NCC201895_Notice of Termination_20210609

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/9/2021 10:38:14 AM (NOT Submittal)
Approve by Morman, Alaina 6/10/2021 10:54:30 AM (NOT Request Review- NCC201895)
• The task was assigned to Morman, Alaina. The due date is: June 14, 2021 5:00 PM
6/9/2021 10:38 AM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC201895
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
Porter's Neck Crossing - Lot 4A
Address
178 Porter's Neck Road, Wilmington, NC
County
New Hanover
Latitude
34.3008
Longitude
-77.7912
Permittee Listed
CRJ Properties, LLC, CCPN Developers, LLC, & SPN Properties,
LLC
Legally Responsible
John Sandlin
Individual
NC Reference No.
NCG01-2020-1895
E&SC Plan ID
GP #4-20
Original NOI
25244
Tracking No.
Date COC Issued
5/11/2020
Prior Rescission
Cute populates only if COCwas already rescinded at tirre of submttal.
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
Add ional We information about the basis of this request, if needed.
Explanation
Supporting upload Supporting DDcurrentation if applicable.
Documentation NLstbeFOFforrrat

Project Close-out Information:
Final Close-out 5/26/2021
Inspection Approval
Project Close-out Final Field Inspection Report- Porters Neck Crossing
Approval 761.14KB
Lot 4A, 05.26.21.pdf
Documentation
Mist be FDFforrrat
North Carolina General Statute 143-215.613 (i) 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 Artide 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 device or method required to be operated or maintained under this Artide or rules of the
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
17 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* John Sandlin
Title * Managing Member
Organization* CRJ Properties, LLC
Date * 06/09/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 910.256.2672
NOT Certification Porters Neck Crossing -NOT Certification form. PDF 889.71 KB
Form Wst be FDF Forrrat
Is this COCAlready Ensure this OOChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Errails
(Optional) [e-mail]
Original Permittee OCdonWificationErrails
Email [e-mail]
Original Site Contact CCd on Notificaiton Errails
Email [e-mail]