NCC211055_NOI Application_20210223

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/22/2021 1:58:45 PM (NCG01 NOI Submission)
Approve by Gamble, Aana C 2/23/2021 8:36:08 AM (Review- Construction NOI 45080)
• Garcia, Lauren V reassigned the task to Gamble, Aana C 2/23/2021 8:21 AM
• The task was assigned to Garcia, Lauren V by round robin distribution 2/22/2021 1:59 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: February 24, 2021 5:00
PM 2/22/2021 1:59 PM
Submit by Selkane, Aziza 2/23/2021 12:51:09 PM (Payment Verification for NCC211055)
* Erica Danielle Britt
Jacob Andrew Britt
• Selkane, Aziza assigned the task to Selkane, Aziza 2/23/2021 12:50 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: April 6, 2021 5:00 PM
2/23/2021 8:36 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 45067
NOI No.
Prior Reviewer Aana Gamble
Name
1a. Project Name * GNZALEZ 2929 WEXFORD RESERVE
1 b. Specific Lot This field may be used to list specifc lot nunbers.
Numbers LOT 25
1 c. Parcel ID List all RW associated w ith this project.
Number(s) (PIN) 1831474759
2. County* Wake
3. Highway or Street 2929 WEXFORD POND WAY
Address* Street name only is acceptable if no address number assigned yet
4. City or Township* WAKE FOREST
5. State * NC
6. Zip Code* 27587
7. Latitude* Enter the latitude in decimal degrees
35.9960
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-78.5450
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* 02/26/2021
Estimated Construction Project Start Rate
10. Date to End * 07/30/2021
Estimated Construction Project End Late

11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521)
Standard Industrial aassification for Development
12. Acres to be 0.50
disturbed* (including off -site borrow and waste areas)
13. Total site area 1.69
(acres) *
14. Post- 1.56
construction (Estirrated)
impervious area
(acres) *
NCC Project NCC-WAKE-2021-GNZALEZ 2929 WEXFORD RESERVE
Tracking ID Assigned autorratically
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 HORSE CREEK
Waterbody* %rreof waterbody into which storrrwater runoff will discharge
15b. Waterbody 27-17-(0.7)
Index No. * NCWaterbody Index Nurrber
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 Responsible Entity
Name * BRITT CONSTRUCTION OF N.C. LLC
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 * Andy
IF Corporation, enter Faegistered Agent First %rre
3. Last Name* Britt
It Corporation, enter Pbegistered Agent Last %rre
3b. Title PRESIDENT
4. Permitee E-mail [e-mail]
Address*
5. Permittee 9197962361
Telephone No.*
6. Permittee Mailing Street Address
Address* 5321 Old Jones Road
Address Line 2
City
Wake Forest
Fbstal / Zip Code
27587-8878
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
F Yes
Street Address
5321 Old Jones Road
Address Line 2
city
Wake Forest
Postal / Zip Code
27587-8878
State / Frovince / Region
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
Andy
Contact - First
Name *
2. Primary Site
Britt
Contact - Last
Name *
3. Title
PRESIDENT
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
9197962361
Telephone No.
6. Organization
BRITT CONSTRUCTION OF NC
Name
7. Site Contact
Street Address
Mailing Address*
5321 Old Jones Road
Address Line 2
city
Wake Forest
Fbstal / Zip Code
27587
8. Consultant Name
(Optional)
First and Last narre
9. Consultant E-mail
This person will be copied on all correspondence.
10. Consultant
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
[e-mail]
Default is legally responsible person a-rrail
12. Billing
(For Annual Fee correspondence)
Telephone
9197962361
Default is legally responsible person telephone
State / Rovince / Region
NC
Country
United States

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 02/17/2021
Approved *
2. E&SC Plan Project SEC-051372-2020
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Wake 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 Approval- 283.68KB
Approval letter or S&E_SingleLot_PlanReviewChecklist_Septic.pdf
Grading Permit
Mast be Ft7Ffon-rat
6. Site Location Map Wst be RDFforrret (lint 201VB)
RBPR-051777-2021_Approved Site plan (2).pdf 3.19MB
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 SJLRR Servi21021717020.pdf 89.35KB
Form Mist 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 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* ANDY BRITT
ale PRESIDENT
Organization Legally Ibsponsible Entity
BRITTCONSTRUCTION OF NC LLC
02/22/2021

F. Tracking and COC Info
NOI Tracking No. 45080
NC Reference No.
NCG01-2021-1055
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC211055
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 1055
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. NCC211055-2021
Invoice Due Date 3/25/2021
Initial Fee $ 100.00
Invoice Status OPEN