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HomeMy WebLinkAboutNCC203888_NOI Application_20200908Action History (UTC-05:00) Eastern Time (US & Canada) Submit by Anonymous User 9/2/2020 5:22:44 PM (NCG01 NOI Submission) Approve by Clark, Paul 9/3/2020 1:36:51 PM (Review- Construction NOI 30874) • The task was assigned to Clark, Paul by round robin distribution 9/2/2020 5:22 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 4, 2020 5:00 PM 9/2/2020 5:22 PM Submit by Selkane, Aziza 9/8/2020 10:52:52 AM (Payment Verification for NCC203888) * FDA LLC • Selkane, Aziza assigned the task to Selkane, Aziza 9/8/2020 10:52 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 15, 2020 5:00 PM 9/3/2020 1:37 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting f• No an NOI that was r Yes rejected before? 1a. Project Name * SPC Mechanical - Zebulon 1 b. Specific Lot This field nay be used to list specifc lot nunbers. Numbers 2. County* Wake 3. Highway or Street 700 E Gannon Avenue Address* Street narre only is acceptable if no address number assigned yet 4.CityorTownship* Zebulon 5. State * NC 6. Zip Code * 27597 7. Latitude* Enter the latitude in decinal degrees 35.8280 8. Longitude* Enter the longitude in decir al degrees (NALIST be negative) -78.2990 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* 09/07/2020 Estinated Construction Project Start Date 10. Date to End * 09/07/2021 Estinated Construction Project End Date 11. SIC (Primary)* Commercial (1542) Standard Industrial Classification for Leveloprrent 12. Acres to be 4.00 disturbed* (including off -site borrow and waste areas) 13. Total site area 4.86 (acres) * 14. Post- 1.80 construction (Estirrated) impervious area (acres) * NCC Project NCC-WAKE-2020-SPC Mechanical - Zebulon Tracking ID Assigned autorraticaly 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 Little Creek Waterbody* %rre of waterbody into which storrrwater runoff will discharge 15b. Waterbody 27-86-2-4 Index No.* NCWaterbody Index Number Stormwater V No discharges will flow r Yes to additional wate rs * 16a. Is this project F Yes subject to the NC r No, not subject to NC SPCA Sediment Pollution Control Act?* B. Permittee Information Part B. ^ Fbrnittee 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 * FDA, LLC It pernittee is an individual (i.e., organization does not apply), enter first and last narre in this field. Note: The organization name must match the business entity name registered with the NC Secretary of State. You can verify the registration here. 2. First Name * Chris If Corporation, enter Faegistered Agent First %rre 3. Last Name* Williford It Corporation, enter F;bgistered Agent Last %rre 3b. Title Managing Member 4. Permitee E-mail chris.williford@spcmechanical.com Address* 5. Permittee 252-205-4099 Telephone No.* 6. Permittee Mailing Street Address Address* SPC Mechanical Headquarters / FDA, LLC Address Line 2 P.O. Box 3006 City State / Frovince / Fbgion Wilson North Carolina Fbstal / Zip Code Country 27895 USA Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* SPC Mechanical Headquarters / FDA, LLC Address Line 2 P.O. Box 3006 City State / Frovince / Region Wilson North Carolina Fbstal / Zip Code Country 27895 USA 8. Type of Non -Government Ownership* C. Site Contact Information Part C. ^ Roject Site Contact Inforrration ....................................................................................................................................................................................................................................................................................................................................................................................... 1. Primary Site Chris Contact - First Name * 2. Primary Site Williford Contact - Last Name * 3. Title Managing Member 4. Site Contact E- chris.williford@spcmechanical.com mail Address* 5. Site Contact 252-205-4099 Telephone No.* 6. Organization FDA, LLC Name 7. Site Contact Street Address Mailing Address* SPC Mechanical Headquarters / FDA, LLC Address Line 2 P.O. Box 3006 City State / Rovince / Region Wilson North Carolina Fbstal / Zip Code Country 27895 USA 8. Consultant Name (Optional) First and Last narre 9. Consultant E-mail This person will be copied on all correspondence. 10. Consultant Telephone No. D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 09/02/2020 Approved * 2. E&SC Plan Project SEC-031012-2020 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Wake County 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 SPC Mechanical - Zebulon Approval letter or Site_Revision_MUNICIPALWatershedManagementA...334.96KB Grading Permit 2-2020.pdf Mast be RFfornat 6. Site Location Map Helpful for linear project review (Optional) Wst be FDFfornat. Rease do not upload entire set of E&SCplans. 7. Notes (Optional) Ffovide any additional information that night help the reviewer better understand how uploaded documents support the application. Include additional w aterbodies for linear projects if necessary. 8. NOI Certification Signed NOI Form.pdf 80.18KB Form Mast be R7Fforrrat This is an Express F No Review Project* r Yes E. Certification North Carolina General Statute 143-215.66 (1) 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 If the Erosion and Sediment Control Plan approved by the delegated program is not compliant with Part II (Stormwater Pollution Prevention Plan) of the NCG010000 General Permit. I will nonetheless ensure that all conditions of Part II of the permit are met on the project at all times. * 17 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* Chris Williford Title Managing Member Organization Legally Ibsponsible Entity FDA, LLC Date * 09/02/2020 F. Tracking and COC Info NOI Tracking No. 30874 NC Reference No. NCG01-2020-3888 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC203888 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 3888 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. NCC203888-2020 Invoice Due Date 10/3/2020 Initial Fee $ 100.00 Invoice Status OPEN