NCC191547_NOI Application_20190911

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/23/2019 10:10:48 AM (NCG01 NOI Submission)
Approve by McCoy, Suzanne 8/23/2019 10:40:03 AM (Review- Construction NOI 15211)
• The task was assigned to McCoy, Suzanne by round robin distribution 8/23/2019 10:11 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: August 27, 2019 5:00
PM 8/23/2019 10:11 AM
Submit by McCoy, Suzanne 9/11/2019 12:04:41 PM (Payment Verification for NCC191547)
* Ingram Tynes.
• McCoy, Suzanne assigned the task to McCoy, Suzanne 9/11/2019 12:04 PM
• Georgoulias, Bethany changed the task's due date to September 22, 2019 5:00 PM
9/5/2019 12:53 PM
• The task was assigned to DEMLR NCG01 Payment Team. The due date is: September 6, 2019 5:00
PM 8/23/2019 10:40 AM

STME
NORTH CAROLINA
Ernvlronmentol qualily
A. Project Information
Part A.
Project Location and Waterbody Information
1. Project Name * Retreat at Arden Farms
2. County* Buncombe
3. Highway or Street 539 Long Shoals Rd.
Address * Street name only is acceptable if no address number assigned yet
4. City or Township* Arden
5. State * NC
1r-i)iTII1T7i)MfiTif_T1IIa10141
6. Zip Code* 28704
7. Latitude * Enter the latitude in decimal degrees
35.4754
8. Longitude * Enter the longitude in decimal degrees (MIST be negative)
-82.5676
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*
08/26/2019
Estimated Construction Project Start Date
10. Date to End*
12/31 /2021
Estimated Construction Project End Date
11. SIC (Primary)*
Residential, Other
than SFE (1522)
Standard Industrial Gassification for Development
12. Acres to be
20.70
disturbed*
(including off -site borrow and waste areas)
13. Total site area
29.19
(acres)*
14. Post-
10.00
construction
(Estimated)
impervious area
(acres) *
NCC Project
NCC-BUNCO-2019-Retreat at Arden Farms
Tracking ID
Assigned automatically

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 Unnamed Tributary to French Broad River
Wate rbody* Narre of waterbody into which stornwater runoff will discharge
15b. Waterbody 6-(54.75)
Index No.* NC Waterbody Index Narrber
Stormwater rJ No
discharges will flow r Yes
to additional
wate rs *
16a. Is this project r Yes
subject to the NC f No, not subject to NC SPCA
Sediment Pollution
Control Act?*

B. Permittee Information
Part B.
Perrrittee Information - Legally Responsible 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 Tynes Development Corporation
Name *
2. First Name* Ingram
ff Corporation, enter Registered Agent First l\b e
3. Last Name * Tynes
Y Corporation, enter Registered Agent Last Barre
3b. Title President
4. Permitee E-mail ([e-mail]
Address*
5. Permittee 205-877-3199
Telephone No.*
6. Permittee Mailing Street Address
Address* 820 Shades Creek Parkway, Suite 2300
Address Line 2
City State / Province / Region
Birmingham Alabaman
Postal / Zip Code Country
38209 United States
Check box if the r% Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 820 Shades Creek Parkway, Suite 2300
Address Line 2
City
State / Province / Region
Birmingham
Alabaman
Pastal / Zip Code
Country
38209
United States

C. Site Contact Information
Part C.
Roiect Site Contact Information
1. Type of Non -Government
Ownership*
2. Primary Site Ingram
Contact - First
Name *
3. Primary Site Tynes
Contact - Last
Name *
4. Title President
5. Site Contact E- [e-mail]
mail Address*
6. Site Contact 205-277-3199
Telephone No.*
7. Organization
Tynes Development Corporation
Name
8. Site Contact
Street Address
Mailing Address*
820 Shades Creek Parkway, Suite 2300
Address Line 2
City
Birmingham
F bstal / Zip Code
38209
9. Consultant Name (optional)
First and Last nacre
10. Consultant E- This person will be copied on all correspondence.
mail
11. Consultant
Telephone No.
State / Rovince / Fbgion
Alabama
Country
United States

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&SC) Ran Approval Information
.......................................................................................................................................................................................................................................
1. Date E&SC Plan 06/14/2019
Approved *
2. E&SC Plan Project ER02019-00029
Number/ID* Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by r Local Program
4. Local Program* Buncombe County
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 Erosion Control Approval.pdf 2.33MB
Approval Erosion Control Placard.pdf 586.68KB
letter/documentation
Mast be RJF format
6. NOI Certification Signed NOI Certification Form.pdf 43.74KB
Form Mist be RJFformat
This is an Express r No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.6B (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.
* V 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.
* V If the Erosion and Sediment Control Plan approved by the delegated program is
not compliant with Part II (Stormwater Pollution Prevention Plan) of the
NCG010000 General Permit, I will nonetheless ensure that all conditions of Part
II of the permit are met on the project at all times.
* I7 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
aiff'-.•f
Type Name* Ingram Tynes
Title President
Organization Tynes Development Corporation
Date * 08/23/2019

F. Tracking and COC Info
NOI Tracking No. 15211
NC Reference No. NCG01-2019-1547
Uses 'count number variable (incremrented by SP)
Certificate of NCC191547
Coverage (COC) Uses'count_nunber'variable (incremented by SF)
No. *
Count Number 1547
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.)