NCC210084_NOI Application_20210112

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 1/6/2021 8:42:32 AM (NCG01 NOI Submission)
Approve by Meloy, Michael 1/6/2021 9:50:34 AM (Review- Construction NOI 40517)
• The task was assigned to Meloy, Michael by round robin distribution 1/6/2021 8:42 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 8, 2021 5:00
PM 1/6/2021 8:42 AM
Submit by McCoy, Suzanne 1/12/2021 3:57:50 PM (Payment Verification for NCC210084)
* A Sydes Construction
• McCoy, Suzanne assigned the task to McCoy, Suzanne 1/12/2021 3:57 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: February 17, 2021 5:00
PM 1/6/2021 9:50 AM

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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 39464
NOI No.
Prior Reviewer Alaina Morman
Name
1a. Project Name * Bennett Place V, Somerset Place V, and Roanoke Bay IV
1 b. Specific Lot This field may be used to list specffc lot numbers.
Numbers
1 c. Parcel ID List all PINS associated w ith this project.
Number(s) (PIN) 052265
2. County* Onslow
3. Highway or Street Wood House Drive
Address* Street name only is acceptable if no address nunber assigned yet
4. City or Township* Jacksonville
5. State * NC
6. Zip Code* 28546
7. Latitude* Enter the latitude in decinal degrees
34.8697
8. Longitude * Enter the longitude in decinal degrees (MJSTbe negative)
-77.4842
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* 01/13/2021
Estimated Construction Project Start Date
10. Date to End* 01/13/2022
Estinated Construction Project End Date

11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521)
Standard Industrial aassification for Development
12. Acres to be 189.50
disturbed* (including off -site borrow and waste areas)
13. Total site area 192.45
(acres) *
14. Post- 0.00
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-ONSLO-2021-Bennett Place V, Somerset Place V, and
Tracking ID Roanoke Bay IV
Assigned automatically
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 Margaret Branch
Waterbody* Pbrreof waterbody into which stormwater runoff will discharge
15b. Waterbody 19-4-3
Index No. * NCWaterbody Index Number
Stormwater F No
discharges will flow 17 Yes
to additional
wate rs *
15c. Additional New River
Receiving Waterbody narre
Waterbody
15d. Waterbody 19-(1)
Index No. NCWaterbody Index Number
15e. Additional Waterbody name
Receiving
Waterbody
15f. Waterbody NCWaterbody Index Number
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 * A. Sydes Construction, Inc.
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 * Anthony
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Sydes
It Corporation, enter Pbegistered Agent Last %rre
3b. Title President
4. Permitee E-mail [e-mail]
Address*
5. Permittee 910-455-6956
Telephone No.*
6. Permittee Mailing Street Address
Address* PO Box7122
Address Line 2
City
Jacksonville
Fbstal / Zip Code
28540
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
F Yes
Street Address
100 Carolina Plantations Boulevard
Address Line 2
City
Jacksonville
Fbstal / Zip Code
28546
State / Frovince / Fbgion
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
Anthony
Contact - First
Name *
2. Primary Site
Sydes
Contact - Last
Name *
3. Title
President
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
910-455-6956
Telephone No.*
6. Organization
A. Sydes Construction, Inc.
Name
7. Site Contact
Street Address
Mailing Address*
PO Box7122
Address Line 2
City
State / Rovince / Region
Jacksonville
NC
Fbstal / Zip Code
Country
28540
us
8. Consultant Name
(Optional)
Anthony Moctezuma
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
9104552414
Telephone No.
11. Billing E-mail (For Annual Fee correspondence)
[e-mail]
Default is legally responsible person a-rrail (older NOIs may not populate)
12. Billing (For Annual Fee correspondence)
Telephone [phone]
Default is legally responsible person telephone (older NCls rray not populate)

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 12/15/2020
Approved *
2. E&SC Plan Project ONSLO-2021-029
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. 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 ONSLO-2021-029 Approval 12-15-2020.pdf 293.2KB
Approval letter or Mast beRDFformat
Grading Permit
6. Site Location Map Mist be RDFforrret (lint 201VB)
Bennett PI, Sec. V.pdf 493.05KB
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 docurrents support
the application. Include additional waterbodies if necessary.
8. NOI Certification SKM_C45820121811390.pdf 78.69KB
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* Anthony W. Sydes
Title President
Organization Legally Responsible Entity
A. Sydes Construction, Inc.
Date * 01 /06/2021

F. Tracking and COC Info
NOI Tracking No. 40517
NC Reference No.
NCG01-2021-0084
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC210084
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 84
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. NCC210084-2021
Invoice Due Date 2/5/2021
Initial Fee $ 100.00
Invoice Status OPEN