NCC204438_Notice of Termination_20210920

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 9/20/2021 2:46:20 PM (NOT Submittal)
Approve by Morman, Alaina 9/27/2021 2:54:07 PM (NOT Request Review- NCC204438)
• The task was assigned to Morman, Alaina. The due date is: September 23, 2021 5:00 PM
9/20/2021 2:46 PM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of
NCC204438
Coverage (COC)
Enter the Certificate of Coverage Nmber
No.*
2020 Annual Fee Status
2021 Annual Fee Status
May be blank (if not yet billed).
Information associated
with this permit:
Project Name
Chapel Ridge Lot 437
Address
49 Deep Creek, Pittsboro, NC
County
Chatham
Latitude
35.7930
Longitude
-79.2320
Permittee Listed
Morningstar Homes Inc
Legally Responsible
Justin Lile
Individual
NC Reference No.
NCG01-2020-4438
E&SC Plan ID
2020-06421
Original NOI
32408
Tracking No.
Date COC Issued
10/6/2020
Prior Rescission
Cate populates only if COCwas already rescinded at tirre of subrrittal.
Date
Reason for Rescission/Termination 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
Additional Nbre information about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Dxurrentation if applicable.
Documentation Mist beFDFformat

Project Close-out Information:
Final Close-out 9/7/2021
Inspection Approval
Project Close-out CERTIFICATE OF COMPLETION.pdf 226KB
Approval Mast be FDFforrrat
Documentation
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes anyfalse 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 knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; orwho falsifies, tampers with, or knowingly renders
inaccurate anyrecording 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 notto 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* Justin Lile
Title * President
Organization* Morningstar Homes Inc
Date * 09/20/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 919-760-7111
NOT Certification Adobe Scan Sep 20, 2021.pdf
Form Mast be FDF Fornat
Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Erails
(Optional)
Original Permittee CCdonWificationBmils
Email [e-mail]
Original Site Contact CCd on Notificaiton Errails
Email [e-mail]
463.65KB