NCC241718_NOI Application_20240607

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 6/4/2024 10:07:47 AM (NCG01 NOI Submission)
Approve by Brooklyn.Broussard 6/4/2024 10:19:27 AM (Review-NOI 200911 Crooked Creek Trunk Sewer Phase II
Inteceptor Improvements)
• The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:June 7,2024 5:00 PM
6/4/2024 10:08:03 AM
• The task was assigned to Brooklyn.Broussard by round robin distribution 6/4/2024 10:08:03 AM
Submit by Austin Sanderford 6/7/2024 1:35:31 PM (Payment Verification for NCC241718)
•Union County
• The task was assigned to DEMLR NCG01 Payment Team.The due date is:July 16,2024 5:00 PM
6/4/2024 10:19:42 AM
• Austin Sanderford assigned the task to Austin Sanderford 6/7/2024 1:34:15 PM

applicationConstruction Stormwater: Notice of Intent (NOI)
National Pollutant Discharge Elimination System(NPDES)
General Permit 1 OOOO:STORMWATER DISCHARGES associated with construction activities
N O RTH 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*
Crooked Creek Trunk Sewer Phase II Inteceptor Improvements
1b.Specific Lot Numbers
This field may be used to list specifc lot numbers.
Various,see attached sheet.
1c.Parcel ID Number(s)(PIN)
List all PINS associated with this project.
7084385
7084412
7084586
7084587
07084588 02
07084588 03
07084588 04
07084588 05
07084588 06
07084588 07
07084588 08
07084588 09
07084588 10
07084588 11
07084588 12
07084588 13
07084589 02
07084589 03
07084589 04
07084589 05
07084589 06
07084589 07
07084589 08
07084589 09
07105004A
07105005D
07105005E
07111018A
07111018J
07111018K
7084328

VO'i J'iV
7084380
7084395
7084400
7084407
7084408
7084409
7084410
07084328A
07084333E
07084380A
07084380B
07084405A
07084405G
7066758
7066759
7066760
7066761
7066762
7066763
7066764
7066765
7087006
07066017A
07084320B
07084325A
07084325B
7066092
7066720
7066721
7066722
7066771
7066772
7066773
7066774
7066775
7066776
7066992
07066013E
07066015B
2.County*
Union
3. Highway or Street Address*
Sardis Church Road
Street name only is acceptable if no address number assigned yet
4.City or Township*
Indian Trail
5.State* NC
6.Zip Code* 28110
7. Latitude* Enter the latitude in decimal degrees
35.0689
8. Longitude* Enter the longitude in decimal degrees(MUST be negative)
-80.6336

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* 06/03/2024
Estimated Construction Project Start Date
10. Date to End* 02/27/2026
Estimated Construction Project End Date
11.SIC(Primary)*
Other(9999)
Standard Industrial Classification for Development
12.Acres to be 10.16
disturbed* (including off-site borrow and waste areas)
13.Total site area 10.16
(acres)*
14. Post-construction 0.00
impervious area (Estimated)
(acres)*
Project Tracking ID NCC-UNION-2024-Crooked Creek Trunk Sewer Phase II Inteceptor
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*
South Fork Crooked Creek
Name of waterbody into which stormwater runoff will discharge
15b.Waterbody Index No.*
13-17-20-2
NC Waterbody Index Number
Stormwater discharges will flow to additional waters*
No
Yes
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 eNOI 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
Union County
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* Thomas
If Corporation,enter Registered Agent First Name
3. Last Name* Mann
If Corporation,enter Registered Agent Last Name
3b.Title CIP Program Manager
4. Permitee E-mail Address*
[e-mail]
5. Permittee Telephone No.*
704.296.2560
6. Permittee Mailing Address*
Street Address
500 North Main Street
Address Line 2
Ste 600
City State/Province/Region
Monroe INC
Postal/Zip Code Country
28112-4728 US
Check box if the street address the same as mailing address
Yes

7.Permittee Street Address
Street Address
500 North Main Street
Address Line 2
Ste 600
City State/Province/Region
Monroe NC
Postal/Zip Code Country
28112-4728 us
8.Type of Ownership*
Ownership is only individual if an individual is named in B.1.above.
Government-County

C. Site Contact Information
Part C.
Project Site Contact Information
................................................................................................................................................................................................................................................................................................................................................................................................
1. Primary Site Contact-First Name*
Randy
2. Primary Site Contact-Last Name*
Smith
3.Title
Superintendent
4.Site Contact E-mail Address*
[e-mail]
5.Site Contact Telephone No.*
336.413.3859
6.Organization Name
Metra Industries Inc.
7.Site Contact Mailing Address*
Street Address
50 Muller Place
Address Line 2
City State/Province/Region
Little Falls NJ
Postal/Zip Code Country
07424-1133 us
8.Consultant Name
(Optional)
Ryan LeBlanc, Brown and Caldwell
First and Last name
9.Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10.Consultant Telephone No.
704.373.7146
11. Billing E-mail
(For Annual Fee correspondence)
[e-mail]
Default is legally responsible person e-mail
12. Billing Telephone
(For Annual Fee correspondence)
704.296.2560
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 10/26/2022
Approved*
2. E&SC Plan Project UNION-2022-090
Number/ID* Assigned by agency or local program
3. E&SC Plan State DEQ Office
Approved by* Local Program
4.State DEQ Office* Mooresville(MRO)
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 20221026-Letter of Approval wtih Modifications.pdf 735.05KB
Approval letter or Must be PDF format
Grading Permit
6.Signed FRO Financial Responsibility/Ownership Form
03_Financial-Responsibility-Form-Signed (1).pdf 568.28KB
Must be PDF format
7.Site Location Map Must be PDF format(limit 20 MB)
06_Crooked-Creek-USGS-Map.pdf 4.01 MB
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 20240604 Crooked CreeklnterceptorPhII-NCDEQ-
Form 1.64MB
NCG01.pdf
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* Thomas Mann
Title CIP Program Manager
Organization Legally Responsible Entity
Union County
Date* 06/04/2024

F. Tracking and COC Info
NOI Tracking No. 200911
NC Reference No. NCG01-2024-1718
Indicates NCG01 or NCG25.Uses NOI number until approved,then uses NUMBER incremented by SIP(passed
from workflow if eNOI approved)
Certificate of NCC241718
Coverage(COC) No.* Uses NOI number until approved,then uses NUMBER incremented by SIP(formatted and passed from workflow if
eNOI approved)
Initial Invoice No. NCC241718-2024
Invoice Due Date 7/4/2024
Initial Fee $ 120.00
Fee increased to$120,effective October 3,2023
Invoice Status OPEN