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HomeMy WebLinkAboutNCC214054_NOI Application_20210712Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 7/9/2021 10:49:33 AM (NCG01 NOI Submission) Approve by Broussard, Brooklyn C 7/9/2021 11:00:03 AM (Review- Construction NOI 58695) • The task was assigned to Broussard, Brooklyn C by round robin distribution 7/9/2021 10:50 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: July 13, 2021 5:00 PM 7/9/2021 10:50 AM Submit by McCoy, Suzanne 7/12/2021 1:59:53 PM (Payment Verification for NCC214054) * Intown Gardeners LLC • McCoy, Suzanne assigned the task to McCoy, Suzanne 7/12/2021 1:59 PM The task was assigned to DEMLR NCG01 Payment Team. The due date is: August 20, 2021 5:00 PM 7/9/2021 11:00 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 * Kirkwood MHP (Muse Property) 1 b. Specific Lot This field rray be used to list specifc lot nunbers. Numbers 1 c. Parcel ID List all Rus associated w ith this project. Number(s) (PIN) 9607-03-9170; 9607-12-2875 2. County* Buncombe 3. Highway or Street 62 Old US Hwy 19/23 Address* Street name only is acceptable if no address nunber assigned yet 4.CityorTownship* Candler 5. State * NC 6. Zip Code* 28715 7. Latitude* Enter the latitude in decinal degrees 35.5419 8. Longitude * Enter the longitude in decinal degrees (MJSTbe negative) -82.6956 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* 07/26/2021 Estinated Construction Project Start Rate 10. Date to End * 07/26/2022 Estinated Construction Project End Cate 11. SIC (Primary)* Residential, Other than SFE (1522) Standard Industrial aassification for Development 12. Acres to be 11.57 disturbed* (including off -site borrow and waste areas) 13. Total site area 11.55 (acres) * 14. Post- 4.73 construction (Estimated) impervious area (acres) * Project Tracking ID NCC-BUNCO-2021-Kirkwood MHP (Muse Property) Assigned automatically (not used) 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 Hominy Creek Waterbody* N3meof waterbody into which stormwater runoff will discharge 15b. Waterbody 6-76 Index No. * NCWaterbody Index Number 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. ^ 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 * WI/Indian Branch, 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 * Richard If Corporation, enter Faegistered Agent First %rre 3. Last Name* Wrenn It Corporation, enter Pbegistered Agent Last %rre 3b. Title Manager 4. Permitee E-mail rwrenn@gileschemical.com Address* 5. Permittee 828-275-7736 Telephone No.* 6. Permittee Mailing Street Address Address* 7 Meadow Knoll Drive Address Line 2 City Candler Fbstal / Zip Code 28715-9556 Check box if the street address the same as mailing address 7. Permittee Street Address* V Yes Street Address 7 Meadow Knoll Drive Address Line 2 city Candler Fbstal / Zip Code 28715-9556 State / Frovince / Fbgion 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 Robbie Contact - First Name * 2. Primary Site Kirkpatrick Contact - Last Name * 3. Title Member 4. Site Contact E- rkirkpatrick53@gmail.com mail Address* 5. Site Contact 828-275-7736 Telephone No. 6. Organization WI/Indian Branch, LLC Name 7. Site Contact Street Address Mailing Address* 7 Meadow Knoll Drive Address Line 2 city CANDLER Fbstal / Zip Code 28715 8. Consultant Name (Optional) Brian Morris First and Last nacre 9. Consultant E-mail intowngardeners@gmail.com This person will be copied on all correspondence. 10. Consultant 8287129429 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) rkirkpatrick53@gmail.com Default is legally responsible person e-rrail 12. Billing (For Annual Fee correspondence) Telephone 828-275-7736 Default is legally responsible person telephone State / Rovince / Region NC Country United States D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 06/22/2021 Approved * 2. E&SC Plan Project EROS2018-00043 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* Buncombe 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 ERO2018-00043LOAM.pdf 418.34KB Approval letter or Mast beRDFformal Grading Permit 6. Site Location Map Mist be RDFforrret (lint 201VB) Kirkwood MHP Vicinity Maps.pdf 264.57KB Rease do not upload entire set of E&SC plans. 7. Notes (Optional) Rovide any additional information that night help the reviewer better understand how uploaded docurrents support the application. Include additional waterbodies if necessary. 8. NOI Certification NCG01-eNO1-Certification-Form-20210514-DEMLR- Form 327.2KB SW Kirkwood MHP_2021_06_08.pdf Mast be R7Fformat 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* Richard Wrenn Title Manager Organization Legally Ibsponsible Entity WI/Indian Branch, LLC Date * 07/09/2021 F. Tracking and COC Info NOI Tracking No. 58695 NC Reference No. NCG01-2021-4054 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC214054 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 4054 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. NCC214054-2021 Invoice Due Date 8/8/2021 Initial Fee $ 100.00 Invoice Status OPEN