NCC205861_NOI Application_20210106

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/17/2020 10:34:17 AM (NCG01 NOI Submission)
Approve by Gamble, Aana C 12/17/2020 3:36:36 PM (Review- Construction NOI 39353)
• The task was assigned to Gamble, Aana C by round robin distribution 12/17/2020 10:35 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 21, 2020 5:00
PM 12/17/2020 10:35 AM
Submit by McCoy, Suzanne 1/6/2021 9:12:37 AM (Payment Verification for NCC205861)
* SDH Raleigh
• McCoy, Suzanne assigned the task to McCoy, Suzanne 1/6/2021 9:12 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 28, 2021 5:00 PM
12/17/2020 3:37 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 39326
NOI No.
Prior Reviewer Aana Gamble
Name
1a. Project Name * Winston Point Phase 3
1 b. Specific Lot
This field may be used to list specifc lot numbers.
Numbers
3-19
1 c. Parcel ID
List all R% associated w ith this project.
Number(s) (PIN)
164801-37-9651
164801-37-8642
164801-37-7622
164801-37-6602
164801-37-4681
164801-37-3680
164801-37-2589
164801-37-1630
164801-37-0487
164801-37-1334
164801-37-2372
164801-37-3375
164801-37-4377
164801-37-5379
164801-37-7403
164801-37-3623
164801-37-3523
2. County*
Johnston
3. Highway or Street Coneflower Court
Address* Street name only is acceptable if no address number assigned yet
4.CityorTownship* Clayton
5. State * NC
6. Zip Code * 27520

7. Latitude * Enter the latitude in decinal degrees
35.6392
8. Longitude* Enter the longitude in decinal degrees (MJSTbe negative)
-78.5163
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*
12/21/2020
Estinated Construction Project Start Date
10. Date to End*
12/20/2021
Estinated Construction Project End Date
11. SIC (Primary)*
Residential, Single Family Houses (SFE) (1521)
Standard Industrial aassification for Ceveloprrent
12. Acres to be
8.48
disturbed*
(including off -site borrow and waste areas)
13. Total site area 143.20
(acres) *
14. Post- 6.50
construction (Estinated)
impervious area
(acres) *
NCC Project NCC-JOHNS-2020-Winston Point Phase 3
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 White Oak Creek
Waterbody* %neof waterbody into which stornwater runoff will discharge
15b. Waterbody 27-43-11
Index No. * NCWaterbody Index Nunber
Stormwater V No
discharges will flow r Yes
to additional
wate rs *
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. ^
F2rnittee 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 * SDH Raleigh, LLC
IF 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 * Robert
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Bowman
IF Corporation, enter F;bgistered Agent Last %rre
3b. Title Vice President, Construction
4. Permitee E-mail [e-mail]
Address*
5. Permittee 919-520-4208
Telephone No.*
6. Permittee Mailing Street Address
Address* 2520 Reliance Avenue
Address Line 2
City
Apex
Fbstal / Zip Code
27539-6346
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
F Yes
Street Address
2520 Reliance Avenue
Address Line 2
City
Apex
Fbstal / Zip Code
27539-6346
State / Frovince / Pegion
NC
Country
us
State / Frovince / Faegion
NC
Country
us
8. Type of Ownership is only individual if an individual is naned in B.1. above.
Ownership* Non -Government

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
...........................................................................................................................................................................................................................................................................
1. Primary Site
Vince
Contact - First
Name *
2. Primary Site
DeCarlo
Contact - Last
Name *
3. Title
Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
919-594-9981
Telephone No.*
6. Organization
SDH Raleigh, LLC
Name
7. Site Contact
Street Address
Mailing Address*
2520 Reliance Avenue
Address Line 2
City
State / Rovince / Region
Apex
NC
Postal / Zip Code
Country
27539-6346
us
8. Consultant Name
(Optional)
Andrea Agee
First and Last narre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
703-785-9115
Telephone No.
11. Billing E-mail (For Annual Fee correspondence)
Default is legally responsible person e-n-ail (older NCAs 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 11/04/2020
Approved *
2. E&SC Plan Project JC# 20-080-P
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Johnston County
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. Please also upload a site map showing the overall extent of the project (for linear projects, can
include the beginning point and end point coordinates in the "Notes" box below).
5. E&SC Plan 20-080 Winston Point Ph 3 Lots 3-19 ESC Appr
Approval letter or 413.09KB
11.04.20.pdf
Grading Permit
Mist be RDFfon-rat
6. Site Location Map Wst be FDFfornat (lint 201VB)
CO - Cover.pdf 468.61 KB
C1 - PERMITTED AREA PLAN.pdf 2.28MB
Rease do not upload entire set of E&SC plans.
7. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional w aterbodies if necessary.
8. NOI Certification 2020-11-10_NCG01 Cert Form-Signed.pdf 1.64MB
Form Mast be FDFformat
This is an Express F 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 Atide; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Atcle; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Amide or rules of the
Commission implementing this Atcle 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 If the Erosion and Sediment Control Plan approved by the delegated program is
not compliant with Part II (Stormwater Pollution Prevention Plan) of the
NCG010000 General Permit. I will nonetheless ensure that all conditions of Part
II of the permit are met on the project at all times.
* 17 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 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* Robert Bowman
Title Vice President, Construction
Organization Legally Ibsponsible Entity
SDH Raleigh, LLC
Date * 12/17/2020

F. Tracking and COC Info
NOI Tracking No. 39353
NC Reference No. NCG01-2020-5861
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of NCC205861
Coverage (COC) Uses 'count number' variable (increrrented by SP)
No.*
Count Number 5861
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. NCC205861-2020
Invoice Due Date 1/16/2021
Initial Fee $ 100.00
Invoice Status OPEN