NCC203798_NOI Application_20200901

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 8/31/2020 8:12:56 AM (NCG01 NOI Submission)
Approve by Clark, Paul 8/31/2020 1:47:34 PM (Review- Construction NOI 30643)
• The task was assigned to Clark, Paul by round robin distribution 8/31/2020 8:13 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 2, 2020 5:00
PM 8/31/2020 8:13 AM
Submit by Selkane, Aziza 9/1/2020 9:06:43 AM (Payment Verification for NCC203798)
* Phil Trauars
• Selkane, Aziza assigned the task to Selkane, Aziza 9/1/2020 9:06 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 12, 2020 5:00 PM
8/31/2020 1:47 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 * Williams Residence - 194 Meadow Run
1 b. Specific Lot This field any be used to list specifc lot numbers.
Numbers Lot 21
2. County* Chatham
3. Highway or Street 194 Meadow Run
Address* Street narre only is acceptable if no address number assigned yet
4. City or Township* Chapel Hill
5. State * NC
6. Zip Code * 27517
7. Latitude* Enter the latitude in decimal degrees
35.8546
8. Longitude* Enter the longitude in decimal degrees (M.JST be negative)
-79.0750
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*
09/04/2020
Estimated Construction Project Start Date
10. Date to End *
05/04/2021
Estinated Construction Project End Date
11. SIC (Primary)*
Residential, Single Family Houses (SFE) (1521)
Standard Industrial Classification for Developrrent
12. Acres to be
0.54
disturbed*
(including off -site borrow and waste areas)
13. Total site area 7.46
(acres) *

14. Post- 0.28
construction (Estirrated)
impervious area
(acres) *
NCC Project NCC-CHATI-1-2020-Williams Residence - 194 Meadow Run
Tracking ID Assignedautorraticaly
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 Wilson Creek
Waterbody* %rre of waterbody into which stornwater runoff will discharge
15b. Waterbody 16-41-2-6
Index No.* NCWaterbody Index Nunber
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 Responsible Entity
Name *
Travars Built Homes Inc
It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field.
2. First Name *
Phil
If Corporation, enter Registered Agent First %rre
3. Last Name*
Travars
It Corporation, enter Pbegistered Agent Last %ne
3b. Title
President
4. Permitee E-mail [e-mail]
Address*
5. Permittee 919-740-9587
Telephone No.*
6. Permittee Mailing Street Address
Address* PO Box309
Address Line 2
City
Pittsboro
Fbstal / Zip Code
27312
Check box if the F Yes
street address the
same as mailing
address
State / Rovince / F;bgion
NC
Country
United States
7. Permittee Street
Street Address
Address*
89 Fern Creek Trail
Address Line 2
City
State / Frovince / Region
Pittsboro
NC
Postal / Zip Code
Country
27312
United States
8. Type of
Non -Government
Ownership*

C. Site Contact Information
Part C.
Roject Site Contact Information
..............................................................................................................................................................................................................................................................................................................................................................................................
1. Primary Site Phil
Contact - First
Name *
2. Primary Site Travars
Contact - Last
Name *
3. Title President
4. Site Contact E- [e-mail]
mail Address*
5. Site Contact 919-740-9587
Telephone No.*
6. Organization Travars Built Homes Inc
Name
7. Site Contact Street Address
Mailing Address* PO Box309
Address Line 2
city
Pittsboro
Fbstal / Zip Code
27312
8. Consultant Name (Optional)
First and Last nave
9. Consultant E-mail This person will be copied on all correspondence.
10. Consultant
Telephone No.
State / Frovince / Fegion
NC
Country
United States

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 08/31/2020
Approved *
2. E&SC Plan Project 2020-05635
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Chatham 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
Letter of Approval - 2020-05635 - Williams.pdf 282.91 KB
Approval letter or
Mist beRDFformat
Grading Permit
6. Site Location Map
Helpful for linear project review
(Optional)
Site Plan with EC and Driveway Crossing -
2.11 MB
Williams.pdf
Mast be RDF format. Rease do not upload entire set of E&SC plans.
7. Notes (Optional)
Provide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional w aterbodies for linear projects if necessary.
8. NOI Certification
NOI Certification Form - Williams Residence - 194
Form
387.71 KB
Meadow Run. pdf
%st 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
/r,,/F5 rre, r? ,,
Type Name* Phil Travars
Title President
Organization Legally Iesponsible Entity
Travars Built Homes Inc
Date * 08/31 /2020

F. Tracking and COC Info
NOI Tracking No. 30643
NC Reference No.
NCG01-2020-3798
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC203798
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 3798
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. NCC203798-2020
Invoice Due Date 9/30/2020
Initial Fee $ 100.00
Invoice Status OPEN