NCC230099_Modification Review_20250220

Action History(UTC-05:00)
Submit by Anonymous User 2/17/2025 3:39:10 PM (ADD TO FILE Submittal)
Approve by bethany.georgoulias 2/20/2025 8:37:21 AM (Construction COC ADD TO FILE Review-NCC230099)
• The task was assigned to bethany.georgoulias.The due date is: February 20,2025 5:00 PM
2/17/2025 3:39:12 PM

Ago Permit for DEQMODIFICATION
Construction0i00
0000
Certificate of NCC230099
Coverage(COC)No.* Enter the Certificate of Coverage Number(Use capital letters)
Initial Permit Fee Status Initial Payment Received
PAID 1/13/2023
(N/A prior to Oct 2020) (N/A prior to Oct 2020)
2020 Annual Fee Status 2021 Annual Fee Status 2022 Annual Fee Status
May be blank if N/A May be blank if N/A May be blank if N/A
2023 Annual Fee Status 2024 Annual Fee Status 2025 Annual Fee Status
May be blank if N/A PAID PAID
May be blank if N/A May be blank if N/A
Information associated with this permit:
Project Name Ryan's Crossing
Address 85 Evander Way, Pittsboro, NC
County Chatham
Latitude 35.8305
Longitude -79.1339
Permittee Listed Triple A Homes
Legally Responsible Dan Morse
Individual At the time of Modification Request(not looked up again at review)
NC Reference No. NCG01-2023-0099
E&SC Plan ID WP-22-662
Original NOI Tracking 122311
No.*
Date COC Issued* Effective Date at Submittal
04/01/2024
Prior Rescission Date This field will populate only if COC has already been rescinded.
Modification Information:
Reason for 0 Closed-Out Lots/Outparcels in E&SC Plan
Modification* Additional Lots/Outparcels Approved-E&SC Revised
J Other Revision(s)to E&SC Plan
0 Legally Responsible Individual and/or Site Contact Has Changed
0 Multiple Reasons(List Below)
0 Other(Describe Below)

Reason for Modification Supporting Doc Name
(CLOSED OUT LOTS)
Reviewer Reference Only(Not Visible on Starting Form)
Additional Description/Explanation
More information(e.g.,if lots are being added,please include specific lot numbers.)
Please remove lot 43 from this coverage. Project complete.
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).
Supporting Documentation
Upload Supporting Documentation(Revised E&SC Approval,Close-Out Doc,etc.)
RC 43 Certificate of Completion.pdf 288.29KB
Must be PDF format
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
This pertains to funding distributed by the N.C.Division of Water Infrastructure(DWI)only.
No
Yes
Is this project funded with N.C.Session Law 2023-134 Section 12.2 Earmark funds?
No
Yes
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
Type Name* Gerry Felton
Title* VP
Organization* Triple A Homes
Date* 02/17/2025
Email Address* [e-mail]
Email for confirmation

Telephone Number* 910-748-6105
Contact number if we need to reach you
Note:Original permittee and site contact are copied on modification correspondence.
Additional Email Additional email for confirmation
(Optional)
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 02/20/2025
Rescinded Since
Submitted?
Current Effective Date Current Expiration Date Permit Version
4/1/2024 3/31/2029 2.00