NCC231812_Modification Review_20230703

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 7/2/2023 8:23:00 AM(ADD TO FILE Submittal)
Approve by bethany.georgoulias 7/3/2023 10:15:56 AM (Construction COC ADD TO FILE Review-NCC231812)
•Information was added to the file regarding the address correction and will be available in the
repository file for reference. Permittee was advised that Mod will not result in a new COC.
• The task was assigned to bethany.georgoulias.The due date is:July 6,2023 5:00 PM
7/2/2023 8:23:02 AM

Ago DEQMODIFICATION
Permit for Construction Activities 0itltl
0000
Certificate of NCC231812
Coverage(COC)No.* Enter the Certificate of Coverage Number(Use capital letters)
Information associated with this permit:
Project Name Coastline Station RV Park
Address Country Club Road, Stump Sound, NC
County Onslow
Latitude 34.5366
Longitude -77.4648
Permittee Listed Lakota Holdings, LLC
Legally Responsible Junie Rivenbark
Individual At the time of Modification Request(not looked up again at review)
NC Reference No. NCG01-2023-1812
E&SC Plan ID ONSLO-2023-057
Original NOI Tracking 145126
No.*
Date COC Issued* 06/28/2023
Prior Rescission Date This field will populate only if COC has already been rescinded.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) Address is incorrect.Should be Winery Road, Sneads Ferry, NC
Addional Explanation
More information(e.g.,new Site Contact details).If lots are being added,please include specific lot numbers.
The coordinates listed are correct, but the address is wrong. It should say Winery Road,Sneads Ferry, NC.The
attached site plan lists the road name.
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.)
Site Plan 1.pdf 264.91 KB
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(i)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
��!l�YI! lj1NN'�YlTlI t.0
Type Name* Junie F. Rivenbark
Title* Manager
Organization* Lakota HOldings, LLC
Date* 07/02/2023
Email Address* [e-mail]
Email for confirmation
Telephone Number* [phone]
Contact number if we need to reach you
Note:Original permittee and site contact are copied on modification correspondence.
Additional Email [e-mail]
(Optional) Additional email for confirmation
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 07/03/2023

Rescinded Since
Submitted?

Georgoulias, Bethany
From: Georgoulias, Bethany
Sent: Monday, July 3, 2023 10:15 AM
To: [e-mail]
Cc: [e-mail]; [e-mail]
Subject: RE: Construction SW Modification Request - Clarification
Importance: High
Good morning,
I just wanted to check in on this request. It is appropriate to add this information to the file with a Modification, but I
wanted to clarify that a new COC will not be generated (with the corrected address) as part of our Mod process. The
COC will still say Country Club Road, but the information regarding the correction will be available for this permit file for
future reference.
Please let us know if you have any questions or concerns.
Best regards,
Bethany Georgoulias (she/her)
Environmental Engineer, Stormwater Program
DEMLR Laserfiche Administrator
Division of Energy, Mineral,and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office
[e-mail]
DEQ is updating its email addresses to @deq.nc.gov in phases from May 1st to June 9th. Employee email addresses
may look different, but email performance will not be impacted.
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
From: [e-mail]<[e-mail]>
Sent: Sunday,July 2, 2023 8:23 AM
To: [e-mail]
Cc: [e-mail]; [e-mail]; [e-mail]
Subject: [External] Construction SW Modification Request Received
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Thank you for submitting a Modification request for Coastline Station RV Park in Onslow County, Certificate of Coverage
(COC) no. NCC231812.
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Modification Reason:Address is incorrect. Should be Winery Road, Sneads Ferry, NC
Additional Details(if provided):The coordinates listed are correct, but the address is wrong. It should say Winery Road,
Sneads Ferry, NC.The attached site plan lists the road name.
If your submittal is accepted, you will receive e-mail confirmation. You will also be notified if additional information is
needed or if the modification request or documents cannot be accepted.
If you have any questions, please contact [e-mail].
Be sure to add [e-mail] to your contacts to avoid future a-mails about this application from
going into Spam filters.
The NC DEMLR Stormwater Program
512 N. Salisbury Street, Archdale Building 6th Floor, 1612 Mail Service Center, Raleigh, NC 27699-1612
This email was automatically generated by Laserfiche. Please do not respond to this email address, as responses are not
monitored.
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