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HomeMy WebLinkAboutNCC210184_NOI Application_20210113Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 1/10/2021 12:23:46 PM (NCG01 NOI Submission) Approve by Gamble, Aana C 1/11/2021 2:02:43 PM (Review- Construction NOI 40796) • The task was assigned to Gamble, Aana C by round robin distribution 1/10/2021 12:24 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: January 13, 2021 5:00 PM 1/10/2021 12:24 PM Submit by Selkane, Aziza 1/13/2021 8:12:36 AM (Payment Verification for NCC210184) * Christopher A Lewis • Selkane, Aziza assigned the task to Selkane, Aziza 1/13/2021 8:11 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: February 22, 2021 5:00 PM 1 /11 /2021 2:03 PM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting f• No an NOI that was r Yes rejected before? 1a. Project Name * Everly Subdivision Ph. 3 & 4 1 b. Specific Lot This field may be used to list specifc lot numbers. Numbers 1 c. Parcel ID List all R% associated w ith this project. Number(s) (PIN) 1842-72-2457, 1842-72-1709, 1842-72- 9426, 1842-73-9118, 1842-82-0667, 1842- 82-1275, 1842-82-4838, 1842-83-1048 & 1842-82-3573 2. County* Franklin 3. Highway or Street 0 Pine View Drive Address* Street name only is acceptable if no address nunber assigned yet 4. CityorTownship* Wake Forest 5. State * NC 6. Zip Code* 27587 7. Latitude* Enter the latitude in decimal degrees 36.0088 8. Longitude * Enter the longitude in decimal degrees (MJST be negative) -78.4971 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* 01/15/2021 Estimated Construction Project Start Date 10. Date to End* 01/15/2022 Estimated Construction Project End Cate 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial C]assification for Development 12. Acres to be 12.99 disturbed* (including off -site borrow and waste areas) 13. Total site area 24.80 (acres) * 14. Post- 7.07 construction (Estirrated) impervious area (acres) * NCC Project NCC-FRANK-2021-Everly Subdivision Ph. 3 & 4 Tracking ID Assignedautonatically 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 Richland Creek Wate rbody* %rre of waterbody into which stornwater runoff will discharge 15b. Waterbody 27-21-(0.5) Index No.* NCWaterbody Index Nirrber 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 * Capital Companies Group, 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 * John If Corporation, enter Faegistered Agent First %rre 3. Last Name* Williams It Corporation, enter Pbegistered Agent Last %rre 3b. Title Manager 4. Permitee E-mail jpw@capitalcompanies.group Address* 5. Permittee 919-215-3956 Telephone No.* 6. Permittee Mailing Street Address Address* 1661 Cash Road Address Line 2 Cty Creedmoor Fbstal / Zip Code 27522-9255 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 1661 Cash Road Address Line 2 city Creedmoor Fbstal / Zip Code 27522-9255 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 Timothy Contact - First Name * 2. Primary Site Kelly Contact - Last Name * 3. Title Managing Partner 4. Site Contact E- tpk@capitalcompanies.group mail Address* 5. Site Contact 716-777-1359 Telephone No.* 6. Organization Capital Companies Group, LLC Name 7. Site Contact Street Address Mailing Address* 1661 Cash Road Address Line 2 City State / Rovince / Region Creedmoor NC Fbstal / Zip Code Country 27522-9255 us 8. Consultant Name (Optional) Christopher Lewis (FLM Engineering) First and Last nacre 9. Consultant E-mail clevas@flmengineering.com This person will be copied on all correspondence. 10. Consultant 919-802-7146 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) jpw@capita lcompan ies.g rou p Default is legally responsible person e-n-ail (older NCAs rray not populate) 12. Billing (For Annual Fee correspondence) Telephone 919-215-3956 Default is legally responsible person telephone (older NCls rray not populate) D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 01/08/2021 Approved * 2. E&SC Plan Project 2020-00000440 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. Please also upload a site map showing the overall extent of the project (for linear projects, can include the beginning point and end point coordinates in the "Notes" box below). 5. E&SC Plan Everly Ph. 3&4 LoA.pdf Approval letter or Mist beRDFformat Grading Permit 96.4KB 6. Site Location Map Wst be RDFforrret (lint 20 NB) Everly Ph 3 & 4_Cover Page with Vicinity Map.pdf 680.76KB 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. The site location (vicinity) map is on the cover page in the top left corner. 8. NOI Certification Everly Ph 3 & 4_eNOI Notification Form.pdf 1.62MB Form Mist be RFformat 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 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 rfia¢�yr�rRCtrr,� �%rllr�m.:' Type Name* John Patrick Williams Title Manager Organization Legally Ibsponsible Entity Capital Companies Group, LLC Date * 01 /10/2021 F. Tracking and COC Info NOI Tracking No. 40796 NC Reference No. NCG01-2021-0184 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC210184 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 184 Sequential nurrber for subrrittal that is incremented by Stored Frocedure COC Year 2021 Year of date reviewed (used to assign YY digits after "NOC' in COCno.) Initial Invoice No. NCC210184-2021 Invoice Due Date 2/10/2021 Initial Fee $ 100.00 Invoice Status OPEN