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HomeMy WebLinkAboutNCC201245_NOI Application_20200327Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 3/23/2020 3:15:15 PM (NCG01 NOI Submission) Approve by Farkas, Jim J 3/26/2020 3:53:57 PM (Review- Construction NOI 23400) • The task was assigned to Farkas, Jim J by round robin distribution 3/23/2020 3:15 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: March 25, 2020 5:00 PM 3/23/2020 3:15 PM Submit by McCoy, Suzanne 3/27/2020 8:00:26 AM (Payment Verification for NCC201245) * Jessica Matyas • McCoy, Suzanne assigned the task to McCoy, Suzanne 3/27/2020 7:59 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: May 7, 2020 5:00 PM 3/26/2020 3:54 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information la. Project Name * Chase Bank -South Cornelius (#403838) 1 b. Specific Lot This field may be used to list specifc lot numbers. Numbers 19501 Jetton Road (formerly 19400 W. Catawba Ave) (PID# 00512312) 2. County* Mecklenburg 3. Highway or Street 19501 Jetton Road (formerly 19400 W. Catawba Ave) Address* Street name only is acceptable if no address number assigned yet 4.CityorTownship* Cornelius 5. State * NC 6. Zip Code * 28031 7. Latitude* Enter the latitude in decimal degrees 35.4774 8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative) -80.8909 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* 03/31/2020 Estimated Construction Project Start Date 10. Date to End* 08/31/2020 Estimated Construction Project End Date 11. SIC (Primary)* Commercial (1542) Standard Industrial aassification for Development 12. Acres to be 1.16 disturbed* (including off -site borrow and waste areas) 13. Total site area 1.50 (acres) * 14. Post- 0.83 construction (Estimated) impervious area (acres) * NCC Project NCC-MECKL-2020-Chase Bank -South Cornelius (#403838) 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 CATAWBA RIVER (Lake Norman below Waterbody* elevation 760) %rre of waterbody into which storrrwater runoff will discharge 15b. Waterbody 11-(75) Index No. * NC Waterbody Index Nurrber Stormwater W No discharges will flow F 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. ^ Fternittee 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 JPMorgan Chase Bank, NA Name * If perrrittee is an individual (i.e., organization does not apply), enter first and last nave in this field. 2. First Name* Matthew IF Corporation, enter Plegistered Agent First Barre 3. Last Name* Wauben If Corporation, enter Faegistered Agent Last Wre 3b. Title Vice President 4. Permitee E-mail matthew.wauben@chase.com Address * 5. Permittee 419-204-7328 Telephone No.* 6. Permittee Mailing Street Address Address* 1111 Polaris Parkway Address Line 2 city Columbus Fbstal / Zip Code 43240 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 1111 Polaris Parkway Address Line 2 City Columbus Flostal / Zip Code 43240 8. Type of Non -Government Ownership* State / Frovince / Region OH Country USA State / Ffovince / Plegion OH Country USA C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Glenn Contact - First Name * 2. Primary Site Milburn Contact - Last Name * 3. Title Superintendent 4. Site Contact E- glenn.milburn@genoaco.com mail Address* 5. Site Contact 4049251859 Telephone No. 6. Organization Genoa Construction Services, Inc Name 7. Site Contact Street Address Mailing Address* 2300 Lakeview Parkway Address Line 2 Suite 100 city Alpharetta Rbstal / Zip Code 28037 8. Consultant Name (Optional) Jason Allinson First and Last narre 9. Consultant E-mail jason.allinson@genoaco.com This person will be copied on all correspondence. 10. Consultant 6785958391 Telephone No. State / Rovince / Region GA Country USA D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 03/12/2020 Approved * 2. E&SC Plan Project Chase Bank -South Cornelius (#403838) Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Mecklenburg County 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 or include the beginning point and end point coordinates in the "Notes" box below. 5. E&SC Plan PCO5 Approval #403838.pdf 150.1 KB Approval letter or Mast beRDFforml Grading Permit Site Map (Optional) Helpful for linear project review Mast be R7Fform3t Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support the application. Include additional w aterbodies for linear projects if necessary. 6. NOI Certification NCG01-eNO1-Certification-Form-20190919-DEMLR- Form 2.01 MB SW MW Signed.pdf Wst be FDFfornat This is an Express r No Review Project* r Yes E. Certification North Carolina General Statute 143-215.66 (1) 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 Amide 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 If the Erosion and Sediment Control Plan approved by the delegated program is not compliant with Part II (Stormwater Pollution Prevention Plan) of the NCG010000 General Permit. I will nonetheless ensure that all conditions of Part II of the permit are met on the project at all times. * 17 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 �,��rrr. t/rr�vL ��rrrrrf sir Type Name* Matthew K Wauben Title Vice President Organization JP Morgan Chase Bank NA Date * 03/23/2020 F. Tracking and COC Info NOI Tracking No. 23400 NC Reference No. NCG01-2020-1245 Uses 'count number' variable (incremrented by SP) Certificate of NCC201245 Coverage (COC) Uses 'count number' variable (incremented by SP) No.* Count Number 1245 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.)