SWG040060_Historical File_20130910

MEMORY TRANSMISSION REPORT
TIME :09-11-2013 09:51
FAX NO.1 .
NAME
FILE NO. : 482
DATE : 09.11 09:50
TO : 93626810
DOCUMENT PAGES : 3
START TIME • 09.11 09:50
END TIME : 09.11 09:50
PAGES SENT 3
STATUS . OK
***SUCCESSFUL TX NOTICE***
State of North Carolina
Dopartmant or Environment and Natural Reaournee
Wtlmirgton Ragtonnl Ofllce
P..g 1lIoCYory Covornor 'PAW CO"t i 613:MIET Jabs. S/tvorla IIZ Speratary
Date: •.� �'- ' - No.Pages(eoto1.cover):
To: From: Jo Caamor
Co: �• �¢'�� Phone: (9I01 796-7336
Fax: ` � — �' �i . Peoc: (9 1 01 350-7-004
Ro: "�� Tlo��-x� . . T" rY�•YiarJ �-�/Ti G�'r>� I��i¢��
vr" i - - - fits r a Go �' l i'n irar —
•
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127 Cardinal Drive L'ictenelon.Wilmlegton.NC 29405•[phone]•An Hquel Q pyortutl3ty Affirmathre Aatl®.Hmp[oyar

State of North Carolina
Department of Environment and Natural Resources
Wilmington Regional Office
Pat McCrory, Governor FAX COVER SHEET John E Skvarla III, Secretary
Date: e' //--,?' /_ ' No. Pages(excl.cover):
To: -D From: Jo Casmer
Co: 19' 7-!G!� Phone: [phone]
Fax: Fax: [phone]
Re: -9 2 "©OGe"ss �% T S9,01-7—/off 7•-"iZ,.7y
127 Cardinal Drive Extension,Wilmington,NC 28405•[phone]•An Equal Opportunity Affirmative Action Employer

PORT CITY CONSULTING ENGINEERS, PLLC arnn 0 P - a ms 10nAl
6216 STONEBRIDGE ROAD DATE 9/9/13 JOB NO.
WILMINGTON, NORTH CAROLINA, ATTENTION
28409 PHONE#
[phone]
GE-90 Process Lift Station & Utility
Plan
TO: Chris Baker
NCDWQ
WE ARE SENDING YOU 0 Attached 0 Under separate cover the following items:
❑Shop Drawings ❑ Prints ® Plans ❑Samples 0 Specifications
❑Copy of Letter 0 Change order ❑ Diskette 0
COPIES DATE NO. DESCRIPTION
Original & Copy of General Permit to Construct a Linear
2 Utility Line and Associated Incidental Built-Upon Area
1 Express Application Fee Check ($1,000)
2 Copies of Plans
1 USGS Map
THESE ARE TRANSMITTED as checked below:
❑ copies for
// For approval ❑Approved as submitted Resubmit approval
copies for
❑ For your use 0 Approved as noted ❑ Submit distribution
❑As requested ❑ Returned for corrections ❑ Return corrected prints
❑ For review and
comment ❑
❑ FOR BIDS DUE 20 ❑ PRINTS RETURNED AFTER LOAN TO US
REMARKS:
r_e;ci" , ...
c, t S 2013
COPY TO: File SIGNED: 11144i
If enclosures are not as noted,kindly notify us at once.

