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HomeMy WebLinkAboutNCC204082_NOI Application_20200922Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 9/16/2020 10:19:44 AM (NCG01 NOI Submission) Approve by Garcia, Lauren V 9/17/2020 2:19:04 PM (Review- Construction NOI 31498) • The task was assigned to Garcia, Lauren V by round robin distribution 9/16/2020 10:19 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 18, 2020 5:00 PM 9/16/2020 10:19 AM Submit by Selkane, Aziza 9/22/2020 8:38:49 AM (Payment Verification for NCC204082) * Rene Mondejar 111 • Selkane, Aziza assigned the task to Selkane, Aziza 9/22/2020 8:37 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 29, 2020 5:00 PM 9/17/2020 2:19 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 * Folkstone Heights 1 b. Specific Lot This field nay be used to list specifc lot nunbers. Numbers 2. County* Onslow 3. Highway or Street Folkstone Road Address* Street narre only is acceptable if no address number assigned yet 4. City or Township* Stump Sound Township 5. State * NC 6. Zip Code * 28445 7. Latitude* Enter the latitude in decinal degrees 34.5140 8. Longitude* Enter the longitude in decir al degrees (MUST be negative) -77.4880 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* 10/01/2020 Estinated Construction Project Start Date 10. Date to End* 12/31/2021 Estirrated Construction Project End fate 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial Classification for Development 12. Acres to be 25.34 disturbed* (including off -site borrow and waste areas) 13. Total site area 25.74 (acres) * 14. Post- 9.25 construction (Estirrated) impervious area (acres) * NCC Project NCC-ONSLO-2020-Folkstone Heights 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 Turkey Creek Waterbody* INbrre of waterbody into which storrrwater runoff will discharge 15b. Waterbody 18-87-1 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. ^ 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 * Folkstone Heights, 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 * Steve If Corporation, enter Faegistered Agent First %rre 3. Last Name* Shuttleworth It Corporation, enter F;bgistered Agent Last %rre 3b. Title Manager 4. Permitee E-mail steve@steveshuttleworth.com Address* 5. Permittee 719-499-1373 Telephone No.* 6. Permittee Mailing Street Address Address* 711 Carolina Beach Avenue North Address Line 2 City State / Frovince / Fbgion Carolina Beach NC Fbstal / Zip Code Country 28428 us Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* 711 Carolina Beach Avenue North Address Line 2 City State / Frovince / Region Carolina Beach NC Fbstal / Zip Code Country 28428 us 8. Type of Non -Government Ownership C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Steve Contact - First Name * 2. Primary Site Shuttleworth Contact - Last Name * 3. Title Owner/Developer 4. Site Contact E- steve@steveshuttlevtorth.com mail Address* 5. Site Contact 719-499-1373 Telephone No. 6. Organization Folkstone Heights, LLC Name 7. Site Contact Street Address Mailing Address* 711 Carolina Beach Avenue North Address Line 2 city Carolina Beach Fbstal / Zip Code 28428 8. Consultant Name (Optional) Howard Resnik, PE First and Last nacre 9. Consultant E-mail mike@csd-engineering.com This person will be copied on all correspondence. 10. Consultant 910-791-4441 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 09/08/2020 Approved * 2. E&SC Plan Project ONSLO-2021-013 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 * Wilmington (WiRO) 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 NCDEQ_EC_Permit_ONSLO-2021-013 Approval 9- Approval letter or 295.12KB 8-2020.pdf Grading Permit Mist be FDFfon-rat 6. Site Location Map Helpful for linear project review (Optional) Mast be RDFform3t. 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 NCG01-eNO1-Certification-Form_signed.pdf 2.27MB Form Mist be RDF format 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 a�il7`�c�eq�t.CfF Type Name * Steve Shuttleworth Title Manager Organization Legally Responsible Entity Folkstone Heights, LLC Date * 09/16/2020 F. Tracking and COC Info NOI Tracking No. 31498 NC Reference No. NCG01-2020-4082 Uses 'count_nunber' variable (increrrented by SP) Certificate of NCC204082 Coverage (COC) Uses 'count nurrber' variable (increrrented by SP) No.* Count Number 4082 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. NCC204082-2020 Invoice Due Date 10/17/2020 Initial Fee $ 100.00 Invoice Status OPEN