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HomeMy WebLinkAboutNCC213531_NOI Application_20210614Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 6/8/2021 4:38:16 PM (NCG01 NOI Submission) Approve by Broussard, Brooklyn C 6/9/2021 8:34:19 AM (Review- Construction NOI 55145) • The task was assigned to Broussard, Brooklyn C by round robin distribution 6/8/2021 4:40 PM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: June 10, 2021 5:00 PM 6/8/2021 4:40 PM Submit by Selkane, Aziza 6/14/2021 9:27:59 AM (Payment Verification for NCC213531) * Gregory Wattson • Selkane, Aziza assigned the task to Selkane, Aziza 6/14/2021 9:27 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: July 21, 2021 5:00 PM 6/9/2021 8:34 AM .• SThF� '; 1 NORTH CAROLINA EnrlronmertW quallly A. Project Information Part A. Project Location and Waterbody Information Are you submitting IT No an NOI that was r Yes rejected before? 1a. Project Name * University Place MF 1 b. Specific Lot This field nay be used to list specifc lot nunbers. Numbers 1 c. Parcel ID List all Rus associated w ith this project. Number(s) (PIN) 04725204, 04725212, 2. County* Mecklenburg 3. Highway or Street 8910 JW Clay Blvd Address* Street name only is acceptable if no address nunber assigned yet 4.CityorTownship* Charlotte 5. State * NC 6. Zip Code* 28262 7. Latitude* Enter the latitude in decinal degrees 35.3122 8. Longitude * Enter the longitude in decinal degrees (MJSTbe negative) -80.7516 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* 06/14/2021 Estir ated Construction Project Start Rate 10. Date to End * 01 /30/2023 Estir ated Construction Project End Cate 11. SIC (Primary)* Residential, Other than SFE (1522) Standard Industrial aassification for Development 12. Acres to be 15.73 disturbed* (including off -site borrow and waste areas) 13. Total site area 20.54 (acres) * 14. Post- 12.72 construction (Estinated) impervious area (acres) * NCC Project NCC-MECKL-2021-University Place MF 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 Mallard Creek Waterbody* Narreof waterbody into which stornwater runoff will discharge 15b. Waterbody 13-17-5 Index No. * NCWaterbody Index Nunber Stormwater F No discharges will flow 17 Yes to additional wate rs * 15c. Additional Doby Creek Receiving Waterbody narre Waterbody 15d. Waterbody 13-17-5-3 Index No. NC Waterbody Index Nmber 15e. Additional Waterbody name Receiving Waterbody 15f. Waterbody NCWaterbody Index Narrber 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. Rarmttee 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 ovens 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 PesponsibleEntity Name * EBA Crystal Real Estate LLC If pernittee is an individual (i.e., organization does not apply), enter first and last nave 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 * Gregory If Corporation, enter Faegistered Agent First None 3. Last Name* Wattson If Corporation, enter Plegistered Agent Last I\bne 3b. Title Executive Vice President of Development 4. Permitee E-mail gregory.wattson@eba-us.com Address* 5. Permittee 214-347-7551 Telephone No.* 6. Permittee Mailing Street Address Address* 5910 North Central Expressway Address Line 2 Suite 1600 City Dallas Postal / Zip Code 75206-5125 Check box if the street address the same as mailing address 7. Permittee Street Address * V Yes Street Address 5910 North Central Expressway Address Line 2 Suite 1600 city Dallas Postal / Zip Code 75206-5125 State / Province / Pegion TX Country us State / Province / Faegion TX Country us 8. Type of Ownership is only individual if an individual is named in B.1. above. Ownership* Non -Government C. Site Contact Information Part C. Roject Site Contact Inforrration .................................................................................................................................................................................................... 1. Primary Site Brian Contact - First Name * 2. Primary Site Peart Contact - Last Name * 3. Title Project Engineer 4. Site Contact E- Brian.Peart@jedunn.com mail Address* 5. Site Contact 9802406182 Telephone No. 6. Organization JE Dunn Name 7. Site Contact Street Address Mailing Address* 1616 Camden Road Address Line 2 Suite 400 city Charlotte Postal / Zip Code 28203-4925 8. Consultant Name (Optional) Robert Keidel First and Last nacre 9. Consultant E-mail rkeidel@landdesign.com This person will be copied on all correspondence. 10. Consultant 7043330325 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) gregory.uvattson@eba-us.com Default is legally responsible person e-rrail 12. Billing (For Annual Fee correspondence) Telephone 214-347-7551 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 05/05/2021 Approved * 2. E&SC Plan Project LDGP-2021-00106 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* City of Charlotte 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 Grading Letter of Approval - University Place MF.pdf 99.62KB Approval letter or Mast beRDFformat Grading Permit 6. Site Location Map Mist be RDFforrret (lint 20 NB) SITE MAP.pdf 2.11 MB 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 NOI Cert Signed.pdf 47.64KB Form Wst be RDFforrret 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 Type Name* Gregory Wattson Title Executive Vice President of Development Organization Legally Ibsponsible Entity EBA Crystal Real Estate LLC Date * 06/08/2021 F. Tracking and COC Info NOI Tracking No. 55145 NC Reference No. NCG01-2021-3531 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC213531 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 3531 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. NCC213531-2021 Invoice Due Date 7/9/2021 Initial Fee $ 100.00 Invoice Status OPEN