HomeMy WebLinkAboutNCC212181_NOI Application_20210413Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 4/9/2021 9:16:23 AM (NCG01 NOI Submission)
Approve by Meloy, Michael 4/12/2021 8:46:22 AM (Review- Construction NO149921)
• Gamble, Aana C reassigned the task to Meloy, Michael 4/9/2021 9:20 AM
• The task was assigned to Gamble, Aana C by round robin distribution 4/9/2021 9:17 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: April 13, 2021 5:00 PM.
The priority is: High 4/9/2021 9:17 AM
Submit by Selkane, Aziza 4/13/2021 8:39:04 AM (Payment Verification for NCC212181)
* Robert Neal
• Selkane, Aziza assigned the task to Selkane, Aziza 4/13/2021 8:37 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: May 24, 2021 5:00 PM. The
priority is: High 4/12/2021 8:46 AM
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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
Are you submitting r No
an NOI that was r Yes
rejected before?
Previous Rejected 49821
NOI No.
Prior Reviewer Michael Meloy
Name
1a. Project Name * Old Ferry Channel & Deer Creek Material Placement
1 b. Specific Lot This field may be used to list specffc lot numbers.
Numbers
1 c. Parcel ID List all R% associated w ith this project.
Number(s) (PIN) 537604908618000
2. County* Carteret
3. Highway or Street 126 Camp Pelletier Road
Address* Street name only is acceptable if no address number assigned yet
4. CityorTownship* Peletier
5. State * NC
6. Zip Code* 28584
7. Latitude* Enter the latitude in decimal degrees
34.7244
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-77.0725
If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of
North Carolina. Look for the coordinates in the bottom left corner.
9. Date to Begin* 04/13/2021
Estimated Construction Project Start late
10. Date to End * 04/30/2021
Estimated Construction Project End late
11. SIC (Primary)* Other (9999)
Standard Industrial (aassification for Development
12. Acres to be 17.00
disturbed* (including off -site borrow and waste areas)
13. Total site area 27.00
(acres) *
14. Post- 0.00
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-CARTE-2021-Old Ferry Channel & Deer Creek Material
Tracking ID Placement
Assigned automatically
Below you must enter waterbody information for surface waters affected by this project. Please consult
DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please
enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You
may enter up to 3 waterbodies if needed.
15a. Receiving Starkey Creek
Waterbody* Plarreof waterbody into which stormwater runoff will discharge
15b. Waterbody 20-29-2
Index No. * NCWaterbody Index Nurrber
Stormwater V No
discharges will flow r Yes
to additional
wate rs *
16a. Is this project r Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*
B. Permittee Information
Part B. ^
F2rnittee Inforrration - Legally Fbsponsible Entity and Individual
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same
organization. That person must be a responsible corporate officer who 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.
1. Organization Legally Pesponsible Entity
Name * Carteret County
It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field.
Note: The organization name must match the business entity name registered with the NC Secretary of State. You can
verify the registration here.
2. First Name * Greg
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Rudolph
It Corporation, enter F;bgistered Agent Last %rre
3b. Title Shore Protection Manager
4. Permitee E-mail grudolph@carteretcountync.gov
Address*
5. Permittee 252.222.5835
Telephone No.*
6. Permittee Mailing Street Address
Address* Carteret County Shore Protection Office
Address Line 2
PO Box 4297
City
Emerald Isle
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
Fbstal / Zip Code
28594
F Yes
Street Address
Carteret County Shore Protection Office
Address Line 2
7500 Emerald Drive
city
Emerald Isle
Fbstal / Zip Code
28594
State / Ffovince / i egion
NC
Country
United States
State / Ftovince / Region
NC
Country
United States
8. Type of Ownership is only individual if an individual is naned in B.1. above.
Ownership* Government - County
C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
Greg
Contact - First
Name *
2. Primary Site
Rudolph
Contact - Last
Name *
3. Title
Shore Protection Manager
4. Site Contact E-
grudolph@carteretcountync.gov
mail Address*
5. Site Contact
252.222.5835
Telephone No.
6. Organization
Carteret County
Name
7. Site Contact
Street Address
Mailing Address*
Carteret County Shore Protection
Address Line 2
PO Box 4297
city
Emerald Isle
Postal / Zip Code
28594
8. Consultant Name
(Optional)
Robert Neal
First and Last narre
9. Consultant E-mail
Rneal@moffattnichol.com
This person will be copied on all correspondence.
10. Consultant
910.218.7082
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
grudolph@carteretcountync.gov
Default is legally responsible person e-rrail
12. Billing
(For Annual Fee correspondence)
Telephone
252.222.5835
Default is legally responsible person telephone
State / Province / Region
NC
Country
United States
D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................................................................................................__
1. Date E&SC Plan 04/06/2021
Approved *
2. E&SC Plan Project CARTE-2021-019
Number/ID * Assigned by agency or local program
3. E&SC Plan r State DEQ Office
Approved by* r Local Program
4. State DEQ Office * Wilmington (WiRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. Please also upload a site map showing the overall extent of the project (for linear projects, can
include the beginning point and end point coordinates in the "Notes" box below).
5. E&SC Plan
CARTE-2021-019 Approval 4-6-2021.pdf 231.28KB
Approval letter or
Mast beRDFformat
Grading Permit
6. Site Location Map
Wst be RDFformat (lint 20 [vB)
10153-OFC-ESC_Permit-LocationMap-040921.pdf 1.62MB
Rease do not upload entire set of E&SC plans.
7. Notes (Optional)
Rovide any additional information that night help the reviewer better understand how uploaded docurrents support
the application. Include additional waterbodies if necessary.
8. NOI Certification
10153-NCG01-eNO1-Certification-Form-20210212-
Form
703.88KB
DEMLR-SW-040721.pdf
IvLst be R7Ffon-rat
This is an Express
r No
Review Project*
F Yes
E. Certification
North Carolina General Statute 143-215.66 (1) provides that:
Any person who knowingly makes anyfalse statement, representation, or certification in any application, record, report, plan, or other
document filed or required to be maintained under this Article or a rule implementing this Atide; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Atcle; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Amide or rules of the
Commission implementing this Atcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
17 I am the person responsible for the construction activities of this project, for
satisfying the requirements of this permit, and for any civil or criminal penalties
incurred due to violations of this permit.
rJ The information submitted in this NOI is, to the best of my knowledge and belief,
true, accurate, and complete based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information.
* 17 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ I hereby request coverage under the NCG010000 General Permit and
understand that coverage under this permit will constitute the permit
requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
Specify if you are:* IT The Legally Responsible Person named on this Notice of Intent
f Authorized Responsible Person* (signing on behalf of Legally Responsible
Person named in Part B)
Important: The person who electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible
person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who
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 * Greg 'Rudi' Rudolph
Title Shore Protection Manager
Organization Legally Plesponsible Entity
Carteret County
Date * 04/09/2021
F. Tracking and COC Info
NOI Tracking No. 49921
NC Reference No. NCG01-2021-2181
Uses 'count_nurber' variable (increrrented by SP)
Certificate of NCC212181
Coverage (COC) Uses 'count number' variable (increrrented by SP)
No.*
Count Number 2181
Sequential nurrber for subrrittal that is incremented by Stored Frocedure
COC Year 2021
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)
Initial Invoice No. NCC212181-2021
Invoice Due Date 5/12/2021
Initial Fee $ 100.00
Invoice Status OPEN