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HomeMy WebLinkAboutNCC201628_NOI Application_20200604Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 4/20/2020 12:53:39 PM (NCG01 NOI Submission) Approve by Morman, Alaina 4/21/2020 8:52:14 PM (Review- Construction NOI 24584) • Morman, Alaina reassigned the task to Morman, Alaina 4/20/2020 1:10 PM • The task was assigned to Clark, Paul by round robin distribution 4/20/2020 12:54 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: April 22, 2020 5:00 PM 4/20/2020 12:54 PM Submit by McCoy, Suzanne 6/4/2020 7:43:31 AM (Payment Verification for NCC201628) * King Holdings of Fayetteville, Inc • McCoy, Suzanne assigned the task to McCoy, Suzanne 6/4/2020 7:42 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: June 2, 2020 5:00 PM 4/21/2020 8:52 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting r No an NOI that was r Yes rejected before? Previous Rejected 24420 NOI No. Prior Reviewer Alaina Morman Name 1a. Project Name * Property of King Holdings, LLC 1 b. Specific Lot This field may be used to list specffc lot numbers. Numbers 2. County* Cumberland 3. Highway or Street 2513 Downing Road Address * Street narre only is acceptable if no address number assigned yet 4. City or Township* Fayetteville 5. State * NC 6. Zip Code * 28301 7. Latitude * Enter the latitude in decirral degrees 35.0464 8. Longitude* Enter the longitude in decinal degrees (M. ST be negative) -78.8272 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* 04/20/2020 Estimated Construction Project Start Date 10. Date to End* 06/15/2020 Estimated Construction Project End Cute 11. SIC (Primary)* Commercial (1542) Standard Industrial Classification for Developrrent 12. Acres to be 1.83 disturbed* (including off -site borrow and waste areas) 13. Total site area 3.04 (acres) * 14. Post- 0.85 construction (Estirrated) impervious area (acres) * NCC Project NCC-CUMBE-2020-Property of King Holdings, LLC Tracking ID Assignedautonatically 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 Lock's Creek (near Vander) Wate rbody* %rre of waterbody into which stornwater runoff will discharge 15b. Waterbody 18-32 Index No.* NCWaterbody Index Nurrber 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 Legally Pesponsible Entity Name * King Holdings of Fayetteville, LLC It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field. 2. First Name * Richard IF Corporation, enter Faegistered Agent First %rre 3. Last Name* King It Corporation, enter F;bgistered Agent Last %ne 3b. Title Member/Manager 4. Permitee E-mail kingrichard1969@aol.com Address* 5. Permittee 910-483-4627 Telephone No.* 6. Permittee Mailing Street Address Address* 135 South Racepath Street Address Line 2 aty State / Rovince / F;bgion Fayetteville NC Fbstal / Zip Code Country 28301 us Check box if the F Yes street address the same as mailing address 7. Permittee Street Street Address Address* 135 South Racepath Street Address Line 2 city State / Frovince / Region Fayetteville NC Fbstal / Zip Code Country 28301 us 8. Type of Non -Government Ownership* C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site George Contact - First Name * 2. Primary Site Rose Contact - Last Name * 3. Title 4. Site Contact E- grose9295@gmail.com mail Address* 5. Site Contact 9109775822 Telephone No. 6. Organization George M. Rose, P.E. Name 7. Site Contact Street Address Mailing Address* 1206 Longleaf Drive Address Line 2 city Fayetteville Fbstal / Zip Code 28305 8. Consultant Name (Optional) George Rose First and Last nacre 9. Consultant E-mail grose9295@gmail.com This person will be copied on all correspondence. 10. Consultant 910-977-5822 Telephone No. State / Rovince / Region North Carolina Country United States D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 01/06/2020 Approved * 2. E&SC Plan Project CUMBE-2020-086 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 * Fayetteville (FRO) Documentation of E&SC Plan approval and the signed Notice of Intent (NOI) Certification Form is required for a complete application. For linear projects, please also upload a site map showing the overall extent of the project or include the beginning point and end point coordinates in the "Notes" box below. 5. E&SC Plan King Downing. ECapprova12020-086.pdf 80.03KB Approval letter or Mist beRDFformat Grading Permit 6. Site Location Map Helpful for linear project review (Optional) KingDowning-SP4.pdf 2.05MB Mast be RDF format. Rease do not upload entire set of E&SCplans. 7. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded docurrents support the application. Include additional waterbodies for linear projects if necessary. 8. NOI Certification King Down i ng-eNOlform. pdf 428.98KB Form Mast be RDFfornat This is an Express r 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 * Richard King Title Member/Manager Organization Legally Responsible Entity King Holdings of Fayetteville, LLC Date * 04/20/2020 F. Tracking and COC Info NOI Tracking No. 24584 NC Reference No. NCG01-2020-1628 Uses 'count number' variable (incremrented by SP) Certificate of NCC201628 Coverage (COC) Uses 'count number' variable (incremented by SP) No.* Count Number 1628 Sequential number for submittal that is incremented by Stored Frocedure COC Year 2020 Year of date reviewed (used to assign YY digits after "NOC' in COCno.)