NCC201327_NOI Application_20200409

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 3/31/2020 10:23:43 AM (NCG01 NOI Submission)
Approve by Morman, Alaina 4/1/2020 5:15:44 PM (Review- Construction NOI 23801)
* C7 - engineer entered county instead of country. Not an error of enough magnitude to reject.
• The task was assigned to Morman, Alaina by round robin distribution 3/31/2020 10:24 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: April 2, 2020 5:00 PM
3/31/2020 10:24 AM
Submit by McCoy, Suzanne 4/9/2020 7:46:27 AM (Payment Verification for NCC201327)
* Pamela J Mclean
• McCoy, Suzanne assigned the task to McCoy, Suzanne 4/9/2020 7:45 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: May 13, 2020 5:00 PM
4/1/2020 5:15 PM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
la. Project Name * Minor Subdivision for Pamela McLean
1 b. Specific Lot This field rray be used to list specifc lot nunbers.
Numbers
2. County* Wake
3. Highway or Street 1525 Pearces Road, Zebu Ion, NC 27597
Address* Street name only is acceptable if no address number assigned yet
4. City or Township* Little River
5. State * NC
6. Zip Code* 27597
7. Latitude* Enter the latitude in decimal degrees
35.8678
8. Longitude * Enter the longitude in decirral degrees (MJSTbe negative)
-78.3175
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*
04/27/2020
Estimated Construction Project Start Date
10. Date to End *
10/09/2020
Estinated Construction Project End Date
11. SIC (Primary)*
Residential, Single Family Houses (SFE) (1521)
Standard Industrial aassification for Developrrent
12. Acres to be
7.20
disturbed*
(including off -site borrow and waste areas)
13. Total site area 22.25
(acres)*
14. Post- 0.50
construction (Estirated)
impervious area
(acres) *

NCC Project NCC-WAKE-2020-Minor Subdivision for Pamela McLean
Tracking ID Assignedautorratically
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 LIT Moccasin Creek (Bunn Lake)
Wate rbody* Narre of waterhody into which storrrwater runoff will discharge
15b. Waterbody 27-86-2
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. ^
Fbrnittee 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
Legally Responsible Entity
Name *
Pamela McLean
It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field.
2. First Name *
Pamela
If Corporation, enter Faegistered Agent First %rre
3. Last Name*
McLean
It Corporation, enter F;bgistered Agent Last %ne
3b. Title
Owner
4. Permitee E-mail [e-mail]
Address*
5. Permittee [phone]
Telephone No.*
6. Permittee Mailing Street Address
Address* 2901 Homegrown Place
Address Line 2
City State / Rovince / F;bgion
Zebulon NC
Fbstal / Zip Code Country
27597-7362 us
Check box if the V Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
2901 Homegrown Place
Address Line 2
City
State / Frovince / Region
Zebulon
NC
Fbstal / Zip Code
Country
27597-7362
us
8. Type of
Individual
Ownership*

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
John
Contact - First
Name *
2. Primary Site
Oglesby
Contact - Last
Name *
3. Title
Project Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
[phone]
Telephone No.
6. Organization
John F. Oglesby, PE
Name
7. Site Contact
Street Address
Mailing Address*
P.O. Box 1250
Address Line 2
city
Wendell
Fbstal / Zip Code
27591
8. Consultant Name
(Optional)
John Oglesby
First and Last narre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
[phone]
Telephone No.
State / Rovince / Region
NC
Country
Wake

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 03/23/2020
Approved *
2. E&SC Plan Project SEC-032706-2020
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Wake 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 Wake County Approval Letter (email)_20200324.pdf 110.35KB
Approval letter or SEC-032706-2020_Approval-
Grading Permit
S&EConstructionPlan ReviewChecklist-V.2 WM 3- 277.09KB
23-2020.pdf
SWF-032704-2020_Approva I-
FloodStudyPlanFReviev,Checklist-V.1_WM_3-23- 241.94KB
20.pdf
Mast be FDFfornat
6. Site Location Map Helpful for linear project review
(Optional) EC1.pdf 765.07KB
Mast be R7F format. Rease do not upload entire set of E&SC plans.
7. Notes (Optional) Ffovide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional waterbodies for linear projects if necessary.
The SEC approval was sent via email by Barney Blackburn on
behalf of Karyn Pageau. A copy of the email is included in the
uploaded documents along with the SEC Approval of Construction
Plans and the SWF Approval of the required flood study. An
individual stormwater permit is not required for this project.
8. NOI Certification NOI Certification Form Pamela
Form 512.59KB
McLean_20200331.pdf
Mast be RDFfornat
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 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 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
C�amc (WI- i
Type Name* Pamela McLean
Title Owner
Organization Legally Ibsponsible Entity
Pamela McLean
Date * 03/31 /2020

F. Tracking and COC Info
NOI Tracking No. 23801
NC Reference No. NCG01-2020-1327
Uses 'count number' variable (incremrented by SP)
Certificate of NCC201327
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 1327
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.)