NCC213274_NOI Application_20210602

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 5/27/2021 6:40:45 AM (NCG01 NOI Submission)
Approve by EADS\bcbroussard 5/28/2021 10:04:31 AM (Review- Construction NOI 53700)
• Morman, Alaina reassigned the task to EADS\bcbroussard 5/27/2021 11:25 AM
• The task was assigned to Meloy, Michael K by round robin distribution 5/27/2021 6:41 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: May 31, 2021 5:00 PM
5/27/2021 6:41 AM
Submit by McCoy, Suzanne 6/2/2021 3:02:45 PM (Payment Verification for NCC213274)
* Merritt Properties LLC
• McCoy, Suzanne assigned the task to McCoy, Suzanne 6/2/2021 3:02 PM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: July 9, 2021 5:00 PM
5/28/2021 10:05 AM

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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 * Merritt Hinton Oaks Blvd
1 b. Specific Lot
This field any be used to list specifc lot numbers.
Numbers
N/A
1 c. Parcel ID
List all Rios associated w ith this project.
Number(s) (PIN)
1744-56-6995, 1744-47-9093, 1744-47-6090, 1744-47-9612
2. County*
Wake
3. Highway or Street Hinton Oaks Blvd
Address* Street name only is acceptable if no address number assigned yet
4. Cityor Township* Town of Knightdale
5. State * NC
6. Zip Code* 27545
7. Latitude* Enter the latitude in decimal degrees
35.7997
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-78.5100
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*
06/01/2021
Estimated Construction Project Start Rate
10. Date to End*
08/31/2022
Estinated Construction Project End Date
11. SIC (Primary)*
Industrial (1541)
Standard Industrial Oassification for Development
12. Acres to be
27.42
disturbed*
(including off -site borrow and waste areas)

13. Total site area 45.70
(acres) *
14. Post- 18.87
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-WAKE-2021-Merritt Hinton Oaks Blvd
Tracking ID Assigned autorratically
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 Milburnie Creek (Milburnie Lake)
Waterbody* Narreof waterbody into which storrrwater runoff will discharge
15b. Waterbody 27-31
Index No. * NCWaterbody Index Nunber
Stormwater V No
discharges will flow r Yes
to additional
wate rs *
16a. Is this project
subject to the NC
Sediment Pollution
Control Act?*
16b. Is this project
subject to the US
Clean Water Act?
r Yes
r No, not subject to NC SPCA
r Yes
f No, not subject to US CWA
This project will be issued a Certificate of Coverage under NCG250000 rather than NCG010000. The Erosion and
Sediment Control Plan shall be reviewed and approved by the appropriate DEMLR Regional Office, and then this Notice
of Intent form shall be completed and submitted.

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 * Merritt-MW1, 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 * Clifton Keith
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Wallace
It Corporation, enter Pbegistered Agent Last %rre
3b. Title Registered Agent
4. Permitee E-mail [e-mail]
Address*
5. Permittee 919.526.0070
Telephone No.*
6. Permittee Mailing Street Address
Address* 4509 Creedmoor Road
Address Line 2
Suite 201
aty
Raleigh
Fbstal / Zip Code
27612-3813
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
4509 Creedmoor Road
Address Line 2
Suite 201
city
Raleigh
Fbstal / Zip Code
27612-3813
State / Ffovince / Fbgion
NC
Country
us
State / Frovince / Faegion
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
Travis
Contact - First
Name *
2. Primary Site
Mohlhenrich
Contact - Last
Name *
3. Title
Site Superintendent
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
443.546.0657
Telephone No.
6. Organization
Merritt-MW1, LLC
Name
7. Site Contact
Street Address
Mailing Address*
4509 Creedmoor Road
Address Line 2
Suite 201
city
RALEIGH
Fbstal / Zip Code
27601
8. Consultant Name
(Optional)
Paul Devlin, PE
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
919.238.0432
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
[e-mail]
Default is legally responsible person e-rrail
12. Billing
(For Annual Fee correspondence)
Telephone
919.526.0070
Default is legally responsible person telephone
State / Rovince / Region
North Carolina
Country
United States

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 05/26/2021
Approved *
2. E&SC Plan Project SEC-053241-2021
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Wake 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 SEC-053241-2021_Approval wModifications -
Approval letter or S&EConstructionPlan ReviewChecklist- 287.87KB
Grading Permit
V.2_WM Rev.1_5-21-21.pdf
Mast be RFfornat
6. Site Location Map Mast be R7Fforrrat (lirrit 20 NB)
Site Map_Merritt Hinton Oaks Blvd.pdf 1.22MB
Rease do not upload entire set of E&SC plans.
7. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional w aterbodies if necessary.
8. NOI Certification Merritt Hinton Oaks Blvd_NCG01-eNOI-Certification-
Form Form.pdf 915.41 KB
Mast be FDFfornat
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
GL-I 771W;AP. Ff W,4 r Acx
Type Name* Clifton Keith Wallace
Title Registered Agent
Organization Legally Ibsponsible Entity
Merritt-MW1. LLC
Date * 05/27/2021

F. Tracking and COC Info
NOI Tracking No. 53700
NC Reference No.
NCG25-2021-3274
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC213274
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 3274
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. NCC213274-2021
Invoice Due Date 6/27/2021
Initial Fee $ 100.00
Invoice Status OPEN