NCC230809_ESC Approval Submitted_20230324

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ROY COOPER
Governor
ELIZABETH BI5ER � I_
Secretary
BRIAR'! WRENN
Director NORTH CAROLINA
Environmental Quality
November 23, 2022
LETTER OF APPROVAL WITH MODIFICATIONS
Town of Walnut Cove
Attention: Mr. Kim Greenwood, Town Manager
208 W. Third Street
Walnut Cove, NC 27502
RE: Project Name: Administration and Maintenance Building for Town of Walnut Cove
Project ID: STOKE-2023-010
Acres Approved: 1.55
County: Stokes
City: Walnut Cove
Address: 208 W. Third Street
River Basin: Roanoke
Stream Classification: Class C
Submitted By: Pilot Surveying & Engineering
Date Received by LQS: October 25, 2022
Plan Type: New
Dear Mr. Greenwood:
This office has reviewed the subject erosion and sedimentation control plan. We find the plan to be
acceptable with modifications and hereby issue this letter of Approval with Modifications. The
modifications required for approval are listed on the attached page. This plan approval shall expire three
(3) years following the date of approval, if no land -disturbing activity has been undertaken, as is
required by Title 15A NCAC 413 .0129.
As of April 1, 2019, all new construction activities are required to complete and submit an electronic
Notice of Intent (eNOI) form requesting a Certificate of Coverage (COC) under the NCG010000
Construction General Permit. After the form is reviewed and found to be complete, you will receive a
link with payment instructions for the $100 annual permit fee. After the fee is processed, you will
receive the COC via email. As the Financially Responsible Party shown on the FRO form submitted for
this project, you MUST obtain the COC prior to commencement of any land disturbing
activity. The eNOI form may be accessed at deq.nc.gov/NCGO 1. Please direct questions about
the eNOI form to the Storinwater Proaratn staff in the Raleigh central office. If the owner/operator of
this project changes in the future, the new responsible party must obtain a new COC.
Title 15A NCAC 4B .0118(a) and the NCG010000 permit require that the following documentation be
kept on file at the job site:
��� Winsi Carolina Department of Environmental ill Road,
SUiston of Energy, Mineral, and Land ling 2
Winston-Salem Regional Office. d30 Hanes Mill Road, Sure 3001 Winston-Salem, North Carolina ::?7105
136-7764800

Letter of Approval with Modifications
Town of Walnut Cove
November 23, 2022
Page 2 of 3
1. The approved E&SC plan as well as any approved deviation.
2. The NCGOI permit and the COC, once it is received.
3. Records of inspections made during the previous 12 months.
Also, this letter gives the notice required by G.S. 113A-61.1(a) of our right of periodic inspection to
insure compliance with the approved plan.
North Carolina's Sedimentation Pollution Control Act is performance -oriented, requiring protection of
existing natural resources and adjoining properties. If, following the commencement of this project, it is
determined that the erosion and sedimentation control plan is inadequate to meet the requirements of the
Sedimentation Pollution Control Act of 1973 (North Carolina General Statute I I3A-51 through 66), this
office may require revisions to the plan and implementation of the revisions to ensure compliance with
the Act.
Acceptance and approval of this plan is conditioned upon your compliance with Federal and State water
quality laws, regulations, and rules. In addition, local city or county ordinances or rules may also apply
to this land -disturbing activity. This approval does not supersede any other permit or approval.
Please note that this approval is based in part on the accuracy of the information provided in the
Financial Responsibility Form, which you provided. You are requested to file an amended form if there
is any change in the information included on the form. In addition. it would be helpful if you notify this
office of the proposed starting date for this project.
Your cooperation is appreciated.
Sincerely,
Tamera Eplin, PE
Regional Engineer
Land Quality Section
Enclosures: Certificate of Approval
Modifications Required for Approval
Pilot Surveying & Engineering
Attention: Jonathan Cory George, PE
106 S. Depot Street, Suite D
Pilot Mountain, NC 27041

