Project ERO2019-00044
Number/ID* Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by r Local Program
4. Local Program* Buncombe 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 ERO2019-00044LDP.pdf
Approval Mast be FDFfornat
letter/documentation
6. NOI Certification NCGO1 NOI Certification Form -
Form 07252019150447.pdf
Mist be RCF format
This is an Express r No
Review Project* r Yes
594.59KB
418.65KB
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
Type Name* Scott Street
Title President
Organization Windsor Built Homes, Inc.
Date * 07/25/2019
F. Tracking and COC Info
NOI Tracking No. 13967
NC Reference No. NCG01-2019-1073
Uses 'count number variable (incremrented by SP)
Certificate of NCC191073
Coverage (COC) Uses 'count _nunber'variable (increrrented bySP)
No. *
Count Number 1073
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.)