NCC200667_NOI Application_20200225

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/19/2020 10:28:09 AM (NCG01 NOI Submission)
Approve by Garcia, Lauren V 2/19/2020 11:06:30 AM (Review- Construction NOI 22117)
• The task was assigned to Garcia, Lauren V by round robin distribution 2/19/2020 10:28 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: February 21, 2020 5:00
PM 2/19/2020 10:28 AM
Submit by McCoy, Suzanne 2/25/2020 1:22:24 PM (Payment Verification for NCC200667)
* Tate Commons Limited Partnership
• McCoy, Suzanne assigned the task to McCoy, Suzanne 2/25/2020 1:22 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: April 1, 2020 5:00 PM
2/19/2020 11:06 AM

.• SThF� ';
1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
la. Project Name * Tate Commons Apartment Complex
1 b. Specific Lot This field any be used to list specifc lot numbers.
Numbers
2. County* Craven
3. Highway or Street Karen Drive
Address* Street name only is acceptable if no address nunber assigned yet
4. City or Township* New Bern
5. State * NC
6. Zip Code* 28560
7. Latitude* Enter the latitude in decimal degrees
35.1205
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-77.0836
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*
06/01/2019
Estimated Construction Project Start Date
10. Date to End*
06/01/2020
Estimated Construction Project End Date
11. SIC (Primary) *
Residential, Other
than SFE (1522)
Standard Industrial C]assification for Development
12. Acres to be
3.70
disturbed*
(including off -site borrow and waste areas)
13. Total site area 8.19
(acres) *
14. Post- 3.70
construction (Estimated)
impervious area
(acres) *

NCC Project NCC-CRAVE-2019-Tate Commons Apartment Complex
Tracking ID 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. 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 Jack Smith Creek
Wate rbody* Narre of waterbody into which stornwater runoff will discharge
15b. Waterbody 27-100
Index No. * NCWaterbody Index Nurrber
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. ^
Flarnittee 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 Tate Commons Limited Partnership
Name *
2. First Name* Anne
IF Corporation, enter Fbgistered Agent First Barre
3. Last Name* Little
If Corporation, enter F3egistered Agent Last %rre
3b. Title VP of Development and Associate General Counsel
4. Permitee E-mail [e-mail]
Address *
5. Permittee [phone]
Telephone No.*
6. Permittee Mailing Street Address
Address* 500 South Front Street
Address Line 2
10th Floor
City State / F rovince / Faegion
Columbus OH
Fbstal / Zip Code Country
43215 United States
Check box if the rJ Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
500 South Front Street
Address Line 2
10th Floor
City
State / Frovince / Fbgion
Columbus
OH
Fbstal / Zip Code
Country
43215
United States
8. Type of
Non -Government
Ownership*

C. Site Contact Information
Part C.
Project Site Contact Inforrration
.........................................................................................................................................................................................................
1. Primary Site
Anne
Contact - First
Name *
2. Primary Site
Little
Contact - Last
Name *
3. Title
Vice President & Assoc General Counsel
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
[phone]
Telephone No.
6. Organization
Tate Commons Limited Partnership
Name
7. Site Contact
Street Address
Mailing Address*
500 South Front Street
Address Line 2
10th Floor
city
Columbus
Postal / Zip Code
43215
8. Consultant Name
(Optional)
First and Last narre
9. Consultant E-mail
This person will be copied on all correspondence.
10. Consultant
Telephone No.
State / Province / Region
OH
Country
United States

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 04/22/2019
Approved *
2. E&SC Plan Project Crave-2019-026
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 * Washington (WaRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. For linear projects, please also upload a site map showing the overall extent of the project.
5. E&SC Plan Crave-2019-026 Tate Commons Apartment Complex
Approval 435.24KB
- 042219 - 21438.pdf
letter/documentation
Mast be R7Fforrrat
Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application.
6. NOI Certification NOI Form.pdf 73.83KB
Form Mast be FDFformat
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 * Anne Little
Title VP of Development & Associate General Counsel
Organization Tate Commons Limited Partnership
Date * 02/19/2020

F. Tracking and COC Info
NOI Tracking No. 22117
NC Reference No. NCG01-2020-0667
Uses 'count number' variable (incremrented by SP)
Certificate of NCC200667
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 667
Sequential number for submittal that is incremented by Stored Frocedure
COC Year 2020
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)