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HomeMy WebLinkAboutNCC205807_NOI Application_20201230Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 12/11/2020 10:46:39 AM (NCG01 NOI Submission) Approve by Garcia, Lauren V 12/15/2020 4:01:53 PM (Review- Construction NOI 38924) • Clark, Paul reassigned the task to Garcia, Lauren V 12/11/2020 2:40 PM * thx • The task was assigned to Clark, Paul by round robin distribution 12/11/2020 10:46 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: December 15, 2020 5:00 PM 12/11/2020 10:46 AM Subnut by McCoy, Suzanne 12/30/2020 2:52:14 PM (Payment Verification for NCC205807) * City of Sanford • McCoy, Suzanne assigned the task to McCoy, Suzanne 12/30/2020 2:51 PM • The task was assigned to DEMLR NCG01 Payment Team. The due date is: January 26, 2021 5:00 PM 12/15/2020 4:02 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 38666 NOI No. Prior Reviewer Lauren Garcia Name 1a. Project Name * Big Buffalo WRF Influent Pump Station Flood Prevention 1 b. Specific Lot This field may be used to list speck lot numbers. Numbers 1 c. Parcel ID List all PIS associated w ith this project. Number(s) (PIN) 2. County* Lee 3. Highway or Street 5327 Iron Furnace Rd Address* Street name only is acceptable if no address number assigned yet 4. CityorTownship* Sanford 5. State * NC 6. Zip Code* 27330 7. Latitude* Enter the latitude in decimal degrees 35.5458 8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative) -79.2175 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* 01/04/2021 Estimated Construction Project Start Date 10. Date to End* 11/30/2021 Estimated Construction Project End Date 11. SIC (Primary)* Commercial (1542) Standard Industrial Classification for Development 12. Acres to be 1.10 disturbed* (including off -site borrow and waste areas) 13. Total site area 5.57 (acres) * 14. Post- 1.24 construction (Estimated) impervious area (acres) * NCC Project NCC-LEE-2021-Big Buffalo WRF Influent Pump Station Flood Tracking ID Prevention 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 Big Buffalo Creek Waterbody* Narreof waterbody into which stormwater runoff will discharge 15b. Waterbody 17-40 Index No. * NCWaterbody Index Nurrber Stormwater F No discharges will flow 17 Yes to additional wate rs * 15c. Additional Deep River Receiving Waterbody narre Waterbody 15d. Waterbody 17-(38.7) Index No. NCWaterbody Index Number 15e. Additional Waterbody name Receiving Waterbody 15f. Waterbody NCWaterbody Index Nurrber Index No. 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. ^ Fternittee 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 * City of Sanford, NC 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 * Hal If Corporation, enter Faegistered Agent First %rre 3. Last Name* Hegwer It Corporation, enter Pbegistered Agent Last %rre 3b. Title City Manager 4. Permitee E-mail hal.hegwer@sanfordnc.net Address* 5. Permittee 919-777-1112 Telephone No.* 6. Permittee Mailing Street Address Address* P.O. Box3729 Address Line 2 City Sanford Fbstal / Zip Code 27331 Check box if the street address the same as mailing address 7. Permittee Street Address* F Yes Street Address 225 East Weatherspoon Street Address Line 2 city Sanford Fbstal / Zip Code 27330-3643 State / Ffovince / Fbgion NC Country us State / Frovince / Region NC Country us 8. Type of Ojvnership is only individual if an individual is naned in B.1. above. Ownership* Government- Municipal C. Site Contact Information Part C. Roject Site Contact Inforrration ........................................................................................................................................................................................................................................................................... 1. Primary Site Scott Contact - First Name * 2. Primary Site Siletzky Contact - Last Name * 3. Title WRF Administrator 4. Site Contact E- scott.siletzky@sanfordnc.net mail Address* 5. Site Contact 919-777-1781 Telephone No.* 6. Organization City of Sanford Name 7. Site Contact Street Address Mailing Address* 5327 Iron Furnace Rd Address Line 2 city State / Province / Region Sanford NC Postal / Zip Code Country 27330 us 8. Consultant Name (Optional) Laura Saleeby (Hazen and Sawyer) First and Last nacre 9. Consultant E-mail Isaleeby@hazenandsawyer.com This person will be copied on all correspondence. 10. Consultant 919-863-9261 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) Default is legally responsible person e-n-ail (older NCts rray not populate) 12. Billing (For Annual Fee correspondence) Telephone Default is legally responsible person telephone (older NCIs rray not populate) D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 11/13/2020 Approved * 2. E&SC Plan Project LEE-2021-008 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 LEE-2021-008_20201113_LOAwM.pdf 212.19KB Approval letter or Mast beRDFformat Grading Permit 6. Site Location Map Mist be RDFforrret (lint 201VB) Fig-1 Vicinity Map.pdf 1.06MB 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 if necessary. 8. NOI Certification NCG01-eNO1-Certification- Form 51.88KB Form Signed2020.11.20.pdf Mast be R7Ffon-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 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:* IT The Legally Responsible Person named on this Notice of Intent f 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* Hal Hegwer Title City Manager Organization Legally Plesponsible Entity City of Sanford Date * 12/11 /2020 F. Tracking and COC Info NOI Tracking No. 38924 NC Reference No. NCG01-2020-5807 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC205807 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 5807 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. NCC205807-2020 Invoice Due Date 1/14/2021 Initial Fee $ 100.00 Invoice Status OPEN