NCC215442_Contact Update Request (Legally Resp and Site Contact)_20221101

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, 61h 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 122.22]
Certificate of Coverage (COC) Number: NCC215442
Name of Project: Greenbriar - Statesville
Legally Responsible Organizational Entity: Lennar Carolinas, LLC
PREVIOUS Legally Responsible Individual: Joel Causey
NEW Legally Responsible Individual: Mark Henninger
The following section is to be completed and signed by the NEW Legally Responsible Individual.
Per NC General Statute 143-215.6B (i), any person who knowingly makes any false statement representation,
or certification in any application, record, report plan, or other documentfiled 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):
V I am the person responsible forthe 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.
N/ I will abide by all conditions of the NCGO10000 General Permit and the approved Erosion and
Sediment Control Plan.
S/ If the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution
Prevention Plan) of the NCG010000 General Permit I will nonetheless ensure that all conditions of
Part 11 of the permit are met on the project at all times.
M 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.
VThis form has been reviewed and is accurate and complete to the best of my knowledge.
Title: Division President
Mailine Address: 6701 Carmel Road, Suite 425, Charlotte, NC 28226
Street Address: 6701 Carmel Road Suite 425 Charlotte NC 28226
Email Address: Mark. Henninger Lennar.com
Phone Number: 704-759-6000
* 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 NCGO10000 permit.
For more information on signatory requirements, see Part IV, Section B, Item (6) of the NCGO10000 permit.
Page 2 of 2

Georgoulias, Bethany
From: Chelsea Ferrara <[e-mail]>
Sent: Tuesday, November 1, 2022 3:54 PM
To: Georgoulias, Bethany
Subject: RE: [External] RE: Signature Authority for NCGO10000 permit COCs and NCC215442
Question
Attachments: NCG01- Legally- Responsible -Change -Form Greenbriar.pdf
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hi Bethany,
Attached is the form for Greenbriar updating the legally responsible person to Mark. Did you want me to submit it
online and mail in the hard copy? Or is this email sufficient?
Thank you!
Chelsea Halley Ferrara
Division Environmental Manager
LEIMIMAM
Chelsea. Ferraraa-Lennar.com
Mobile [phone]
Charlotte, NC
From: Georgoulias, Bethany <[e-mail]>
Sent: Friday, October 28, 2022 4:12 PM
To: Chelsea Ferrara <[e-mail]>
Subject: RE: [External] RE: Signature Authority for NCG010000 permit COCs and NCC215442 Question
Sounds good — thank you!
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
[e-mail]
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

D- E
kj/�
NORTH CAROLINA
Department of Environmental Quality
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: Chelsea Ferrara <[e-mail]>
Sent: Friday, October 28, 2022 11:46 AM
To: Georgoulias, Bethany<[e-mail]>
Cc: Mark Henninger <[e-mail]>
Subject: [External] RE: Signature Authority for NCG010000 permit COCs and NCC215442 Question
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an attachment to
Report Spam.
Hi Bethany,
Thanks for bringing that to our attention! I will fill out the form to update the legally responsible person for Greenbriar
to Mark and email it to you once I have the signatures.
Thank you,
Chelsea Halley Ferrara
Division Environmental Manager
LEIMMAIT
Chelsea. Ferraraa-Lennar.com
Mobile [phone]
Charlotte, NC
From: "Georgoulias, Bethany"<[e-mail]>
Date: October 28, 2022 at 9:53:16 AM EDT
To: Mark Henninger <[e-mail]>
Subject: Signature Authority for NCG010000 permit COCs and NCC215442 Question
Good morning, Mark,
We received the attached letter, and we will record it in the permit files. Thank you for the thorough list
of COC numbers. I just wanted to check on NCC215442 (Greenbrier) because a different legally
responsible person is listed for that project: Joel Causey. Does that need to be updated to you?
If so, please feel free to email me the completed attached form, and I can make the update.
Thank you so much,

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
[e-mail]
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/stormwatgr