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HomeMy WebLinkAboutNCC192799_NOI Application_20191118Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 11/13/2019 10:19:36 AM (NCG01 NOI Submission) Approve by Farkas, Jim J 11/15/2019 11:48:10 AM (Review- Construction NOI 18378) • The task was assigned to Farkas, Jim J by round robin distribution 11/13/2019 10:19 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 15, 2019 5:00 PM 11/13/2019 10:19 AM Submit by McCoy, Suzanne 11/18/2019 7:35:14 AM (Payment Verification for NCC192799) * Rick Baker • McCoy, Suzanne assigned the task to McCoy, Suzanne 11/18/2019 7:34 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 27, 2019 5:00 PM 11/15/2019 11:48 AM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information 1. Project Name * SPC Mechanical HQ - Early/Mass Grading 2. County* Wake 3. Highway or Street 1500 Wendell Boulevard Address * Street narre only is acceptable if no address number assigned yet 4. City or Township* Wendell 5. State * NC 6. Zip Code * 27591 7. Latitude * Enter the latitude in decimal degrees 35.8018 8. Longitude* Enter the longitude in decimal degrees (M. ST be negative) -78.4031 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* 11/22/2019 Estimated Construction Project Start Date 10. Date to End* 12/30/2019 Estimated Construction Project End Date 11. SIC (Primary)* Commercial (1542) Standard Industrial Classification for Developrrent 12. Acres to be 10.00 disturbed* (including off -site borrow and waste areas) 13. Total site area 20.03 (acres) * 14. Post- 1.00 construction (Estimated) impervious area (acres) * NCC Project NCC-WAKE-2019-SPC Mechanical HQ - Early/Mass Grading 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. Please enter only immediate receiving waterbodies - not waters downstream of those unless the project extends there. You may enter up to 3 waterbodies if needed. 15a. Receiving Buffalo Creek Wate rbody* INbrre of waterbody into which storrrwater runoff will discharge 15b. Waterbody 27-57-16-(2) Index No.* NCWaterbody Index Ninber Stormwater V No discharges will flow r Yes to additional wate rs * 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. ^ F2rnittee Inforrration - Legally Fbsponsible Entity and Individual 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 FDA, LLC Name * 2. First Name* Chris IF Corporation, enter Fbgistered Agent First Barre 3. Last Name* Williford If Corporation, enter Pegistered Agent Last %rre 3b. Title Managing Member 4. Permitee E-mail chris.williford@spcmechanical.com Address * 5. Permittee 252-291-3909 Telephone No.* 6. Permittee Mailing Street Address Address* P.O. Box3006 Address Line 2 city Wilson Fbstal / Zip Code 27895 Check box if the street address the same as mailing address 7. Permittee Street Address* r Yes Street Address 1908 Baldree Road South Address Line 2 City Wilson Fbstal / Zip Code 27893-9509 State / Frovince / Faegion NC Country us State / Frovince / Fbgion NC Country us C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Type of Non -Government Ownership * 2. Primary Site Patrick Contact - First Name * 3. Primary Site Barbeau Contact - Last Name * 4. Title Project Manager 5. Site Contact E- patrick.barbeau@timmons.com mail Address* 6. Site Contact 919-866-4512 Telephone No.* 7. Organization Timmons Group Name 8. Site Contact Street Address Mailing Address* 5410 Trinity Road Address Line 2 Suite 102 Cty Raleigh Fbstal / Zip Code 27607 9. Consultant Name (Optional) First and Last narre 10. Consultant E- This person will be copied on all correspondence. mail 11. Consultant Telephone No. State / Rovince / Fbgion NC Country us D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 11/07/2019 Approved * 2. E&SC Plan Project SEC-025103-2019 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Wake 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 SPC Mechanical HQ - Mass Approval Grad ing_MUNICIPALWatershedManagementAppro... 314.2KB letter/documentation 7-19.pdf Mist be RDFfornat 6. NOI Certification NCG01 Form Signed 11-11-19.pdf 99.77KB Form Mist be RDFfornat This is an Express r No Review Project* r Yes E. Certification North Carolina General Statute 143-215.66 (1) provides that: Any person who knowingly makes anyfalse 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 Artcle; 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 Artcle shall be guilty ofa Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). Under penalty of law, I certify that: 17 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. * 17 I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control Plan. * rJ 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. * 17 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 f Authorized Responsible Person* Important: The person who electronically signs this Certification above must be the same person who signs the NOI Certification Form. If that person is signing on behalf of the Permittee, that individual must be an authorized responsible person within the same organization as the Permittee. *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* Chris Williford Title Managing Member Organization FDA, LLC Date * 11 /13/2019 F. Tracking and COC Info NOI Tracking No. 18378 NC Reference No. NCG01-2019-2799 Uses 'count number' variable (incremrented by SP) Certificate of NCC192799 Coverage (COC) Uses 'count number' variable (incremented by SP) No.* Count Number 2799 Sequential number for submittal that is incremented by Stored Frocedure COC Year 2019 Year of date reviewed (used to assign YY digits after "NOC' in COCno.)