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HomeMy WebLinkAboutNCC202131_Notice of Termination_20210331Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 3/31/2021 8:29:56 AM (NOT Submittal) Approve by Morman, Alaina 4/5/2021 3:15:32 PM (NOT Request Review- NCC202131) • The task was assigned to Morman, Alaina. The due date is: April 5, 2021 5:00 PM 3/31/2021 8:30 AM 1 � NORTH CAROLINA Enrlronmenral Quallly Certificate of NCC202131 Coverage (COC) Enter the Certificate of Coverage Nmber No.* 2020 Annual Fee Status 2021 Annual Fee Status May be blank (if not yet billed) Information associated with this permit: Project Name Brookwood Phase 1 A - Lots 1, 7 & 14 Address Enfield Drive, McNeill, NC County Moore Latitude 35.0000 Longitude -79.0000 Permittee Listed Caviness Land Development, Inc Legally Responsible Watson Caviness Individual NC Reference No. NCG01-2020-2131 E&SC Plan ID MOORE-2020-070 Original NOI 25921 Tracking No. Date COC Issued 5/21/2020 Prior Rescission Date populates only if OOC was already rescinded at tirre of submittal.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 obtained a new COC) Coverage * U Mistake or Invalid Coverage r Other Ad d i o n a I Nbre information about the basis of this request, if needed. Explanation Supporting Upload Supporting Docurrentation if applicable. Documentation Mist beFDFformat Project Close-out Information: Final Close-out 11/24/2020 Inspection Approval Project Close-out close out inspection 11.24.20.pdf 58.26KB Approval Mast be FDFforrrat Documentation 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 +j��rl�at�r. ��`�rrr�sr�lrl Type Name* Watson G Caviness Title * President Organization* Caviness Land Development Date * 03/31 /2021 Email for pj@cavinessland.com Confirmation * Contact Telephone* 9193396330 NOT Certification NOT Cert Form.pdf 269.3KB Form Mast be FDF Forrrst Is this COC Already Ensure this CCChas not been rescinded since subrrittal! Rescinded? Additional Email (Optional) Original Permittee Email CCd on Notification Erails CCd on Notification Erails pj@cavinessland.com Original Site Contact CCd on Notificaiton Errails Email pj@cavinessland.com