NCC205345_NOT Signed Certification_20201203

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Print this form, complete, scan and upload to the electronic NOT (Rescission) form.
Then, mail the original form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 6th Floor
1612 Mail Service Center
Raleigh, NC 27699-1612
General Permit Certificate of Coverage (COC) No
Name of Project: V' �Ll?SJA
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Per NC General Statute 143-215.6B (i), any person who knowingly makes any false 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 ... shall be guilty of a Class 2 misdemeanor which may
include a fine not to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
❑ 1, as an authorized representative, hereby request rescission of coverage under the NPDES
Stormwater Permit for the subject facility. 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.
Legally Responsible Organizational Entity: S'e'� c "ac e-j evAaj
* Legally Responsible Person:
Title of Legally Responsible Person:
�r .mac %10 Signature: ��__._� �''�''y� Date: �
* IMPORTANT NOTE: 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 NCGO10000 permit.
For more information on signatory requirements, see Part IV, Section 8, Item (6) of the NCGO10000 permit.

McCoy, Suzanne
From: John R. Parker <[e-mail]>
Sent: Thursday, December 3, 2020 3:54 PM
To: McCoy, Suzanne
Subject: [External] Re: Stormwater - Shoppes at Biltmore NCC205345
CAUTION. External email. Do not click links or open attachments unless you verify. Submit all suspicious email using the Phish Alarm
button or as an attachment to Report Spam.
Suzanne,
Yes, you may destroy the permit request that was filed in error as it was already covered by
NCC 192078 Shoppes at Biltmore. Thank you again for your time and effort in completing the application
process. You are the best. Kind regards, John
hC mail.mobile.aolxoni
On Thursday, December 3, 2020, McCoy, Suzanne <[e-mail]> wrote:
Good afternoon 'John.
I hope you are well.
t need your permission to Terminate the attached. COC that we worked. on too -ether 11/19/2020 before we
realized you prolect was already covered by NCC192078 Shoppes at Biltmore.
Your response to this email will be sufficient.
Your voicemail
Sincerely,
Stormwater Program Administrative Specialist
Division of Energy, Mineral and Land Resources