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HomeMy WebLinkAboutNCC204042_NOI Application_20200917Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 9/14/2020 4:42:26 PM (NCG01 NOI Submission) Approve by Garcia, Lauren V 9/15/2020 8:31:02 AM (Review- Construction NOI 31426) • The task was assigned to Garcia, Lauren V by round robin distribution 9/14/2020 4:43 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 16, 2020 5:00 PM 9/14/2020 4:43 PM Submit by McCoy, Suzanne 9/17/2020 11:09:08 AM (Payment Verification for NCC204042) * Michael Cain • McCoy, Suzanne assigned the task to McCoy, Suzanne 9/17/2020 11:08 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 27, 2020 5:00 PM 9/15/2020 8:31 AM .• 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 * Nettlewood Office Bldg 1 b. Specific Lot This field nay be used to list specifc lot nunbers. Numbers 2. County* Buncombe 3. Highway or Street 20 Peachtree Road Address* Street narre only is acceptable if no address number assigned yet 4.CityorTownship* Asheville 5. State * NC 6. Zip Code * 28803 7. Latitude* Enter the latitude in decirral degrees 35.5150 8. Longitude* Enter the longitude in decir al degrees (M.JST be negative) -82.5250 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* 09/14/2020 Estimated Construction Project Start Date 10. Date to End* 12/31/2021 Estimated Construction Project End Date 11. SIC (Primary)* Commercial (1542) Standard Industrial Classification for Developrrent 12. Acres to be 2.34 disturbed* (including off -site borrow and waste areas) 13. Total site area 2.80 (acres) * 14. Post- 0.00 construction (Estirrated) impervious area (acres) * NCC Project NCC-BUNCO-2020-Nettlewood Office Bldg Tracking ID 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 Four Mile Branch Waterbody* arm of waterbody into which stornwater runoff will discharge 15b. Waterbody 6-72 Index No.* NCWaterbody Index Nunber 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. ^ 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 * Nettlewood Associates, 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 * Rick If Corporation, enter Faegistered Agent First %rre 3. Last Name* Grant It Corporation, enter Pbegistered Agent Last %rre 3b. Title President 4. Permitee E-mail rgrant@beverly-grant.com Address* 5. Permittee 828-274-7084 Telephone No.* 6. Permittee Mailing Street Address Address* 80 Peachtree Road Address Line 2 Suite 210 City State / Frovince / Fbgion Asheville NC Fbstal / Zip Code Country 28803 us Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* 80 Peachtree Road Address Line 2 Suite 210 City State / Frovince / Region Asheville NC Fbstal / Zip Code Country 28803 us 8. Type of Non -Government Ownership* C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Michael Contact - First Name * 2. Primary Site Cain Contact - Last Name * 3. Title Engineer 4. Site Contact E- mcain@cdcgo.com mail Address* 5. Site Contact 8282525388 Telephone No. 6. Organization Civil Design Concepts Name 7. Site Contact Street Address Mailing Address* 168 Patton Avenue Address Line 2 city Asheville Fbstal / Zip Code 28801 8. Consultant Name (Optional) Michael J Cain First and Last nacre 9. Consultant E-mail mcain@cdcgo.com This person will be copied on all correspondence. 10. Consultant 8282525388 Telephone No. State / Rovince / Region NC Country United States D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 08/31/2020 Approved * 2. E&SC Plan Project 20-05071 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* City of Asheville 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 Formal Grading Letter of Approval_8-31-20.pdf 198.67KB Approval letter or Mast beRDFformat Grading Permit 6. Site Location Map Helpful for linear project review (Optional) Mast be FCFfornat. 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 2020-09-14 NOI Certification Form - SIGNED.PDF 1.06MB Form Mist be RDFfornat This is an Express r 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 Atide; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Atcle; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Atide or rules of the Commission implementing this Atcle 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* Rick Grant Title President Organization Legally Ibsponsible Entity Nettlewood Associates, LLC Date * 09/14/2020 F. Tracking and COC Info NOI Tracking No. 31426 NC Reference No. NCG01-2020-4042 Uses 'count_nunber' variable (increrrented by SP) Certificate of NCC204042 Coverage (COC) Uses 'count nurrber' variable (increrrented by SP) No.* Count Number 4042 Sequential nunber for subnittal 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. NCC204042-2020 Invoice Due Date 10/15/2020 Initial Fee $ 100.00 Invoice Status OPEN