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HomeMy WebLinkAboutNCC203825_Modification Review_20201005Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 10/5/2020 9:40:10 AM (ADD TO FILE Submittal) Approve by Georgoulias, Bethany 10/5/2020 1:09:44 PM (Construction COC ADD TO FILE Review- NCC203825) • The task was assigned to Georgoulias, Bethany. The due date is: October 8, 2020 5:00 PM 10/5/2020 9:40 AM Y . Ta4M1 NORTH CAPOLINA EnYlrenmemf& Qnalay Certificate of NCC203825 Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters) No.* Information associated with this permit Project Name Sanctuary Address 2337 Sanctuary Drive, Raleigh, NC County Wake Latitude 35.7150 Longitude -78.7340 Permittee Listed Upright Builders Inc Legally Responsible Wes Carroll Individual NC Reference No. NCG01-2020-3825 E&SC Plan ID SEC-043381-2020 Original NOI 30773 Tracking No.* Date COC Issued* 09/02/2020 Prior Rescission This field will populate only if COChas already been rescinded. Date Modification Information: Reason for r Closed -Out Lots/Outparcels in E&SC Plan Modification * F Additional Lots/Outparcels Approved - E&SC Revised r Other Revision(s) to E&SC Plan r Legally Responsible Individual Has Changed f Multiple Reasons (List) Addional IVbre information if necessary Explanation You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable sheets). For changes to the legally responsible individual, you must upload this form. Supporting Upload Supporting Documentation (%vised ERSC Approval, (lose -Cut Doc, etc.) Documentation SYM 13 SEC-043381-2020_Approval- S&EConstruction Plan ReviewChecklist-V.2 WM 8- 290.02KB 27-20 (4).pdf Mast be FDFformat North Carolina General Statute 143-215.66 (1) provides that: Anyperson who knowinglymakes any false statement, representation, or certification in anyapplication, record, report, plan, or other documentfiled or required to be maintained under this A tide or a rule implementing this Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case underthis Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Artide or rules of the Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand dollars ($10,000). 17 I hereby request modification to coverage under the NPDES Stormwater Permit for the subject project site. I am familiar with the information contained in this request and to the best of my knowledge and belief such information is true, complete and accurate. Specify if you are:* r The Legally Responsible Individual r Authorized Responsible Person* *This form must be signed by a responsible corporate officer that 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 was c,ap.,o ou_ Type Name* Wes Carroll Title * President Organization* Upright Builders Inc. Date * 10/05/2020 Email Address* annette@uprightbuilders.com Errail for confirrration Telephone Number* 919-858-8383 Contact number if we need to reach you Note: Original permittee and site contact are copied on modification correspondence. Additional Email Additional email for confirmation (Optional) Original Permittee annette@uprightbuilders.com Email Original Site Contact jekin@uprightbuilders.com Email Review Date 10/05/2020 Rescinded Since Submitted? Request Date 20201005 Formatted Review Date 20201005 Formatted