NCC192303_Notice of Termination_20210225

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 2/25/2021 4:08:58 PM (NOT Submittal)
Approve by Morman, Alaina 2/28/2021 6:46:55 PM (NOT Request Review- NCC192303)
• The task was assigned to Morman, Alaina. The due date is: March 2, 2021 5:00 PM
2/25/2021 4:09 PM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC192303
Coverage (COC) Enter the Certificate of Coverage Ninber
No.*
2020 Annual Fee Status PAST DUE
2021 Annual Fee Status Nbybeblank (if not yet billed).
This permittee owes a fee that is PAST DUE and has a pending NOD or NOV. Do not approve this NOT request
until payment is resolved. If this NOT request is acceptable, payment may be waived if applicable, but that action must
be completed first (at the NOD or NOV Reviewstep) to ensure records are routed to the correct folder in the
repository.
However, you can reject the NOT now if it is not acceptable.
Information associated with this permit:
Project Name
Eagle Point Cottage Addition and Parking Expansion
Address
1640 Eagle Point Drive, Wilmington, NC
County
New Hanover
Latitude
34.2847
Longitude
-77.7575
Permittee Listed
Eagle Point Golf Club Inc.
Legally Responsible
Billy Anderson
Individual
NC Reference No.
NCG01-2019-2303
E&SC Plan ID
43-98 Rev 8
Original NOI
17056
Tracking No.
Date COC Issued
10/14/2019
Prior Rescission
Cate populates only if CDC was already rescinded at tirre of submittal.
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 *
F Mistake or Invalid Coverage
r Other

Add ional Mare information about the basis of this request, if needed
Explanation This is a duplicate, we have closed
NCC192515, which is the same project. This
is an accidental duplicate COC.
Supporting Upload Supporting Dxurrentation if applicable.
Documentation Executed NOT _NCC192303.pdf
Wst be RYfornat
Project Close-out Information:
Final Close-out
Inspection Approval
Project Close-out Mist beFDFfornat
Approval
Documentation
North Carolina General Statute 143-215.66 (1) provides that:
184.33KB
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 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 Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine notto exceed ten thousand
dollars ($10,000).
rJ 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* Danielle Conway
Title * Project Manager
Organization* Monteith Construction Corp
Date * 02/25/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 910-431-3057
NOT Certification Executed NOT _NCC192303.pdf 184.33KB
Form Mast be FDF Fornat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?

Additional Email GCd on Notification BTails
(Optional)
Original Permittee GCdonNotification BTails
Email [e-mail]
Original Site Contact CCd on Notificaiton Bmils
Email [e-mail]