NCC210183_NOI Application_20210112

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 1/8/2021 4:41:39 PM (NCG01 NOI Submission)
Approve by Gamble, Aana C 1/11/2021 1:33:06 PM (Review- Construction NOI 40774)
• The task was assigned to Gamble, Aana C by round robin distribution 1/8/2021 4:42 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 12, 2021 5:00
PM 1/8/2021 4:42 PM
Submit by Selkane, Aziza 1/12/2021 11:37:41 AM (Payment Verification for NCC210183)
* Mario Sclarandis
• Selkane, Aziza assigned the task to Selkane, Aziza 1/12/2021 11:36 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: February 22, 2021 5:00
PM 1 /11 /2021 1:34 PM

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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 *
EB-5807 Greenway
1 b. Specific Lot
This field may be used to list specifc lot numbers.
Numbers
N/A
1 c. Parcel ID List all R% associated w ith this project.
Number(s) (PIN) #1794737408; #1794801539; #1794709290;
#1794801062;#1793897418;#1793982833;
#1793986722;#1793987639;#1793988638;
#1793980636;#2703080634;#2703080489;
#1793989591;#1793989502
2. County* Burke
3. Highway or Street Sanford Dr.
Address* Street name only is acceptable if no address number assigned yet
4. City or Township* Morganton
5. State * NC
6. Zip Code* 28655
7. Latitude* Enter the latitude in decimal degrees
35.7560
8. Longitude * Enter the longitude in decimal degrees (UBTbe negative)
-81.7030
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* 01/11/2021
Estimated Construction Project Start Date
10. Date to End* 01/10/2022
Estimated Construction Project End Date
11. SIC (Primary) * Other (9999)
Standard Industrial C]assification for Development

12. Acres to be 4.75
disturbed* (including off -site borrow and waste areas)
13. Total site area 5.00
(acres) *
14. Post- 1.19
construction (Estirrated)
impervious area
(acres) *
NCC Project NCC-BURKE-2021-EB-5807 Greenway
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 Catawba River
Wate rbody* %rre of waterbody into which stornwater runoff will discharge
15b. Waterbody 11-(32.7)
Index No.* NCWaterbody Index Nurrber
Stormwater rJ 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. ^
Fl rnittee 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 * City of Morganton
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 *
Phillip
If Corporation, enter Faegistered Agent First %rre
3. Last Name*
Lookadoo
It Corporation, enter Pegistered Agent Last %rre
3b. Title
Director of Development and Design Services
4. Permitee E-mail
[e-mail]
Address*
5. Permittee 828-438-5270
Telephone No.*
6. Permittee Mailing Street Address
Address* 305 East Union Street, Suite A100
Address Line 2
PO BOX 3448, Morganton, NC 28680-3448
C7ty State / Ffovince / Fbgion
Morganton NC
Fbstal / Zip Code Country
28655 US
Check box if the V Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 305 East Union Street, Suite A100
Address Line 2
PO BOX 3448, Morganton, NC 28680-3448
Qty State / F rovince / Faegion
Morganton NC
Fbstal / Zip Code Country
28655 US
8. Type of ONnership is only individual if an individual is naned in B.1. above.
Ownership* Government -Municipal

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
...........................................................................................................................................................................................................................................................................
1. Primary Site
Kaitlyn
Contact - First
Name *
2. Primary Site
Cox
Contact - Last
Name *
3. Title
Project Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
336-246-7244
Telephone No.*
6. Organization
Tri-County Paving Inc.
Name
7. Site Contact
Street Address
Mailing Address*
PO Box863
Address Line 2
City
State / Rovince / Region
West Jefferson
NC
Fbstal / Zip Code
Country
28694
Ashe
8. Consultant Name
(Optional)
Kelly Marshall P.E.
First and Last narre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
980-266-6024
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
[e-mail]
Default is legally responsible person a-rrail (older NOIs rray not populate)
12. Billing
(For Annual Fee correspondence)
Telephone
828-438-5270
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 12/11/2019
Approved *
2. E&SC Plan Project BURKE-2020-010
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 * Asheville (ARO)
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 LOAwMPR & COPA 12-11-2019.docx.pdf 135.15KB
Approval letter or Mast beRDFformat
Grading Permit
6. Site Location Map Mist be RDFforrret (lint 201VB)
GW Trail Plans 9-30-20 - Reduced.pdf 12.36MB
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 NCG01 Form.pdf 895.88KB
Form Wst be RDFforrret
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* Phillip Lookadoo
Title Director of Development and Design Services
Organization Legally Responsible Entity
City of Morganton
Date * 01 /08/2021

F. Tracking and COC Info
NOI Tracking No. 40774
NC Reference No.
NCG01-2021-0183
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC210183
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 183
Sequential nurrber for subrrittal that is incremented by Stored Frocedure
COC Year 2021
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)
Initial Invoice No. NCC210183-2021
Invoice Due Date 2/10/2021
Initial Fee $ 100.00
Invoice Status OPEN