HomeMy WebLinkAboutNCC211495_Modification Review ADD LOT 9_20210802Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 7/30/2021 3:13:21 PM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany A 8/2/2021 6:59:23 AM (Construction COC ADD TO FILE Review- NCC211495)
The task was assigned to Georgoulias, Bethany A. The due date is: August 4, 2021 5:00 PM
7/30/2021 3:13 PM
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NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of NCC211495
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
Information associated with this permit
Project Name
Southern Hill Estates Lot 32
Address
sky vista way, Raleigh, NC
County
Wake
Latitude
35.9580
Longitude
-78.6909
Permittee Listed
St. Clair Construction Group LLC
Legally Responsible
Samuel St Clair
Individual
NC Reference No.
NCG01-2021-1495
E&SC Plan ID
SEC-053642-2021
Original NOI
47649
Tracking No.*
Date COC Issued*
03/15/2021
Prior Rescission
This field will populate only if CCChas already been rescinded.
Date
Modification Information:
Reason for r Closed -Out Lots/Outparcels in E&SC Plan
Modification * F Additional Lots/Outparcels Approved - E&SC Revised
r Other Revision(s) to E&SC Plan
r Legally Responsible Individual and/or Site Contact Has Changed
r Multiple Reasons (List)
Addional Ivbre information (e.g., new Site Contact details). If lots are being added, please include specific lot nunbers.
Explanation I am building on another lot in the same subdivision where I already have a COC
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets).
For changes to the legally responsible individual, you must upload this form.
Supporting Upload Supporting Documentation (%vised ESCApproval, (lose -Out Doc, etc.)
Documentation lot 9 sec plan approval.pdf 289.21KB
Mast be FDFformat
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 Artide; 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 Amide 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 hereby request modification to coverage under the NPDES Stormwater Permit
for the subject project site. 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.
Specify if you are:* r The Legally Responsible Individual
f Authorized Responsible Person*
*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* Samuel K St Clair II
Title * President
Organization * St. Clair Construction Group LLC
Date * 07/30/2021
Email Address* stclairconstructiongroup@gmail.com
Errail for confirmation
Telephone Number* 9195592071
Contact nun ber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email Additional email for confirmation
(Optional)
Original Permittee stclairconstructiongroup@gmail.com
Email
Original Site Contact stclairconstructiongroup@gmail.com
Email
Review Date 08/02/2021
Rescinded Since
Submitted?
Request Date 20210730
Formatted
Review Date 20210802
Formatted