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HomeMy WebLinkAboutNCC202780_NOI Application_20200702Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 6/30/2020 8:23:29 AM (NCG01 NOI Submission) Approve by Clark, Paul 6/30/2020 2:44:29 PM (Review- Construction NOI 27668) . The task was assigned to Clark, Paul by round robin distribution 6/30/2020 8:23 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: July 2, 2020 5:00 PM 6/30/2020 8:23 AM Submit by Selkane, Aziza 7/2/2020 11:44:54 AM (Payment Verification for NCC202780) * New Day Development • Selkane, Aziza assigned the task to Selkane, Aziza 7/2/2020 11:44 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: August 11, 2020 5:00 PM 6/30/2020 2:44 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting IT No an NOI that was r Yes rejected before? 1a. Project Name * Scottie's Ridge Pump Station, Force Main & Gravity Sewer 1 b. Specific Lot This field rray be used to list specifc lot numbers. Numbers 2. County* Johnston 3. Highway or Street Hwy 70A Address* Street narre only is acceptable if no address number assigned yet 4. City or Township* Pine Level Township 5. State * NC 6. Zip Code * 27576 7. Latitude* Enter the latitude in decimal degrees 35.4940 8. Longitude* Enter the longitude in decimal degrees (KUST be negative) -78.2150 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* 06/29/2020 Estimated Construction Project Start Date 10. Date to End* 10/01/2020 Estimated Construction Project End Date 11. SIC (Primary) * Other (9999) Standard Industrial Cassification for Developrrent 12. Acres to be 4.74 disturbed* (including off -site borrow and waste areas) 13. Total site area 4.74 (acres) * 14. Post- 0.30 construction (Estirrated) impervious area (acres) * NCC Project NCC-JOHNS-2020-Scottie's Ridge Pump Station, Force Main & Tracking ID Gravity Sewer 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 Moccasin Creek Wate rbody* %rre of waterbody into which storrrwater runoff will discharge 15b. Waterbody 27-53-(0.5) Index No.* NCWaterbody Index Nunber 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 * New Day Development Corporation It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field. 2. First Name * Richard IF Corporation, enter Faegistered Agent First %rre 3. Last Name* Braswell It Corporation, enter F;bgistered Agent Last %ne 3b. Title President 4. Permitee E-mail rdbraswell@rdbraswell.com Address* 5. Permittee 919-965-3131 Telephone No.* 6. Permittee Mailing Street Address Address* 810 Pondfield Rd Address Line 2 City State / Rovince / F;bgion Pine Level NC Fbstal / Zip Code Country 27569-7301 us Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* 810 Pondfield Rd Address Line 2 City State / Frovince / Region Pine Level NC Fbstal / Zip Code Country 27569-7301 us 8. Type of Non -Government Ownership* C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Richard Contact - First Name * 2. Primary Site Braswell Contact - Last Name * 3. Title 4. Site Contact E- rdbraswell@rdbraswell.com mail Address* 5. Site Contact 919-965-3131 Telephone No. 6. Organization Name 7. Site Contact Street Address Mailing Address* 810 Pondfield Road Address Line 2 city Pine Level Fbstal / Zip Code 27520 8. Consultant Name (Optional) AMANDA GRIMM First and Last nacre 9. Consultant E-mail amanda@adamsandhodge.com This person will be copied on all correspondence. 10. Consultant 513-325-3192 Telephone No. State / Rovince / Region North Carolina Country United States D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 06/16/2020 Approved * 2. E&SC Plan Project JC# 20-050-P Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Johnston 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 20-050 Scottie's Rldge Pump Station ESC appr Approval letter or 188.59KB 6.16.2020.pdf Grading Permit Mast be RDFforrrat 6. Site Location Map Helpful for linear project review (Optional) VICINITY MAP-PS.pdf 621.88KB Mast be RDFfornat. Rease do not upload entire set of E&SCplans. 7. Notes (Optional) Provide any additional information that night help the reviewer better understand how uploaded documents support the application. Include additional waterbodies for linear projects if necessary. 8. NOI Certification Scottie'sRidgeExecutedNCG01.pdf 68.19KB Form 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 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 Atide 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 ' i .-? tat &O ffta'4 W'1 Type Name* Richard D. Braswell Title President Organization Legally Ibsponsible Entity New Day Development Corporation Date * 06/30/2020 F. Tracking and COC Info NOI Tracking No. 27668 NC Reference No. NCG01-2020-2780 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC202780 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 2780 Sequential nurrber for subrrittal that is incremented by Stored Frocedure COC Year 2020 Year of date reviewed (used to assign YY digits after "NOC' in COCno.) Initial Invoice No. NCC202780-2020 Invoice Due Date 7/30/2020 Initial Fee $ 100.00 Invoice Status OPEN