NCC205583_NOI Application_20201204

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 12/3/2020 11:19:07 AM (NCG01 NOI Submission)
Approve by Meloy, Michael 12/3/2020 1:59:09 PM (Review- Construction NOI 38025)
• The task was assigned to Meloy, Michael by round robin distribution 12/3/2020 11:19 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 7, 2020 5:00
PM 12/3/2020 11:19 AM
Submit by Selkane, Aziza 12/4/2020 9:32:23 AM (Payment Verification for NCC205583)
* North View Partners LLC
• Selkane, Aziza assigned the task to Selkane, Aziza 12/4/2020 9:31 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 14, 2021 5:00 PM
12/3/2020 1:59 PM

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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 * Meridian at Rogers Branch
1 b. Specific Lot This field rray be used to list specifc lot nunbers.
Numbers
2. County* Wake
3. Highway or Street 3700 Rogers Branch Road
Address* Street narre only is acceptable if no address number assigned yet
4. City or Township* Wake Forest
5. State * NC
6. Zip Code * 27587
7. Latitude* Enter the latitude in decinal degrees
35.9432
8. Longitude* Enter the longitude in decir al degrees (M.JST be negative)
-78.5030
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*
12/07/2020
Estimated Construction Project Start Date
10. Date to End *
12/07/2022
Estinated Construction Project End Date
11. SIC (Primary)*
Residential, Other than SFE (1522)
Standard Industrial aassification for Developrrent
12. Acres to be
11.70
disturbed*
(including off -site borrow and waste areas)
13. Total site area 11.39
(acres) *

14. Post- 6.95
construction (Estirrated)
impervious area
(acres) *
NCC Project NCC-WAKE-2020-Meridian at Rogers Branch
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 Sanford Creek
Waterbody* INbrre of waterbody into which stormwater runoff will discharge
15b. Waterbody 27-23-5
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 Responsible Entity
Name * Meridian at Rogers Branch, LLC
IF 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 Registered Agent First Wre
3. Last Name* Barker
IF Corporation, enter F;bgistered Agent Last %rre
3b. Title Manager
4. Permitee E-mail [e-mail]
Address*
5. Permittee [phone]
Telephone No.*
6. Permittee Mailing Street Address
Address* 6131 Falls of Neuse Road, Suite 202
Address Line 2
6310-250 Chapel Hill Road
City
Raleigh
Fbstal / Zip Code
27609
Check box if the V Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 6131 Falls of Neuse Road, Suite 202
Address Line 2
State / Frovince / i egion
NC
Country
United States
city State / Ftovince / Region
Raleigh NC
Fbstal / Zip Code Country
27609 Wake
8. Type of Non -Government
Ownership*

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
...........................................................................................................................................................................................................................................................................
1. Primary Site
Bryan
Contact - First
Name *
2. Primary Site
Ward
Contact - Last
Name *
3. Title
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
[phone]
Telephone No.*
6. Organization
Northview Partners
Name
7. Site Contact
Street Address
Mailing Address*
6131 Falls of Neuse Road, Suite 202
Address Line 2
City
State / Rovince / Region
Raleigh
NC
Postal / Zip Code
Country
27609
United States
8. Consultant Name (Optional)
Bass, Nixon and Kennedy, Inc. - David L. Dunn, PE
First and Last nacre
9. Consultant E-mail [e-mail]
This person will be copied on all correspondence.
10. Consultant [phone]
Telephone No.

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 11/30/2020
Approved *
2. E&SC Plan Project 2019-00002378
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Town of Wake Forest
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 Meridian at Rogers Branch - ESC Plan Approval
Approval letter or 85.73KB
Letter.pdf
Grading Permit
Mast be FL7Fforrrat
6. Site Location Map Wst be RDFforrret (lint 201VB)
Meridian at Rogers Branch - Site Location Map.pdf 917.33KB
Rease do not upload entire set of E&SC plans.
7. Notes (Optional) Provide 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 Meridian at Rogers Branch - NOI Cetification Form
Form 123.2KB
(Signed).pdf
Mast be PDFfon-rat
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* Mark R. Barker
Title Manager
Organization Legally Ibsponsible Entity
Meridian at Rogers Branch, LLC
Date * 12/03/2020

F. Tracking and COC Info
NOI Tracking No. 38025
NC Reference No.
NCG01-2020-5583
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC205583
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5583
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. NCC205583-2020
Invoice Due Date 1/2/2021
Initial Fee $ 100.00
Invoice Status OPEN