NCC200053_Modification Review_20200513

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/12/2020 2:32:48 PM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 5/13/2020 7:38:21 AM (Construction COC ADD TO FILE Review- NCC200053)
• The task was assigned to Georgoulias, Bethany. The due date is: May 15, 2020 5:00 PM
5/12/2020 2:32 PM

Y. ,
NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of NCC200053
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
Information associated with this permit:
Project Name The Cove at Mackintosh
Address 4595 Bonner Bridge Parkway, Burlington, NC
County Guilford
Latitude 36.0568
Longitude-79.5416
Permittee Listed DR Horton, Inc.
Legally Responsible Jessica Meyer
Individual
NC Reference No. NCG01-2020-0053
E&SC Plan ID 652, 621, 634, 585
Original NOI 20220
Tracking No.*
Date COC Issued* 01/07/2020
Prior Rescission This field will populate only if CCChas already been rescinded.
Date
Modification Information:
Reason for F Closed -Out Lots/Outparcels in E&SC Plan
Modification * r Additional Lots/Outparcels Approved - E&SC Revised
O Other Revision(s) to E&SC Plan
r Legally Responsible Individual Has Changed
r Multiple Reasons (List)
Addional Mire information if necessary
Explanation Permits for Phases 1 B and 2A have been closed. This is City of Burlington Permit
#'s 634 (8.85ac) and 648 (7.97ac) have been closed. This Modification is to
remove those two permits from our coverage. A total of 16.82 acres to be
removed.
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets). For changes to the legally responsible individual, you must upload this form.

Supporting Upload Supporting Ibcurrentation (Pevised E&SCApproval, nose -Out Doc, etc.)
Documentation The Cove at Mackintosh Phases 1 B and 2A Close
806.36KB
Out.pdf
Mist be PDFforrrat
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes anyfalse statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Atcle; orwho falsifies, tampers with, or knowinglyrenders
inaccurate anyrecording or monitoring device or method required to be operated or maintained under this Article or rules of the
Commission implementing this Atcle shall be guiltyofa Class 2 misdemeanor which mayinclude a fine notto exceed ten thousand
dollars ($10,000).
17 I hereby request modification to coverage under the NPDES Stormwater Permit
for the subject project site. I am familiar with the information contained in this
request and to the best of my knowledge and belief such information is true,
complete and accurate.
Specify if you are:* r The Legally Responsible Individual
f Authorized Responsible Person*
*This form must be signed by a responsible corporate officer that 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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
Signature
Type Name* Jessica Meyer
Title * NPDES Technical Compliance Administrator
Organization* DR Horton, Inc.
Date * 05/12/2020
Email Address* [e-mail]
Grail for confirrration
Telephone Number* 919-215-6561
Contact nun ber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email Additional en -ail for confimation
(Optional)
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 05/13/2020
Request Date 20200512
Formatted

Review Date 20200513
Formatted