NCC190048_Modification Review CONTACT CHANGES_20201208

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/8/2020 8:04:21 AM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 12/8/2020 12:09:58 PM (Construction COC ADD TO FILE Review- NCC190048)
• The task was assigned to Georgoulias, Bethany. The due date is: December 11, 2020 5:00 PM
12/8/2020 8:04 AM

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NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of NCC190048
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
Information associated with this permit
Project Name
Cadence Mint Hill Phases 2 - 4
Address
8841 Fairview, Mint Hill, NC
County
Mecklenburg
Latitude
38.1811
Longitude
-80.6333
Permittee Listed
Mattamy Carolina Corporation
Legally Responsible
Joe Walker
Individual
NC Reference No.
NCG01-2019-0048
E&SC Plan ID
389911
Original NOI
10172
Tracking No.*
Date COC Issued*
04/16/2019
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This field will populate only if COChas already been rescinded.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 * a Additional Lots/Outparcels Approved - E&SC Revised
r Other Revision(s) to E&SC Plan
F Legally Responsible Individual and/or Site Contact Has Changed
r Multiple Reasons (List)
Addional Nbre information if needed (e.g., new Site Contact details can be included here)
Explanation Brian Johnson VP
704-507-7547
[e-mail]
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 Lbcurrentation (%vised IRSCApproval, (lose -Out Doc, etc.)
Documentation _Cadence at Mint Hill Phase 2-4 Site Development
83.22MB
Set - 06-13-19 (CURRENT).pdf
Mast be RYformat
North Carolina General Statute 143-215.6B (i) provides that:
Anyperson who knowinglymakes anyfalse 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 knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; orwho 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 Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine notto exceed ten thousand
dollars ($10,000).
rJ 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
f 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
f r'1& Kc
Type Name* Brian Johnson
Title * VP
Organization* Mattamy Homes
Date * 12/08/2020
Email Address* [e-mail]
En -ail for confirmation
Telephone Number* 7045077547
Contact number if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email Additional email for conf irrration
(Optional)
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 12/08/2020

Rescinded Since
Submitted?
Request Date 20201208
Formatted
Review Date 20201208
Formatted