Fast Track Storm Applicaiton Page Revision_20181214.pdf

❑ Major Modification, replacing an existing stormwater permit — provide existing permit number: SW
Status of construction? ❑ Not Started ❑ Partially Completed ❑ Completed
Major modifications must be submitted by the original permitfee and are allowed only if the SW permit is
not expired. Minor modifications must use Standard Permitting Process. By choosing this option, you
are also requesting that DEQ rescind the previous SW Permit upon Issuance of the new Fast
Track ATC Permit.
❑ Transfer of existing Fast Track ATC Permit — provide existing ATC permit number: SWA
2. Applicable state stormwater program(s) (check all that apply):
❑ Coastal SA-HQW ❑ Urbanizing Areas (Phase 2)
❑ Coastal SA-ORW ❑ Non -Coastal HQW
Is any portion of the project within 575 feet
of SA-ORW waters? ❑ Yes ❑ No ❑ Non -Coastal ORW
❑ Coastal Freshwater ORW ❑ USMP
❑ Coastal — Other
3. Other Permits (as applicable; write "NA" for those permit types that are not applicable):
Project Name
PermitiAppl
Issue Date
Other Information
No.
CAMA Major
NA
Erosion &
Sedimentation Control
Nesbitt Subdivision - Phase 2
HENDE
Under
Disturbed Area 3.7
2018-014
Review
acre
NPDES Industrial
NA
Stormwater
404/401 Permit
Proposed Impacts
Iflac
4. Local jurisdiction for building permits: Town of Mills River
Point of Contact:Brian Bur ess Phone #: (828 } 890-2901
D. CONTACT INFORMATION
Applicant/Financially Responsible Party (may be an Organization): The Farm at Mills River, LLC
Signing Official Name & Title: Billy Taylor
Street Address: 1005 Cane Creek Rd.
City: Fletcher State: NC Zip: 28732
Mailing Address (if different):
City: State: Zip:
Phone: [phone] Fax: ( ]
Email: [e-mail]
2. If the Applicant is a Corporation or LLC (Address must match address on file with NC Dept of the Secretary of
State):
Name of Registered Agent:The Farm at Mills River LLC
Mailing Address:1005 Cane Creek Rd.
City:Fletcher State:NC Zip:28732
Phone: (828) 77M705 Fax:
Email:
Stormwater Fast Track ATC Application Form Page 2 of 9 Feb. 10, 2018