NCC205521_NOI Application_20201202

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 11/30/2020 1:47:15 PM (NCG01 NOI Submission)
Approve by Gamble, Aana C 11/30/2020 3:42:50 PM (Review- Construction NOI 37506)
• The task was assigned to Gamble, Aana C by round robin distribution 11/30/2020 1:47 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 2, 2020 5:00
PM 11/30/2020 1:47 PM
Submit by Selkane, Aziza 12/2/2020 9:19:22 AM (Payment Verification for NCC205521)
* Colleen Tully
• Selkane, Aziza assigned the task to Selkane, Aziza 12/2/2020 9:18 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 11, 2021 5:00 PM
11/30/2020 3:43 PM

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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 37366
NOI No.
Prior Reviewer Aana Gamble
Name
1a. Project Name * Howie Acres P2 Neighborhood Improvement Project
1 b. Specific Lot This field may be used to list specffc lot numbers.
Numbers
2. County* Mecklenburg
3. Highway or Street Dinglewood Ave.
Address * Street narre only is acceptable if no address number assigned yet
4. City or Township* Charlotte
5. State * NC
6. Zip Code * 28205
7. Latitude * Enter the latitude in decimal degrees
35.2500
8. Longitude* Enter the longitude in decimal degrees (M. ST be negative)
-80.7860
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* 01/04/2021
Estimated Construction Project Start Date
10. Date to End* 10/29/2021
Estimated Construction Project End Cute
11. SIC (Primary)* Highway (1611)
Standard Industrial aassification for Ceveloprrent

12. Acres to be 3.00
disturbed* (including off -site borrow and waste areas)
13. Total site area 3.00
(acres) *
14. Post- 0.10
construction (Estirrated)
impervious area
(acres) *
NCC Project NCC-MECKL-2021-Howie Acres P2 Neighborhood Improvement
Tracking ID Project
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 Little Sugar Creek
Wate rbody* N3rre of waterbody into which stornwater runoff will discharge
15b. Waterbody 11-137-8
Index No.* NCWaterbody Index Ninber
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 Pesponsible Entity
Name * City of Charlotte
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 * Jennifer
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Smith
It Corporation, enter Pbegistered Agent Last %rre
3b. Title City Engineer
4. Permitee E-mail [e-mail]
Address*
5. Permittee 704-336-7924
Telephone No.*
6. Permittee Mailing Street Address
Address* 600 East 4th Street
Address Line 2
City State / Frovince / Fbgion
Charlotte NC
Fbstal / Zip Code Country
28202-2816 us
Check box if the V Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
600 East 4th Street
Address Line 2
City
State / Frovince / Region
Charlotte
NC
Fbstal / Zip Code
Country
28202-2816
us
8. Type of
Government - Municipal
Ownership

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
Mark
Contact - First
Name *
2. Primary Site
Grimshaw
Contact - Last
Name *
3. Title
Project Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
704-619-4333
Telephone No.
6. Organization
City of Charlotte
Name
7. Site Contact
Street Address
Mailing Address*
600 East 4th Street
Address Line 2
city
Charlotte
Fbstal / Zip Code
28202-2816
8. Consultant Name
(Optional)
Arcadis, Dennis Kachmarsky, PE
First and Last narre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
704-544-5483
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 09/22/2020
Approved *
2. E&SC Plan Project MECKL-2020-093
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 Howie Acres P2 - Approved EC Permit - MECKL-
Approval letter or 2.15MB
2020-093-09222020.pdf
Grading Permit
Mast be FL7Ffon-rat
6. Site Location Map Mist be RDFforrret (lint 201VB)
Howie Acres Phase 2 Vicinity Map.pdf 106.63KB
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 docurrents support
the application. Include additional waterbodies for linear projects if necessary.
8. NOI Certification eNO1 Certification Form_jgsmith_11-25-2020_Howie
Form 539.27KB
Acres P2 NIP.pdf
Mast be R7Ffon-rat
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 * Jennifer Smith, PE
Title City Engineer
Organization Legally Responsible Entity
City of Charlotte, North Carolina
Date * 11/30/2020

F. Tracking and COC Info
NOI Tracking No. 37506
NC Reference No. NCG01-2020-5521
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of NCC205521
Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5521
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. NCC205521-2020
Invoice Due Date 12/30/2020
Initial Fee $ 100.00
Invoice Status OPEN