HomeMy WebLinkAboutNCC213831_NOI Application_20210702Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 6/24/2021 2:12:41 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 6/25/2021 9:36:38 AM (Review- Construction NOI 57210)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 6/24/2021 2:13 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: June 28, 2021 5:00 PM
6/24/2021 2:13 PM
Submit by Selkane, Aziza 7/2/2021 10:22:57 AM (Payment Verification for NCC213831)
* Herring -Sutton & Associates PA
• Selkane, Aziza assigned the task to Selkane, Aziza 7/2/2021 10:19 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: August 6, 2021 5:00 PM
6/25/2021 9:37 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 * Wilson Academy of Applied Technology
1 b. Specific Lot This field may be used to list specifc lot numbers.
Numbers
1 c. Parcel ID List all Rios associated w ith this project.
Number(s) (PIN) 3722-80-6151
2. County* Wilson
3. Highway or Street 4809 Ward Blvd
Address* Street name only is acceptable if no address number assigned yet
4. Cityor Township* Wilson
5. State * NC
6. Zip Code* 27894
7. Latitude* Enter the latitude in decimal degrees
35.7230
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-77.8920
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*
07/15/2021
Estimated Construction Project Start Rate
10. Date to End *
07/15/2022
Estimated Construction Project End Date
11. SIC (Primary) *
Other (9999)
Standard Industrial C]assification for Development
12. Acres to be
7.30
disturbed*
(including off -site borrow and waste areas)
13. Total site area 10.18
(acres) *
14. Post- 8.57
construction (Estimated)
impervious area
(acres) *
NCC Project NCC-WILSO-2021-Wilson Academy of Applied Technology
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 Toisnot Swamp
Waterbody* Narreof waterbody into which storrrwater runoff will discharge
15b. Waterbody 27-86-11-(5)
Index No. * NCWaterbody Index Nurrber
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. ^
Fternittee 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 * Wilson County Board of Education
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 * Lane
If Corporation, enter Faegistered Agent First %rre
3. Last Name* Mills
It Corporation, enter Pbegistered Agent Last %rre
3b. Title Superintendent
4. Permitee E-mail lane.mills@WIsonschoolsnc.net
Address*
5. Permittee 252-399-7700
Telephone No.*
6. Permittee Mailing Street Address
Address* PO Box2048
Address Line 2
City
Wilson
Fbstal / Zip Code
27893
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
117 NE Tarboro Street
Address Line 2
city
Wilson
Fbstal / Zip Code
27893
State / Ffovince / Fbgion
NC
Country
USA
State / Frovince / Region
NC
Country
USA
8. Type of Ojvnership 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
Matt
Contact - First
Name *
2. Primary Site
Ruffin
Contact - Last
Name *
3. Title
Project Superintendent
4. Site Contact E-
mruffin@barnhillcontracting.com
mail Address*
5. Site Contact
252-903-3622
Telephone No.
6. Organization
Barnhill Contracting Company
Name
7. Site Contact
Street Address
Mailing Address*
800 Tiffany Blvd
Address Line 2
city
Rocky Mount
Fbstal / Zip Code
27804
8. Consultant Name
(Optional)
Richard R. Herring, PLS
First and Last narre
9. Consultant E-mail
rherring@herring-sutton.com
This person will be copied on all correspondence.
10. Consultant
252-291-8887
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
lane.mills@WIsonschoolsnc.net
Default is legally responsible person a-rrail
12. Billing
(For Annual Fee correspondence)
Telephone
252-399-7700
Default is legally responsible person telephone
State / Rovince / Region
NC
Country
USA
D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 06/12/2021
Approved *
2. E&SC Plan Project WILSO-2021-007
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 * Raleigh (RRO)
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 1905E-NCDEQ Approval Letter.pdf 218.45KB
Approval letter or Mist beRFformat
Grading Permit
6. Site Location Map Mast be RDFforrret (lint 20 NB)
1905E-NCG01 Project Vicinity Map.pdf 1.96MB
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 1905E-NCG01-eNO1 Certification Form.pdf 956.23KB
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
L..0 Ni{b
Type Name* Lane Mills
Title Superintendent
Organization Legally Responsible Entity
Wilson County Board of Education
Date * 06/24/2021
F. Tracking and COC Info
NOI Tracking No. 57210
NC Reference No. NCG25-2021-3831
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of NCC213831
Coverage (COC) Uses 'count number' variable (increrrented by SP)
No.*
Count Number 3831
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. NCC213831-2021
Invoice Due Date 7/25/2021
Initial Fee $ 100.00
Invoice Status OPEN