NCC204180_NOI Application_20200930

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/23/2020 8:44:45 AM (NCG01 NOI Submission)
Approve by Clark, Paul 9/23/2020 12:11:23 PM (Review- Construction NOI 31806)
• The task was assigned to Clark, Paul by round robin distribution 9/23/2020 8:44 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 25, 2020 5:00
PM. The priority is: High 9/23/2020 8:44 AM
Submit by Selkane, Aziza 9/30/2020 8:28:02 AM (Payment Verification for NCC204180)
* Jeffrey Goto
• Selkane, Aziza assigned the task to Selkane, Aziza 9/30/2020 8:27 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 4, 2020 5:00 PM.
The priority is: High 9/23/2020 12:11 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 * Abandon 9W4121 Telecom
1 b. Specific Lot This field rray be used to list specifc lot nunbers.
Numbers
2. County* Mecklenburg
3. Highway or Street Watson Drive
Address* Street narre only is acceptable if no address number assigned yet
4.CityorTownship* Charlotte
5. State * NC
6. Zip Code * 28202
7. Latitude* Enter the latitude in decinal degrees
35.2189
8. Longitude* Enter the longitude in decir al degrees (KUST be negative)
-80.8841
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*
09/25/2020
Estimated Construction Project Start Date
10. Date to End*
03/01/2021
Estinated Construction Project End Date
11. SIC (Primary) *
Other (9999)
Standard Industrial Cassification for Developrrent
12. Acres to be
32.00
disturbed*
(including off -site borrow and waste areas)
13. Total site area 32.00
(acres) *

14. Post- 0.00
construction (Estirrated)
impervious area
(acres) *
NCC Project NCC-MECKL-2020-Abandon 9W4121 Telecom
Tracking ID 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 Stewart Creek
Waterbody* Nbrre of waterbody into which storrrwater runoff will discharge
15b. Waterbody 11-137-1-2
Index No.* NCWaterbody Index Narrber
Stormwater r No
discharges will flow V Yes
to additional
wate rs *
15c. Additional Irwin Creek
Receiving Waterbody nacre
Waterbody
15d. Waterbody 11-137-1
Index No. NCWaterbody Index Nurrber
15e. Additional Waterbody nacre
Receiving
Waterbody
15f. Waterbody NCWaterbody Index Ninber
Index No.
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. ^
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 * Duke Energy Carolinas, LLC
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 * Randy
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Veltri
It Corporation, enter Registered Agent Last %rre
3b. Title Manager, Transmission Permitting
4. Permitee E-mail [e-mail]
Address*
5. Permittee 704-382-2741
Telephone No.*
6. Permittee Mailing Street Address
Address* 526 South Church Street
Address Line 2
ECI 09Q
City State / Frovince / Fbgion
Charlotte NC
Fbstal / Zip Code Country
28202 us
Check box if the V Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
526 South Church Street
Address Line 2
ECI 09Q
City
State / Frovince / Region
Charlotte
NC
Fbstal / Zip Code
Country
28202
us
8. Type of
Non -Government
Ownership*

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
Neal
Contact - First
Name *
2. Primary Site
Cary
Contact - Last
Name *
3. Title
Sr. Environmental Oversight Tech
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
704-575-3424
Telephone No.
6. Organization
Duke Energy Carolinas
Name
7. Site Contact
Street Address
Mailing Address*
526 South Church Street
Address Line 2
ECI 09Q
City
Charlotte
Fbstal / Zip Code
28202
8. Consultant Name
(Optional)
First and Last narre
9. Consultant E-mail
This person will be copied on all correspondence.
10. Consultant
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 05/12/2020
Approved *
2. E&SC Plan Project MECKL-2020-082
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 MECKL-2020-082-05122020.pdf 241.42KB
Approval letter or Mast beRDFformat
Grading Permit
6. Site Location Map Helpful for linear project review
(Optional) Abandon 9W4121 Telecom - Location Map.pdf 450.19KB
Mast be RDF format. Rease do not upload entire set of E&SCplans.
7. Notes (Optional) Rovide any additional information that night help the reviewer better understand how uploaded docurrents support
the application. Include additional waterbodies for linear projects if necessary.
The project involves removing 5 miles of abandoned transmission
line (wood poles and remaining static wire) starting from the
intersection of Yeoman Rd and Made Street, north Norwood Dr
near the Lakewood Retail Substation
8. NOI Certification eNO1 Certification Form —Abandon 9W4121
Form 483.55KB
Telecom_Signed.pdf
Mast be R7Ffon-rat
This is an Express r No
Review Project* F 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 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 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
r 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 * Randy Veltri
Title Manager, Transmission Permitting
Organization Legally Plesponsible Entity
Duke Energy Carolinas
Date * 09/23/2020

F. Tracking and COC Info
NOI Tracking No. 31806
NC Reference No.
NCG01-2020-4180
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC204180
Coverage (COC)
Uses 'count number' variable (increrrented by SP)
No.*
Count Number 4180
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. NCC204180-2020
Invoice Due Date 10/23/2020
Initial Fee $ 100.00
Invoice Status OPEN