Loading...
HomeMy WebLinkAboutNCC192983_NOI Application_20191202Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 11/26/2019 6:16:24 PM (NCG01 NOI Submission) Approve by Farkas, Jim J 12/2/2019 1:19:16 PM (Review- Construction NOI 18933) • The task was assigned to Farkas, Jim J by round robin distribution 11/26/2019 6:16 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 28, 2019 5:00 PM. The priority is: High 11/26/2019 6:16 PM Submit by McCoy, Suzanne 12/2/2019 3:45:20 PM (Payment Verification for NCC192983) * Jeff Edwards Tarumianz • McCoy, Suzanne assigned the task to McCoy, Suzanne 12/2/2019 3:44 PM The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 13, 2020 5:00 PM. The priority is: High 12/2/2019 1:19 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information 1. Project Name * Deer Creek Farm 2. County* Union 3. Highway or Street New Town Road (Building Address TBD) Address * Street nacre only is acceptable if no address number assigned yet 4. City or Township* Village of Wesley Chapel 5. State * NC 6. Zip Code * 28173 7. Latitude * Enter the latitude in decimal degrees 34.9842 8. Longitude* Enter the longitude in decimal degrees (M. ST be negative) -80.6978 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* 12/04/2019 Estimated Construction Project Start Date 10. Date to End* 03/31/2020 Estimated Construction Project End Cute 11. SIC (Primary) * Residential, Other than SFE (1522) Standard Industrial aassification for Ceveloprrent 12. Acres to be 10.50 disturbed* (including off -site borrow and waste areas) 13. Total site area 25.98 (acres) * 14. Post- 0.60 construction (Estimated) impervious area (acres) * NCC Project NCC-UNION-2019-Deer Creek Farm 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 Twelvemile Creek Wate rbody* %rre of waterbody into which storrrwater runoff will discharge 15b. Waterbody 11-138-2 Index No.* NCWaterbody Index Number Stormwater rJ No discharges will flow r- Yes to additional wate rs * 16a. Is this project r 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 Deer Creek Farm LLC Name * 2. First Name* Elizabeth IF Corporation, enter Fbgistered Agent First Barre 3. Last Name* Tarumianz If Corporation, enter F3egistered Agent Last %rre 3b. Title Organizer / Manager 4. Permitee E-mail liztarumianz@yahoo.com Address * 5. Permittee 423-304-6888 Telephone No.* 6. Permittee Mailing Street Address Address* 237 Cherokee Road Address Line 2 city Charlotte Fbstal / Zip Code 28207-1905 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 237 Cherokee Road Address Line 2 City Charlotte Fbstal / Zip Code 28207-1905 State / F rovince / 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 Elizabeth Contact - First Name * 3. Primary Site Tarumianz Contact - Last Name * 4. Title Organizer / Manager 5. Site Contact E- liztarumianz@yahoo.com mail Address* 6. Site Contact 423-304-6888 Telephone No.* 7. Organization Deer Creek Farm LLC Name 8. Site Contact Street Address Mailing Address* 237 Cherokee Road Address Line 2 City Charlotte Fbstal / Zip Code 28269 9. Consultant Name (Optional) Tristan McMannis, PLA First and Last narre 10. Consultant E- tmcmannis@dewberry.com mail This person will be copied on all correspondence. 11. Consultant 7042641233 Telephone No. State / Rovince / Fbgion NC Country United States D. E&SC Plan Part D. Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 11/22/2019 Approved * 2. E&SC Plan Project UNION-2020-038 Number/ID * Assigned by agency or local program 3. E&SC Plan r State DEQ Office Approved by* r Local Program 4. State DEQ Office * Mooresville (MRO) 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 EC Permit.pdf 80.03KB Approval Wst be RDFfornat letter/documentation 6. NOI Certification NCG01-eNO1-Certification-Form-20190919-DEMLR- Form 920.65KB SW signed.pdf Wst be RDFfornat This is an Express f No Review Project* r Yes E. Certification North Carolina General Statute 143-215.6E (i) 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 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 * Elizabeth Tarumianz Title Organizer / Manager Organization Deer Creek LLC Date * 11 /26/2019 F. Tracking and COC Info NOI Tracking No. 18933 NC Reference No. NCG01-2019-2983 Uses 'count number' variable (incremrented by SP) Certificate of NCC192983 Coverage (COC) Uses 'count number' variable (incremented by SP) No.* Count Number 2983 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.)