NCC201803_Notice of Termination_20201207

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/7/2020 11:15:47 AM (NOT Submittal)
Approve by Georgoulias, Bethany 12/7/2020 1:00:18 PM (NOT Request Review- NCC201803)
• The task was assigned to Georgoulias, Bethany. The due date is: December 10, 2020 5:00 PM
12/7/2020 11:15 AM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC201803
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
Information associated with this permit
Project Name
Riverlights Lot 89
Address
4539 Old Towne Street, Wilmington, NC
County
New Hanover
Latitude
34.1447
Longitude
-77.9355
Permittee Listed
Seventy West Builders, Inc
Legally Responsible
Craig Smith
Individual
NC Reference No.
NCG01-2020-1803
E&SC Plan ID
GP 28-15
Original NOI
25040
Tracking No.
Date COC Issued
5/5/2020
Prior Rescission
Date populates only if OOCwas already rescinded at tirre of subaittal.
Date
Reason for Rescission/Termination Request:
Reason for F Project Closed -Out
Termination of r Sale (Another Owner/Operator will apply for a new COC)
Coverage * O Mistake or Invalid Coverage
r Other
Addional We inforrration about the basis of this request, if needed.
Explanation
Supporting upload Supporting Docurrentation if applicable.
Documentation Mist beFDFforrrat
Project Close-out Information:
Final Close-out 11/19/2020
Inspection Approval

Project Close-out 70 West in River Lights Lot Finals- 11.19.20.pdf 298.45KB
Approval Mast be RYforrrat
Documentation
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 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 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 Article or rules ofthe
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
17 I, 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.
*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
n-'3,P 5/0s-
Type Name* Craig Smith
Title * President
Organization* Seventy West Builders, Inc
Date * 12/07/2020
Email for [e-mail]
Confirmation *
Contact Telephone* 9103244447
NOT Certification RL 89 - NOT Signed.pdf 352.75KB
Form Mast be FDF Forrrat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Original Permittee CCd on Wification Errails
Email [e-mail]
Original Site Contact CCd on Kbtificaiton Bmils
Email [e-mail]