NCC203114_ESC Approval Submitted_20200723

SITE ADDRESS: 263 CHAMPIONS RIDGE DR
PROJECT NAME: 263 Champions Ridge
Town of Southern Pines
140 Memorial Park Court
Southern Pines, NO 28387
[phone]
Minor Erosion and Sediment Contro
ISSUED: 07/02/202(
EXPIRES:
PARCEL: 857200135302 LAT.35.186425 LONG:-79,430067
APPLICANT. OWNER: FINANC14LLYRESPONSIBLE PARTY.•
Integrity Builders of the Sandhills LLC Integrity Builders of the Sandhills LLC Integrity Builders of the Sandhills LLC
10205 NC HWY 15-501 Unit 26 10205 NC HWY 15-501 Unit 26 10205 NO HWY 15-501 Unit 26
SOUTHERN PINES, NO 28387 SOUTHERN PINES, NO 28387 SOUTHERN PINES, NC 28387
CITY. SOUTHERN PINES COUNT': MOORE ACRES APPROVED: 0.07 HQW: NO
RECEIVING WATER: Unnamed
Tributary at Southern RIVER BASIN; Lumber STREAM CLASSIFICATION: C
DATE RECEIVED BY TOSP: 2020-07-01 PLAN TYPE. Standard
The review of the above referenced erosion control plan has been completed and the plan submitted has been found
acceptab)e.
Amendments to the plan should be submitted to this office under the same procedure as followed for the original plan.
Title 15A NCAC 4B .0118(a) and the NCG01 permit require that the following documentation be kept on file at the job site:
1. The approved E&SC plan as well as any approved deviation.
2. The NCG01 permit and the COC, once it is received.
3. Records of inspections made during the previous 30 days.
This project is subject to the National Pollutant Discharge Elimination System (NPDES). As of April 1, 2019, all new construction activities
are required to complete and submit an electronic Notice of Intent (NOI) from requesting a Certificate of Coverage (COO) under the
NCG010000 Construction Sormwater General Permit. This form MUST be submitted prior to the commencement of any land disturbing
activity on the above named project. The NOI form maybe accessed at deq.nc.gov/NCG01. After you submit a complete and correct NOI
Form, a COC will be emailed to you within three business days. DEMLR will charge a fee for coverage under the NCG01 permit. This fee
is to be sent to the DEMLR Stormwater Central Office staff in Raleigh. Please see North Carolina Department of Environmental Quality
(NCDEQ) documentation regarding procedures for obtaining permit NCG010000. Refer to the NCDEQNCG01 Ground Stabilization and
Materials Handling Sheet for additional details on compliance with these requirements. Should you have questions contact the Division of
Energy, Mineral and Land Resources, 919-707-3639.
Acceptance and approval of this plan is conditioned upon your compliance with Federal and State water quality laws, regulations, and rules.
In addition, focal city or county ordinances or rules may also apply to this land -disturbing activity. This approval does not supersede any
other permit or approval.
This Approval Shall Expire:
1. There is no substantial construction, erection, alteration, excavation, demolition or similar work authorized by such permits within one (1)
year after issuance.
2. Work has commenced, but there is no substantial progress on the project for a period of one (1) year.
3. The project has not been completed within two (2) years of issuance of the permit.
Authorized Signature: pate: 07/0212020
Town Official Date

