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HomeMy WebLinkAboutNCC205670_Modification Review_20210407Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 4/6/2021 2:28:01 PM (ADD TO FILE Submittal) Approve by Georgoulias, Bethany 4/7/2021 7:42:05 AM (Construction COC ADD TO FILE Review- NCC205670) • The task was assigned to Georgoulias, Bethany. The due date is: April 9, 2021 5:00 PM 4/6/2021 2:28 PM Y. , NORTH CAPOLINA EnYlrenmemf& Qualay Certificate of NCC205670 Coverage (COC) Enter the Certificate of Coverage N nber (Use capital letters) No.* Information associated with this permit: Project Name MASON OAKS SUBDIVISION- LOTS 33, 204, 205 Address HWY US 1 @ MASON OAKS DRIVE, WAKE FOREST, NC County Franklin Latitude 36.0171 Longitude-78.5137 Permittee Listed NVR, Inc. Legally Responsible MEREDITH SWEITZER Individual NC Reference No. NCG01-2020-5670 E&SC Plan ID Original NOI Tracking No. 2020-00002610 38118 Date COC Issued* 12/09/2020 Prior Rescission This field will populate only if CCChas already been rescinded.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 * F Additional Lots/Outparcels Approved - E&SC Revised r Other Revision(s) to E&SC Plan r Legally Responsible Individual and/or Site Contact Has Changed r Multiple Reasons (List) Addional We information (e.g., new Site Contact details). If lots are being added, please include specific lot nunbers. Explanation ADDITION OF LOTS 209, 254, 255, 54, 55, 56, 57 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 (%vised IRSCApproval, (lose -Out Doc, etc.) Documentation MASON OAKS- LOTS 209, 254, 255, 54-57 100.42KB LETTER OF APPROVAL.pdf Mist be FDFforrrat North Carolina General Statute 143-215.6113 (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). � 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 r 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 jot Ire/W Type Name* JOE SCHMIDTKE Title * VICE PRESIDENT Organization* NVR, Inc. Date * 04/06/2021 Email Address* msweitze@nvrinc.com En -ail for confin-ration Telephone Number* 9199871930 Contact nunber if we need to reach you Note: Original permittee and site contact are copied on modification correspondence. Additional Email Additional errailfor confirrration (Optional) Original Permittee msweitze@nvrinc.com Email Original Site Contact jriley@nvrinc.com Email Review Date 04/07/2021 Rescinded Since Submitted? Request Date 20210406 Formatted Review Date 20210407 Formatted