NCC200053_Notice of Termination_20210205

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/5/2021 1:43:50 PM (NOT Submittal)
Approve by Morman, Alaina 2/8/2021 11:57:04 AM (NOT Request Review- NCC200053)
• The task was assigned to Morman, Alaina. The due date is: February 10, 2021 5:00 PM
2/5/2021 1:44 PM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC200053
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
2020 Annual Fee Status
2021 Annual Fee Status OPEN
May be blank (if not yet billed).
Information associated with this permit:
Project Name
The Cove at Mackintosh
Address
4595 Bonner Bridge Parkway, Burlington, NC
County
Guilford
Latitude
36.0568
Longitude
-79.5416
Permittee Listed
DR Horton, Inc.
Legally Responsible
Jessica Meyer
Individual
NC Reference No.
NCG01-2020-0053
E&SC Plan ID
652, 621, 634, 585
Original NOI
20220
Tracking No.
Date COC Issued
1/7/2020
Prior Rescission
Cate populates only if COCwas already rescinded at tirre of subrrittal.
Date
Reason for Rescission/Termination Request:
Reason for
r Project Closed -Out
Termination of
r Sale (Another Owner/Operator will apply for a new COC)
Coverage *
r Mistake or Invalid Coverage
r Other

Add ional We information about the basis of this request, if needed.
Explanation All 4 permits are listed separately. Phases
1 A and 21B were closed out on 2-2-21 and
Phases 1 B and 2A were closed out on 3-8-
20. 1 have included all 4 final inspections
from Burlington so there is no confusion.
This COC was modified after the first two
permits were closed. I used the last date as
the close out date.
Supporting Upload Supporting DDcurrentation if applicable.
Documentation Mist beFCFform3t
Project Close-out Information:
Final Close-out
2/2/2021
Inspection Approval
Project Close-out
The Cove at Mackintosh Phases 1A, 1B, 2A, 213
Approval
Close Out Reports.pdf
Documentation
Mist be FCFforrrat
North Carolina General Statute 143-215.66 (1) provides that:
1.39MB
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 Atcle; orwho falsifies, tampers with, or knowinglyrenders
inaccurate anyrecording or monitoring device or method required to be operated or maintained under this Article or rules of the
Commission implementing this Atcle shall be guiltyofa Class 2 misdemeanor which mayinclude a fine notto exceed ten thousand
dollars ($10,000).
17 I, as an authorized representative, hereby request rescission of coverage under
the NPDES Stormwater Permit for the subject facility. 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.
*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
Type Name* Jessica Meyer
Title * NPDES Technical Compliance Administrator
Organization* DR Horton, Inc.
Date * 02/05/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 919-215-6561
NOT Certification The Cove at Mackintosh NOT Form.pdf 378.7KB
Form Mast be FDF Forrret

Is this COCAlready Ensure this OOChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Emils
(Optional) [e-mail]
Original Permittee CCd on Notification Errails
Email [e-mail]
Original Site Contact CCd on Notificaiton Errails
Email [e-mail]