NCC203594_NOI Application_20200820

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 8/17/2020 11:00:01 AM (NCG01 NOI Submission)
Approve by Morman, Alaina 8/18/2020 4:10:29 PM (Review- Construction NOI 29990)
• The task was assigned to Morman, Alaina by round robin distribution 8/17/2020 11:00 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: August 19, 2020 5:00
PM 8/17/2020 11:00 AM
Submit by McCoy, Suzanne 8/20/2020 1:24:36 PM (Payment Verification for NCC203594)
* Pedcor Investments LLC
• McCoy, Suzanne assigned the task to McCoy, Suzanne 8/20/2020 1:23 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: September 29, 2020 5:00
PM 8/18/2020 4:10 PM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
Are you submitting f• No
an NOI that was r Yes
rejected before?
1a. Project Name * Springbrook Apartment Homes
1 b. Specific Lot This field nay be used to list specifc lot nunbers.
Numbers
2. County* Mecklenburg
3. Highway or Street 5025 Taggart Springs Way
Address* Street narre only is acceptable if no address number assigned yet
4.CityorTownship* Charlotte
5. State * NC
6. Zip Code * 28208
7. Latitude* Enter the latitude in decinal degrees
35.2380
8. Longitude* Enter the longitude in decir al degrees (NALIST be negative)
-80.9040
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*
08/18/2020
Estimated Construction Project Start Date
10. Date to End *
08/18/2022
Estinated Construction Project End Date
11. SIC (Primary)*
Residential, Other than SFE (1522)
Standard Industrial aassification for Developrrent
12. Acres to be
15.00
disturbed*
(including off -site borrow and waste areas)
13. Total site area 17.70
(acres) *

14. Post- 7.67
construction (Estirreted)
impervious area
(acres) *
NCC Project NCC-MECKL-2020-Springbrook Apartment Homes
Tracking ID Assigned autorretically
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 Taggart Creek
Waterbody* Narre of waterbody into which storrrwater runoff will discharge
15b. Waterbody 11-137-2
Index No.* NCWaterbody Index Number
Stormwater V No
discharges will flow r Yes
to additional
wate rs *
16a. Is this project F Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B. ^
Fbrnittee 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 *
Pedcor Investments-2017-CLXV, L.P.
It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field.
2. First Name *
Jared
If Corporation, enter Faegistered Agent First %rre
3. Last Name*
Houser
It Corporation, enter F;bgistered Agent Last %ne
3b. Title
Executive Vice President
4. Permitee E-mail [e-mail]
Address*
5. Permittee 317-587-0320
Telephone No.*
6. Permittee Mailing Street Address
Address* 770 3rd Ave SW
Address Line 2
City
State / Rovince / Pbegion
Carmel
IN
Fbstal / Zip Code
Country
46032-2070
us
Check box if the V Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
770 3rd Ave SW
Address Line 2
City
State / Frovince / Region
Carmel
IN
Fbstal / Zip Code
Country
46032-2070
us
8. Type of
Non -Government
Ownership*

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
Michael
Contact - First
Name *
2. Primary Site
Edwards
Contact - Last
Name *
3. Title
Project Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
317-705-7944
Telephone No.
6. Organization
Signature Construction
Name
7. Site Contact
Street Address
Mailing Address*
385 City Center Drive
Address Line 2
Suite 100
city
Carmel
Fbstal / Zip Code
46032
8. Consultant Name
(Optional)
McKenzie Publicover, PE
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
7049547461
Telephone No.
State / Rovince / Region
IN
Country
us

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 05/13/2020
Approved *
2. E&SC Plan Project LDGP-2020-00098
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* City of Charlotte
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
Letter of Approval modified April 2019 - Springbrook
Approval letter or
29.98KB
Apartment Homes.pdf
Grading Permit
Mast be FDFforrrat
6. Site Location Map
Helpful for linear project review
(Optional)
Mast be PDFfornat. 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 - Notice of Intent (NOI) Certification Form.pdf 83.98KB
Form
Mist be RDF format
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 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 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
IT 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
Type Name* Jared M. Houser
Title Executive Vice President
Organization Legally Pesponsible Entity
Pedcor Investments-2017-CLXV, L.P., by Alleghany Housing
Company, LLC, its General Partner; by Pedcor Investments, A
Limited Liability Company, its Manager
Date * 08/17/2020

F. Tracking and COC Info
NOI Tracking No. 29990
NC Reference No.
NCG01-2020-3594
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC203594
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 3594
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. NCC203594-2020
Invoice Due Date 9/17/2020
Initial Fee $ 100.00
Invoice Status OPEN