NCC205797_NOI Application_20201229

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/14/2020 10:16:55 AM (NCG01 NOI Submission)
Approve by Clark, Paul 12/15/2020 10:19:44 AM (Review- Construction NOI 39032)
• The task was assigned to Clark, Paul by round robin distribution 12/14/2020 10:17 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 16, 2020 5:00
PM 12/14/2020 10:17 AM
Submit by McCoy, Suzanne 12/29/2020 9:19:59 AM (Payment Verification for NCC205797)
* Michelle M Conway
• McCoy, Suzanne assigned the task to McCoy, Suzanne 12/29/2020 9:19 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 26, 2021 5:00 PM
12/15/2020 10:20 AM

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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 *
Eagle Island Cell 1 Improvements FY 20-21
1 b. Specific Lot
This field may be used to list specifc lot numbers.
Numbers
N/A
1 c. Parcel ID List all Rios associated w ith this project.
Number(s) (PIN) 03800029
2. County* Brunswick
3. Highway or Street Battleship Road Northeast
Address* Street name only is acceptable if no address number assigned yet
4. City or Township* Eagle Island
5. State * NC
6. Zip Code* 28401
7. Latitude* Enter the latitude in decimal degrees
34.1950
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-77.9639
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*
02/01/2021
Estimated Construction Project Start Rate
10. Date to End*
02/01/2024
Estinated Construction Project End Date
11. SIC (Primary) *
Other (9999)
Standard Industrial Classification for Development
12. Acres to be
30.00
disturbed*
(including off -site borrow and waste areas)

13. Total site area 305.00
(acres) *
14. Post- 0.00
construction (Estinated)
impervious area
(acres) *
NCC Project NCC-BRUNS-2021-Eagle Island Cell 1 Improvements FY 20-21
Tracking ID Assignedautonatically
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 Brunswick River
Waterbody* Narreof waterbody into which stornwater runoff will discharge
15b. Waterbody 18-77
Index No. * NCWaterbody Index Nunber
Stormwater F No
discharges will flow 17 Yes
to additional
wate rs *
15c. Additional Cape Fear River
Receiving Waterbody narre
Waterbody
15d. Waterbody 18-(71)a3
Index No. NCWaterbody Index Nunber
15e. Additional Waterbody name
Receiving
Waterbody
15f. Waterbody NCWaterbody Index Nunber
Index No.
16a. Is this project r 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 * US Army Corps of Engineers
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 *
Gregory
If Corporation, enter Faegistered Agent First %rre
3. Last Name*
Williams
It Corporation, enter Pbegistered Agent Last %rre
3b. Title
Chief, Engineering Branch, Wilmington District
4. Permitee E-mail
[e-mail]
Address*
5. Permittee 910-251-4767
Telephone No.*
6. Permittee Mailing Street Address
Address* 69 Darlington Avenue
Address Line 2
City
Wilmington
Fbstal / Zip Code
28403-1343
Check box if the V Yes
street address the
same as mailing
address
State / Ffovince / Fbgion
NC
Country
US
7. Permittee Street
Street Address
Address*
69 Darlington Avenue
Address Line 2
City
State / Frovince / Region
Wilmington
NC
Fbstal / Zip Code
Country
28403-1343
US
8. Type of
Ojvnership is only individual if an individual is naned in B.1. above.
Ownership*
Government- Federal

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
...........................................................................................................................................................................................................................................................................
1. Primary Site
Rolando
Contact - First
Name *
2. Primary Site
Serrano
Contact - Last
Name *
3. Title
Eagle Island Contract Officers
Representative
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
[phone]
Telephone No.*
6. Organization
US Army Corps of Engineers
Name
7. Site Contact
Street Address
Mailing Address*
69 Darlington Avenue
Address Line 2
City
State / Rovince / Fbgion
Wilmington
NC
Flostal / Zip Code
Country
28403-1343
US
8. Consultant Name
(Optional)
First and Last narre
9. Consultant E-mail
This person will be copied on all correspondence.
10. Consultant
Telephone No.
11. Billing E-mail (For Annual Fee correspondence)
Default is legally responsible person a -Trail (older NOIs may not populate)
12. Billing (For Annual Fee correspondence)
Telephone Default is legally responsible person telephone (older NOls rray not populate)

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 12/07/2020
Approved *
2. E&SC Plan Project BRUNS-2021-032
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 * Wilmington (WiRO)
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 BRUNS-2021-032 Approval 12-7-2020.pdf 304.99KB
Approval letter or Mast beRDFforml
Grading Permit
6. Site Location Map Mist be RDFfornat (lint 20 NB)
EI21 _G I01 _CeII1-2-3_VicMa p. pdf 1.07MB
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 docurrents support
the application. Include additional waterbodies if necessary.
8. NOI Certification Eagle Island NOI Certification Form_signed.pdf 585.36KB
Form Wst be RDFfornat
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 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:* IT The Legally Responsible Person named on this Notice of Intent
f Authorized Responsible Person* (signing on behalf of Legally Responsible
Person named in Part B)
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 * Gregory L Williams
Title Chief, Engineering Branch
Organization Legally Plesponsible Entity
U.S. Army Corps of Engineers, Wilmington District
Date * 12/14/2020

F. Tracking and COC Info
NOI Tracking No. 39032
NC Reference No.
NCG01-2020-5797
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC205797
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5797
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. NCC205797-2020
Invoice Due Date 1/14/2021
Initial Fee $ 100.00
Invoice Status OPEN