NCC205038_Modification Review CONTACT UPDATES_20210322

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 3/22/2021 11:34:31 AM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 3/22/2021 1:00:59 PM (Construction COC ADD TO FILE Review- NCC205038)
p Contact updates to NCC205038 will follow.
• The task was assigned to Georgoulias, Bethany. The due date is: March 25, 2021 5:00 PM
3/22/2021 11:34 AM

Y . Ta4M1
NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of NCC205038
Coverage (COC) Enter the Certificate of Coverage N nber (Use capital letters)
No.*
Information associated with this permit:
Project Name Magnolia Park Subdivision
Address New Bethel Church Road, Garner, NC
County Wake
Latitude 35.6572
Longitude-78.5720
Permittee Listed Mattamy Homes, LLC
Legally Responsible Rob Bailey
Individual
NC Reference No. NCG01-2020-5038
E&SC Plan ID
Original NOI
Tracking No.
SEC-036338-2020
34985
Date COC Issued* 11/05/2020
Prior Rescission This field will populate only if CCChas already been rescinded.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 * a Additional Lots/Outparcels Approved - E&SC Revised
O Other Revision(s) to E&SC Plan
r Legally Responsible Individual and/or Site Contact Has Changed
F Multiple Reasons (List)
Additional Disturbed Area, Legally Responsible Individual and
Site Contact has changed.
Add ion al We inforrration (e.g., new Site Contact details). If lots are being added, please include specific lot nunbers.
Explanation We have added additional disturbed area to the Phase 1 permit to accommodate
grading along the sanitary sewer outfall. Previously 75 acres; now 81 acres. Also,
please note that Rob Bailey is no longer with Mattamy and Joe Conlan should be
listed as the legally responsible individual.
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 Docurrentation (Devised E&SCApproval, Close -Cut Doc, etc.)
Documentation SEC-036338-2020_Approval_Sewer Outfall
Revision S&EConstructionPlanReviewChecklist- 284.82KB
V.2_WM 3-19-2021.pdf
C12.0-Additional Phase 1 LOD-81 AC Total.pdf 3.47MB
20210322 Mag Park NCG01-Legally Resp
1.05MB
Change.pdf
Mast be RYforrrat
North Carolina General Statute 143-215.6B (i) 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 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 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
Cam& L 117W
Type Name* Joe Conlan
Title * Director of Land Development
Organization* Mattamy Homes, LLC
Date * 03/22/2021
Email Address* [e-mail]
En -ail for confirnation
Telephone Number* 269-547-3807
Contact nunber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email [e-mail]
(Optional) Additional en -ail for confirnation
Original Permittee [e-mail]
Email

Original Site Contact [e-mail]
Email
Review Date 03/22/2021
Rescinded Since
Submitted?
Request Date 20210322
Formatted
Review Date 20210322
Formatted