NCC205707_Modification Review_20210604

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 6/3/2021 10:24:22 AM (ADD TO FILE Submittal)
Approve by Georgoulias, Bethany A 6/4/2021 10:42:05 AM (Construction COC ADD TO FILE Review -
NCC205707)
* Permittee included legally responsible change form, but the responsible individual is the same (change
not necessary).
• The task was assigned to Georgoulias, Bethany A. The due date is: June 8, 2021 5:00 PM
6/3/2021 10:24 AM

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NORTH CAPOLINA
EnYlrenmemf& Qualay
Certificate of NCC205707
Coverage (COC) Enter the Certificate of Coverage Ninber (Use capital letters)
No.*
Information associated with this permit:
Project Name Oak Island Resort Marina
Address Old Bridge Road, Oak Island, NC
County Brunswick
Latitude 34.0000
Longitude-78.0000
Permittee Listed Oak Island Property Holdings, LLC
Legally Responsible Ronald McNeill
Individual
NC Reference No. NCG01-2020-5707
E&SC Plan ID
Original NOI
Tracking No.
BRUNS-2021-031
38759
Date COC Issued* 01/07/2021
Prior Rescission This field will populate only if CCChas already been rescinded.
Date
Modification Information:
Reason for r Closed -Out Lots/Outparcels in E&SC Plan
Modification * r Additional Lots/Outparcels Approved - E&SC Revised
F Other Revision(s) to E&SC Plan
r Legally Responsible Individual and/or Site Contact Has Changed
r Multiple Reasons (List)
Addional Ivbre information (e.g., new Site Contact details). If lots are being added, please include specific lot nunbers.
Explanation The plans have been revised and do not exceed the December 03, 2020
Approved disturbed area of 15 acres.
You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan
sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable
sheets).
For changes to the legally responsible individual, you must upload this form.

Supporting Upload Supporting Documentation (Revised E&SCApproval, nose -Out Doc, etc.)
Documentation Approval - BRUNS-2021-031 Revised issued 5-26-
238.6KB
2021.pdf
NCG01.pdf 185.03KB
Mist be FDFfornat
North Carolina General Statute 143-215.6113 (i) provides that:
Anyperson who knowinglymakes anyfalse statement, representation, or certification in anyapplication, record, report, plan, or other
documentfiled or required to be maintained under this Article or a rule implementing this Article; or who knowinglymakes a false statement
of a material fact in a rulemaking proceeding or contested case underthis Article; orwho 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 Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine notto exceed ten thousand
dollars ($10,000).
rJ I hereby request modification to coverage under the NPDES Stormwater Permit
for the subject project site. I am familiar with the information contained in this
request and to the best of my knowledge and belief such information is true,
complete and accurate.
Specify if you are:* r The Legally Responsible Individual
r Authorized Responsible Person*
*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 NCGO10000 General Permit. For more information on signatory requirements, see Part IV, Section B,
Item (6) of that permit.
Signature
Type Name* Robert McNeill
Title * Member/Manager
Organization* Oak Island Property Holdings, LLC
Date * 06/03/2021
Email Address* [e-mail]
En -ail for confirnation
Telephone Number* 910- 840-61942 / 910-332-1765
Contact nunber if we need to reach you
Note: Original permittee and site contact are copied on modification correspondence.
Additional Email [e-mail]
(Optional) Additional en -ail for confirnation
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 06/04/2021
Rescinded Since
Submitted?

Request Date 20210603
Formatted
Review Date 20210604
Formatted