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HomeMy WebLinkAboutNCC211221_NOI Application_20210304Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 2/26/2021 8:08:30 AM (NCG01 NOI Submission) Approve by Meloy, Michael 3/1/2021 11:08:13 AM (Review- Construction NOI 45497) • Gamble, Aana C reassigned the task to Meloy, Michael 2/26/2021 8:46 AM • The task was assigned to Gamble, Aana C by round robin distribution 2/26/2021 8:08 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: March 2, 2021 5:00 PM 2/26/2021 8:08 AM Submit by Selkane, Aziza 3/4/2021 3:50:58 PM (Payment Verification for NCC211221) * Earpsboro, LLC • Selkane, Aziza assigned the task to Selkane, Aziza 3/4/2021 3:50 PM The task was assigned to DEMLR NCG01 Payment Team. The due date is: April 12, 2021 5:00 PM 3/1/2021 11:08 AM .• 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 45392 NOI No. Prior Reviewer Michael Meloy Name 1a. Project Name * Earpsboro Road Subdivision Phase 2 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) 271300-09-2585, 271300-08-0559, 271300-18-7006, 271300-28-9307 2. County* Johnston 3. Highway or Street Earpsboro Rd Address* Street name only is acceptable if no address nunber assigned yet 4. CityorTownship* O'Neals 5. State * NC 6. Zip Code* 27597 7. Latitude* Enter the latitude in decimal degrees 35.7808 8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative) -78.2907 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* 03/01/2021 Estimated Construction Project Start Date 10. Date to End* 03/01/2023 Estimated Construction Project End Date 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial aassification for Development 12. Acres to be 63.57 disturbed* (including off -site borrow and waste areas) 13. Total site area 104.53 (acres) * 14. Post- 12.54 construction (Estinated) impervious area (acres) * NCC Project NCC-JOHNS-2021-Earpsboro Road Subdivision Phase 2 Tracking ID 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 Snipes Creek Waterbody* %rreof waterbody into which stormwater runoff will discharge 15b. Waterbody 27-57-12 Index No. * NCWaterbody Index Nunber Stormwater r- No discharges will flow 17 Yes to additional wate rs * 15c. Additional Little River Receiving Waterbody narre Waterbody 15d. Waterbody 27-57-(8.5) Index No. NCWaterbody Index Nunber 15e. Additional Waterbody name Receiving Waterbody 15f. Waterbody NCWaterbody Index Nunber 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. ^ 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 * River Wild, 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 * Reid If Corporation, enter Faegistered Agent First %rre 3. Last Name* Smith It Corporation, enter Pbegistered Agent Last %rre 3b. Title Owner 4. Permitee E-mail reid@theriverwildteam.com Address* 5. Permittee 919-422-6815 Telephone No.* 6. Permittee Mailing Street Address Address* 114 West Main Street Address Line 2 Clayton Fbstal / Zip Code 27520-2321 Check box if the V Yes street address the same as mailing address State / Frovince / Fbgion NC Country us 7. Permittee Street Street Address Address* 114 West Main Street Address Line 2 city State / Frovince / Faegion Clayton NC Fbstal / Zip Code Country 27520-2321 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 Harrison Contact - First Name * 2. Primary Site Smith Contact - Last Name * 3. Title President 4. Site Contact E- harrison@providence. construction mail Address* 5. Site Contact 919-697-1101 Telephone No. 6. Organization Providence Construction Name 7. Site Contact Street Address Mailing Address* 114 West Main Street Address Line 2 city Clayton Fbstal / Zip Code 27520-2321 8. Consultant Name (Optional) Ethan Averette First and Last nacre 9. Consultant E-mail eaverette@stocksengineering.com This person will be copied on all correspondence. 10. Consultant 252-459-8196 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) reid@theriverwildteam.com Default is legally responsible person e-rrail 12. Billing (For Annual Fee correspondence) Telephone 919-422-6815 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 02/11/2021 Approved * 2. E&SC Plan Project JC# 20-038-P Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Johnston County 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 20-038 Earpsboro Road Subdivision Ph 2 ESC Appr Approval letter or 399.51KB 2.11.21.pdf Grading Permit Mist be FDFforrrat 6. Site Location Map Mist be RDFforrret (lint 201VB) Site Location Map.pdf 119.58KB 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 SIGNED_NCG01-eNO1-Certification-Form- Form 48.87KB Earpsboro Road Phase 2.pdf Mast be FCFfon-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 Article; or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Artcle; or who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under this Article or rules of the Commission implementing this Artcle 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 Type Name* Reid Smith Title Owner Organization Legally Ibsponsible Entity River Wild. LLC Date * 02/26/2021 F. Tracking and COC Info NOI Tracking No. 45497 NC Reference No. NCG01-2021-1221 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC211221 Coverage (COC) Uses 'count number' variable (increrrented by SP) No.* Count Number 1221 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. NCC211221-2021 Invoice Due Date 3/31/2021 Initial Fee $ 100.00 Invoice Status OPEN