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HomeMy WebLinkAboutNCC203066_NOI Application_20200721Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 7/17/2020 11:57:36 AM (NCG01 NOI Submission) Approve by Clark, Paul 7/17/2020 12:59:50 PM (Review- Construction NOI 28443) • The task was assigned to Clark, Paul by round robin distribution 7/17/2020 11:58 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: July 21, 2020 5:00 PM 7/17/2020 11:58 AM Submit by Selkane, Aziza 7/21/2020 8:45:00 AM (Payment Verification for NCC203066) * Graham Coggins • Selkane, Aziza assigned the task to Selkane, Aziza 7/21/2020 8:44 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: August 28, 2020 5:00 PM 7/17/2020 1:00 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting IT No an NOI that was r Yes rejected before? 1a. Project Name * Mallard Creek WRF - Reliability & UV Improvements 1 b. Specific Lot This field any be used to list specifc lot numbers. Numbers 05108124, 05130176 2. County* Mecklenburg 3. Highway or Street US Highway 29 Address* Street narre only is acceptable if no address number assigned yet 4.CityorTownship* Charlotte 5. State * NC 6. Zip Code * 28262 7. Latitude* Enter the latitude in decimal degrees 35.3358 8. Longitude* Enter the longitude in decimal degrees (M.JST be negative) -80.6976 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* 05/04/2020 Estimated Construction Project Start Date 10. Date to End * 08/05/2022 Estinated Construction Project End Date 11. SIC (Primary)* Industrial (1541) Standard Industrial Classification for Leveloprrent 12. Acres to be 4.54 disturbed* (including off -site borrow and waste areas) 13. Total site area 136.50 (acres) * 14. Post- 6.63 construction (Estirrated) impervious area (acres) * NCC Project NCC-MECKL-2020-Mallard Creek WRF - Reliability & W Tracking ID Improvements Assigned autorratically 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 Mallard Creek Wate rbody* %rre of waterbody into which storrrwater runoff will discharge 15b. Waterbody 13-17-5 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. ^ Fl rnittee 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 * Charlotte Water It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field. 2. First Name * Joseph C. IF Corporation, enter Faegistered Agent First %rre 3. Last Name* Wilson It Corporation, enter F;bgistered Agent Last %ne 3b. Title Chief Engineer 4. Permitee E-mail cWlson@ci.charlotte.nc.us Address* 5. Permittee 704-336-1083 Telephone No.* 6. Permittee Mailing Street Address Address* 5100 Brookshire Boulevard Address Line 2 City State / Rovince / F;bgion Charlotte NC Fbstal / Zip Code Country 28216-3371 us Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* 5100 Brookshire Boulevard Address Line 2 City State / Frovince / Region Charlotte NC Fbstal / Zip Code Country 28216-3371 us 8. Type of Government - Municipal Ownership* C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Jeff Contact - First Name * 2. Primary Site Davis Contact - Last Name * 3. Title Project Manager 4. Site Contact E- jeff.davis@ci.charlotte.nc.us mail Address* 5. Site Contact 704-942-6943 Telephone No. 6. Organization Charlotte Water Name 7. Site Contact Street Address Mailing Address* 5100 Brookshire Boulevard Address Line 2 City Charlotte Fbstal / Zip Code 28216-3371 8. Consultant Name (Optional) Alan Petty First and Last narre 9. Consultant E-mail PettyAC@bv.com This person will be copied on all correspondence. 10. Consultant +17045108426 Telephone No. State / Rovince / Region NC Country us D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 10/14/2019 Approved * 2. E&SC Plan Project MECKL-2019-073 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. 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 ESC Approval Letter 101419.pdf 243.91 KB Approval letter or Mast beRDFformat Grading Permit 6. Site Location Map Helpful for linear project review (Optional) dwgs_finaldesign_MallardWRFRWI_20190912_SI... 2.32MB LOCATION MAP.pdf Mast be R7F format. Rease do not upload entire set of E&SC plans. 7. Notes (Optional) Frovide any additional information that might help the reviewer better understand how uploaded documents support the application. Include additional w aterbodies for linear projects if necessary. 8. NOI Certification NOI Certification Form_JCWilson.pdf 4.57MB Form Mast be FDFformat 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 ,TOSep� C. ),ISOl4 Type Name * Joseph C. Wilson Title Chief Engineer Organization Legally Responsible Entity City of Charlotte Date * 07/17/2020 F. Tracking and COC Info NOI Tracking No. 28443 NC Reference No. NCG01-2020-3066 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC203066 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 3066 Sequential nurrber for subrrittal that is incremented by Stored Frocedure COC Year 2020 Year of date reviewed (used to assign YY digits after "NOC' in COCno.) Initial Invoice No. NCC203066-2020 Invoice Due Date 8/16/2020 Initial Fee $ 100.00 Invoice Status OPEN