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HomeMy WebLinkAboutNCC232914_Modification Review_20231220 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by Anonymous User 12/19/2023 6:58:33 AM (ADD TO FILE Submittal) Approve by bethany.georgoulias 12/20/2023 9:21:17 AM(Construction COC ADD TO FILE Review-NCC232914) • The task was assigned to bethany.georgoulias.The due date is: December 22,2023 5:00 PM 12/19/2023 6:58:34 AM Ago DEQMODIFICATION Permit for Construction Activities 0itltl 0000 Certificate of NCC232914 Coverage(COC)No.* Enter the Certificate of Coverage Number(Use capital letters) Information associated with this permit: Project Name Briar Farm-Phase IIA&IIB Water,Sewer and Turn Lane Address Sand Pit Rd., Peacock Bridge Rd., NC Hwy 58,Town of Stantonsburg, NC County Wilson Latitude 35.6020 Longitude -77.8030 Permittee Listed Toisnot Preserve, LLC Legally Responsible Robert L. Brown Individual At the time of Modification Request(not looked up again at review) NC Reference No. NCG01-2023-2914 E&SC Plan ID WILSO-2024-002 Original NOI Tracking 161055 No.* Date COC Issued* 09/27/2023 Prior Rescission Date This field will populate only if COC has already been rescinded.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) Addional Explanation More information(e.g.,new Site Contact details).If lots are being added,please include specific lot numbers. Additional future lot area added to S&E Plan to allow for clear&grub. 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.) WILSO-2024-002_20231218_LOA.pdf 329.25KB 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 --�iA�-tt,efftdx'w Type Name* Robert L Brown Title* Owner/Member Organization* Toisnot Preserve Date* 12/19/2023 Email Address* tobacc@yahoo.com Email for confirmation Telephone Number* 252-230-0348 Contact number if we need to reach you Note:Original permittee and site contact are copied on modification correspondence. Additional Email steve@bartletteng.com (Optional) Additional email for confirmation Original Permittee tobacc@yahoo.com Email Original Site Contact tobacc@yahoo.com Email Review Date 12/20/2023 Rescinded Since Submitted?