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Home My WebLink AboutNCC241434_NOI Application_20240513 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by Anonymous User 5/8/2024 2:17:45 PM(NCG01 NOI Submission) Approve by Brooklyn.Broussard 5/9/2024 6:23:44 AM(Review-NOI 196801 ECIA Transmission Main Improvements) • The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: May 13,2024 5:00 PM 5/8/2024 2:17:54 PM • The task was assigned to Brooklyn.Broussard by round robin distribution 5/8/2024 2:17:54 PM Submit by Tev.Holloman 5/13/2024 12:40:50 PM (Payment Verification for NCC241434) •Henry Louis Duffie • The task was assigned to DEMLR NCG01 Payment Team.The due date is:June 20,2024 5:00 PM 5/9/2024 6:23:59 AM • Tev.Holloman assigned the task to Tev.Holloman 5/13/2024 12:40:19 PM applicationConstruction Stormwater: Notice of Intent (NOI) National Pollutant Discharge Elimination System(NPDES) General Permit 1 OOOO:STORMWATER DISCHARGES associated with construction activities NORTH CAROUNA Environmental Quality A. Project Information Part A. Project Location and Waterbody Information ................................................................................................................................................................................................................................................................................................................................................................................................... Are you submitting an NOI that was rejected before? No Yes 1a. Project Name* ECIA Transmission Main Improvements 1b.Specific Lot Numbers This field may be used to list specifc lot numbers. 05105019E 05105001 D 05105017F 05105017H 05105017 05E99001Z 05105040B 05105041 05HO4032F 05HO4032G 05105001 B 05E990221 05105001 H 05105004F 05105001 C 05HO3198S 05HO4002C 05HO3100C 05HO3009P 05GO2191C 05037011 05104199N 05037010A 05E99016 05105199E 5037010 05104006D 05HO3199G 05HO1199A 05GO2191D 05037010D 05037008V 05105001 F 1c. Parcel ID Number(s)(PIN) List all PINs associated with this project. 167800-40-6031 167800-21-6344 167800-30-8086 167700-39-0281 167700-39-0870 167700-29-0735 167800-20-0142 167800-11-0239 166800-82-0725 167800-02-6327 167800-12-0881 167800-03-7068 167800-03-5248 167800-14-6267 167800-15-8905 166800-86-0769 166811-76-0449 166808-78-6185 166807-68-1490 166807-68-1400 166806-38-9809 166807-58-9209 166807-58-8300 166807-58-7351 166807-58-7304 166807-58-6433 166807-58-3397 166807-58-0398 166807-58-0453 166806-48-9442 166806-48-5430 166818-39-6977 167800-32-4766 2.County* Johnston 3. Highway or Street Address* NC 42 Street name only is acceptable if no address number assigned yet 4.City or Township* Clayton 5.State* NC 6.Zip Code* 27520 7. Latitude* Enter the latitude in decimal degrees 35.6191 B. Longitude* Enter the longitude in decimal degrees(MUST be negative) -78.4147 If you do not know the latitude and longitude coordinates for this project,you can search the location on this map of North Carolina. Look for the coordinates in the bottom left corner. 9. Date to Begin* 01/01/2025 Estimated Construction Project Start Date 10. Date to End* 09/01/2026 Estimated Construction Project End Date 11.SIC(Primary)* Other(9999) Standard Industrial Classification for Development 12.Acres to be 19.14 disturbed* (including off-site borrow and waste areas) 13.Total site area 19.14 (acres)* 14. Post-construction 0.04 impervious area (Estimated) (acres)* Project Tracking ID NCC-JOHNS-2025-ECIA Transmission Main Improvements Assigned automatically(not used) Below you must enter waterbody information for surface waters affected by this project. Please consult DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. Please enter only immediate receiving waterbodies-not waters downstream of those unless the project extends there. You may enter up to 3 waterbodies if needed. 15a.Receiving Waterbody* Cooper Branch Name of waterbody into which stormwater runoff will discharge 15b.Waterbody Index No.* 27-43-13 NC Waterbody Index Number Stormwater discharges will flow to additional waters L No Yes 15c.Additional Receiving Waterbody Neuse River Waterbody name 15d.Waterbody Index No. 27-(38.5) NC Waterbody Index Number 15e.Additional Receiving Waterbody Waterbody name 15f.Waterbody Index No. NC Waterbody Index Number 16a.Is this project subject to the NC Sediment Pollution Control Act? Yes No, not subject to NC SPCA 17. Is this project funded with ARPA(American Rescue Plan Act)grant funds? No Yes This question was added to the eNOl on 1/26/2023 and will not be answered in applications submitted prior to that date. B. Permittee Information Part B. Permittee Information-Legally Responsible Entity and Individual ...................................................................................................................................................................... Important:The person who signs the NOI Certification Form and signs the Certification in Section E of this application form must be the same person as listed in THIS SECTION,or an authorized responsible individual within the same organization. That person must be a responsible corporate officer who 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. 