NCC205670_Modification Review (Recovered)_20210903

4/14/23, 4:31 PM
Construction COC ADD TO FILE Review - NCC205670
DEQ�� MODIFICATION FORM - NPDES Stormwater
Deparhnent NORTHNA Permit for Construction Activities
M oof f EEmnvironmental Duality
NCGO10000 or NCG250000
Certificate of NCC205670
Coverage (COC) Enter the Certificate of Coverage Number (Use capital letters)
No.*
Information associated with this permit:
Project Name MASON OAKS SUBDIVISION- LOTS 33, 204, 205
Address HWY US 1 @ MASON OAKS DRIVE, WAKE FOREST, NC
County Franklin
Latitude 36.0171
Longitude-78.5137
Permittee Listed NVR, Inc.
Legally Responsible MEREDITH SWEITZER
Individual At the time of Modification Request (not looked up again at review)
NC Reference No. NCG01-2020-5670
E&SC Plan ID
Original NOI
Tracking No.*
2020-00002610
Date COC Issued * 12/09/2020
Prior Rescission This field will populate only if COC has already been rescinded.
Date
Modification Information:
https://edocs.deq.nc.gov/Forms/form/submission/history/64097/150975?hideHeader=true&show InstanceDetaiIs=false&fromInstances=true 1 /3

4/14/23, 4:31 PM Construction COC ADD TO FILE Review - NCC205670
Reason for Modification*
Closed -Out Lots/Outparcels in E&SC Plan
Additional Lots/Outparcels Approved - E&SC Revised
Other Revision(s) to E&SC Plan
Legally Responsible Individual and/or Site Contact Has Changed
Multiple Reasons (List)
Addional Explanation
More information (e.g., new Site Contact details). If lots are being added, please include specific lot numbers.
ADDITION OF LOTS 21, 49
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 Documentation
Upload Supporting Documentation (Revised E&SC Approval, Close -Out Doc, etc.)
MASON OAKS LOTS 21, 49- LETTER OF APPROVAL.pdf 99.82KB
Must be PDF format
Is this project funded with ARPA (American Rescue Plan Act) grant funds?
No
Yes
This question was added to the eNOI on 2/3/2023 and will not be answered in applications submitted prior to that date.
North Carolina General Statute 143-215.6113 (1) provides that:
Any person who knowingly makes any false 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 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 Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
* 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: * The Legally Responsible Individual
Authorized Responsible Person*
https://edocs.deq.nc.gov/Forms/form/submission/history/64097/150975?hideHeader=true&show InstanceDetaiIs=false&fromInstances=true 2/3

4/14/23, 4:31 PM
Construction COC ADD TO FILE Review - NCC205670
*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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
Signature
P11c m
Type Name* JOE SCHMIDTKE
Title* VICE PRESIDENT
Organization* NVR INC DBA RYAN HOMES
Date * 09/02/2021
Email Address* [e-mail]
Email for confirmation
Telephone Number* 9199871930
Contact number 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 [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 09/03/2021
Rescinded Since
Submitted?
https://edocs.deq.nc.gov/Forms/form/submission/history/64097/150975?hideHeader=true&showlnstanceDetails=false&frominstances=true 3/3