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HomeMy WebLinkAboutNCC214728_NOI Application_20210820Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 8/18/2021 9:28:16 AM (NCG01 NOI Submission) Approve by Broussard, Brooklyn C 8/18/2021 9:33:54 AM (Review- Construction NOI 62400) • The task was assigned to Broussard, Brooklyn C by round robin distribution 8/18/2021 9:28 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: August 20, 2021 5:00 PM 8/18/2021 9:28 AM Submit by EADS\almiller3 8/20/2021 8:44:26 AM (Payment Verification for NCC214728) * Highland Paving Co. LLC • EADS\almiller3 assigned the task to EADS\almiller3 8/20/2021 8:40 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: September 29, 2021 5:00 PM 8/18/2021 9:34 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 * US 401 Industrial Site 1 b. Specific Lot This field rray be used to list specifc lot nunbers. Numbers 1 c. Parcel ID List all Rios associated w ith this project. Number(s) (PIN) 0651-50-0955.000 & 0650-38-2894.000 2. County* Harnett 3. Highway or Street US 401 Address* Street name only is acceptable if no address nunber assigned yet 4. City or Township* Lillington 5. State * NC 6. Zip Code* 27546 7. Latitude* Enter the latitude in decinal degrees 35.4267 8. Longitude * Enter the longitude in decinal degrees (MJSTbe negative) -78.8177 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* 08/23/2021 Estinated Construction Project Start Rate 10. Date to End * 10/29/2021 Estinated Construction Project End Date 11. SIC (Primary)* Commercial (1542) Standard Industrial aassification for Development 12. Acres to be 11.50 disturbed* (including off -site borrow and waste areas) 13. Total site area 41.50 (acres) * 14. Post- 4.80 construction (Estimated) impervious area (acres) * Project Tracking ID NCC-HARNE-2021-US 401 Industrial Site 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 Neills Creek Waterbody* Name of waterbody into which stormwater runoff will discharge 15b. Waterbody 18-16-(0.7) 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 * ABJ Investments, 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 * Brian If Corporation, enter Faegistered Agent First %rre 3. Last Name* Raynor It Corporation, enter Pbegistered Agent Last %rre 3b. Title Manager 4. Permitee E-mail BRAYNOR@HIGHLANDPAVING.COM Address* 5. Permittee 910-824-1238 Telephone No.* 6. Permittee Mailing Street Address Address* 2031 Middle Road Address Line 2 City Fayetteville Fbstal / Zip Code 28312 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* 2031 Middle Road Address Line 2 City State / Frovince / Faegion Fayetteville NC Fbstal / Zip Code Country 28312 us 8. Type of Ojvnership 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 Brian Contact - First Name * 2. Primary Site Raynor Contact - Last Name * 3. Title Manager 4. Site Contact E- BRAYNOR@HIGHLANDPAVING.COM mail Address* 5. Site Contact 910-824-1238 Telephone No. 6. Organization ABJ Investments, LLC Name 7. Site Contact Street Address Mailing Address* 2031 Middle Road Address Line 2 city Fayetteville Postal / Zip Code 28385 8. Consultant Name (Optional) Scott Brown First and Last narre 9. Consultant E-mail sbrown@4dsitesolutions.com This person will be copied on all correspondence. 10. Consultant 910-426-6777 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) BRAYNOR@HIGHLANDPAVING.COM Default is legally responsible person e-rrail 12. Billing (For Annual Fee correspondence) Telephone 910-824-1238 Default is legally responsible person telephone State / Province / Region NC Country United States D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 08/12/2021 Approved * 2. E&SC Plan Project HARNE-2022-002 Number/ID * Assigned by agency or local program 3. E&SC Plan r State DEQ Office Approved by* r Local Program 4. State DEQ Office * Fayetteville (FRO) 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 1816-Approved ec permit.pdf 809.35KB Approval letter or Mast beRDFformat Grading Permit 6. Site Location Map Mist be RDFforrret (lint 20 NB) Site plan.pdf 1.28MB 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 certification.pdf 64.84KB 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 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 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:* IT 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* Brian Raynor Title Manager Organization Legally Plesponsible Entity ABJ Investments, LLC Date * 08/18/2021 F. Tracking and COC Info NOI Tracking No. 62400 NC Reference No. NCG01-2021-4728 Uses 'count_nurrber' variable (increrrented by SP) Certificate of NCC214728 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 4728 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. NCC214728-2021 Invoice Due Date 9/17/2021 Initial Fee $ 100.00 Invoice Status OPEN