NCC205311_NOI Application_20201120

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/18/2020 2:57:04 PM (NCG01 NOI Submission)
Approve by Garcia, Lauren V 11/18/2020 3:23:45 PM (Review- Construction NOI 36541)
• The task was assigned to Garcia, Lauren V by round robin distribution 11/18/2020 2:58 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 20, 2020 5:00
PM 11/18/2020 2:58 PM
Submit by Selkane, Aziza 11/20/2020 7:50:49 AM (Payment Verification for NCC205311)
* Meredith Switzer
• Selkane, Aziza assigned the task to Selkane, Aziza 11/20/2020 7:49 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 30, 2020 5:00
PM 11/18/2020 3:24 PM

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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 * MAGNOLIA CREEK PHASE 3 LOT 181
1 b. Specific Lot This field may be used to list specifc lot numbers.
Numbers LOT 181
2. County* Durham
3. Highway or Street BRIDGEWATER DRIVE
Address* Street narre only is acceptable if no address number assigned yet
4.City orTownship* DURHAM
5. State * NC
6. Zip Code * 27704
7. Latitude* Enter the latitude in decimal degrees
36.0579
8. Longitude* Enter the longitude in decimal degrees (M.JST be negative)
-78.8831
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*
01/25/2021
Estimated Construction Project Start Date
10. Date to End*
01/25/2023
Estinated Construction Project End Date
11. SIC (Primary)*
Residential, Single Family Houses (SFE) (1521)
Standard Industrial Classification for Developrrent
12. Acres to be
0.19
disturbed*
(including off -site borrow and waste areas)
13. Total site area 12.34
(acres) *

14. Post- 0.06
construction (Estirrated)
impervious area
(acres) *
NCC Project NCC-DURRA-2021-MAGNOLIA CREEK PHASE 3 LOT 181
Tracking ID Assigned automatically
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 CUB CREEK
Waterbody* %rm of waterbody into which storrrwater runoff will discharge
15b. Waterbody 27-2-20
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 Responsible Entity
Name * NVR, Inc.
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 * MEREDITH
IF Corporation, enter Registered Agent First Wre
3. Last Name* SWEITZER
It Corporation, enter F;bgistered Agent Last %rre
3b. Title PRODUCTION ADMINISTRATION
4. Permitee E-mail [e-mail]
Address*
5. Permittee 9199871930
Telephone No.*
6. Permittee Mailing Street Address
Address* 5734 Trinity Road
Address Line 2
SUITE 200
City State / Frovince / Fbgion
Raleigh NC
Fbstal / Zip Code Country
27607-3800 US
Check box if the V Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
5734 Trinity Road
Address Line 2
SUITE 200
City
State / Frovince / Region
Raleigh
NC
Fbstal / Zip Code
Country
27607-3800
US
8. Type of
Non -Government
Ownership*

C. Site Contact Information
Part C.
Project Site Contact Information
..............................................................................................................................................................................................................................................................................................................................................................................................
1. Primary Site JORDAN
Contact - First
Name *
2. Primary Site RILEY
Contact - Last
Name *
3. Title PRODUCTION MANAGER
4. Site Contact E- [e-mail]
mail Address*
5. Site Contact 803-873-0961
Telephone No.*
6. Organization
NVR, Inc.
Name
7. Site Contact
Street Address
Mailing Address*
5734 Trinity Rd.
Address Line 2
Ste 200
Raleigh
Pbstal / Zip Code
27607
8. Consultant Name
(Optional)
First and Last nacre
9. Consultant E-mail This person will be copied on all correspondence.
10. Consultant
Telephone No.
State / Province / Region
North Carolina
Country
United States

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 11/13/2020
Approved *
2. E&SC Plan Project 6207
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Durham City/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 MAGNOLIA CR- LOT 181 LID PERMIT.pdf 60.24KB
Approval letter or Mast beRDFformat
Grading Permit
6. Site Location Map Mist be RDFforrrat (lint 20 NB)
MAGNOLIA CR- LOT 181 plans.pdf 5.21 MB
Rease do not upload entire set of E&SC plans.
7. Notes (Optional) Rovide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional waterbodies for linear projects if necessary.
8. NOI Certification MAGNOLIA CR- LOT 181 SIGNED NOI.pdf 471.77KB
Form Wst be RDFforrrat
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 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 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
Jo( lro/m
Type Name* JOE SCHMIDTKE
Title VICE PRESIDENT
Organization Legally Ibsponsible Entity
NVR, Inc.
Date * 11 /18/2020

F. Tracking and COC Info
NOI Tracking No. 36541
NC Reference No. NCG01-2020-5311
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of NCC205311
Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5311
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. NCC205311-2020
Invoice Due Date 12/18/2020
Initial Fee $ 100.00
Invoice Status OPEN