NCC200546_Modification Review (LEG RESP CHANGE)_20200518

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 5/15/2020 11:23:59 AM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany 5/18/2020 7:46:30 AM (Construction COC ADD TO FILE Review- NCC200546)
• The task was assigned to Georgoulias, Bethany. The due date is: May 20, 2020 5:00 PM
5/15/2020 11:24 AM

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NORTH CAPOLINA
EnYlrenmemf& Qnalay
Certificate of NCC200546
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
Information associated with this permit
Project Name
Preston Park
Address
460 Marie Way, Pineville, NC
County
Mecklenburg
Latitude
35.0934
Longitude
-80.8933
Permittee Listed
Meritage Homes of the Carolinas, LLC
Legally Responsible
Brett Manery
Individual
NC Reference No.
NCG01-2020-0546
E&SC Plan ID
392334
Original NOI
21754
Tracking No.*
Date COC Issued*
02/17/2020
Prior Rescission
This field will populate only if CCChas already been rescinded.
Date
Modification Information:
Reason for r Closed -Out Lots/Outparcels in E&SC Plan
Modification * a Additional Lots/Outparcels Approved - E&SC Revised
r Other Revision(s) to E&SC Plan
F Legally Responsible Individual Has Changed
f Multiple Reasons (List)
Addional IVbre information if necessary
Explanation
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). For changes to the legally responsible individual, you must upload this form.

Supporting Upload Supporting Documentation (%vised ESCApproval, (lose -Cut Doc, etc.)
Documentation SKM C55820051509210.pdf 99.53KB
Mast be FDFfon-rat
North Carolina General Statute 143-215.66 (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 Artide; or who knowingly makes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring device or method required to be operated or maintained under this Artide or rules of the
Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to e)ceed ten thousand
dollars ($10,000).
rJ I 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.
Specify if you are:* r The Legally Responsible Individual
f Authorized Responsible Person*
*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* Tad Lugibihl
Title * Vice President of Finance
Organization * Meritage Homes of the Carolinas, Inc.
Date * 05/15/2020
Email Address* [e-mail]
Errail for confirrration
Telephone Number* 704-944-8905
Contact nun ber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email Additional email for confirmation
(Optional)
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 05/18/2020
Request Date 20200515
Formatted

Review Date 20200518
Formatted