NCC202716_Notice of Termination_20210817

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 8/17/2021 12:05:36 PM (NOT Submittal)
Approve by Morman, Alaina 8/18/2021 10:56:21 AM (NOT Request Review- NCC202716)
• The task was assigned to Morman, Alaina. The due date is: August 20, 2021 5:00 PM
8/17/2021 12:05 PM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC202716
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
2020 Annual Fee Status
2021 Annual Fee Status PAST DUE
Nby be blank (iF not yet billed).
This permittee owes a fee that is PAST DUE and has a pending NOD or NOV. Do not approve this NOT request
until payment is resolved. If this NOT request is acceptable, payment may be waived if applicable, but that action must
be completed first (at the NOD or NOV Review step) to ensure records are routed to the correct folder in the
repository.
However, you can reject the NOT now if it is not acceptable.
Information associated with this permit:
Project Name
Parmer RTP Campus Improvements
Address
40 Moore Dr, Durham, NC
County
Durham
Latitude
35.9350
Longitude
-78.8600
Permittee Listed
Parmer RTP, LLC
Legally Responsible
Matthew Schwab
Individual
NC Reference No.
NCG01-2020-2716
E&SC Plan ID
5179-11
Original NOI
27409
Tracking No.
Date COC Issued
6/30/2020
Prior Rescission
Date populates only if OOC was already rescinded at tirre of subaittal.
Date
Reason for Rescission/Termination Request:

Reason for f Project Closed -Out
Termination of r Sale (Another Owner/Operator obtained a newCOC)
Coverage * r Mistake or Invalid Coverage
r Other Sale (Another Owner/Operator obtained new COC)
Add ional Mxe information about the basis of this request, if needed.
Explanation The Project Name remains the same;
however, there is a new owner.
Supporting Upload Supporting Docurrentation if applicable.
Documentation 6118 LD Permit.pdf 179.34KB
6118 LD Placard.pdf 148.86KB
Certificate of Coverage.pdf 36.39KB
2020034816 Deed.pdf 247.67KB
Mist be PDFformat
Project Close-out Information:
Final Close-out
Inspection Approval
Project Close-out NLstbePDFformat
Approval
Documentation
North Carolina General Statute 143-215.6113 (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 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 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).
fJ 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
Na(jkwlrua.b
Type Name* Matthew Schwab
Title * Authorized Agent
Organization* Parmer RTP, LLC
Date * 08/17/2021
Email for [e-mail]
Confirmation *

Contact Telephone* 336-413-7948
NOT Certification NCG01-eNOT-Parmer Certification Form-20210305-
Form DEMLR-SW (05.07.21).pdf
Mist be RY Fornat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Additional Email 0Cd on Notification Errails
(Optional) [e-mail]
Original Permittee 0Cd onNlotificationBmils
Email [e-mail]
Original Site Contact 0Cd on Notificaiton Errails
Email [e-mail]
484.4KB