Town of
(Aiuthern tees
t !I North 5m[iw
The Mad $oath R2esort
inter rkuaWa v Recognized for Program Ercelknce
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
Public Works Department
140 Memorial Park Court
Southern Pines, North Carolina 28387
Telephone: [phone] — Fax: [phone]
No person may initiate any land -disturbing activity greater than 30,000 sq. ft. (including lots or tracts of land that are
a part of a Common Plan of Development that the total disturbance will exceed 30,000 sq. ft.) as covered by the
Town's Code of Ordinances before this form and an acceptable erosion and sedimentation control plan have been
completed and approved by the Town of Southern Pines. (Please type or print and, if the question is not applicable
or information unavai#able, place N/A in the blank.)
Part A.
1. Project Name:..4W
2. Location of land -disturbing activity: County; Moore City or Township: Southern Pines
Street Address A0 �J ��G.1'�, r �. �^
3. Latitude: 1t 1131)) Longitude: 2 CI PIN: t� �
4. Percent Impervious: � /
5. Approximate date that land -disturbing activity will commence: ( `�
6. Purpose of development (residential, commercial, industrial, institutional,
7. Total acreage disturbed or uncovered (including off -site borrow and waste areas):
8. Amount of fee enclosed: $ ­`
The application fee is $300.00 for the first acre plus $150.00 for each additional acre, or part thereof.
The revised plan review fee is $50 for each submittal after the 2nd review.
Any substantial revision to a previously approved, active plan is $60 per acre, or part thereof.
No Fee for Minor Construcfion Activities less than 30 r?t?0 s , ft. of disturbance,
9. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name 6_�° �_ E-mail Address
Telephone Cell #
Fax #
10. Landowner(s) of Record (attach accompanied page to list additional owners):
Na�
_ T enhone
>
Current Mailing Addre s
Cr Y State Zip
Fax ##
Current Street Address _.
City
State
Zip
11. Deed Book No. 5W-b — Page No. �� (Provide a copy of the most current deed).

Pam B.
1. Person(s) or firm(s) who is financially responsible for the land -disturbing activity
(Provide a comprehensive list of all responsible parties on an attached sheet):
� r
N
�/Y� E} 6
Current Mailing Add ess Current Street Address
w m i ),
City _ State Zip City State
Zip
Telephone id` r\A_09� Fax #
(a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name of Registered NC Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State
Zip
Telephone Fax #
(b) If the Financially Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name. If the Financially Responsible
Party is a Corporation, give name and street address of the Registered Agent
Name of NC Registered Agent E-mail Address
Current Mailing Address
City State
Telephone
Current Street Address
Zip City
Fax #
State
Zip

The above information is true and correct to the best of my knowledge and belief and was provided
by me under oath (This form must be signed by the Financially Responsible Person if an individual
or his attorney -in -fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Person). I agree to provide
orrected information should there be any change in the information provided herein.
ype or print name Title or Authority
�A�J
4iat"ure4
Date
a Notary Public of the Count of
Ida -
State of North Carolina, hereby certify that County
appeared personally before me this day and being duly sworn acknowledged that the above form
was executed by him.
Witness my hand and notarial seal, this
day of
Seal
FOR TOWN USE ONLY:
Covered by 5/70 Provision: Yes ❑
Notary
My commission expires A/
No
0';1141i1i1liitfiljlpI
NpWY Pub" �
Moore
CounlY
REVISED January 9, 2020

SOH 'Erosion and Sedimentation Control PUT OPTIC iNS
The Town of Southern Pines Soil Erosion and Sedimentation Control Chapter requires that the minimum erosion control
measures, as outlined in Section 154.07 (A), be instailed when the disturbed area on a tract of land is less than thirty -
thousand square feet (30,000 SF), unless otherwise exempt from installation of measures/devices or ESC Plan Approval is
required. Furthermore, no person shall initiate any land -disturbing activity on a tract if more than thirty -thousand square feet
(30,000 SF) is to be uncovered unless, thirty (30) days or more prior to initiating the activity; a Plan for such activity is fifed
with and approved by the Town. Failure to install and/or maintain erosion control measures/devices may result in penalties
Of up to $5,000.00 per day.
INSTRUCTIONS:
Identify One or Any Combination of Letters for the Schematic That Best Describes the Erosion Control Measures That Will
be Used at Your Site During Construction.
LEGEE N D7
SILT FENCE
?SI CONSTRUCTION ENTRANCE
DIRECTION OF FLOW (POINT DOWNHILL)
A. Flow to the Rear
FLOW
FLOW
F50U5E
D. Flow to the Right
13. Flow to the Front
C. Flow to the Left
FL0�1A1
iiOV5E
FLOW
E. Flow to the Front & Rear
FLOW l
HOVSE
FLOW
REVISED: 6-2013