NCC190747_Modification Review_20200217

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 2/11/2020 2:01:49 PM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 2/17/2020 12:07:52 PM (Construction COC ADD TO FILE Review- NCC190747)
• The task was assigned to Georgoulias, Bethany. The due date is: February 14, 2020 5:00 PM
2/11/2020 2:01 PM

Y. ,
NORTH CAPCLINA
Emlremmentel Quality
Certificate of NCC190747
Coverage (COC) Enter the Certificate of Coverage N nber (Use capital letters)
No.*
Information associated with this permit
Project Name
Briar Chapel Lots 97, 317-319
Address
15/501 & Briar Chapel Parkway, Chapel Hill, NC
County
Chatham
Latitude
35.8198
Longitude
-79.0856
Permittee Listed
Homes by Dickerson
Legally Responsible
Jonathan Showalter
Individual
NC Reference No.
NCG01-2019-0747
E&SC Plan ID
2019-05311
Original NOI
12842
Tracking No.*
Date COC Issued*
06/26/2019
Prior Rescission
This field will populate only ff ODChas already been rescinded.
Date
Modification Information:
Reason for r Closed -Out Lots/Outparcels in E&SC Plan
Modification* F Additional Lots/Outparcels Approved - E&SC Revised
r Other Revision(s) to E&SC Plan
r Multiple Reasons (List)
Addional ivbre irifornation if necessary
Explanation Adding US Steel lots 68-73, 83, 84, 86, 107,109,121
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets).

Supporting Upload Supporting Documentation (%vised ESCApproval, (lose -Out Doc, etc.)
Documentation Letter of Approval.pdf 289.68KB
Mast be FDFfon-rat
North Carolina General Statute 143-215.66 (1) provides that:
Anyperson who knowinglymakes anyfalse 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 underthis Article; orwho falsifies, tampers with, or knowinglyrenders
inaccurate any recording or monitoring device 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 notto exceed ten thousand
dollars ($10,000).
17 I, as an authorized representative, hereby request modification to coverage
under the NPDES Stormwater Permit for the subject project site. I am familiar
with the information contained in this request and to the best of my knowledge
and belief such information is true, complete and accurate.
*This form must be signed by a responsible corporate officer that 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* Jonathan M Showalter
Title * VP/ COO
Organization* Homes by Dickerson
Date * 02/11 /2020
Email Address* [e-mail]
Email for Confirmation
Telephone Number* 9198474447
Contact Nurrber if we need to reach you
Date Formatted 20200211