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HomeMy WebLinkAboutNCC201323_Notice of Termination_20210401Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 4/1/2021 8:01:56 AM (NOT Submittal) Approve by Morman, Alaina 4/6/2021 1:38:09 PM (NOT Request Review- NCC201323) • The task was assigned to Morman, Alaina. The due date is: April 6, 2021 5:00 PM 4/1/2021 8:01 AM 1 � NORTH CAROLINA Enrlronmenral Quallly Certificate of NCC201323 Coverage (COC) Enter the Certificate of Coverage Nmber No.* 2020 Annual Fee Status 2021 Annual Fee Status OPEN K/hy be blank (if not yet billed). Information associated with this permit: Project Name Stonewater Lot 168 Address 1321 Yardley Dr., Wake Forest, NC County Wake Latitude 35.9336 Longitude -78.4973 Permittee Listed ICG Homes, LLC Legally Responsible Ryan Perry Individual NC Reference No. NCG01-2020-1323 E&SC Plan ID SEC-032392-2020 Original NOI 23871 Tracking No. Date COC Issued 4/1/2020 Prior Rescission Cate populates only if COCwas already rescinded at time of submittal.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 IVbre information about the basis of this request, if needed. Explanation Supporting upload Supporting Documentation if applicable. Documentation M st be R Fforrrat Project Close-out Information: Final Close-out 2/21/2021 Inspection Approval Project Close-out STW168 - SEC-032392-2020 Certificate of Approval 1.02MB Completion-2-2-21.pdf Documentation Mast 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 Type Name* Ryan Perry Title * Owner Organization* ICG Homes, LLC Date * 04/01 /2021 Email for hbrazell@icghomes.com Confirmation * Contact Telephone* 8033481944 NOT Certification STW168 - NCG01 NOT Cert. Form.pdf 681.05KB Form Mast be PDF 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 Bmils rperry@icghomes.com Original Site Contact CCd on Notificaiton Errails Email hbrazell@icghomes.com