NCC193188_NOI Application_20191216

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/12/2019 5:03:48 PM (NCG01 NOI Submission)
Approve by Clark, Paul 12/13/2019 8:25:20 AM (Review- Construction NOI 19515)
• The task was assigned to Clark, Paul by round robin distribution 12/12/2019 5:04 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 16, 2019 5:00
PM 12/12/2019 5:04 PM
Submit by McCoy, Suzanne 12/16/2019 7:39:02 AM (Payment Verification for NCC193188)
* Mary -Beth Sewell
• McCoy, Suzanne assigned the task to McCoy, Suzanne 12/16/2019 7:38 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 24, 2020 5:00 PM
12/13/2019 8:25 AM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name * Durham Technical Community College - New Applied Technology
Building
2. County* Durham
3. Highway or Street 1604 East Lawson Street
Address* Street narre only is acceptable if no address number assigned yet
4. City or Township* Durham
5. State * NC
6. Zip Code* 27703
7. Latitude* Enter the latitude in decimal degrees
35.9727
8. Longitude * Enter the longitude in decimal degrees (MJST be negative)
-78.8821
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*
12/02/2019
Estimated Construction Project Start Date
10. Date to End*
01/15/2021
Estimated Construction Project End Date
11. SIC (Primary) *
Other (0000)
Standard Industrial cassification for Development
12. Acres to be
3.15
disturbed*
(including off -site borrow and waste areas)
13. Total site area 3.15
(acres) *
14. Post- 1.34
construction (Estirated)
impervious area
(acres) *

NCC Project NCC-DURHA-2019-Durham Technical Community College - New
Tracking ID Applied Technology Building
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. 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 Third Fork Creek
Waterbody* Narreof waterbody into which stormwater runoff will discharge
15b. Waterbody 16-41-1-12-(1)
Index No. * NCWaterbody Index Number
Stormwater r- No
discharges will flow 17 Yes
to additional
wate rs *
15c. Additional Cape Fear River Basin
Receiving Waterbody narre
Waterbody
15d. Waterbody NCWaterbody Index Number
Index No.
15e. Additional Waterbody name
Receiving
Waterbody
15f. Waterbody NCWaterbody Index Number
Index No.
16a. Is this project r Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B. ^
F2rnittee Inforrration - Legally Fbsponsible 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 Bordeaux Construction
Name *
2. First Name* Matthew
If Corporation, enter Pegistered Agent First Barre
3. Last Name* Woodlief
If Corporation, enter Faegistered Agent Last %rre
3b. Title Project Manager
4. Permitee E-mail [e-mail]
Address *
5. Permittee 919-220-1141
Telephone No.*
6. Permittee Mailing Street Address
Address* 135 E. Martin Street
Address Line 2
#101
city
Raleigh
Fostal / Zip Code
27601
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
135 E. Martin Street
Address Line 2
#101
City
Raleigh
Fbstal / Zip Code
27601
State / Ftovince / Region
North Carolina
Country
United States
State / Frovince / Fbgion
North Carolina
Country
United States

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Type of
Government - County
Ownership *
2. Primary Site
Roy
Contact - First
Name *
3. Primary Site
Weaver
Contact - Last
Name *
4. Title
Project Superintendent
5. Site Contact E-
[e-mail]
mail Address*
6. Site Contact
919-201-7513
Telephone No.*
7. Organization
Bordeaux Construction
Name
8. Site Contact
Street Address
Mailing Address*
135 E. Martin Street
Address Line 2
#101
Cty
Raleigh
Fbstal / Zip Code
27601
9. Consultant Name
(Optional)
First and Last narre
10. Consultant E-
This person will be copied on all correspondence.
mail
11. Consultant
Telephone No.
State / Rovince / Fbgion
North Carolina
Country
United States

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 07/30/2019
Approved *
2. E&SC Plan Project DURHA-2020-001
Number/ID * Assigned by agency or local program
3. E&SC Plan r State DEQ Office
Approved by* r Local Program
4. State DEQ Office * Raleigh (RRO)
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 DURHA-2020-001 LOA 20190730.pdf 60.14KB
Approval Wst be RDFfornat
letter/documentation
6. NOI Certification DTCC - eNO1 Certificate Form.pdf 924.06KB
Form Mist be RDFfon-rat
This is an Express F No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.6E (i) provides that:
Any person who knowingly makes anyfalse 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 Atide; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Atcle; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Atide or rules of the
Commission implementing this Atcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
17 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.
* 17 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
f 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 *
Matthew C Woodlief
Title
Project Manager
Organization
Bordeaux Construction Company
Date *
12/12/2019

F. Tracking and COC Info
NOI Tracking No. 19515
NC Reference No. NCG01-2019-3188
Uses 'count number' variable (incremrented by SP)
Certificate of NCC193188
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 3188
Sequential number for submittal that is incremented by Stored Frocedure
COC Year 2019
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)