Letter of Approval with Modifications
Town of Walnut Cove
November 23, 2022
Page 3 of 3
MODIFICATIONS REQUIRED FOR APPROVAL
Project Name: Administration and Maintenance Building for Town of Walnut Cove
Project ID: STOKE-2023-010
County: Stokes
Modifications pursuant to applicable North Carolina General Statutes and/or Regulations:
Any off -site borrow and waste required for this project must come from a site with an
approved erosion control plan, a site regulated under the Mining Act of 1971, or a landfill
regulated by the Division of Solid Waste Management. Trash/debris from demolition
activities or generated by any activities on site must be disposed of at a facility regulated by
the Division of Solid Waste Management or per Division of Solid Waste Management or
Division of Water Resources rules and regulations. [15A NCAC 4B .0110]
2. Additional measures may be required - The applicant is responsible for the control of
sediment on -site. If the approved erosion and sedimentation control measures prove
insufficient, the applicant must take those additional steps necessary to stop sediment from
leaving this site_ [15A NCAC 4B .0115]
3. The NCGO1 has a $100 yearly fee and our office often receives closure inspection requests
days prior to yearly NCGO1 fee payment due dates. Be advised the project requires a closure
inspection report by DEMLR prior to filing the Notice of Termination (NOT) to terminate
NC001 coverage. The closure inspection should not be requested until after the site has
achieved full vegetative stabilization and measures have been removed. The removal of
temporary ESC measures, including basins, requires prior approval. Often, a full growing
season is necessary between initial seeding/mulching and removal of measures. Please plan
your construction accordingly to avoid contacting our office prematurely for a closure
inspection. Also be advised you may be asked for representative site pictures prior to a
Closure inspection. [General Comment]
4. Verify that the sanitary sewer line connection is within the Limits of Disturbance (LOD) for
the proposed work. If this connection is located outside the LOD, then the LOD must be
modified, and a new copy of the plans submitted to our office to assist with inspections.
Ref: G.S. 113A-54.1 through G.S. 113A-57
Sections 15A NCAC 04A.0101 through 15A NCAC 04E.0504
General Permit NCG 010000 NPDES for Construction Activities

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N C Department of
Environmental Quality
Received
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM OCT 2 5 2Q'21
SEDIMENTATION POLLUTION CONTROL ACT
Winston-5,; , -,,
No person may initiate any land -disturbing activity on one or more acres as covered by the AclR0d#6MAfs form`
and an acceptable erosion and sedimentation control plan have been completed and approved by the Land
Quality Section, N.C. Department of Environmental Quality. Submit the completed form to the appropriate
Regional Office. (Please type or print and, if the question is not applicable or the e-mail address or phone
number is unavailable, place NIA in the blank.)
Part A.
1. Proi.ect Name Administration and Maintenance Building for Town of Walnut Cove
2. Location of land -disturbing activity: County Stokes City or Township Walnut Cove
W Third Street 36.295786 -aa.t42sa�
HighwaylStreet LatltLldetdecimaldegraes} Long ltUde(rtecimaldegrees)
3. Approximate date land -disturbing activity will commence: 12/1 /2022
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Public
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 1.55
6. Amount of fee enclosed: $ 200.00 . The application fee of $100.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: 8.10-acre application fee Is $900).
Checks should be addressed to NCDEQ.
7. Has an erosion and sediment control plan been filed? Yes ❑ Enclosed ® No 171
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity;
Name Mr. Kim Greenwood E-mail Address [e-mail]
Phone: Office # 336-591-4809 Mobile #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Town of Walnut Cove 336-591-4809
Name Phone: Office # Mobile #
208 W. Third Street 208 W. Third Street
Current Mailing Address
Walnut Cove, NC 27052
Current Street Address
Walnut Cove, NC 27052
City State Zip City
Deed Book No. 650 Page No. 644
State
Zip
Provide a copy of the most current deed.

Part B.
1 Company(ies) who are financially responsible for the land -disturbing activity (Provide a comprehensive list
of all responsible parties on accompanied page.) if the company is a sole proprietorship or if the landowner(s) is
an individual(s), the names) of the owner(s) may be listed as the financially responsible party(ies)
Town of Walnut Cove [e-mail]
Company Name E-mail Address
PO Box 130 208 W. Third Street
Current Mailing Address
Walnut Cove, NC 27052
City State Zip
Phone: office # 336-591-4809
Current Street Address
Walnut Cove, NC 27052
City State Zip
Mobile #
Note: If the Financially Responsible Party is not the owner of the land to be disturbed, include with this form
the landowner's signed and dated written consent for the applicant to submit a draft erosion and sedimentation
control plan and to conduct the anticipated land disturbing activity.
2. (a) If the Financially Responsible Party is a domestic company registered on the NC Secretary of State
business registry, give name and street address of the Registered Agent:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Name of Individual to Contact (if Registered Agent is a company)
(b) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina agent who is registered on the NC Secretary of State business registry.
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Phone: Office # Mobile #
Name of Individual to Contact (if Registered Agent is a company)

(c) If the Financially Responsible Party is engaging in business under an assumed name, give name under
which the company is Doing Business As If the Financially Responsible Party is an individual, General
Partnership, or other company not registered and doing business under an assumed name, attach a copy
of the Certificate of Assumed Name.
Company DBA Name
The above information is true and correct to the best of my knowledge and belief and was provided
by me under oath. (This form must be signed by the Financially Responsible Person if an individual(s)
or his attorney -in -fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Party). I agree to provide
corrected information should there be any change in the information provided herein.
Type or psi name Title or Authority <7tj—
TKA-2-
SignIture Date
I, Aim YdjO, —&-1A OLK—" , a Notary' Public of the County of �S+p� 5
State of North Carolina, hereby certify that KI)M C-1V'444 Y1,A)M d _appeared personally
before me this day and being duly sworn acknowledged that the above form was executed by him/her.
Witness my hand and notarial seal, this
L. BRYANTfiAMANDA
Notary Pubiic
North Caroi#na
i7 ty.
day of 20
Not ry
My commission expires