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HomeMy WebLinkAboutNCC205250_NOI Application_20201120Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 11/16/2020 8:39:40 AM (NCG01 NOI Submission) Approve by Morman, Alaina 11/16/2020 1:30:45 PM (Review- Construction NOI 36040) • Morman, Alaina reassigned the task to Morman, Alaina 11/16/2020 8:43 AM • The task was assigned to Gamble, Aana C by round robin distribution 11/16/2020 8:40 AM • The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: November 18, 2020 5:00 PM. The priority is: High 11/16/2020 8:40 AM Submit by Selkane, Aziza 11/20/2020 7:17:42 AM (Payment Verification for NCC205250) * Shannon Alcock • Selkane, Aziza assigned the task to Selkane, Aziza 11/20/2020 7:16 AM • The task was assigned to DEMLR NCG01 Payment Team. The due date is: December 28, 2020 5:00 PM. The priority is: High 11/16/2020 1:32 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting r No an NOI that was r Yes rejected before? Previous Rejected 35667 NOI No. Prior Reviewer Alaina Morman Name 1a. Project Name * Horace Baker Road Subdivision 1 b. Specific Lot This field may be used to list specffc lot numbers. Numbers 2. County* Franklin 3. Highway or Street Horace Baker Road Address * Street narre only is acceptable if no address number assigned yet 4. City or Township* Youngsville 5. State * NC 6. Zip Code * 27597 7. Latitude * Enter the latitude in decimal degrees 35.9217 8. Longitude* Enter the longitude in decimal degrees (M. ST be negative) -78.3404 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* 11/10/2020 Estimated Construction Project Start Date 10. Date to End* 01/12/2021 Estimated Construction Project End Date 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial aassification for Developrrent 12. Acres to be 2.00 disturbed* (including off -site borrow and waste areas) 13. Total site area 14.40 (acres) * 14. Post- 0.50 construction (Estimated) impervious area (acres) * NCC Project NCC-FRANK-2020-Horace Baker Road Subdivision Tracking ID Assigned automatically 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 Moccasin Creek Wate rbody* %rre of waterbody into which stormwater runoff will discharge 15b. Waterbody 27-86-2 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. ^ 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 * Shannon Homes Design Build, 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 * Mark IF Corporation, enter Faegistered Agent First Wre 3. Last Name* Dowdy It Corporation, enter F;bgistered Agent Last %rre 3b. Title Member 4. Permitee E-mail mark@shannonhomesdesignbuild.com Address* 5. Permittee 919-669-5929 Telephone No.* 6. Permittee Mailing Street Address Address* 4912 Hermitage Drive Address Line 2 City State / Frovince / Fbgion Raleigh NC Fbstal / Zip Code Country 27612-2712 us Check box if the F Yes street address the same as mailing address 7. Permittee Street Street Address Address* 4912 Hermitage Drive Address Line 2 City State / Frovince / Region Raleigh NC Fbstal / Zip Code Country 27612-2712 us 8. Type of Non -Government Ownership C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Mark Contact - First Name * 2. Primary Site Dowdy Contact - Last Name * 3. Title 4. Site Contact E- mark@shannonhomesdesignbuild.com mail Address* 5. Site Contact 919-669-5929 Telephone No. 6. Organization Shannon Homes Design Build, LLC Name 7. Site Contact Street Address Mailing Address* 4912 Hermitage Drive Address Line 2 city Raleigh Fbstal / Zip Code 27612-2712 8. Consultant Name (Optional) First and Last nacre 9. Consultant E-mail cmassey@flmengineering.com This person will be copied on all correspondence. 10. Consultant 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 09/10/2020 Approved * 2. E&SC Plan Project FRANK-2021-006 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 * Raleigh (RRO) 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 FRANK-2021-006_20200910_LOA.pdf 380.53KB Approval letter or Mist beRDFformat Grading Permit 6. Site Location Map Mist be RDFforrret (lint 201VB) Horace Baker —Wetland Sketch Map.pdf 409.92KB Rease do not upload entire set of E&SC plans. 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 Horace Baker _Signed NCG01.pdf 598.42KB Form Wst be RDF format 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 c are oww* Type Name * Mark Dowdy Title Manager Organization Legally Responsible Entity Shannon Homes Design Build, LLC Date * 11/16/2020 F. Tracking and COC Info NOI Tracking No. 36040 NC Reference No. NCG01-2020-5250 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC205250 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 5250 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. NCC205250-2020 Invoice Due Date 12/16/2020 Initial Fee $ 100.00 Invoice Status OPEN