HomeMy WebLinkAboutNCC215377_NOI Application_20210929Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 9/27/2021 2:50:46 PM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 9/28/2021 8:16:04 AM (Review- Construction NOI 66634)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 9/27/2021 2:53 PM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 29, 2021 5:00
PM 9/27/2021 2:53 PM
Submit by Evans, Shaundra M 9/29/2021 7:57:21 AM (Payment Verification for NCC215377)
* Skela Homes LLC
• Evans, Shaundra M assigned the task to Evans, Shaundra M 9/29/2021 7:55 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 9, 2021 5:00
PM 9/28/2021 8:16 AM
.• SThF� ';
1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
Are you submitting
IT No
an NOI that was
r Yes
rejected before?
1a. Project Name *
GC Lot 701 Vance Knoll
1 b. Specific Lot
This field rray be used to list speck lot numbers.
Numbers
Lot 701
1 c. Parcel ID List all R% associated w ith this project.
Number(s) (PIN) 0073934 (Legal Desc: N2-81-701)
2. County* Chatham
3. Highway or Street 95130 Vance Knoll
Address* Street name only is acceptable if no address number assigned yet
4. CityorTownship* Chapel Hill
5. State * NC
6. Zip Code* 27517
7. Latitude* Enter the latitude in decimal degrees
35.8436
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-79.0414
If you do not know the latitude and longitude coordinates for this project, you can search the location on this map of
North Carolina. Look for the coordinates in the bottom left corner.
9. Date to Begin*
10/01/2021
Estimated Construction Project Start Rate
10. Date to End *
04/15/2022
Estimated Construction Project End Cate
11. SIC (Primary)*
Residential, Single Family Houses (SFE) (1521)
Standard Industrial Oassification for Development
12. Acres to be
0.18
disturbed*
(including off -site borrow and waste areas)
13. Total site area 0.21
(acres) *
14. Post- 0.15
construction (Estimated)
impervious area
(acres) *
Project Tracking ID NCC-CHATH-2021-GC Lot 701 Vance Knoll
Assigned automatically (not used)
Below you must enter waterbody information for surface waters affected by this project. Please consult
DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please
enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You
may enter up to 3 waterbodies if needed.
15a. Receiving Overcup Creek/B Everett Jordan Lake
Waterbody* %neof waterbody into which stormwater runoff will discharge
15b. Waterbody 16-41-4-2-(1)
Index No. * NCWaterbody Index Narrber
Stormwater V No
discharges will flow r Yes
to additional
wate rs *
16a. Is this project r Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*
B. Permittee Information
Part B.
Fbrnittee Inforrration - Legally Fbsponsible Entity and Individual
.........................................................................................................................................................
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form must be the same person as listed in THIS SECTION, or an authorized responsible individual within the same
organization. That person must be a responsible corporate officer who 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.
1. Permittee * Legally Pesponsible Entity
Skela Homes, LLC
IF pernittee is an individual, enter first and last narre in this field. otherwise, enter organization/business narre.
Note: If the permittee is a business, the business must be registered with the NC Secretary of State. You can verify the
registration here.
2. First Name * Josif
IF Corporation, enter Faegistered Agent First Wre
3. Last Name* Skela
IF Corporation, enter F;bgistered Agent Last %rre
3b. Title General Manager
4. Permitee E-mail jskela@gmail.com
Address*
5. Permittee 9195371491
Telephone No.*
6. Permittee Mailing Street Address
Address* 1006 CLARENCE DR
Address Line 2
City
CHAPEL HILL
Fbstal / Zip Code
27516-3108
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
1006 CLARENCE DR
Address Line 2
city
CHAPEL HILL
Fbstal / Zip Code
27516-3108
State / Frovince / Fbgion
NC
Country
United States
State / Frovince / Faegion
NC
Country
United States
8. Type of Ownership is only individual if an individual is naned in B.1. above.
Ownership* Non -Government
C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
Josif
Contact - First
Name *
2. Primary Site
Skela
Contact - Last
Name *
3. Title
General Contractor
4. Site Contact E-
jskela@gmail.com
mail Address*
5. Site Contact
9195371491
Telephone No.
