HomeMy WebLinkAboutNCC191319_NOI Application_20190909 Action History (UTC-05:00) Eastern Time(US&Canada)
Submit by Anonymous User 8/8/2019 1:53:49 PM(NCG01 NOI Submission)
Approve by Lucas,Annette 8/9/2019 4:35:13 PM(Review-Construction NOI 14641)
• The task was assigned to Lucas,Annette by round robin distribution 8/8/2019 1:54 PM
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:August 12,2019 5:00
PM 8/8/2019 1:54 PM
Submit by McCoy,Suzanne 9/9/2019 11:19:06 AM(Payment Verification for NCC191319)
* April Chianese.
• McCoy, Suzanne assigned the task to McCoy,Suzanne 9/9/2019 11:18 AM
• Georgoulias, Bethany changed the task's due date to September 8,2019 5:00 PM 9/5/2019 12:49 PM
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:August 23,2019 5:00 PM
8/9/2019 4:35 PM
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A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name* San Marino Phase 1-2 Lots 1-2; 7-58; 63-65; 86-89; 95-97;244-
246
2.County* Johnston
3. Highway or Street 24 Carbone Ln.
Address* Street narre only is acceptable if no address nun-ber assigned yet
4. City or Township* Clayton
5. State* NC
6.Zip Code* 27527
7. Latitude* Enter the latitude in decimal degrees
35.6507
8. Longitude* Enter the longitude in decirral degrees(MJST be negative)
-78.3772
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* 08/07/2019
Estirrated Construction Project Start Date
10. Date to End* 08/07/2021
Estirrated Construction Project End hate
11. SIC(Primary)* Residential, Single
Family Houses(SFE)
(1521)
Standard Industrial aassification for Developrrent
12.Acres to be 14.64
disturbed* (including off-site borrow and waste areas)
13.Total site area 14.64
(acres)*
14. Post- 4.82
construction (Estirrated)
impervious area
(acres)*
NCC Project NCC-JOHNS-2019-San Marino Phase 1-2 Lots 1-2; 7-58; 63-65;
Tracking ID 86-89; 95-97; 244-246
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 Mill Creek
Waterbody* Narre of waterbody into which storrrwater runoff will discharge
15b.Waterbody 27-39
Index No.* NC Waterbody Index Ninber
Stormwater r No
discharges will flow pr Yes
to additional
wate rs*
15c.Additional Neuse River
Receiving Waterbody narra
Waterbody
15d.Waterbody 27-38.5
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 Taylor Morrison of Carolinas, Inc.
Name*
2. First Name* Jeremy
ff Corporation,enter Registered Agent First l\b e
3. Last Name* Medlin
ff Corporation,enter Registered Agent Last Barre
3b.Title VP Land Acquisition and Development
4. Permitee E-mail jmedlin@taylormorrison.com
Address*
5. Permittee 919-291-3819
Telephone No.*
6. Permittee Mailing Street Address
Address* 15501 Weston Parkway
Address Line 2
Suite 100
City State/Province/Region
Cary NC
Pastal/Zip Code Country
27513 us
Check box if the rJ Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 15501 Weston Parkway
Address Line 2
Suite 100
City State/Province/Region
Cary NC
Pastal/Zip Code Country
27513 US
C. Site Contact Information
Part C.
Project Site Contact Information
....................................................................................................................
1.Type of Non-Government
Ownership*
2. Primary Site Jimmy
Contact-First
Name*
3.Primary Site Little
Contact-Last
Name*
4.Title Land Development Manager
5.Site Contact E- jlittle@taylormorrison.com
mail Address*
6.Site Contact 984-363-5453
Telephone No.*
7.Organization Taylor Morrison of Carolinas, Inc.
Name
8.Site Contact Street Address
Mailing Address* 15501 Weston Parkway
Address Line 2
Suite 100
aty State/Province/Pegion
Cary NC
Fbstal/Zip Code Country
27513 us
9.Consultant Name (optional)
First and Last nacre
10.Consultant E- This person will be copied on all correspondence.
mail
11. Consultant
Telephone No.
D. E&SC Plan
Part D.
Erosion&Sediment Control(E&SC)Ran Approval Information
....................................................................................................................................................................................................................................... .............................................................................................
1. Date E&SC Plan 07/23/2019
Approved*
2. E&SC Plan Project JC#17-013-P
Number/ID* Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by r Local Program
4. Local Program* Johnston 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 Approval Letter San Marino P1A 2A lots 1-2 7-58
Approval 152.33KB
63-65 86-89 95-97 244-246 ESC appr 7.23.19.pdf
letter/documentation
Mist be RJF forrrat
6. NOI Certification NCG01 San Marino.pdf 86.77KB
Form Mist be RJFfornat
This is an Express r No
Review Project* r 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
C'gtevtr�11 KW-�W
Type Name* Jeremy Medlin
Title VP of Land Acquisition and Development
Organization Taylor Morrison of Carolinas, Inc.
Date* 08/08/2019
F. Tracking and COC Info
NOI Tracking No. 14641
NC Reference No. NCG01-2019-1319
Uses'count number variable(incremented by SP)
Certificate of NCC191319
Coverage (COC) Uses'count_nunber'variable(increrrented bySP)
No.*
Count Number 1319
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.)