The URL can be used to link to this page

Home My WebLink AboutNCC211157_NOI Signed Certification_20210226NCG01 Notice of Intent (NOI) Certification Form Directions: Print this form, complete, scan and upload to the electronic NOI. Then, mail the original form to the NC DEMLR Stormwater Program (with $100 check if paying by check) at: Division of Energy, Mineral & Land Resources Stormwater Program 512 N. Salisbury Street, 6,1 Floor (Office 640K) 1612 Mail Service Center Raleigh, NC 27699-1612 DO NOT MAIL THIS FORM OR PAYMENT UNTIL YOUR APPLICATION HAS BEEN REVIEWED AND ACCEPTED AS COMPLETE Per NC General Statute 143-215.6E (i), any person who knowingly makes any false 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 Article ... shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000). Under penalty of law, I certify that (check all boxes to indicate your agreement): P9 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. ® 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. ® I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control Plan. ® If the approved Erosion and Sediment Control Plan 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. �J 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. CDIA - Taxiway F Extension, Deicing Pad, South Cross Field Name of Proiect (must match Ala): Taxiway Realignment - Package 1 Specific Lot Numbers (must match Alb): See attached Ilv Responsible OrPanizational Entitv (must match Bl): City of Charlotte - Aviation Legally Responsible Person (must match B2 & B3): Jeff MCSwain Title of Legally Responsible Person (must match B3b): Airport Development Manager Name & Title of Signed if Authorized Individual Differs from Legally Responsible Person: Phone Number: 704-359-1913 P# 7 esmaea Signature of Legally Responsible Person or Authorized Individual 919419091 Date IMPORTANT NOTE: This form must be signed by a responsible corporate officer that 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 permit. DEED INFORMATION Name Telephone Fax Mailing Address City State zip Street Address City State ZZP DB No. Pg No. Parcel ID City of Charlotte 600 E Trade St Charlotte NC 28202 4939 Hangar Rd Charlotte NC 28208 3612 4 14102318 City of Charlotte 600 E Trade St Charlotte NC 28202 4733 Hangar Rd Charlotte NC 28208 6638 218 14119101 City of Charlotte 600 E Trade St Charlotte NC 28202 3628 Yorkmont Rd Charlotte NC 28208 2669 228 14119206 City of Charlotte 600 E Trade St Charlotte NC 28202 4417 Yorkmount Rd Charlotte NC 28208 6636 691 14119204 City of Charlotte 600 E Trade St Charlotte NC 28202 4501 Hangar Rd Charlotte NC 28208 6650 346 14119203 City of Charlotte 600 ETrade St Charlotte NC 28202 4020 Yorkmont Charlotte NC 28208 6367 873 14119202 City of Charlotte 600 E Trade St Charlotte NC 28202 NA NA NA NA 2085 244 14102319 City of Charlotte 600 E Trade St Charlotte NC 28202 5631 West By Charlotte NC 28208 3423 1 567 14120201 City of Charlotte 600 E Trade St Charlotte NC 28202 NA NA NA NA 14108 460 14101104 City of Charlotte 600 E Trade St Charlotte NC 28202 4906 Piney Top Dr Charlotte NC 28208 3799 702 14101106 City of Charlotte 600 E Trade St Charlotte NC 28202 8200 Byrum Dr Charlotte NC 28208 8605 40 14101113 City of Charlotte 600 E Trade St Charlotte NC 28202 8116 Byrum Dr Charlotte NC 28208 6176 301 14101114 City of Charlotte 600 E Trade St Charlotte NC 28202 8200 Byrum Dr Charlotte NC 28208 8605 40 14101113 City of Charlotte 600 E Trade St Charlotte NC 28202 8000 Byrum Dr Charlotte NC 28208 8965 557 14101116 City of Charlotte 600 E Trade St Charlotte NC 28202 NA NA NA NA 8605 37 14101112 City of Charlotte 600 E Trade St Charlotte NC 28202 4923 Larkmoore Ct Charlotte NC 28208 17034 326 14101142 City of Charlotte 600 E Trade St Charlotte NC 28202 4923 Larkmoore Ct Charlotte NC 28208 1 11081 881 14101142 City of Charlotte 600 E Trade St Charlotte NC 28202 4926 Larkmoore Ct Charlotte NC 28208 8116 251 14101143 City of Charlotte 600 E Trade St Charlotte NC 28202 4200 Yorkmont Rd Charlotte NC 28208 11423 345 11521109 City of Charlotte 600 E Trade St Charlotte NC 28202 5205 Hangar Rd Charlotte NC 28208 6158 996 14102313 City of Charlotte 600 E Trade St Charlotte NC 28202 8216 Byrum Dr Charlotte NC 28208 6084 546 14101111 AFB-TWO LP PO BOX 286 Hasbrouck Heights NJ 7604 4815 Sirus Ln Charlotte NC 28208 7951 313 14101138 Colonial Fuel and Lubricant Services Inc 101 North Lathrop Ave Savannah GA 31415 4901 Sirus Ln Charlotte NC 28208 33470 678 14101146 Aubrey JR Elam 5017 Sirus Ln Charlotte NC 28208 5017 Sirus Ln Charlotte NC 28208 10634 721 14101148 Griffin & Griffin Prime Investment 4801 West By Charlotte NC 28208 4801 West By Charlotte NC 28208 5383 408 14101402 International Express Holdings INC 141 Robin St Lowell NC 28098 4749 West By Charlotte NC 28208 32237 175 14101401 Carolina Printwear & Sports Equipment 11512 Winding Way rd Charlotte NC 282226 4920 Larkmoore Ct Chaelotte NC 28208 11313 881 14101144 Sun Enterprises LLC PO Box 12658 Charlotte NC 28220 NA NA NA NA 33095 858 14101141 Hans Joachim Nocher 5001 Sirus Ln Charlotte NC 28208 5001 Sirus Ln Charlotte NC 28208 22285 105 14101147 Brown Craig INC 250 N Trade St Charlotte NC 28105 4800 Sirus Ln Charlotte NC 28208 9152 574 14101407 D+F Realty -Lc 3020 Bridgewick Rd Waxhaw NC 28173 4816 Sirus Ln Charlotte NC 28208 34005 98 14101406 Felton Family Partnership LLP 259 Bobby Jones Expressway Augusta GA 30907 4916 Sirus Ln Charlotte NC 28208 31259 675 1410141.