NCC210934_Notice of Termination_20210706

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 7/6/2021 1:25:25 PM (NOT Submittal)
Approve by Morman, Alaina 7/8/2021 9:14:12 AM (NOT Request Review- NCC210934)
• The task was assigned to Morman, Alaina. The due date is: July 9, 2021 5:00 PM 7/6/2021 1:25 PM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC210934
Coverage (COC) Enter the Certificate of Coverage Narrber
No.*
2020 Annual Fee Status
2021 Annual Fee Status May be blank (if not yet billed)
Information associated with this permit:
Project Name
Richmond Place SFD Erosion Control Plan
Address
Grand Cedar Lane (Pvt), TOBACCOVILLE, NC
County
Forsyth
Latitude
36.2017
Longitude
-80.3897
Permittee Listed
True Homes, LLC
Legally Responsible
Brian McWhirter
Individual
NC Reference No.
NCG01-2021-0934
E&SC Plan ID
EN2100025
Original NOI
43470
Tracking No.
Date COC Issued
2/16/2021
Prior Rescission
Cate populates only if COCwas already rescinded at tirre of subrrittal.
Date
Reason for Rescission/Ternnination Request:
Reason for
F Project Closed -Out
Termination of
r Sale (Another Owner/Operator obtained a new COC)
Coverage *
O Mistake or Invalid Coverage
r Other
Addional Nbre information about the basis of this request, if needed.
Explanation Home construction phase complete. Final
inspection report provided.
Supporting upload Supporting Dccurrentation if applicable.
Documentation Mast beFDFforrrat

Project Close-out Information:
Final Close-out 6/25/2021
Inspection Approval
Project Close-out sir RICHMOND PLACE SFD 6-25-21 n.o.t..pdf 82.08KB
Approval Mist be FDFforrrat
Documentation
North Carolina General Statute 143-215.66 (1) 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 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 underthis Article; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring deice or method required to be operated or maintained under this Article or rules ofthe
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
rJ 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* Brian McWhirter
Title * Member -Manager
Organization* True Homes, LLC
Date * 07/06/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 704-507-0295
NOT Certification NCG01-eNOT-Certification-Form-20210514-
Form DEMLR-SW - signed.pdf
Mist be FDF Forrrat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Errails
(Optional) [e-mail]
Original Permittee CCdonWificationErrails
Email [e-mail]
Original Site Contact CCd on Notificaiton Errnils
Email [e-mail]
2.09MB