NCC213630_NOI Application_20210617

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 6/15/2021 7:17:39 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 6/16/2021 7:25:51 AM (Review- Construction NOI 56515)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 6/15/2021 7:17 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: June 17, 2021 5:00 PM
6/15/2021 7:17 AM
Submit by Selkane, Aziza 6/17/2021 8:41:11 AM (Payment Verification for NCC213630)
* NVR Operations
• Selkane, Aziza assigned the task to Selkane, Aziza 6/17/2021 8:40 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: July 28, 2021 5:00 PM
6/16/2021 7:26 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 * Hunton Forest Supplemental EC Plan for Ryan Homes (Lots 264-279 & 253-258)
1 b. Specific Lot This field may be used to list specifc lot numbers.
Numbers Lots 264-279 & 253-258
1 c. Parcel ID
List all Rios associated w ith this project.
Number(s) (PIN)
5611024482
5611024477
5611024563
5611024548
5611024800
5611024633
5611024619
5611023948
5611023996
5611024953
5611025809
5611025855
5611025789
5611026703
5611026617
5611026799
5611027785
5611028627
5611028518
5611027561
5611026544
5611026560
5611026473
2. County*
Cabarrus
3. Highway or Street 4550 Hunton Dale Rd NW
Address* Street name only is acceptable if no address nunber assigned yet
4. City or Township* Concord
5. State * NC
6. Zip Code* 28027

7. Latitude * Enter the latitude in decinal degrees
35.4216
8. Longitude* Enter the longitude in decinal degrees (MJSTbe negative)
-80.6432
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*
02/03/2020
Estinated Construction Project Start Date
10. Date to End*
06/07/2021
Estinated Construction Project End Date
11. SIC (Primary)*
Residential, Single Family Houses (SFE) (1521)
Standard Industrial aassification for Ceveloprrent
12. Acres to be
4.50
disturbed*
(including off -site borrow and waste areas)
13. Total site area 115.00
(acres) *
14. Post- 27.50
construction (Estinated)
impervious area
(acres) *
NCC Project NCC-CABAR-2020-Hunton Forest Supplemental EC Plan for Ryan
Tracking ID Homes (Lots 264-279 & 253-258)
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 Irish Buffalo Creek
Waterbody* Narreof waterbody into which stornwater runoff will discharge
15b. Waterbody 13-17-9-(2)
Index No. * NCWaterbody Index Nunber
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 * NVR, Inc. (dba Ryan Homes)
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 * Kevin
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Connery
It Corporation, enter Pbegistered Agent Last %rre
3b. Title Division Manager
4. Permitee E-mail [e-mail]
Address*
5. Permittee [phone]
Telephone No.*
6. Permittee Mailing Street Address
Address* 13924 Professional Center Drive
Address Line 2
Suite 100
City
Huntersville
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
Fbstal / Zip Code
28078-7949
V Yes
Street Address
13924 Professional Center Drive
Address Line 2
Suite 100
city
Huntersville
Fbstal / Zip Code
28078-7949
State / Ffovince / i egion
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
Luke
Contact - First
Name *
2. Primary Site
Huther
Contact - Last
Name *
3. Title
Project Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
[phone]
Telephone No.*
6. Organization
Ryan Homes
Name
7. Site Contact
Street Address
Mailing Address*
13924 Professional Center Drive
Address Line 2
Suite 100
City
State / Rovince / Region
Huntersville
NC
Postal / Zip Code
Country
28078-7949
us
8. Consultant Name
(Optional)
Harris Engineering / Wayne M. Harris, P.E.
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
[phone]
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
[phone]
Default is legally responsible person telephone

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 01/31/2020
Approved *
2. E&SC Plan Project CABAR-2020-041
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 * Mooresville (MRO)
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 Hunton Forest 264 et al LOA.pdf 1.18MB
Approval letter or Mast beRDFformat
Grading Permit
6. Site Location Map Mist be RDFforrret (lint 20 NB)
HF V-map.pdf 186.37KB
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 docurrents support
the application. Include additional waterbodies if necessary.
8. NOI Certification eNO1-Cent Form _signed.pdf 55.6KB
Form Wst 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 Article; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Artcle; or who 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 Artcle 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
/ 1i1CIIAIW Y
Type Name* Kevin Connery
Title Division Manager
Organization Legally Plesponsible Entity
NVR, Inc. (dba Ryan Homes)
Date * 06/15/2021

F. Tracking and COC Info
NOI Tracking No. 56515
NC Reference No.
NCG01-2021-3630
Uses 'count_nunber' variable (increrrented by SP)
Certificate of
NCC213630
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 3630
Sequential nunber for subnittal 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. NCC213630-2021
Invoice Due Date 7/16/2021
Initial Fee $ 100.00
Invoice Status OPEN