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HomeMy WebLinkAboutNCC213886_NOI Application_20210721 Action History (UTC-05:00)Eastern Time(US&Canada) Subrrit by Anonymous User 6/29/2021 2:34:07 PM(NCG01 NOI Submission) Approve by Broussard, Brooklyn C 6/30/2021 9:04:43 AM(Review-Construction NOI 57486) • The task was assigned to Broussard, Brooklyn C by round robin distribution 6/29/2021 2:35 PM • The task was assigned to DEMLR NCG01 NOI Review Team.The due date is:July 1,2021 5:00 PM 6/29/2021 2:35 PM Submit by McCoy, Suzanne 7/21/2021 8:08:05 AM(Payment Verification for NCC213886) * Robert Sayler • McCoy,Suzanne assigned the task to McCoy, Suzanne 7/21/2021 8:07 AM • The task was assigned to DEMLR NCG01 Payment Team.The due date is:August 11, 2021 5:00 PM 6/30/2021 9:05 AM �ThF1 1Construction Stormwater: Notice of Intent (NOI) National Pollutant Discharge Eliminatio em 'D application for•• - .•-under NorthCarolina's General Permit 1 1111:STORIMATER DISCHARGES associated with construction activities(or NORTH CAROLINA Enrlrnnmenfu�Qr�arlry A. Project Information Part A. Project Location and Waterbody Information Are you submitting f•No an NOI that was r Yes rejected before? 1a. Project Name* Woodland Trace Subdivision 1 b.Specific Lot This field may be used to list specifc lot numbers. Numbers 1 c. Parcel ID List all Rios associated w ith this project. Number(s)(PIN) 9606-58-5292 2. County* Buncombe 3. Highway or Street 16 Dynasty Lane Address* Street name only is acceptable if no address number assigned yet 4.City or Township* Candler 5. State* NC 6.Zip Code* 28715 7. Latitude* Enter the latitude in decimal degrees 35.5328 8. Longitude* Enter the longitude in decinal degrees(MJSTbe negative) -82.6786 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* 08/01/2021 Estimated Construction Project Start Rate 10. Date to End* 03/01/2022 Estimated Construction Project End Cate 11.SIC(Primary)* Residential, Single Family Houses(SFE)(1521) Standard Industrial Oassification for Development 12.Acres to be 2.54 disturbed* (including off-site borrow and waste areas) 13.Total site area 22.68 (acres)* 14. Post- 1.28 construction (Estimated) impervious area (acres)* Project Tracking ID NCC-BUNCO-2021-Woodland Trace Subdivision 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* Woodland Trace, 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* Tom If Corporation,enter Faegistered Agent First%rre 3. Last Name* Chapman It Corporation,enter F;bgistered Agent Last%rre 3b.Title Member 4. Permitee E-mail woodlandtrace01@gmail.com Address* 5. Permittee 828-779-7800 Telephone No.* 6. Permittee Mailing Street Address Address* 1901 Ulmerton Road Address Line 2 City State/Frovince/Region Clearwater FL Fbstal/Zip Code Country 33762 US Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* 1901 Ulmerton Road Address Line 2 City State/Frovince/Faegion Clearwater FL Postal/Zip Code Country 33762 US 8.Type of ONnership 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 Bob Contact-First Name* 2. Primary Site Sayler Contact-Last Name* 3.Title 4.Site Contact E- woodlandtrace01@gmail.com mail Address* 5.Site Contact 828-779-7800 Telephone No.* 6.Organization Woodland Trace, LLC Name 7.Site Contact Street Address Mailing Address* 1901 Ulmerton Road Address Line 2 City State/Rovince/Region Clearwater FL Fbstal/Zip Code Country 33762 US 8. Consultant Name (Optional) Michael Goforth First and Last narre 9. Consultant E-mail mgoforth@hcepc.net This person will be copied on all correspondence. 10. Consultant 828-230-4511 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) woodlandtrace01 @gmail.com Default is legally responsible person e-rrail 12. Billing (For Annual Fee correspondence) Telephone 828-779-7800 Default is legally responsible person telephone D. E&SC Plan Part D. ^ Erosion&Sediment Control(E&SC)Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 06/24/2021 Approved* 2. E&SC Plan Project ERO2021-00058 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 ERO2021-00058LOAM.pdf 419.03KB Approval letter or Mast beRDFformat Grading Permit 6.Site Location Map Wst be RDFfornat(linit 20 NB) Location Map.pdf 349.15KB 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 Form Signed.pdf 256.75KB Form Wst be RDFfornat This is an Express r No Review Project* r Yes E. Certification North Carolina General Statute 143-215.66(1) provides that: Anyperson who knowinglymakes any false 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 knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case underthis 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 guiltyofa Class 2 misdemeanor which mayinclude 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* Tom Chapman Title Member Organization Legally Ibsponsible Entity Woodland Trace, LLC Date* 06/29/2021 F. Tracking and COC Info NOI Tracking No. 57486 NC Reference No. NCG01-2021-3886 Uses'count_nurrber'variable(increrrented by SP) Certificate of NCC213886 Coverage (COC) Uses'count_nurrber'variable(increrrented by SP) No.* Count Number 3886 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. NCC213886-2021 Invoice Due Date 7/30/2021 Initial Fee $ 100.00 Invoice Status OPEN