NCC220172_Modification Review_20230608

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 6/7/2023 2:43:24 PM(ADD TO FILE Submittal)
Approve by bethany.georgoulias 6/8/2023 1:38:37 PM(Construction COC ADD TO FILE Review-NCC220172)
•Contacts updated 6/8/2023.
• The task was assigned to bethany.georgoulias.The due date is:June 12,2023 5:00 PM
6/7/2023 2:43:25 PM

Ago Permit for Construction Activities DEQMODIFICATION
0itltl
0000
Certificate of NCC220172
Coverage(COC)No.* Enter the Certificate of Coverage Number(Use capital letters)
Information associated with this permit:
Project Name Hilltop Needmore Road Elementary School
Address 4575 Hilltop Needmore Road, Fuquay-Varina, NC
County Wake
Latitude 35.6301
Longitude -78.7369
Permittee Listed Wake County Board of Education
Legally Responsible Mark Strickland
Individual At the time of Modification Request(not looked up again at review)
NC Reference No. NCG01-2022-0172
E&SC Plan ID WAKE-2022-023
Original NOI Tracking 77798
No.*
Date COC Issued* 01/26/2022
Prior Rescission Date This field will populate only if COC has already been rescinded.
Modification Information:
Reason for Modification*
Closed-Out Lots/Outparcels in E&SC Plan
Additional Lots/Outparcels Approved-E&SC Revised
Other Revision(s)to E&SC Plan
Legally Responsible Individual and/or Site Contact Has Changed
Multiple Reasons(List)
Addional Explanation
More information(e.g.,new Site Contact details).If lots are being added,please include specific lot numbers.
Acreage increased from 11.0 acres issued issued in the Wake-2022-023_20211207_LOA letter to 23.24ac
issued in the Wake-2022-023 20230413 LOA letter.
Correcting Mark Strickland's email address per the updated FRO Signed by [e-mail]
Adding additional contact-Brandon Williams per the updated FRO Sign by [e-mail]
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload
applicable sheets).

For changes to the legally responsible individual, you must upload this form.
Supporting Documentation
Upload Supporting Documentation(Revised E&SC Approval,Close-Out Doc,etc.)
WAKE-2022-023 20211207 LOA.PDF 135.31KB
WAKE-2022-023_20230413_LOA.pdf 161.89KB
Updated FRO Signed by WCPSS.pdf 246.58KB
Must be PDF format
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
No
Yes
This question was added to the eNOl on 2/3/2023 and will not be answered in applications submitted prior to that date.
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 hereby request modification to coverage under the NPDES Stormwater Permit for the
subject project site. 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.
Specify if you are:* The Legally Responsible Individual
Authorized Responsible Person*
*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
Type Name* Mark Strickland
Title* Chief Facilities and Operations Officer
Organization* Wake County Board of Education
Date* 06/07/2023
Email Address* [e-mail]
Email for confirmation
Telephone Number* 919.694.7542
Contact number if we need to reach you
Note:Original permittee and site contact are copied on modification correspondence.
Additional Email Additional email for confirmation
(Optional)
Original Permittee [e-mail]
Email

Original Site Contact [e-mail]
Email
Review Date 06/08/2023
Rescinded Since
Submitted?