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HomeMy WebLinkAboutNCC210587_NOI Application_20210203Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 1/29/2021 2:21:04 PM (NCG01 NOI Submission) Approve by Clark, Paul 1/29/2021 2:53:42 PM (Review- Construction NOI 42374) • Georgoulias, Bethany reassigned the task to Clark, Paul 1/29/2021 2:23 PM • The task was assigned to Meloy, Michael by round robin distribution 1/29/2021 2:21 PM • The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: February 2, 2021 5:00 PM. The priority is: High 1/29/2021 2:21 PM Submit by Selkane, Aziza 2/3/2021 9:49:41 AM (Payment Verification for NCC210587) * Alexander Hedrick • Selkane, Aziza assigned the task to Selkane, Aziza 2/3/2021 9:49 AM • The task was assigned to DEMLR NCG01 Payment Team. The due date is: March 12, 2021 5:00 PM. The priority is: High 1/29/2021 2:54 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 41702 NOI No. Prior Reviewer Not Sure or Not Listed Name 1a. Project Name * Marine Raider HQ P-1395 1 b. Specific Lot This field may be used to list specffc lot numbers. Numbers 1 c. Parcel ID List all R% associated w ith this project. Number(s) (PIN) Government Project 2. County* Onslow 3. Highway or Street Everett Creek Road Address* Street name only is acceptable if no address number assigned yet 4. CityorTownship* Camp Lejeune 5. State * NC 6. Zip Code* 28547 7. Latitude* Enter the latitude in decimal degrees 34.5740 8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative) -77.4400 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* 02/18/2021 Estimated Construction Project Start late 10. Date to End * 12/16/2022 Estinated Construction Project End late 11. SIC (Primary)* Other (9999) Standard Industrial aasslfication for Development 12. Acres to be 8.00 disturbed* (including off -site borrow and waste areas) 13. Total site area 8.00 (acres) * 14. Post- 3.00 construction (Estimated) impervious area (acres) * NCC Project NCC-ONSLO-2021-Marine Raider HQ P-1395 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 Everett Creek Waterbody* %rreof waterbody into which storrrwater runoff will discharge 15b. Waterbody 19-32 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. ^ 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 * Daniels & Daniels Construction Company inc 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 * Jeremiah If Corporation, enter Faegistered Agent First %rre 3. Last Name* Daniels IF Corporation, enter F;bgistered Agent Last %rre 3b. Title Vice President 4. Permitee E-mail alexh@danddcc.com Address* 5. Permittee 919-778-4525 Telephone No.* 6. Permittee Mailing Street Address Address* 178 North Carolina 111 Address Line 2 City Goldsboro Fbstal / Zip Code 27534 Check box if the street address the same as mailing address 7. Permittee Street Address* F Yes Street Address 178 North Carolina 111 Address Line 2 city Goldsboro Fbstal / Zip Code 27534 State / Frovince / Plegion 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 Mark Contact - First Name * 2. Primary Site Wetherington Contact - Last Name * 3. Title Superentindent 4. Site Contact E- markw@danddcc.com mail Address* 5. Site Contact 919-778-4525 Telephone No. 6. Organization Name 7. Site Contact Street Address Mailing Address* 178 North Carolina 111 Address Line 2 City Goldsboro Fbstal / Zip Code 27534 8. Consultant Name (Optional) First and Last nave 9. Consultant E-mail This person will be copied on all correspondence. 10. Consultant Telephone No. 11. Billing E-mail (For Annual Fee correspondence) alexh@danddcc.com Default is legally responsible person a-rrail 12. Billing (For Annual Fee correspondence) Telephone 919-778-4525 Default is legally responsible person telephone 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 ONSLO-2021-015 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 * Wilmington (WiRO) 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 SW8 200902 - P1395 Marine Raider Approval letter or 1.23MB Headquarters. pdf Grading Permit Mast be FDFfon-rat 6. Site Location Map Wst be RDFforrret (lint 201VB) G-001 (1).pdf 356.02KB 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 SKM_554e21012511200.pdf 53.95KB Form Mist be RDFforrret This is an Express f 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:* 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* Alex Hedrick Title Project Engineer Organization Legally Plesponsible Entity Daniels & Daniels Construction Company Inc Date * 01 /29/2021 F. Tracking and COC Info NOI Tracking No. 42374 NC Reference No. NCG01-2021-0587 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC210587 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 587 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. NCC210587-2021 Invoice Due Date 2/28/2021 Initial Fee $ 100.00 Invoice Status OPEN