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HomeMy WebLinkAboutNCC204917_Notice of Termination_20211110Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 11/10/2021 2:07:38 PM (NOT Submittal) Approve by Morman, Alaina 11/10/2021 4:29:52 PM (NOT Request Review - NCC204917) • The task was assigned to Morman, Alaina. The due date is: November 15, 2021 5:00 PM 11/10/2021 2:07 PM NORTH CAROLINA Rrf OmFkm&tral Qualrly Certificate of NCC204917 Coverage (COC) No.* Enter the Certificate of Coverage Number 2020 Annual Fee Status 2021 Annual Fee Status OPEN May be blank (if not yet billed). Information associated with this permit: Project Name Fairfield Farms - Lots 99, 100, & 249 Address Carswell Dr. & Longthorpe Rd, Carvers Creek, NC County Cumberland Latitude 35.1660 Longitude -78.8750 Permittee Listed McKee Homes, LLC Legally Responsible Kelsey Rivera Individual NC Reference No. NCG01-2020-4917 E&SC Plan ID CUMBE - 2020- 083 Original NOI Tracking 34540 No. Date COC Issued 11/2/2020 Prior Rescission Date Date populates only if COC was already rescinded at time of submittal. Reason for Rescission/Termination Request: Reason for Project Closed -Out Termination of Sale (Another Owner/Operator obtained a new COC) Coverage* Mistake or Invalid Coverage Other Additional More information about the basis of this request, if needed. Explanation Supporting Upload Supporting Documentation if applicable. Documentation Must be PDF format Project Close-out Information: Final Close-out 12/3/2020 Inspection Approval Project Close-out MCKEE FAIRFIELD FARMS CUMBE-2020-083 Approval 91.76KB INSP20201203 CO.pdf Documentation Must be PDF format North Carolina General Statute 143-215.613 (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, 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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of that permit. Signature �ew Type Name* Nicole Oleson Title* Pre Construction coordinator Organization * Mckee homes LLC Date * 11 /10/2021 Email for noleson@mckeehomesNC.com Confirmation * Contact Telephone* 9104757100 NOT Certification 99,100,249 FAIRFIELD FARMS - Hanover NOT Form TERMINATION.pdf Must be PDF Format Is this CDC Already Ensure this COC has not been rescinded since submittal! Rescinded? Additional Email CC'd on Notification Emails (Optional) Original Permittee CC'd on Notification Emails Email krivera@mckeehomesnc.com Original Site Contact CC'd on Notificaiton Emails Email krivera@mckeehomesnc.com 775.07KB