NCC192460_NOI Application_20191029

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/22/2019 9:16:48 AM (NCG01 NOI Submission)
Approve by Garcia, Lauren V 10/22/2019 9:42:28 AM (Review- Construction NOI 17472)
• The task was assigned to Garcia, Lauren V by round robin distribution 10/22/2019 9:17 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 24, 2019 5:00
PM 10/22/2019 9:17 AM
Submit by McCoy, Suzanne 10/29/2019 1:18:33 PM (Payment Verification for NCC192460)
* Thomas Engineering
• McCoy, Suzanne assigned the task to McCoy, Suzanne 10/29/2019 1:17 PM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 3, 2019 5:00
PM 10/22/2019 9:42 AM

!17-8)ao-T2,G)M aIif_T1IIa10141
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name * Monitor Cape at Bluewater Rise
2. County* Craven
3. Highway or Street Old Airport Road
Address * Street narre only is acceptable if no address nurrtrer assigned yet
4. City or Township * New Bern
5. State * NC
6. Zip Code* 28562
7. Latitude * Enter the latitude in decirral degrees
35.0016
8. Longitude * Enter the longitude in decirral degrees (MJSTbe negative)
-77.0271
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*
01/01/2020
Estimated Construction Project Start Date
10. Date to End*
01 /01 /2021
Estimated Construction Project End Date
11. SIC (Primary)*
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial aassification for Development
12. Acres to be
39.00
disturbed*
(including off -site borrow and waste areas)
13. Total site area 45.33
(acres)*
14. Post- 14.78
construction (Estimated)
impervious area
(acres) *

NCC Project NCC-CRAVE-2020-Monitor Cape at Bluewater Rise
Tracking ID Assigned autor atically
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 Brice Creek
Waterbody* Narre of waterbody into which stornwater runoff will discharge
15b. Waterbody 27-101-40-(1)
Index No. * NCWaterbody Index Nunber
Stormwater fJ 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
.....................................................................................................................................................................
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 A. Sydes Construction, Inc.
Name *
2. First Name* Anthony
ff Corporation, enter Registered Agent First l\b e
3. Last Name * Sydes
Y Corporation, enter Registered Agent Last Barre
3b. Title President
4. Permitee E-mail [e-mail]
Address*
5. Permittee 910.455.6956
Telephone No.*
6. Permittee Mailing Street Address
Address* PO Box7122
Address Line 2
City
Jacksonville
Postal / Zip Code
28540
Check box if the r Yes
street address the
same as mailing
address
State / Province / Region
NC
Country
United States
7. Permittee Street Street Address
Address* 100 Carolina Plantations Boulevard
Address Line 2
City
State / Province / Region
Jacksonville
NC
Fbstal / Zip Code
Country
28546
US

C. Site Contact Information
Part C.
Proiect Site Contact Information
1. Type of
Ownership*
2. Primary Site
Contact - First
Name *
3. Primary Site
Contact - Last
Name *
4. Title
5. Site Contact E-
mail Address*
6. Site Contact
Telephone No.*
7. Organization
Name
8. Site Contact
Mailing Address*
Non -Government
Bobby
Billingsley
Project Engineer
[e-mail]
252.637.2727
Thomas Engineering, PA
Street Address
1316-B Commerce Drive
Address Line 2
city
New Bern
Fbstal / Zip Code
28562
9. Consultant Name (optional)
John G. Thomas
First and Last narre
10. Consultant E- [e-mail]
mail This person will be copied on all correspondence.
11. Consultant 252.637.2727
Telephone No.
State / Province / Region
NC
Country
us

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 10/17/2019
Approved *
2. E&SC Plan Project Crave-2020-013
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 * Washington (WaRO)
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 Crave-2020-013 Monitor Cape at Bluewater Rise -
Approval 879.45KB
10172019. pdf
letter/documentation
Mist be R7F forrret
6. NOI Certification 2019_10_20_TonySignedNOICert.pdf 329.41KB
Form Mist be RDFfornet
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 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
Type Name * Anthony W. Sydes
Title President
Organization A. Sydes Construction, Inc.
Date * 10/22/2019

F. Tracking and COC Info
NOI Tracking No. 17472
NC Reference No. NCG01-2019-2460
Uses 'count _nunber'variable (increrrented by SP)
Certificate of NCC192460
Coverage (COC) Uses'count_nunber'variable (incremented by SF)
No. *
Count Number 2460
Sequential nunber for subrrittal that is increrrented by Stored Procedure
COC Year 2019
Year of date reviewed (used to assign YY digits after "NGC' in OOCno.)