NCC202595_Contact Update Request (Site Contact and Leg Resp Change)_20220914

NCG01 legally Responsible Individual Change Form
Use this form when:
The person who is legally responsible for the permit has changed, but there is NO CHANGE in the project name
or ownership.
**If the project name has changed, or if the ownership of the project has changed, do NOT use this form.**
Instead, you must submit a new NCG01 electronic Notice of Intent (eNOI).
Directions:
Print this form, complete, scan and upload to the Construction Stormwater Permit MODIFICATION Form.
Then, mail the original form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral & Land Resources Stormwater Program
512 N. Salisbury Street, 6th Floor (Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS FORM UNTIL YOUR MODIFICATION HAS BEEN REVIEWED AND ACCEPTED AS COMPLETE.
THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE (NOT DIGITAL) [40 CFR 122.221
Certificate of Coverage (COC) Number: NCC202595
Name of Project: Heritage at Moss Creek (aka Heritage Ridge)
Legally Responsible Organizational Entity: Forestar (USA) Real Estate Group, Inc.
PREVIOUS Legally Responsible Individual: Mallie Colavita
NEW Legally Responsible Individual: Caleb Saruse
The following section is to be completed and signed by the NEW Legally Responsible Individual.
Per NC General Statute 143-215.6E (i), 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 ... shall be guilty of a Class 2 misdemeanor which may
include a fine not to exceed ten thousand dollars ($10,000).
Page 1 of 2

NCG01 Legally Responsible Individual Change Form
THE FORM YOU MAIL MUST BE COMPLETED WITH AN ORIGINAL SIGNATURE (NOT DIGITAL) [40 CFR 122.221
Under penalty of law, I certify that (check all boxes to indicate your agreement):
❑x 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.
® I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and
Sediment Control Plan.
If the approved Erosion and Sediment Control Plan is not compliant with Part 11 (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.
x❑ I 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.
x❑ This form has been reviewed and is accurate and complete to the best of my knowledge.
*Signature: ��( Date:
Print Name of Signed: Caleb Saruse
Title: Director of Land Development
Mailing Address: 481 Munn Road E., Suite 150 Fort Mill, SC 29715
Street Address: 481 Munn Road E., Suite 150 Fort Mill, SC 29715
Email Address: [e-mail]
Phone Number: 336-870-0429
* IMPORTANT NOTE: 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 permit.
For more information on signatory requirements, see Part IV, Section 8, Item (6) of the NCG010000 permit.
Page 2 of 2

Georgoulias, Bethany
From: Caleb S Saruse <[e-mail]>
Sent: Tuesday, September 13, 2022 9:08 AM
To: Georgoulias, Bethany
Cc: Tran, Kieu M
Subject: [External] RE: Secrest Commons- COC # NCC213907
Attachments: NCG01- Legally- Responsible-Change-Form-20210517-DEMLR-SW (002)- Change of
Legally Responsible- Signed.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Attached is the signed form to change the legally responsible individual for NCC202595. I will mail the original
today. Again, please change the site contact for both NCC202595 and NCC213907 to myself.
Thanks for your help.
da-
FORESTAR
Caleb Saruse, PE
Director of Land Development - Charlotte
481 Munn Rd. E, Suite 150
Fort Mill, SC 29715
c: [phone]
CalebSaruse() Forestar.com
Forestar.com
From: Georgoulias, Bethany <[e-mail]>
Sent: Tuesday, September 13, 2022 8:12 AM
To: Caleb S Saruse <[e-mail]>
Cc: Tran, Kieu M <[e-mail]>
Subject: RE: Secrest Commons- COC # NCC213907
Importance: High
[External]
Good morning, Caleb,
Mr. Robert Price is listed as both the site contact and legally responsible individual for NCC213907. Does Robert Price
remain the legally responsible individual? Or will that also be you? If they both need to be changed to you, you need
to fill out the attached form and return it to us (you can email me a scanned copy, but you must mail in the original
signed copy to our office).
For NCC202595, Steven Jackson is listed as Site Contact. I can update that, but before I do, I want to verify that Mallie
Colavita should stay listed as the legally responsible individual for that permit. If not, the same form needs to be filled
out before we make changes.
Please let us know.

