NCC202977_Notice of Termination_20210818

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 8/18/2021 11:41:07 AM (NOT Submittal)
Approve by Morman, Alaina 8/18/2021 2:34:24 PM (NOT Request Review- NCC202977)
• The task was assigned to Morman, Alaina. The due date is: August 23, 2021 5:00 PM
8/18/2021 11:42 AM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC202977
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
Reeds Cove on Lake Norman
Address
W. Waterlynn Road, Mooresville, NC
County
Iredell
Latitude
36.0000
Longitude
-81.0000
Permittee Listed
JBH Development, LLC
Legally Responsible
Bart Hopper
Individual
NC Reference No.
NCG01-2020-2977
E&SC Plan ID
MVLLE-2020-072
Original NOI
28095
Tracking No.
Date COC Issued
7/21/2020
Prior Rescission
Cate populates only ff OOCwas already rescinded at tirre of subaittal.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 NCC211009
Supporting Upload Supporting Ibcurrentation if applicable.
Documentation Reeds Cove Deed.pdf
NUst be FDFformat
Project Close-out Information:
Final Close-out
Inspection Approval
Project Close-out Mist beFDFformat
Approval
Documentation
North Carolina General Statute 143-215.66 (1) provides that:
909.87KB
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 under this 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 Article or rules of the
Commission implementing this Artcle 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
Ulu 1
Type Name* Wyatt Kalapp
Title * Assistant Manager
Organization* JBH Development, LLC
Date * 08/18/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 9043056822
NOT Certification NOT - Certification Form 8.18.21.pdf 399.4KB
Form Mast be FDF Format

Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Errails
(Optional)
Original Permittee CCdonNotificationErrails
Email [e-mail]
Original Site Contact CCd on Notificaiton Errails
Email [e-mail]