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HomeMy WebLinkAboutNCC202332_NOI Signed Certification_20200610NCG01 Notice of Intent (N01) Certification Form Print this form, complete, scan and upload to the electronic N01. Then, mail the original form to the NC DEMLR Stormwater Program at: Division of Energy, Mineral & Land Resources Stormwater Program 512 N. Salisbury Street, 6th Floor 1612 Mail Service Center Raleigh, NC 27699-1612 Per NC General Statute 143-215.6E (i), 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 ... shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). Under penalty of law, I certify that (check all boxes to indicate your agreement): p 1 am the person responsible forthe 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. O 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. © I will abide by all conditions of the NCG010000 General hermit and the approved Erosion and Sediment Control Plan. ® if the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution Prevention Plan) of the NCG010000 General Permit, I will nonetheless ensure that all conditions of Part it of the permit are met on the project at all times. ® I hereby request coverage under the MCC010000 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. Name of Project: Stones Landing. Section IiI and Paradise Point, Section IV C? Onslow Bay Legally Responsible Organizational Entity: Clearly Development, Inc. * Legally Responsible Person: Anthony W. Sydes Title of Lega ?Vrponsible, Person: President WJ Signatu e: /Z -K Date: r * IMPORTANT NOTE: 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 (5) of the NCG010000 permit. For more information on signatory requirements, see Part IV, Section B, Item (6) of the NCGGO10000 permit.