NCC201502_NOI Application_20200616

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 4/14/2020 8:28:02 AM (NCG01 NOI Submission)
Approve by Morman, Alaina 4/15/2020 9:07:28 AM (Review- Construction NOI 24290)
• The task was assigned to Morman, Alaina by round robin distribution 4/14/2020 8:28 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: April 16, 2020 5:00 PM
4/14/2020 8:28 AM
Submit by McCoy, Suzanne 6/16/2020 7:06:57 AM (Payment Verification for NCC201502)
* Stephen Roberts
• McCoy, Suzanne assigned the task to McCoy, Suzanne 6/16/2020 7:06 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: May 27, 2020 5:00 PM
4/15/2020 9:07 AM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
Are you submitting r No
an NOI that was r Yes
rejected before?
Previous Rejected 24063
NOI No.
Prior Reviewer Alaina Morman
Name
1a. Project Name * Willow Spring Elementary School Drive Aisle Expansion
1 b. Specific Lot This field may be used to list spedc lot numbers.
Numbers
2. County* Wake
3. Highway or Street 6800 Dwight Rowland Road
Address * Street narre only is acceptable if no address number assigned yet
4. Cityor Township* Willow Spring
5. State * NC
6. Zip Code * 27592
7. Latitude * Enter the latitude in decimal degrees
35.5944
8. Longitude* Enter the longitude in decimal degrees (M. ST be negative)
-78.7289
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* 04/14/2020
Estimated Construction Project Start Date
10. Date to End* 09/25/2020
Estimated Construction Project End Cute
11. SIC (Primary) * Other (9999)
Standard Industrial Classification for Ceveloprrent

12. Acres to be 1.93
disturbed* (including off -site borrow and waste areas)
13. Total site area 13.97
(acres) *
14. Post- 5.60
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-WAKE-2020-Willow Spring Elementary School Drive Aisle
Tracking ID Expansion
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 Terrible Creek
Wate rbody* N larre of waterbody into which stormwater runoff will discharge
15b. Waterbody 27-43-15-8-(2)
Index No.* NCWaterbody Index Number
Stormwater rJ 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. ^
F2rnittee 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 Pesponsible Entity
Name * Wake County Public Schools
It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field.
2. First Name * Brandon
IF Corporation, enter Faegistered Agent First %rre
3. Last Name* Williams
It Corporation, enter F;bgistered Agent Last %ne
3b. Title Senior Project Manager
4. Permitee E-mail [e-mail]
Address*
5. Permittee 9195003664
Telephone No.*
6. Permittee Mailing Street Address
Address* 111 Corning Rd, suite 190
Address Line 2
City State / Rovince / Pegion
Cary North Carolina
Fbstal / Zip Code Country
27518 USA
Check box if the V Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 111 Corning Rd, suite 190
Address Line 2
City State / Frovince / Region
Cary North Carolina
Fbstal / Zip Code Country
27518 USA
8. Type of Government - County
Ownership*

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
Brandon
Contact - First
Name *
2. Primary Site
Williams
Contact - Last
Name *
3. Title
Senior Project Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
919-500-3664
Telephone No.
6. Organization
Wake County Public Schools
Name
7. Site Contact
Street Address
Mailing Address*
111 Corning Rd, suite 190
Address Line 2
city
Cary
Postal / Zip Code
27518
8. Consultant Name
(Optional)
Sam MacDonald
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
9198559989
Telephone No.
State / Province / Region
North Carolina
Country
USA

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 05/31/2019
Approved *
2. E&SC Plan Project WAKE-2019-091
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 * Raleigh (RRO)
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-2019-091 LOA MOD 20190531 approved
Approval letter or 99.22KB
acres added.pdf
Grading Permit
Mist be FDFforrrat
6. Site Location Map Helpful for linear project review
(Optional) Mast be FDFfornat. Rease do not upload entire set of E&SCplans.
7. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded docurrents support
the application. Include additional waterbodies for linear projects if necessary.
8. NOI Certification NCG01-eNO1-Certification-Form-20190919-DEMLR-
Form SW.pdf 693.19KB
Mast be FDFfornat
This is an Express r 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 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 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
�i�J}s�dr�'r'ar �1�Y/i�rrrJ
Type Name * Brandon Williams
Title Senior Project Manager
Organization Legally Responsible Entity
Wake County Public Schools
Date * 04/14/2020

F. Tracking and COC Info
NOI Tracking No. 24290
NC Reference No. NCG01-2020-1502
Uses 'count number' variable (incremrented by SP)
Certificate of NCC201502
Coverage (COC) Uses 'count number' variable (incremented by SP)
No.*
Count Number 1502
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.)