NCC222241_NOI Application_20220617

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/15/2022 10:52:04 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 6/16/2022 10:13:06 AM (Review - NOI 94385 Duke Energy Silas 100 kV Rebuild)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 6/15/2022 10:52 PM
• The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: June 20, 2022 5:00 PM
6/15/2022 10:52 PM
by Workflow 6/16/2022 10:13:15 AM (Workflow Start Event)
Submit by Georgoulias, Bethany A 6/17/2022 7:30:29 AM (Payment Verification for NCC222241)
F Jeffrey Goto
• Georgoulias, Bethany A assigned the task to Georgoulias, Bethany A 6/17/2022 7:30 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: July 28, 2022 5:00 PM
6/16/2022 10:13 AM

a
NORTH CAROLINA,
Enri--tn! C2-1;ly
A. Project Information
Part A.
Project Location and Waterbody Information
................................................................................................................... .
Are you submitting No
an NOI that was Yes
rejected before?
la. Project Name* Duke Energy Silas 100 kV Rebuild
1 b. Specific Lot This field may be used to list specifc lot numbers.
Numbers
1 c. Parcel ID List all PINS associated with this project.
Number(s) (PIN) 5737897493
5738816115
5738816552
5748016116
5738828110
5738920040
5738922050
5738922045
5738924100
5738924108
5738910797
5738912853
5738912953
5738927022
5738924000
5748010989
5748016116
5748021808
5748024826
5748035270
5748024617
5748028905
5748120933
5748336779
5748258742
5748356709
5748454401
5748451941
5748453866
5748456833
5748464236
5748560148
5748575136
5748563385
5748575136

5748567624
5748579535
5748673307
5748674404
5748674573
5748675577
5748677628
5748678748
5748770910
5748771919
5748783123
5748785392
5748660904
5748670091
5748671077
5748672163
5748673149
5748674236
5748675312
5748676308
5748676493
5748678538
5748679667
5748771729
5748772837
5748784011
5748786114
5748787211
5748788402
5748789638
5748886648
5748897352
5748891080
5748891080
5748995787
5758184406
5759015275
5758380543
5759200493
5759116454
5759224225
5759228205
5759226542
5759314750
5759334990
5759536842
5759664062
5759760451
5759765307
5759766423
5759767450
5759769412
5759854813
5759868686
5759964376
5759963823
5759966811
5759979251
5759978324
5769073030
5769089325
R7aamaanp

5769196311
5769196311
5860208765
5860307293
5860506782
5860405603
5860415529
5860506782
5860626080
5860626080
5860629738
5860724506
5860732381
5860735342
5860737680
5860646971
5860659340
5860743492
5860745687
5860561470
5860832141
5860739874
5860842100
5860835959
5860832084
5860835584
5860837544
5860839512
5860836774
5860943430
5870044511
5870055676
5870152171
5870068175
5870154446
5870154922
5870169189
5870167103
5870263199
5870358683
5870367446
5870376489
5870387403
5870553878
5870469621
5870564954
5870575177
5870568617
5870597280
5870690312
5870691336
5870692337
5870693388
5870696494
5870697638
5870588998
5870690170
5870692151
5870693171
5870694192
5870697249

5870792456
5870797479
5870882909
5870798219
5870893294
5870891668
5870893528
5870892581
5870898679
5871801512
5871902134
5871902400
5870994880
5880096281
5871917448
5881108815
5881324585
5881324585
5880493311
5880398696
5881306106
27006-0000
5881403824
5881405700
5881611162
5881611162
5881510625
5881621957
5881633871
5881750376
5881555272
2. County* Davie
3. Highway or Street E Lexington Road
Address* Street name only is acceptable if no address number assigned yet
4. City or Township* Mocksville
5. State*
NC
6. Zip Code*
27028
7. Latitude*
Enter the latitude in decimal degrees
35.8875
8. Longitude*
Enter the longitude in decimal degrees (MUST be negative)
-80.5567
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*
06/17/2022
Estimated Construction Project Start Date
10. Date to End*
07/28/2023
Estimated Construction Project End Date
11. SIC (Primary)*
Industrial (1541)
Standard Industrial Classification for Development

