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HomeMy WebLinkAboutNCC201120_Notice of Termination_20210315Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 3/15/2021 12:30:11 AM (NOT Submittal) Approve by Morman, Alaina 3/15/2021 5:13:21 PM (NOT Request Review- NCC201120) • The task was assigned to Morman, Alaina. The due date is: March 18, 2021 5:00 PM 3/15/2021 12:30 AM 1 � NORTH CAROLINA Enrlronmenral Quallly Certificate of NCC201120 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 Stonewater S/D Phase 5, Lot 192 Address 616 Pelzer Drive, Wake Forest, NC County Wake Latitude 35.9031 Longitude -78.4972 Permittee Listed Brandywine Homes, Inc. Legally Responsible Colleen Cunningham Individual NC Reference No. NCG01-2020-1120 E&SC Plan ID Stonewater S/D Phase 5, Lot 192 Original NOI 23251 Tracking No. Date COC Issued 3/19/2020 Prior Rescission Date populates only if COCwas already rescinded at time of submittal. Date Reason for Rescission/Termination Request: Reason for r Project Closed -Out Termination of r Sale (Another Owner/Operator obtained a new COC) Coverage * r Mistake or Invalid Coverage r Other Addional Nbre information about the basis of this request, if needed. Explanation Supporting upload Supporting Documentation if applicable. Documentation NlastbeRYforrrat Project Close-out Information: Final Close-out 11/30/2020 Inspection Approval Project Close-out SEC-033611-2020_Certificate of Completion_11-30- Approval 20.pdf 165.23KB Documentation Mist be FDFforrrat North Carolina General Statute 143-215.66 (1) provides that: Anyperson who knowinglymakes any false 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 knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case underthis Article; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring deice or method required to be operated or maintained under this Article or rules ofthe Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to 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 L .�O2�le rfN �/fl L lMlll.Y�lB/9Q" Type Name* Colleen M Cunningham Title * President Organization* Brandywine Homes, Inc. Date * 03/15/2021 Email for bwhomes02@gmail.com Confirmation * Contact Telephone* 9195543351 NOT Certification NCG01-eNOT-Certification-Form-20210305- Form 977.45KB DEMLR-SW sw192.pdf Mist be FDF Format Is this COC Already Ensure this CCChas not been rescinded since subrrittal! Rescinded? Additional Email (Optional) Original Permittee Email CCd on Notification Errails bwhomes02@gmail.com CCd on Notification Erails bwhomes02@gmail.com Original Site Contact CCd on Notificaiton EiTails Email bwhomes02@gmail.com