SW3220701_Supplemental Info Review_20240313

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 3/13/2024 9:11:12 AM(Supplemental Submittal)
Accept by Kaitlin Peck 3/13/2024 9:22:36 AM (Supplemental Info Submittal)
• The task was assigned to Kaitlin Peck 3/13/2024 9:11:13 AM

pEQNC Stormwater - Supplemental Information Upload
Submittal from 3/13/2024
Permit Information:
Please provide specific permit details below.
...................................................................................................................................................................................................................................................................................................................................................................................................
What Type of Permit? Choose one:
* rl NPDES Industrial or MS4 Permit
State Stormwater(Post-Construction)Permit
Other
Permit Number* SW3220701
Begins with"SW","NCG",or"NCS'
What DEQ Office is Reviewer:Please correct if misidentified,close this review form,and reassign task to the appropriate contact.
the Primary Contact? Central Office
*
Washington Regional Office(Attn: Carl Dunn)
Wilmington Regional Office(Attn:Christine Hall)
.................................................................................................................................................................................................................................................................................................................................................................................................
Project Name* OLD TOWN VILLAGE
Owner/Operator* TRI POINTE HOMES HOLDINGS, INC
County: Union
Submitter Name:* MASON GREESON, PE
Who is submitting this information?
E-mail Address:* [e-mail]
Phone Number* 7049004755
Additional E-mail for (Optional)
Submittal
Confirmation:
State Stormwater (Post-Construction) Information Uploads
Choose file type and upload attachment(Reviewer may remove unnecessary submittals)
..................................................................................................................................................... ........
File Type* Deed Restriction/Protective Covenant Form
File Upload Click the upload button,or drag and drop files to attach
Deed Restrictions.pdf 1.06MB
Only PDF files are accepted.
File Type* Change of Permittee Information
File Upload Click the upload button,or drag and drop files to attach
NCDEQ SSW PERMIT TRANSFER APPLICATION
338.36KB
OTV rev 2-16-24.pdf
Only PDF files are accepted.

File Type* Signing Official Title&Position Information
File Upload Click the upload button,or drag and drop files to attach
08.14.23 Secretary's Certificate of Tri Pointe Homes
261.88K6
Holdings Inc. (Project Management Authority).pdf
Only PDF files are accepted.
Is this project funded No
with ARPA grant Yes
funds?*
Uploads contain NO
Confidential YES
Information* NOTE:The following information cannot be claimed as confidential:the name and address of any permit applicant
or permittee,permit applications,permits,effluent data,information required by NPDES application forms provided
by the Director inclusive of all forms and attachments[Ref.40 CFR 122.7(b)and(c)].
Notes about the attachments:
•Please provided official documentation showing the title and position of the signing official, Margaret Puckett,within
the applicant organization,Tri Point Homes Holding, Inc..This item is required per 15A NCAC 02J .1045(2)(b)(ii)see
also signatory information on the cover page of the Transfer Application Form. Response: Documentation has been
included in this submittal.
•Please provide a copy of the deed restrictions for this project(per the permit,this project requires deed restrictions
and,similar to the O&M Agreement Form,a signed and notarized copy of this form needs to be provided by the new
permittee). Response: Deed restrictions for new owner has been provided in this submittal.This item is required per
15A NCAC 02H .1045(2)(e)and Section C.7.of the Transfer Application Form(please also revise the form to indicate
that this item is required/provided)Response,application has been revised to indicate section C.7. is required and
provided.. I have attached the originally approved copy of this form and included the link to the blank version of this
form
* By checking the box and signing box below, I certify that:
d I have given true,accurate,and complete information on this form;
d I agree that submission of this Supplemental Information form is a"transaction"subject to Chapter 66,Article 40 of the
NC General Statutes(the"Uniform Electronic Transactions Act")
o I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes
(the"Uniform Electronic Transactions Act");
d I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
o I intend to electronically sign and submit the Supplemental Information Upload form.
Full Name:* Mason Greeson, PE
Signature:
44A"A/e�Xf d
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Date Submitted: 03/13/2024

Initial Review
Verify Permit No.* IMPORTANT:REVIEWER SHOULD VERIFY and revise here if necessary.
SW3220701
Who needs a Copy?* Reviewer selections will only be required for offices checked here.
Central Office Staff
Regional Office Stormwater Contact
State Stormwater RO Staff
No Copy Needed
Central Office Reviewer:*
Notifies CO Staff with Email
Jim Farkas
Any Comments or
Added Info for CO
Staff Reviewer?
Review Date* 03/13/2024