NCC193376_NOI Application_20200109

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/31/2019 11:13:14 AM (NCG01 NOI Submission)
Approve by Garcia, Lauren V 12/31/2019 2:27:21 PM (Review- Construction NOI 20070)
• Morman, Alaina reassigned the task to Garcia, Lauren V 12/31/2019 2:14 PM
* These are Jim's and I'm sending them along because you've helped out me so much and he
deserves the same opportunity.:)
• The task was assigned to Farkas, Jim J by round robin distribution 12/31/2019 11:13 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 2, 2020 5:00
PM 12/31/2019 11:13 AM
Submit by McCoy, Suzanne 1/9/2020 1:08:41 PM (Payment Verification for NCC193376)
* The Spaulding Group PA
• McCoy, Suzanne assigned the task to McCoy, Suzanne 1/9/2020 1:08 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: February 11, 2020 5:00
PM 12/31/2019 2:27 PM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name * Timberlake Reserve - Phase 2
2. County* Franklin
3. Highway or Street South Cross Street
Address * Street narre only is acceptable if no address number assigned yet
4. City or Township* Youngsville
5. State * NC
6. Zip Code * 27596
7. Latitude * Enter the latitude in decimal degrees
36.0140
8. Longitude* Enter the longitude in decinal degrees (M. ST be negative)
-78.4736
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*
02/05/2020
Estimated Construction Project Start Cate
10. Date to End*
02/05/2023
Estimated Construction Project End Cute
11. SIC (Primary) *
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial aassification for Developrrent
12. Acres to be
25.60
disturbed*
(including off -site borrow and waste areas)
13. Total site area 31.20
(acres) *
14. Post- 11.40
construction (Estimated)
impervious area
(acres)*

NCC Project NCC-FRANK-2020-Timberlake Reserve - Phase 2
Tracking ID 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 Hattles Branch
Waterbody* Name of waterbody into which stormwater runoff will discharge
15b. Waterbody 27-21-1
Index No. * NC Waterbody Index N n ber
Stormwater V No
discharges will flow r Yes
to additional
wate rs *
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 LGI Homes - NC, LLC
Name *
2. First Name* Drew
IF Corporation, enter Fbgistered Agent First Barre
3. Last Name* Kirchner
If Corporation, enter Faegistered Agent Last %rre
3b. Title Land Development Manager
4. Permitee E-mail [e-mail]
Address *
5. Permittee [phone]
Telephone No.*
6. Permittee Mailing Street Address
Address* 6500 Creedmoor Road, Suite 212
Address Line 2
city State / Frovince / Faegion
Raleigh NC
Fbstal / Zip Code Country
27613-3698 us
Check box if the rJ Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 6500 Creedmoor Road, Suite 212
Address Line 2
City
State / Frovince / Pegion
Raleigh
NC
Fbstal / Zip Code
Country
27613-3698
us

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
_...........................................................................................................................................................
1. Type of
Non -Government
Ownership *
2. Primary Site
Tom
Contact - First
Name *
3. Primary Site
Spaulding
Contact - Last
Name *
4. Title
Engineering Consultant
5. Site Contact E-
[e-mail]
mail Address*
6. Site Contact
[phone]
Telephone No.*
7. Organization
The Spaulding Group, PA
Name
8. Site Contact
Street Address
Mailing Address*
1611 Jones Franklin Road, Suite 101
Address Line 2
City
Raleigh
Fbstal / Zip Code
27606
9. Consultant Name
(Optional)
Justin Rohde
First and Last narre
10. Consultant E-
[e-mail]
mail
This person will be copied on all correspondence.
11. Consultant
[phone]
Telephone No.
State / Rovince / Fbgion
NC
Country
us

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 12/16/2019
Approved *
2. E&SC Plan Project FRANK-2020-015
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 FRANK-2020-015 LOA 20191216 APPROVAL.pdf 58.64KB
Approval Mist be RDFfornat
letter/documentation
6. NOI Certification 803-15 Ph2 NOI signed.pdf 43.95KB
Form Mist be R7Ffon-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 Article; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Artcle; 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 Artcle 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 *
Drew Kirchner
Title
Land Development Manager
Organization
LGI Homes - NC, LLC
Date *
12/31 /2019

F. Tracking and COC Info
NOI Tracking No. 20070
NC Reference No. NCG01-2019-3376
Uses 'count number' variable (incremrented by SP)
Certificate of NCC193376
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 3376
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.)