1. Permittee* Legally Responsible Entity Town of Clayton If permittee is an individual,enter first and last name in this field.Otherwise,enter organization/business name. Note: If the permittee is a business,the business must be registered with the INC Secretary of State.You can verify the registration here. Permittee must be the same entity that is responsible for the land-disturbing activity as listed on the NC SPCA Financial Responsibility/Ownership(FRO)Form. 2. First Name* Richard If Corporation,enter Registered Agent First Name 3. Last Name* Cappola If Corporation,enter Registered Agent Last Name 3b.Title Town Manager 4. Permitee E-mail Address* townmanager@townofclaytonnc.org 5. Permittee Telephone No.* 919-553-1554 6. Permittee Mailing Address* Street Address 111 East Second Street Address Line 2 City State/Province/Region Clayton INC Postal/Zip Code Country 27520-2459 us Check box if the street address the same as mailing address Yes 7. Permittee Street Address* Street Address 111 East Second Street Address Line 2 City State/Province/Region Clayton NC Postal/Zip Code Country 27520-2459 us B.Type of Ownership* Ownership is only individual if an individual is named in B.1.above. Government-Municipal C. Site Contact Information Part C. Project Site Contact Information ................................................................................................................................................................................................................................................................................................................................................................................................ 1. Primary Site Contact-First Name* Louis 2. Primary Site Contact-Last Name* Duffie 3.Title Project Manager 4.Site Contact E-mail Address* engineering@townofclaytonnc.org 5.Site Contact Telephone No.* 919-553-1554 6.Organization Name Town of Clayton 7.Site Contact Mailing Address* Street Address 111 East Second Street Address Line 2 City State/Province/Region Clayton NC Postal/Zip Code Country 27520-2459 US 8.Consultant Name (Optional) McKim&Creed First and Last name 9.Consultant E-mail mpenny@mckimcreed.com This person will be copied on all correspondence. 10.Consultant Telephone No. 9192338091 11. Billing E-mail (For Annual Fee correspondence) engineering@townofclaytonnc.org Default is legally responsible person e-mail 12. Billing Telephone (For Annual Fee correspondence) 919-553-1554 Default is legally responsible person telephone D. E&SC Plan Part D. Erosion&Sediment Control(E&SC)Plan Approval Information ...................................................................................................................................................................... 1. Date E&SC Plan 03/06/2024 Approved* 2. E&SC Plan Project JOHNS-2024-0112 Number/ID* Assigned by agency or local program 3. E&SC Plan State DEQ Office Approved by* Local Program 4.State DEQ Office* Raleigh (RRO) Documentation of E&SC Plan approval and the signed Notice of Intent(NOI)Certification Form is required for a complete application. Please also upload a site map showing the overall extent of the project(for linear projects,can include the beginning point and end point coordinates in the"Notes"box below). 5. E&SC Plan E&SC Plan Approval letter or Grading Permit.pdf 299.99KB Approval letter or Must be PDF format Grading Permit 6.Signed FRO Financial Responsibility/Ownership Form Signed FRO.pdf 169.78KB Must be PDF format 7.Site Location Map Must be PDF format(limit 20 MB) Site Location Map.pdf 425.9KB Please do not upload entire set of E&SC plans. 8. Notes(Optional) Provide any additional information that might help the reviewer better understand how uploaded documents support the application.Include additional waterbodies if necessary. 9. NOI Certification NOI Certification Form.pdf 987.18KB Form Must be PDF format This is an Express No Review Project* Yes E. Certification 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). Under penalty of law, I certify that: * I am the person responsible for the construction activities of this project,for satisfying the requirements of this permit,and for any civil or criminal penalties incurred due to violations of this permit. * The information submitted in this NOI is,to the best of my knowledge and belief,true, accurate,and complete based on my inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information. * I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control Plan. * I hereby request coverage under the NCG010000 General Permit and understand that coverage under this permit will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an individual permit. Specify if you are:* The Legally Responsible Person named on this Notice of Intent Authorized Responsible Person'(signing on behalf of Legally Responsible Person named in Part B) Important:The person who electronically signs this Certification above must be the same person who signs the NOI Certification Form. If that person is signing on behalf of the Permittee,that individual must be an authorized responsible person within the same organization as the Permittee. 'An authorized individual is a responsible corporate officer who 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* Richard D. Cappola,Jr Title Town Manager Organization Legally Responsible Entity Town of Clayton Date* 05/08/2024 F. Tracking and COC Info NOI Tracking No. 196801 NC Reference No. NCG01-2024-1434 Indicates NCG01 or NCG25.Uses NOI number until approved,then uses NUMBER incremented by SP(passed from workflow if eNOI approved) Certificate of NCC241434 Coverage(COC)No.* Uses NOI number until approved,then uses NUMBER incremented by SP(formatted and passed from workflow if eNOI approved) Initial Invoice No. NCC241434-2024 Invoice Due Date 6/8/2024 Initial Fee $ 120.00 Fee increased to$120,effective October 3,2023 Invoice Status OPEN