NCC201473_NOI Signed Certification_20200414

NCGO1 Notice of intent (NOI) Certification Form
Directions:
Print this form. c€=ple :scan::and uplmd tDthe electronir-NO1.
Then, mail the.original form, t1Dthe QEMLIRUwrmvater Pn4va m. tMth M:checic g..cbet*yat:
Division -of Ene%y. hftwal & Land Steer Program
512 N. S4*wy Sb-eO, a Flea (Moe 6 4t )
1E12 htlaii Service. Center
We►gh, NC 27699-1612
tfi• NOTsPAYMENT UNTIL YOUR APPLICATION
REVIEWED AND ACCEPTED AS
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UnderPenalty of law, I certify that (check all boxes to indicate your agreement):
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.
The information submitted in this NOl 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.
l I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and
Sediment Control Plan.
If the approved Erosion and Sediment Control Plan is not compliant with Part 11(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.
tail' 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.
Name cif project: Hitda Lane Subdivision
Legally Responsible Organizational EnW. Aggressive Properties & Deve4opment LLC
Legally Responsible Person- Thorrcas Christ
*Sienature:/�`" '"i /!� "" r— Fates* l 1 C, • * o a o
*Print Naf �4gned if a4�al
lm nd Title o led
mionemmtben �-2 - -713- YI10
* : a rt ; Thisfmm must be signed! by o . le corporaWoffiscer ter ~5 or operas_ the
construakm a cdvitp, such as a Vint, sevwZwy, &easurer, or Wce presdent or a mwxger M& is
auMarked inzamrdia nm vidth tl-V, Secbw'A Mm,1b)' ;theACWIl"'pew.
For rr we ij*r t = )o a si rWory requkemenM see , Sectian%B. item, (6) c f ,the 1C 71WW'permif.