NCC203746_NOI Application_20200902

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/26/2020 3:55:54 PM (NCG01 NOI Submission)
Approve by Morman, Alaina 8/27/2020 8:33:53 AM (Review- Construction NOI 30511)
• Morman, Alaina reassigned the task to Morman, Alaina 8/27/2020 8:09 AM
• The task was assigned to Clark, Paul by round robin distribution 8/26/2020 3:57 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: August 28, 2020 5:00
PM 8/26/2020 3:57 PM
Submit by Selkane, Aziza 9/2/2020 3:41:03 PM (Payment Verification for NCC203746)
* WIRTH Associates Inc
• Selkane, Aziza assigned the task to Selkane, Aziza 9/2/2020 3:40 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 8, 2020 5:00 PM
8/27/2020 8:35 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 30282
NOI No.
Prior Reviewer Alaina Morman
Name
1a. Project Name * Mountain Creek Park
1 b. Specific Lot This field may be used to list specffc lot numbers.
Numbers
2. County* Catawba
3. Highway or Street 6554 Little Mountain Road
Address * Street narre only is acceptable if no address number assigned yet
4. City or Township* Sherrills Ford
5. State * NC
6. Zip Code * 28673
7. Latitude * Enter the latitude in decimal degrees
35.5992
8. Longitude* Enter the longitude in decimal degrees (M. ST be negative)
-81.0322
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* 09/01/2020
Estimated Construction Project Start Date
10. Date to End* 08/30/2021
Estimated Construction Project End Cute
11. SIC (Primary) * Other (9999)
Standard Industrial Classification for Ceveloprrent

12. Acres to be 28.00
disturbed* (including off -site borrow and waste areas)
13. Total site area 606.12
(acres) *
14. Post- 8.56
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-CATAW-2020-Mountain Creek Park
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 Catawba River
Wate rbody* %rre of waterbody into which stornwater runoff will discharge
15b. Waterbody 11-(75)
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. ^
Fl rnittee 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 * Catawba County
It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field.
Note: The organization name must match the business entity name registered with the NC Secretary of State. You can
verify the registration here.
2. First Name * John
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Cameron
It Corporation, enter Pbegistered Agent Last %rre
3b. Title Construction & Project Manager
4. Permitee E-mail [e-mail]
Address*
5. Permittee 828-466-7279
Telephone No.*
6. Permittee Mailing Street Address
Address* PO Box839
Address Line 2
City
Newton
Fbstal / Zip Code
28658-0389
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
F Yes
Street Address
25 Government Drive
Address Line 2
City
Newton
Fbstal / Zip Code
28658
8. Type of Government - County
Ownership *
State / Frovince / Pegion
NC
Country
us
State / Frovince / Region
NC
Country
us

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
John
Contact - First
Name *
2. Primary Site
Cameron
Contact - Last
Name *
3. Title
Construction & Project Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
828-466-7279
Telephone No.
6. Organization
Catawba County
Name
7. Site Contact
Street Address
Mailing Address*
25 Government Drive
Address Line 2
city
Newton
Fbstal / Zip Code
28658
8. Consultant Name
(Optional)
9
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
704-375-1588
Telephone No.
State / Rovince / Region
NC
Country
us

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 07/22/2020
Approved *
2. E&SC Plan Project CATAW-2020-018
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 * Mooresville (MRO)
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
Mountain Creek Park NCDEQ Approval Letter 7-22-
Approval letter or
238.16KB
2020.pdf
Grading Permit
Mast be RDFforrrat
6. Site Location Map
Helpful for linear project review
(Optional)
7 Site Vicinity Map.pdf 727.24KB
MOUNTAIN CREEK PARK WATER
897.28KB
CLASSIFICATION.pdf
Mist be RFfornat. 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 docurrents support
the application. Include additional waterbodies for linear projects if necessary.
Added water classification map that shows the specific disturbed
area within the overall site for this NOI. This area drains into Lake
Norman (Catawba River).
8. NOI Certification MtCreekNO1-signed 8-24-20.pdf 48.18KB
Form Mist be RDFformat
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 Article; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Artcle; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the
Commission implementing this Artcle 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
Type Name * John Cameron
Title Construction & Project Manager
Organization Legally Responsible Entity
Catawba County NC
Date * 08/26/2020

F. Tracking and COC Info
NOI Tracking No. 30511
NC Reference No.
NCG01-2020-3746
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC203746
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 3746
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. NCC203746-2020
Invoice Due Date 9/26/2020
Initial Fee $ 100.00
Invoice Status OPEN