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HomeMy WebLinkAboutNCC190543_NOI Application_20190607 Action History (UTC-05:00) Eastern Time(US&Canada) Submit by Anonymous User 6/7/2019 9:42:12 AM(NCG01 NOI Submission) Approve by Clark, Paul 6/7/2019 2:55:43 PM(Review-Construction NOI 11872) • The task was assigned to Clark, Paul by round robin distribution 6/7/2019 9:42 AM • The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:June 11,2019 5:00 PM 6/7/2019 9:42 AM Submit by Clark, Paul 6/7/2019 2:56:32 PM(Payment Verification-NCG01-2019-0543) • The task was assigned to Clark, Paul.The due date is: June 10, 2019 5:00 PM 6/7/2019 2:55 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* The Falls at Weddington Phase 3 Individual Plan#1-9&25-34 2. County* Union 3. Highway or Street Antioch Church Road Address* Street narra only is acceptable if no address nurrber assigned yet 4. City or Township* Weddington 5. State* NC 6.Zip Code* 28104 7. Latitude* Enter the latitude in decirral degrees 35.0411 8. Longitude* Enter the longitude in decirral degrees(MIST be negative) -80.7260 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* 06/10/2019 Estimated Construction Project Start Date 10. Date to End* 08/31/2019 Estimated Construction Project End Date 11. SIC(Primary)* Residential, Single Family Houses(SFE) (1521) Standard Industrial aassification for Developrrant 12.Acres to be 6.10 disturbed* (including off-site borrow and waste areas) 13.Total site area 7.36 (acres)* 14. Post- 2.30 construction (Estimated) impervious area (acres)* NCC Project NCC-UNION-2019-The Falls at Weddington Phase 3 Individual Plan Tracking ID #1-9&25-34 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 West Fork Twelve Mile Creek Wate rbody* Narre of waterbody into which storrrwater runoff will discharge 15b.Waterbody 11-138-1 Index No.* NC Waterbody Index Ninber Stormwater PF No discharges will flow r Yes to additional wate rs* 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 JCH Falls, LLC Name* 2. First Name* Ed ff Corporation,enter Registered Agent First l\brre 3. Last Name* White ff Corporation,enter Registered Agent Last Barre 3b.Title VP Charlotte 4. Permitee E-mail ewhite@joneshomesusa.com Address* 5. Permittee 704-909-9246 Telephone No.* 6. Permittee Mailing Street Address Address* 370 Center Pointe Circle Address Line 2 City State/Province/Region Altamonte Springs FL Postal/Zip Code Country 32701 us Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* 370 Center Pointe Circle Address Line 2 City State/Province/Region Altamonte Springs FL Pastal/Zip Code Country 32701 US C. Site Contact Information Part C. Project Site Contact Information .................................................................................................................... 1.Type of Non-Government Ownership* 2. Primary Site Ben Contact-First Name* 3.Primary Site Kuhn Contact-Last Name* 4.Title 5.Site Contact E- bkuhn@joneshomesusa.com mail Address* 6.Site Contact 704-909-9246 Telephone No.* 7.Organization Name 8.Site Contact Street Address Mailing Address* 370 Center Pointe Circle Address Line 2 City State/Province/Region Altamonte Springs FL Fbstal/Zip Code Country 32701 us D. E&SC Plan Part D. Erosion&Sediment Control(E&SC)Ran Approval Information ............................................................................................................................................................ 1. Date E&SC Plan 05/29/2019 Approved* 2. E&SC Plan Project UNION-2019-071 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* Mooresville(MRO) 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 Falls at Weddington (19 Lot plan)_Erosion Control Approval 78.84KB Plan_Approval_05.29.19.pdf letter/documentation Mist be RDF format 6. NOI Certification Signed_Falls at Weddington (19 lots)_NOI Form 70.68KB Ce rtification_06.07.19.pdf Wst be RDF format 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* Ed White Title VP Charlotte Organization JCH Falls, LLC Date* 06/07/2019 F. Tracking and COC Info NOI Tracking No. 11872 NC Reference No. NCG01-2019-0543 Uses'count number variable(incremented by SP) Certificate of NCC190543 Coverage (COC) Uses'count_nunber'variable(incremrented by SF) No.* Count Number 543 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.)