NCC202825_Notice of Termination_20210928

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 9/28/2021 8:33:27 AM (NOT Submittal)
Approve by Morman, Alaina 9/29/2021 11:27:15 AM (NOT Request Review- NCC202825)
• The task was assigned to Morman, Alaina. The due date is: October 1, 2021 5:00 PM
9/28/2021 8:33 AM

1 �
NORTH CAROLINA
Enrlronmenral Quallly
Certificate of NCC202825
Coverage (COC) Enter the Certificate of Coverage Nmber
No.*
2020 Annual Fee Status
2021 Annual Fee Status PAST DUE
fvby 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
chapel ridge lot 101
Address
742 chapel ridge dr, pittsboro, NC
County
Chatham
Latitude
35.7850
Longitude
-79.2240
Permittee Listed
mcs homes
Legally Responsible
steve satterwhite
Individual
NC Reference No.
NCG01-2020-2825
E&SC Plan ID
2020-04197
Original NOI
27705
Tracking No.
Date COC Issued
7/6/2020
Prior Rescission
Cate populates only if OOC was already rescinded at tirre of submittal.
Date
Reason for Rescission/Termination Request:

Reason for r Project Closed -Out
Termination of r Sale (Another Owner/Operator obtained a newCOC)
Coverage * r Mistake or Invalid Coverage
f Other
Additional We information about the basis of this request, if needed.
Explanation
Supporting Upload Supporting Ibcurrentation if applicable.
Documentation Mist bePDFformat
Project Close-out Information:
Final Close-out 8/26/2021
Inspection Approval
Project Close-out Certificate of Completion 101 erosion.pdf 286.34KB
Approval lot 1010 ncg01 termination.pdf 68.17KB
Documentation
Mist be Ft7Fforrrat
North Carolina General Statute 143-215.66 (1) 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 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 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 Article 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).
I7 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
amgl f s
Type Name * STEVEN SATTERWHITE
Title * PRESIDENT
Organization* MCS HOMES
Date * 09/28/2021
Email for [e-mail]
Confirmation *
Contact Telephone* 9196307443
NOT Certification lot 1010 ncg01 termination.pdf 68.17KB
Form Mist be PDF Forrrat

Is this COC Already Ensure this CCChas not been rescinded since subrrittal!
Rescinded?
Additional Email CCd on Notification Errails
(Optional)
Original Permittee CCdonNiotificationBmils
Email [e-mail]
Original Site Contact 0Cd on Notificaiton Errails
Email [e-mail]