NCC215215_NOI Application (Original Copy Recovery)_20210920

NORTH CAROLINA
EltOMFkMomral Qualrly
A. Project Information
Part A.
Proiect Location and Waterbodv Information
Are you submitting 0 No
an NOI that was f• Yes
rejected before?
Previous Rejected 64842
NOI No. Enter the N01 no. (previous rejections should pre -populate mast information when you rmve to the next field.)
By wh ich We can alert the previous reviewer about this re-suburT ttal
reviewer?* Brooklyn Broussard
1a. Project Name * Stockbridge at Tanglewood Phase 2
The information for 1b. and 1c. is not captured from a previously rejected eNOI form. Be sure to enter.
1 b. Specific Lot
This field may be used to list specifc lot nun-bers.
Numbers
166-177, 180-183, 187-190
1 c. Parcel ID
List all RNs associated with this project.
Number(s) (PIN)*
8903 056165, 8903 056068, 8903 056073, 8903 046977, 8903 046971, 8903
046875, 8903 046880, 8903 046784, 8903 046687, 8903 047509, 8903 047496,
8903 048449, 8903 049501, 8903 049564, 8903 048667, 8903 048753, 8903
048850, 8903 048857, 8903 048926, 8903 048987, 7993953234
2. County*
Pasquotank
3. Highway or Street 3800 Union Street
Address* Street narre only is acceptable if no address nun-ber assigned yet
4. Cityor Township* Elizabeth City
5. State * NC
6. Zip Code * 27909
7. Latitude* Enter the latitude in decimal degrees
36.2891
8. Longitude* Enter the longitude in decimal degrees (NL&Fbe negative)
-76.2825
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*
09/24/2021
Estirrated Construction Project Start Date
10. Date to End*
02/28/2023
Estirrated Construction Project End Date
11. SIC (Primary) *
Residential, Single Family Houses (SFE) (1521)
Standard Industrial Classification for Developrrent
12. Acres to be
48.50
disturbed*
(including off -site borrow and waste areas)
13. Total site area 46.98
(acres) *
14. Post- 2.73
construction (Estirrated)
impervious area
(acres) *
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 Little River
Wate rbody* �brre of waterbody into which storrrwater runoff will discharge
15b. Waterbody 30-5-(1)
Index No.* NCWaterbody Index Nin-ber
Ensure the right box is checked and review previous waterbody entries.
Stormwater PF 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?*
Note: Stormwater discharges from construction activities associated with oil and gas exploration, production,
processing, treatment, or transmission facilities are eligible for the exemption from NPDES permit coverage except
in very limited instances. Do not proceed with this application before consulting this EPA fact sheet and verifying a
permit applies.

B. Permittee Information
Part B.
Permittee Information - Legally Responsible Entity and Individual
....................................................................................................................................................................................................................................................................................................................................
Important: The person who signs the NOI Certification Form and signs the Certification in Section E of this application
form must 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.
C * Legally Responsible Entity
NVR, Inc.
IF permittee is an individual, enter first and last narre in this field. Ctherw ise, enter organization/business narre.
Note: If the permittee is a business, the business must be registered with the NC Secretary of State. You can verify the
registration here.
2. First Name* Gregg
IF Corporation, enter Registered Agent First Ibrre
3. Last Name* Knapp
IF Corporation, enter Registered Agent Last Ibrre
Enter Permittee Title. This information is not captured from a previously rejected eNO1 form.
3b. Title *
4. Permitee E-mail
Address*
5. Permittee
Telephone No.*
Vice President
[e-mail]
[phone]
6. Permittee Mailing Street Address
Address* 4525 South Blvd. Suite 100
Address Line 2
caty State / Province / Pegion
Virginia Beach VA
Postal / Zip Code Country
23452 us
Check box if the Yes
street address the
same as mailing
address
7. Permittee Street Street Address
Address* 4525 South Blvd Suite 100
Address Line 2
caty
State / Province / Pegion
Virginia Beach
VA
Postal / Zip Code
Country
23452
us

8. Type of Ownership is only individual if an individual is narred in B.1. above.
Ownership* Mon -Government

C. Site Contact information
Part C.
Project Site Contact Information
1. Primary Site Adam
Contact - First
Name *
2. Primary Site Beck
Contact - Last
Name *
3. Title Production Manager
4. Site Contact E- [e-mail]
mail Address* This person will be copied on all correspondence.
5. Site Contact [phone]
Telephone No.*
6. Organization
Ryan Homes
Name
7. Site Contact
Street Address
Mailing Address*
4525 South Blvd
Address Line 2
Oty
State / Province / Region
Virginia Beach
VA
Postal / Zip Code
Country
23452
us
Enter consultant contact details below (if applicable) and verify billing contact details. This information is
not captured from a previously rejected eNO1 form.
8. Consultant Name (Optional)
First and Last narre
9. Consultant E-mail This person will be copied on all correspondence.
10. Consultant
Telephone No.
11. Billing E-mail* ( For Annual Fee correspondence)
[e-mail]
Wault is legally responsible person e-mail
12. Billing ( For Annual Fee correspondence)
Telephone* [phone]
Wault is legally responsible person telephone

D. E&SC Plan
Part D.
Erosion & Sediment Control (E&sq Ran Approval Information
....................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 01/01/2016
Approved *
2. E&SC Plan Project Pasqu-2015-014
Number/I D * Assigned by agency or local program
Ensure the right approved by option is chosen and review previous entries.
3. E&SC Plan r State DEQ Office
Approved by* r Local Program
4. State DEQ Office * Washington Regional Office (WaRO)
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 Approval documentation only! DO NOT upload entire set(s) of E&SCRans
Approval letter or E&SC Plan Approval Letter.pdf 181.71 KB
Grading Permit* Mist beFDFformat
6. Signed FRO* Financial Fgsponsibility/Cwnership Form
Stockbridge FRO 9.14.pdf 946.56KB
Mast be FDFformat
7. Site Location Mast be FDFforrrat (limit 20 IVB)
Map* Stockbridge 20 lots map.pdf 947.26KB
Pease do not upload entire set of E&SC plans.
8. Notes (Optional) Provide any additional information that might help the reviewer better understand how uploaded documents support
the application. Include additional waterbodies if necessary.
D1: Date should be February 11 2015; When I attempt to put in this
date the application will not allow it.
9. NOI Certification eNOI Signed.pdf
Form* Mast be FDFforrrat
497.22KB
YOU MUST MAIL THE ORIGINAL SIGNED NOI CERTIFICATION FORM (click on this link) to The Stormwater Program
at the address on the form for the application to fulfill federal application requirements. The Certification Form must be
signed by the person listed in Section B (Permittee Information) or by an authorized responsible person within the same
organization. NOTE: The person who signs the paper form must be the same person to electronically certify
and sign the eNOI.
This is an Express r No
Review Project* r Yes

E. Certification
North Carolina General Statute 143-215.613 (i) provides that:
Any person who knowingly makes anyfalse statement, representation, or certification in anyapplication, 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 Article; or who falsifies, tampers with, or knowingly renders
inaccurate any recording or monitoring deice or method required to be operated or maintained under this Article or rules of the
Commission implementing this Article shall be guiltyof a Class 2 misdemeanor which may include a fine not to exceed ten thousand
dollars ($10,000).
Under penalty of law, I certify that
* rJ 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.
* rJ 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:* r The Legally Responsible Person named on this Notice of Intent
r 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*
Greg Knapp
Title *
Vice President
Organization*
Legally Plesponsible Entity
NVR, Inc.
Date *
09/15/2021