Thanks,
Bethany Georgoulias (she/her)
Environmental Engineer
Stormwater Program, Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
bethany.georgoulias@ncdenngov
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: htt12: //deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
Gum
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
Based on the current guidance to minimize the spread of COVID-19, the Department of Environmental Quality has
adjusted operations to protect the health and safety of the staff and public. Many employees are working remotely or
are on staggered shifts. To accommodate these staffing changes, all DEQ office locations are limiting public access to
appointments only. Please check with the appropriate staff before visiting our offices, as we may be able to handle your
requests by phone or email. We appreciate your patience as we continue to serve the public during this challenging
time.
From: Tran, Kieu M <[e-mail]>
Sent: Monday, September 12, 2022 1:19 PM
To: Caleb S Saruse <CalebSaruse @forestar.com>
Cc: Georgoulias, Bethany<[e-mail]>
Subject: RE: [External] Secrest Commons- COC # NCC213907
Bethany Georgoulias can help with that (I've cc her to this email).
Mrs. Kieu Tran
Stormwater Program Administrative Assistant
Office: (919) 707- 3640
Kieu.Tran @ncdenrgov
North Carolina Department of Environmental Quality
Division of Energy, Mineral, and Land Resources Stormwater Program
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater

`Q--!�
-X
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties
From: Caleb S Saruse <[e-mail]>
Sent: Monday, September 12, 2022 1:17 PM
To: Tran, Kieu M <[e-mail]>
Subject: RE: [External] Secrest Commons- COC # NCC213907
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Thanks again. One last thing and I will leave you alone, lol. How do I change the site contact for COC # NCC213907 &
NCC202595 to myself as I am now responsible for these projects?
Thanks,
Caleb Saruse, PE
Director of Land Development - Charlotte
481 Munn Rd. E, Suite 150
Fort Mill, SC 29715
c: [phone]
[e-mail]
Forestar.com
From: Tran, Kieu M <[e-mail]>
Sent: Monday, September 12, 2022 12:48 PM
To: Caleb S Saruse <[e-mail]>
Subject: RE: [External] Secrest Commons- COC # NCC213907
[External]
That is right, there are two invoices due for NCC202595
Mrs. Kieu Tran
Stormwater Program Administrative Assistant
Office: (919) 707- 3640
Kieu. Tran @ncdenr.gov
North Carolina Department of Environmental Quality
Division of Energy, Mineral, and Land Resources Stormwater Program
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater

..-_,QE�--.QO
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties
From: Caleb S Saruse <[e-mail]>
Sent: Monday, September 12, 2022 12:46 PM
To: Tran, Kieu M <[e-mail]>
Subject: RE: [External] Secrest Commons- COC # NCC213907
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Your website says there are two outstanding for COC # NCC202595. Trying to get all of them up to date.
Thanks,
dw-
466'
FORESTAR
Caleb Saruse, PE
Director of Land Development - Charlotte
481 Munn Rd. E, Suite 150
Fort Mill, SC 29715
c: [phone]
[e-mail]
Forestar.com
From: Tran, Kieu M <[e-mail]>
Sent: Monday, September 12, 2022 12:42 PM
To: Caleb S Saruse <[e-mail]>
Subject: RE: [External] Secrest Commons- COC # NCC213907
[External]
Here you go
Mrs. Kieu Tran
Stormwater Program Administrative Assistant
Office: (919) 707- 3640
Kieu. Tran @ncdenr.gov
North Carolina Department of Environmental Quality
Division of Energy, Mineral, and Land Resources Stormwater Program
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater

Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties
From: Caleb S Saruse <CalebSaruse @forestar.com>
Sent: Monday, September 12, 2022 12:39 PM
To: Tran, Kieu M <[e-mail]>
Subject: RE: [External] Secrest Commons- COC # NCC213907
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Thank you. Could you also send me the outstanding invoices for COC # NCC202595.
�a?
FORESTAR
Caleb Saruse, PE
Director of Land Development -Charlotte
481 Munn Rd. E, Suite 150
Fort Mill, SC 29715
c: [phone]
[e-mail]
Forestar.com
From: Tran, Kieu M <[e-mail]>
Sent: Monday, September 12, 2022 12:37 PM
To: Caleb S Saruse <[e-mail]>
Subject: RE: [External] Secrest Commons- COC # NCC213907
[External]
There is no payment for NCC213907, I've attached the annual invoice for this permit.
Mrs. Kieu Tran
Stormwater Program Administrative Assistant
Office: (919) 707- 3640
Kieu.Tran @ncdenr.gov
North Carolina Department of Environmental Quality
Division of Energy, Mineral, and Land Resources Stormwater Program
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: httl2://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater

Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed
to third parties
From: Caleb S Saruse <CalebSaruse @forestar.com>
Sent: Monday, September 12, 2022 12:04 PM
To: Tran, Kieu M <[e-mail]>
Subject: [External] Secrest Commons- COC # NCC213907
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hello,
I am reaching out concerning the Secret Commons annual permit fee. It was just brought to my attention that the
annual fee may have not been paid. This is in reference to COC # NCC213907 (Invoice # NCC213907-2022). Can you
please see if payment was ever received and if not could you please send me the invoice so I can make sure this gets
addressed ASAP.
Thank you,
�a?
FORESTAR
Caleb Saruse, PE
Director of Land Development -Charlotte
481 Munn Rd. E, Suite 150
Fort Mill, SC 29715
c: [phone]
[e-mail]
Forestar.com
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