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HomeMy WebLinkAboutNCC212239_NOI Application_20210415Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 4/13/2021 1:34:50 PM (NCG01 NOI Submission) Approve by Gamble, Aana C 4/14/2021 11:07:11 AM (Review- Construction NOI 50143) • The task was assigned to Gamble, Aana C by round robin distribution 4/13/2021 1:36 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: April 15, 2021 5:00 PM 4/13/2021 1:36 PM Submit by Selkane, Aziza 4/15/2021 9:34:40 AM (Payment Verification for NCC212239) * Thomas Parker Stone • Selkane, Aziza assigned the task to Selkane, Aziza 4/15/2021 9:28 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: May 26, 2021 5:00 PM 4/14/2021 11:07 AM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting IT No an NOI that was r Yes rejected before? 1a. Project Name * Westfall Lot 105 1 b. Specific Lot This field rray be used to list speck lot numbers. Numbers 105 1 c. Parcel ID List all RED associated w ith this project. Number(s) (PIN) 93549 2. County* Chatham 3. Highway or Street 270 West Beech Slope Ct. Address* Street name only is acceptable if no address number assigned yet 4. CityorTownship* Chapel Hill 5. State * NC 6. Zip Code* 27517 7. Latitude* Enter the latitude in decimal degrees 35.8258 8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative) -79.0580 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* 04/23/2021 Estimated Construction Project Start Rate 10. Date to End * 04/29/2022 Estimated Construction Project End Cate 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial Oassification for Development 12. Acres to be 0.39 disturbed* (including off -site borrow and waste areas) 13. Total site area 1.02 (acres) * 14. Post- 0.13 construction (Estirreted) impervious area (acres) * NCC Project NCC-CHATH-2021-Westfall Lot 105 Tracking ID 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 Hendon Creek Wate rbody* Narre of waterbody into which storrrwater runoff will discharge 15b. Waterbody 16-41-4-1-(0.5) Index No.* NCWaterbody Index 11unber 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. ^ Fbrnittee 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 Responsible Entity Name * ICG Homes, LLC 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 * Ryan If Corporation, enter Registered Agent First Wre 3. Last Name* Perry It Corporation, enter F;bgistered Agent Last %rre 3b. Title Owner 4. Permitee E-mail rperry@icghomes.com Address* 5. Permittee 919-291-0777 Telephone No.* 6. Permittee Mailing Street Address Address* 4020 Wake Forest Road Address Line 2 Suite 306 Cty Raleigh Fbstal / Zip Code 27609 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 4020 Wake Forest Road Address Line 2 Suite 306 city Raleigh Fbstal / Zip Code 27609 State / Ffovince / Fbgion NC Country us State / Frovince / Region NC Country us 8. Type of Ownership is only individual if an individual is naned in B.1. above. Ownership* Non -Government C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site John Contact - First Name * 2. Primary Site Benson Contact - Last Name * 3. Title PM 4. Site Contact E- hbrazell@icghomes.com mail Address* 5. Site Contact 919-951-5581 Telephone No. 6. Organization ICG Homes, LLC Name 7. Site Contact Street Address Mailing Address* 4020 Wake Forest Road Address Line 2 Suite 306 city Raleigh Fbstal / Zip Code 27609 8. Consultant Name (Optional) First and Last narre 9. Consultant E-mail This person will be copied on all correspondence. 10. Consultant Telephone No. 11. Billing E-mail (For Annual Fee correspondence) hbrazell@icghomes.com Default is legally responsible person a-rrail 12. Billing (For Annual Fee correspondence) Telephone 919-291-0777 Default is legally responsible person telephone State / Rovince / Region NC Country us D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 04/13/2021 Approved * 2. E&SC Plan Project WP-21-57 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Chatham County 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 WFL105 - LDP - Letter of Approval_Westfall Lot Approval letter or 105. pdf 138.29KB Grading Permit Mist be RDFforrrat 6. Site Location Map Mist be RDFforrret (lint 201VB) WFL105 - PP for NCG01.pdf 118.48KB Rease do not upload entire set of E&SC plans. 7. Notes (Optional) Provide any additional information that night help the reviewer better understand how uploaded docurrents support the application. Include additional waterbodies if necessary. 8. NOI Certification WFL105 - NCG01 NOI Cert. Form.pdf 783.25KB Form Mist be RDFforrret This is an Express r No Review Project* r 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 If the Erosion and Sediment Control Plan approved by the delegated program is not compliant with Part II (Stormwater Pollution Prevention Plan) of the NCG010000 General Permit. I will nonetheless ensure that all conditions of Part II of the permit are met on the project at all times. * 17 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:* r 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* Ryan Perry Title Owner Organization Legally Pesponsible Entity ICG Homes, LLC Date * 04/13/2021 F. Tracking and COC Info NOI Tracking No. 50143 NC Reference No. NCG01-2021-2239 Uses 'count_nurber' variable (increrrented by SP) Certificate of NCC212239 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 2239 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. NCC212239-2021 Invoice Due Date 5/14/2021 Initial Fee $ 100.00 Invoice Status OPEN