6. Organization
Skela Homes, LLC
Name
7. Site Contact
Street Address
Mailing Address*
1006 CLARENCE DR
Address Line 2
city
CHAPEL HILL
Fbstal / Zip Code
27516-3108
8. Consultant Name
(Optional)
First and Last nacre
9. Consultant E-mail
This person will be copied on all correspondence.
10. Consultant
Telephone No.
11. Billing E-mail
(For Annual Fee correspondence)
jskela@gmail.com
Default is legally responsible person e-rrail
12. Billing
(For Annual Fee correspondence)
Telephone
9195371491
Default is legally responsible person telephone
State / Rovince / Region
NC
Country
United States
D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 09/20/2021
Approved *
2. E&SC Plan Project WP-21-354
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Chatham County
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application. Please also upload a site map showing the overall extent of the project (for linear projects, can
include the beginning point and end point coordinates in the "Notes" box below).
5. E&SC Plan
Erosion & Sediment Control Plan Approval for Lot
Approval letter or
701.pdf
128.07KB
Grading Permit
Mist be FL7Fforrrat
6. Signed FRO
Financial Pesponsibility/Ojvnership Form
Deed for Lot 688,689,692,693,701.pdf
163.92KB
Financial Responsibility_Ownership Form
—Lot
1.38MB
701.pdf
Mist be RFfornat
7. Site Location Map
Mast be RDFforrrat (lirrit 20 NB)
Erosion Control Plan for Lot 701.pdf
706.48KB
Grading and Drainage Plan for Lot 701.pdf
615.97KB
Site Dev Plan for Lot 701.pdf
1.6MB
Rease do not upload entire set of E&SC plans.
8. Notes (Optional)
Frovide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional w aterbodies if necessary.
9. NOI Certification
NOI Certification Form for Lot 701 Vance Knoll.pdf
818.73KB
Form
Mast be RDFforrrat
This is an Express
F No
Review Project*
r Yes
E. Certification
North Carolina General Statute 143-215.66 (1) provides that:
Any person who knowingly makes anyfalse 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 Atide; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case under this Atcle; 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 Atcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
17 I am the person responsible for the construction activities of this project, for
satisfying the requirements of this permit, and for any civil or criminal penalties
incurred due to violations of this permit.
rJ The information submitted in this NOI is, to the best of my knowledge and belief,
true, accurate, and complete based on my inquiry of the person or persons who
manage the system, or those persons directly responsible for gathering the
information.
* 17 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ If the Erosion and Sediment Control Plan approved by the delegated program is
not compliant with Part II (Stormwater Pollution Prevention Plan) of the
NCG010000 General Permit. I will nonetheless ensure that all conditions of Part
II of the permit are met on the project at all times.
* 17 I hereby request coverage under the NCG010000 General Permit and
understand that coverage under this permit will constitute the permit
requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
Specify if you are:* r The Legally Responsible Person named on this Notice of Intent
f Authorized Responsible Person' (signing on behalf of Legally Responsible
Person named in Part B)
Important: The person who electronically signs this Certification above must be the same person who signs the NOI
Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible
person within the same organization as the Permittee. *An authorized individual is a responsible corporate officer who
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
%dcfl�it fJ.���f!
Type Name* Josif Skela
Title General Manager
Organization Legally Pesponsible Entity
Skela Homes. LLC
Date * 09/27/2021
F. Tracking and COC Info
NOI Tracking No. 66634
NC Reference No.
NCG01-2021-5377
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC215377
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5377
Sequential nurrber for subrrittal that is incremented by Stored Frocedure
COC Year 2021
Year of date reviewed (used to assign YY digits after "NOC' in COCno.)
Initial Invoice No. NCC215377-2021
Invoice Due Date 10/28/2021
Initial Fee $ 100.00
Invoice Status OPEN