12. Acres to be 98.00
disturbed* (including off -site borrow and waste areas)
13. Total site area 98.00
(acres) *
14. Post -construction 0.00
impervious area (Estimated)
(acres)*
Project Tracking ID NCC-DAVIE-2022-Duke Energy Silas 100 kV Rebuild
Assigned automatically (not used)
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. Please enter
only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You may enter
up to 3 waterbodies if needed.
15a. Receiving Elisha Creek
Waterbody * Name of waterbody into which stormwater runoff will discharge
15b. Waterbody Index 12-102-15
No. * NC Waterbody Index Number
Stormwater No
discharges will flow Yes
to additional waters*
15c. Additional Carter Creek
Receiving Waterbody Waterbody name
15d. Waterbody Index 12-93
No. NC Waterbody Index Number
15e. Additional Buffalo Creek
Receiving Waterbody Waterbody name
15f. Waterbody Index 12-102-14
No. NC Waterbody Index Number
16a. Is this project Yes
subject to the NC No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B.
Permittee 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 must 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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
1. Permittee* Legally Responsible Entity
Duke Energy Carolinas, LLC
If permittee is an individual, enter first and last name in this field. Otherwise, enter organization/business name.
Note: If the permittee is a business, the business must be registered with the NC Secretary of State. You can verify the
registration here. Permittee must be the same entity that is responsible for the land -disturbing activity as listed on the NC
SPCA Financial Responsibility/Ownership (FRO) Form.
2. First Name* Jeffrey
If Corporation, enter Registered Agent First Name
3. Last Name* Goto
If Corporation, enter Registered Agent Last Name
3b. Title Lead Transmission Permitting Manager
4. Permitee E-mail [e-mail]
Address*
5. Permittee 760-445-3332
Telephone No.*
6. Permittee Mailing Street Address
Address* EC09Q 526 South Church Street
Address Line 2
City State / Province / Region
Charlotte NC
Postal / Zip Code Country
28202-1006 us
Check box if the Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
526 South Church Street
Address Line 2
City
State / Province / Region
Charlotte
us
Postal / Zip Code
Country
28202-1802
NC
8. Type of
Ownership is only individual if an individual
is named in B.1. above.
Ownership*
Non -Government

C. Site Contact Information
Part C.
Project Site Contact Information
.................................................................................................................................................................................................................................................................................................................................................................................................
1. Primary Site Eric
Contact - First
Name*
2. Primary Site Shook
Contact - Last Name*
3. Title
4. Site Contact E-mail [e-mail]
Address*
5. Site Contact 336-971-4176
Telephone No.*
6. Organization Name Duke Energy Carolinas, LLC
7. Site Contact Street Address
Mailing Address* EC09Q 526 South Church Street
Address Line 2
City
Charlotte
Postal / Zip Code
28202-1006
8. Consultant Name (optional)
Brooke Ahrens
First and Last name
9. Consultant E-mail [e-mail]
This person will be copied on all correspondence.
10. Consultant [phone]
Telephone No.
11. Billing E-mail (For Annual Fee correspondence)
[e-mail]
Default is legally responsible person e-mail
12. Billing Telephone (For Annual Fee correspondence)
760-445-3332
Default is legally responsible person telephone
State / Province / Region
NC
Country
us

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Plan Approval Information
1. Date E&SC Plan 06/07/2022
Approved *
2. E&SC Plan Project DAVIE-2022-021
Number/ID* Assigned by agency or local program
3. E&SC Plan State DEQ Office
Approved by* Local Program
4. State DEQ Office* Winston-Salem (WSRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. Please also upload a site map showing the overall extent of the project (for linear projects, can
include the beginning point and end point coordinates in the "Notes" box below).
5. E&SC Plan
LoA-M DAVIE-2022-021_20220607.pdf 278.67KB
Approval letter or
Must be PDF format
Grading Permit
6. Signed FRO
Financial Responsibility/Ownership Form
04_FRO_Silas_signed_JG.pdf 1.15MB
Must be PDF format
7. Site Location Map
Must be PDF format (limit 20 MB)
Vicinity Map_Silas Cover Page.pdf 932.05KB
Please do not upload entire set of E&SC plans.
8. Notes (Optional)
Provide any additional information that might help the reviewer better understand how uploaded documents
support the application. Include additional waterbodies if necessary.
This is a linear project so the project location includes the existing
Duke Energy right-of-way (ROW) from start to end as shown with the
dashed blue line on our vicinity map. The project location coordinate
submitted is the start point at the western side as representative for
the entire limits of disturbance along the linear ROW to match the
FRO and Letter of Approval referenced County / Address. Two
additional crossing waterbodies are also associated with this project:
Dutchman Creek (12-102-(2)) and Yadkin River (12-(93.5))
9. NOI Certification
Silas_eNOI Cert Form_Signed_JG.pdf 539.02KB
Form
Must be PDF format
This is an Express • No
Review Project* Yes

E. Certification
North Carolina General Statute 143-215.613 (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document
filed or required to be maintained under this Article or a rule implementing this Article; or who knowingly makes 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 device or method required to be operated or maintained under this Article or rules of the Commission implementing this Article shall
be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
* 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.
* 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.
* I will abide by all conditions of the NCG010000 General Permit and the approved
Erosion and Sediment Control Plan.
* 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:* The Legally Responsible Person named on this Notice of Intent
Authorized Responsible Person' (signing on behalf of Legally Responsible Person
named in Part B)
Important: The person who electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible
person within the same organization as the Permittee.
*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
Xlll �t
Type Name* Jeffrey Goto
Title Lead Transmission Permitting Manager
Organization Legally Responsible Entity
Duke Energy Carolinas, LLC
Date * 06/15/2022

F. Tracking and COC Info
NOI Tracking No. 94385
NC Reference No. NCG01-2022-2241
Indicates NCG01 or NCG25. Uses NOI number until approved, then uses NUMBER incremented by SP (passed
from workflow if eNOI approved)
Certificate of NCC222241
Coverage (COC) No.* Uses NOI number until approved, then uses NUMBER incremented by SIP (formatted and passed from workflow if
eNOI approved)
Initial Invoice No. NCC222241-2022
Invoice Due Date 7/16/2022
Initial Fee $ 100.00
Invoice Status OPEN