FOR AGENCY USE ONLY
N.C.DIVISION OF WATER QUALITY Date Received
Year Month Dav
SURFACE WATER PROTECTION SECTION
tftrmage
STATE STORMWATER NOTICE OF INTENT(NON) SIWI�llffeNe 1 111 1 I
Check# Amount
SWG040000-.GENERAL PERMIT TO CONSTRUCT A LINEAR.UTILITY LINE Permit Assinnr d to
AND ASSOCIATED INCIDENTAL BUILT-UPON AREA
State Stormir ater Management Application Notice of Intent for coverage under the General Stormwater Management
Permit to construct a utility line and incidental built-upon area associated with a linear utility project including water,
sewer,gas,telephone,and electric.
For the construction,operation and maintenance of incidental impervious areas associated with the construction of a
linear utility line. Incidental built-upon area associated with the utility project includes small,single pump stations,
access roads which minimize their built-upon area,concrete pads,manhole covers,etc.
(Please print or type)
1. Meiling address of ownerldeveloperc(The address m which all permit correspondence Will be mailed.)
Owner/Developer Name &£ q�y
Street Address 3 7 a) CA,A Net-pi r keeLd /
city li9 ;1 a.:n3 vet State ,u ZIP Code 2 8 Sio/
Telephone No. (is") S 1 et- 68/D Fax (Silo) 3 .cdria
2. Proposed Project Information: /
Project Name C iF- Q O Pro e.�Cd5 Z.44 54,4, 014 d- tit /;/7 P/44
Street Address
of the Project 3 qv 1 Ca-$lir- A 7L ice
City lV i a t Ai
Apr. State /0 ZIP Code a3 cP slop/
Ccwnt ,4 �Glv Al a s r&+ '-
Contact Person !e2re Algae
h ro
Melling Address ?`/D i Ca S /,c c 'a A 1 le-OeLet
City et),/, t rtr5 119n- State AJ C_ ZIP Code a 4+0/
Telephone No, (9/p) 6 7 S- 64223 6 Fax (p'/© ) csi`T-- $'7S'4
3. Physical Location Information:
Please provide the street address of the project and describe how to get to the project,using street names,
state road numbers,and the distance and direction from the nearest"J major intersection: 31 v/
AIM
j,=Abe t~r. eri e`et+r ae_ a st'T v ra�;3 - e/-3-o F n a r,M
v :n4-t ells e.:y4'ors O !el tsS !-t+f D s- #JG•/ls.) /33 (£4.SO/t 401 j
4. What is the name of the receiving stream? IV E. 4.r /�-•'u� Y
5. River Basin r- Receiving Stream Classification CJ
8. This Certificate of Coverage is being Submitted as a result of:
C4 New or proposed project 0 Modification to an existing project
Existing COC or Permit Number:
Date project is scheduled to begin constrvuctlon 0,4r I) to/3
T. What is the total project area above mean high water? 2.1 )c a fe
8. What is the total amount of built-upon area proposed at this site? 9 e ftz
(Please include all manhole covers,pump stations,concrete pads,and gravel access roads)
ECEIVE
SWU-116.17FEB2010 Page 1 of 3 44
SEP 09 2013
EiY:

9 What type of uttwty project will be constructed?
0 Water ❑Sewer 0 Gas ❑Telephone 0 Electric IKE Other P a ,e.4 5 sek„�r`
10. Has the built-upon area been minimized to the extent practicable?
YES 0 NO
11. Is the runoff from the built-upon.area outside the vegetative buffer directed away from surface waters,to the
extent practicable.?
1:$1 YES ❑NO
12. Is the project within 575'of the Mean High Water line of Class ORW waters?
❑YES (Please show the 575'AEC line on plans) II NO
(ff yes,total built-upon area be less than or equal 10 25%othee toad project area rotten the AEC above mean high xa 1er.)
13. Are there are/attends-on the site? ❑YES(please debate on the plans) El NO
Name and afilon of person making this determination:
14. Please list all Best Management Practices emgloyed at this site:
ku is ,c i; c tt 4 f i 44 tote 4 t' - b y
. 3 47.am
15. Certification:
North Carolina General Statute 143 215.BB(I)provides that
Any person who knowingly makes any false statement mpreseniation,or certification In any application,record,report,plan,
or other document filed or required to be maintained under this Articlo or a rule impk ntirig 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 recordkaj or monitoring device or method required to be operated or
maintained under this Article or rules of the Commission implementing this Article shag be guilty of a Class 2 misdemeanor
which may dude a fine not to exceed$10,000. (18 U.S.C.Section 1001 provides a punishment by a fine of not more than
$10,000 or irtiprisorenent of not more than 5 years,or both,for a stinger offense.)
I hereby request coverage under the referenced General Permit.I understand that coverage under this permit will
constitute the permit requirement for the project and is enforceable in the same manner as an individual permit
I certify that I am familiar with the information contained in the application and that to the best of my knowledge and
belief such information is true.complete.and accurate.
Printed name of person signing: 72 dt ,eke-
Tine: •
M et ,, l c�JJ, e4 oL. /it4 9-fn.anc-c
(Signature of Mire-ant) Mate signed)
A check or Money order must accompany this Notice of intent for$505.00,made payable to:NCDENR.
Your application Will be returned unprocessed unless al of the following items are submitted:
❑ This completed form
❑ Two sets of site and grading plans
❑ A check for$505.00
❑ A USGS map with the project clearly located on it.
Mail the entire package to: NCDENR Division of Water Quality
Surface Water Protection Section—Stormwater
at the Appropriate Contact Address(see the following per)
Note:The sub on of this document does not guarantee the issuance of a Certiffeate of Coverage under the
General Permit.
SWU-116-17FEB2010 Page 2 of 3

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