NCC191441_NOI Application_20190820

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/16/2019 10:06:31 AM (NCG01 NOI Submission)
Approve by Lucas, Annette 8/16/2019 5:20:07 PM (Review- Construction NOI 14937)
• The task was assigned to Lucas, Annette by round robin distribution 8/16/2019 10:06 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: August 20, 2019 5:00
PM 8/16/2019 10:06 AM
Submit by McCoy, Suzanne 8/20/2019 11:22:47 AM (Payment Verification for NCC191441)
* Stacy Simmons
• McCoy, Suzanne assigned the task to McCoy, Suzanne 8/20/2019 11:22 AM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: August 30, 2019 5:00 PM
8/16/2019 5:20 PM

1 r-i) iTII T:2,0)M 1-11 f_T1II a 1010
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Inforrration
1. Project Name * The Manors at Lexington Plantation, Part 2C lots 665-669 & 673
2. County* Harnett
3. Highway or Street Artillery Lane
Address * Street name only is acceptable if no address nurrtrer assigned yet
4. City or Township* Anderson Creek Township
5. State * NC
6. Zip Code* 28326
7. Latitude * Enter the latitude in decirral degrees
35.2668
8. Longitude * Enter the longitude in decirral degrees (MJSTbe negative)
-79.0190
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*
08/13/2019
Estimated Construction Project Start Date
10. Date to End*
09/01 /2020
Estimated Construction Project End Date
11. SIC (Primary)*
Residential, Single
Family Houses (SFE)
(1521)
Standard Industrial aassification for Development
12. Acres to be
1.34
disturbed*
(including off -site borrow and waste areas)
13. Total site area 1.34
(acres)*
14. Post- 0.55
construction (Estimated)
impervious area
(acres) *

NCC Project NCC-HARNE-2019-The Manors at Lexington Plantation, Part 2C
Tracking ID lots 665-669 & 673
Assigned autorratically
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. You may
enter up to 3 waterbodies.
15a. Receiving Reedys Swamp (Little Bridge Branch)
Waterbody* Narre of waterbody into which storrrwater runoff will discharge
15b. Waterbody 18-23-29-2
Index No. * NC Waterbody Index Ninber
Stormwater r No
discharges will flow pr Yes
to additional
wate rs *
15c. Additional McLeod Creek
Receiving Waterbody narra
Waterbody
15d. Waterbody 18-23-29-2
Index No. NCWaterbody Index Pbnber
15e. Additional Waterbody nacre
Receiving
Waterbody
15f. Waterbody NCWaterbody Index Ninber
Index No.
16a. Is this project F Yes
subject to the NC r No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B.
Perrrittee Information - Legally Fbsponsible Entity and Individual
.....................................................................................................................................................................
h
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form should 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. Organization H&H Constructors, Inc.
Name *
2. First Name* Brian
ff Corporation, enter Fbgistered Agent First 1\brre
3. Last Name * Walker
ff Corporation, enter Faegistered Agent Last Barre
3b. Title Division President
4. Permitee E-mail [e-mail]
Address*
5. Permittee 910-849-5272
Telephone No.*
6. Permittee Mailing Street Address
Address* 2919 Breezewood Avenue, Suite 400
Address Line 2
City State / Province / Region
Fayetteville NC
Postal / Zip Code Country
28303 us
Check box if the r% Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 2919 Breezewood Avenue, Suite 400
Address Line 2
City
State / Province / Region
Fayetteville
NC
Pastal / Zip Code
Country
28303
us

C. Site Contact Information
Part C.
Roiect Site Contact Information
1. Type of Non -Government
Ownership*
2. Primary Site Brian
Contact - First
Name *
3. Primary Site Walker
Contact - Last
Name *
4. Title Division President
5. Site Contact E- [e-mail]
mail Address*
6. Site Contact 910-849-5272
Telephone No.*
7. Organization H&H Constructors, Inc.
Name
8. Site Contact Street Address
Mailing Address* 2919 Breezewood Avenue, Suite 400
Address Line 2
city
Fayetteville
Fbstal / Zip Code
28303
State / Province / Region
NC
Country
us

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 08/13/2019
Approved *
2. E&SC Plan Project HARNE-2020-008
Number/ID* Assigned by agency or local program
3. E&SC Plan f• State DEQ Office
Approved by r Local Program
4. State DEQ Office * Fayetteville (FRO)
Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a
complete application.
5. E&SC Plan APPROVAL HARNE 2020 008 HH.pdf 68.69KB
Approval Mist be PCFfornat
letter/documentation
6. NOI Certification NOI Certificate.pdf 215.74KB
Form Mist be RDFfornat
This is an Express f• No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.613 (1) provides that:
Anyperson who knowinglymakes any false statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes 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 deice or method required to be operated or maintained under this Article or rules of the
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that:
rJ 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.
* rJ 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.
* I7 I will abide by all conditions of the NCG010000 General Permit and the
approved Erosion and Sediment Control Plan.
* rJ 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:* r The Responsible Person named on this Notice of Intent
r Authorized Responsible Person*
Important: The person who signs this Certification above and signs the NOI Certification Form should be the same
person (or authorized responsible person within the same organization) as listed in Section B (Permittee Information)
of this form. *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 *
Brian Walker
Title
Agent
Organization
H & H Constructors, Inc.
Date *
08/16/2019

F. Tracking and COC Info
NOI Tracking No. 14937
NC Reference No. NCG01-2019-1441
Uses 'count number variable (incremrented by SP)
Certificate of NCC191441
Coverage (COC) Uses'count_nunber'variable (incremrented by SF)
No. *
Count Number 1441
Sequential nunber for subrrittal that is incremented by Stored Procedure
COC Year 2019
Year of date reviewed (used to assign YY digits after "NGC' in OOCno.)