NCC210116_Modification Review LOT 774_20210122

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 1/21/2021 12:21:35 PM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 1/22/2021 9:15:22 AM (Construction COC ADD TO FILE Review- NCC210116)
• The task was assigned to Georgoulias, Bethany. The due date is: January 26, 2021 5:00 PM
1 /21 /2021 12:21 PM

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NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of NCC210116
Coverage (COC) Enter the Certificate of Coverage Ninber (use capital letters)
No.*
Information associated with this permit:
Project Name Chapel Ridge Lot 126 - 236 High Ridge Court
Address 236 High Ridge Court, Pittsboro, NC
County Chatham
Latitude 36.0000
Longitude-79.0000
Permittee Listed Absolute Construction and Development LLC
Legally Responsible Joe Kennedy
Individual
NC Reference No. NCG01-2021-0116
E&SC Plan ID LDP 20 30
Original NOI 40544
Tracking No.*
Date COC Issued* 01/11/2021
Prior Rescission This field will populate only if CCChas already been rescinded.
Date
Modification Information:
Reason for r Closed -Out Lots/Outparcels in E&SC Plan
Modification * F Additional Lots/Outparcels Approved - E&SC Revised
r Other Revision(s) to E&SC Plan
r Legally Responsible Individual and/or Site Contact Has Changed
r Multiple Reasons (List)
Addional We information if needed (e.g., new Site Contact details can be included here)
Explanation adding an additional lot within the same subdivision
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 Documentation (%vised ESCApproval, (lose -Out Doc, etc.)
Documentation Letter of Approval_Chapel Ridge Lot 774.pdf 288.5KB
Mast be FDFformat
North Carolina General Statute 143-215.66 (1) 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 knowinglyrenders
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 e)ceed 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
,72f-4FpW-1k"A1APY
Type Name* Joseph Kennedy
Title * Project Manager
Organization* Absolute Construction and Development LLC
Date * 01 /21 /2021
Email Address* [e-mail]
Errail for confirmation
Telephone Number* 8282312081
Contact nun ber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email Additional email for confirmation
(Optional)
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 01/22/2021
Rescinded Since
Submitted?

Request Date 20210121
Formatted
Review Date 20210122
Formatted