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HomeMy WebLinkAboutNCC205767_NOI Application_20201230Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 12/10/2020 10:49:30 PM (NCG01 NOI Submission) Approve by Clark, Paul 12/11/2020 2:39:37 PM (Review- Construction NOI 38903) • Garcia, Lauren V reassigned the task to Clark, Paul 12/11/2020 8:40 AM • The task was assigned to Garcia, Lauren V by round robin distribution 12/10/2020 10:49 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 14, 2020 5:00 PM 12/10/2020 10:49 PM Submit by McCoy, Suzanne 12/30/2020 2:25:26 PM (Payment Verification for NCC205767) * NW Lake Wylie LLC • McCoy, Suzanne assigned the task to McCoy, Suzanne 12/30/2020 2:24 PM The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 22, 2021 5:00 PM 12/11/2020 2:39 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 38811 NOI No. Prior Reviewer Paul Clark Name 1a. Project Name * South Shore 2A 1 b. Specific Lot This field may be used to list specffc lot numbers. Numbers 1 c. Parcel ID List all PIS associated w ith this project. Number(s) (PIN) 2. County* Gaston 3. Highway or Street 6901 S. New Hope Road Address* Street name only is acceptable if no address number assigned yet 4. CityorTownship* Belmont 5. State * NC 6. Zip Code* 28012 7. Latitude* Enter the latitude in decimal degrees 35.1563 8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative) -81.0507 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* 12/14/2020 Estimated Construction Project Start Date 10. Date to End* 07/31/2021 Estimated Construction Project End Date 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial aassification for Development 12. Acres to be 64.00 disturbed* (including off -site borrow and waste areas) 13. Total site area 69.59 (acres) * 14. Post- 25.69 construction (Estirrated) impervious area (acres) * NCC Project NCC-GASTO-2020-South Shore 2A 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 Catawba River Waterbody* %rreof waterbody into which storrrwater runoff will discharge 15b. Waterbody 11-(123.5)a Index No. * NCWaterbody Index Nurrber Stormwater V 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 * NW Lake Wylie 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 * Steven If Corporation, enter Faegistered Agent First %rre 3. Last Name* Hinshaw It Corporation, enter Pbegistered Agent Last %rre 3b. Title Member 4. Permitee E-mail steven@hinshawproperties.com Address* 5. Permittee 704-650-6176 Telephone No.* 6. Permittee Mailing Street Address Address* 419 South Sharon Amity Road Address Line 2 City Charlotte Fbstal / Zip Code 28211 Check box if the street address the same as mailing address 7. Permittee Street Address* F Yes Street Address 419 South Sharon Amity Road Address Line 2 City Charlotte Fbstal / Zip Code 28211 State / Frovince / Pegion NC Country us State / Frovince / Faegion NC Country us 8. Type of Ownership is only individual if an individual is naned in B.1. above. Ownership* Non -Government C. Site Contact Information Part C. Roject Site Contact Inforrration _................................................................................................................................................. 1. Primary Site Shay Contact - First Name * 2. Primary Site Baird Contact - Last Name * 3. Title 4. Site Contact E- sbaird@shaybaird.com mail Address* 5. Site Contact 704-361-0069 Telephone No. 6. Organization Name 7. Site Contact Street Address Mailing Address* 419 South Sharon Amity Road Address Line 2 City State / Rovince / Region Charlotte NC Postal / Zip Code Country 28211 us 8. Consultant Name (Optional) Justin McDonald (Merrick & Company) First and Last nacre 9. Consultant E-mail justin.mcdonald@merrick.com This person will be copied on all correspondence. 10. Consultant 704-612-0702 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) Default is legally responsible person e-n-ail (older NOIs may not populate) 12. Billing (For Annual Fee correspondence) Telephone Default is legally responsible person telephone (older NOls rray not populate) D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 08/28/2020 Approved * 2. E&SC Plan Project 3659 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Gaston 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 South Shore 2A EC Letter of Approval.pdf 359.45KB Approval letter or Mast beRDFformat Grading Permit 6. Site Location Map Mist be RDFforrrat (lint 201VB) C100-Cover Sheet. pdf 2.43MB Rease do not upload entire set of E&SC plans. 7. Notes (Optional) Rovide any additional information that night help the reviewer better understand how uploaded documents support the application. Include additional waterbodies if necessary. 8. NOI Certification NCG01-eNO1-Certification-Form-20190919-DEMLR- Form 284.43KB SW_SIGNED.pdf Mast be FDFformat 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 Amide 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 Legally Responsible Person named on this Notice of Intent r Authorized Responsible Person' (signing on behalf of Legally Responsible Person named in Part B) 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* Steven Hinshaw Title Member Organization Legally Pesponsible Entity NW Lake Wylie, LLC Date * 12/10/2020 F. Tracking and COC Info NOI Tracking No. 38903 NC Reference No. NCG01-2020-5767 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC205767 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 5767 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. NCC205767-2020 Invoice Due Date 1/10/2021 Initial Fee $ 100.00 Invoice Status OPEN