NCC215040_NOI Application_20210927

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 9/4/2021 9:20:06 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 9/7/2021 7:59:08 AM (Review- Construction NOI 64178)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 9/4/2021 9:20 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: September 8, 2021 5:00
PM 9/4/2021 9:20 AM
Submit by Selkane, Aziza 9/27/2021 10:46:50 AM (Payment Verification for NCC215040)
* Hwy 3 LCID LLC
• Selkane, Aziza assigned the task to Selkane, Aziza 9/27/2021 10:46 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: October 19, 2021 5:00 PM
9/7/2021 7:59 AM

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1
NORTH CAROLINA
EnrlronmertW quallly
A. Project Information
Part A.
Project Location and Waterbody Information
Are you submitting r No
an NOI that was r Yes
rejected before?
Previous Rejected 64056
NOI No.
Prior Reviewer Brooklyn Broussard
Name
1a. Project Name * Hwy 3 LCID Landfill/Sawmill Site
1 b. Specific Lot This field rray be used to list specifc lot numbers.
Numbers
1 c. Parcel ID List all R% associated w ith this project.
Number(s) (PIN) 4675430992
2. County* Iredell
3. Highway or Street 1855 Coddle Creek Highway
Address* Street name only is acceptable if no address number assigned yet
4. CityorTownship* Mooresville
5. State * NC
6. Zip Code* 28115
7. Latitude* Enter the latitude in decimal degrees
35.5346
8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative)
-80.7691
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 Date
10. Date to End* 08/31/2026
Estimated Construction Project End Date

11. SIC (Primary)* Commercial (1542)
Standard Industrial Classification for Development
12. Acres to be 6.00
disturbed* (including off -site borrow and waste areas)
13. Total site area 13.02
(acres) *
14. Post- 1.00
construction (Estimated)
impervious area
(acres) *
Project Tracking ID NCC-IREDE-2021-Hwy 3 LCID Landfill/Sawmill 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 Coddle Creek
Waterbody* Name of waterbody into which stormwater runoff will discharge
15b. Waterbody 13-17-6-(0.5)
Index No. * NCWaterbody Index Nurrber
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 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.
1. Permittee * Legally Pesponsible Entity
Bradley W. & Nicole R. Mills
It pernittee is an individual, enter first and last narre in this field. Otherwise, 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 * Bradley
IF Corporation, enter Faegistered Agent First Wre
3. Last Name* Mills
It Corporation, enter F;bgistered Agent Last %rre
3b. Title owner
4. Permitee E-mail [e-mail]
Address*
5. Permittee 704-657-2234
Telephone No.*
6. Permittee Mailing Street Address
Address* 284 Barfield Road
Address Line 2
City State / Frovince / Fbgion
Mooresville NC
Fbstal / Zip Code Country
28115 USA
Check box if the F Yes
street address the
same as mailing
address
7. Permittee Street
Street Address
Address*
284 Barfield Road
Address Line 2
City
State / Frovince / Faegion
Mooresville
NC
Fbstal / Zip Code
Country
28115
USA
8. Type of
ONnership is only individual if an individual
is named in B.1. above.
Ownership*
Individual

C. Site Contact Information
Part C.
Roject Site Contact Inforrration
....................................................................................................................................................................................................
1. Primary Site
Bradley
Contact - First
Name *
2. Primary Site
Mills
Contact - Last
Name *
3. Title
Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
704-657-2234
Telephone No.
6. Organization
Name
7. Site Contact
Street Address
Mailing Address*
284 Barfield Road
Address Line 2
City
Mooresville
Fbstal / Zip Code
28115
8. Consultant Name
(Optional)
First and Last nacre
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]
Default is legally responsible person e-rrail
12. Billing
(For Annual Fee correspondence)
Telephone
704-657-2234
Default is legally responsible person telephone
State / Rovince / Region
North Carolina
Country
United States

D. E&SC Plan
Part D. ^
Erosion & Sediment Control (E&SC) Ran Approval Information
......................................................................................................................................................................................................................................................................................................................................
1. Date E&SC Plan 04/15/2019
Approved *
2. E&SC Plan Project IREDE-2019-075
Number/ID * Assigned by agency or local program
3. E&SC Plan f State DEQ Office
Approved by* r Local Program
4. Local Program* Iredell 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 Letter of Approval.pdf 970.96KB
Approval letter or Mist beRDFformat
Grading Permit
6. Signed FRO Financial Responsibility/Ojvnership Form
Mast be RDFform3t
7. Site Location Map Mast be RDFfornat (lint 20 W)
Approved Erosion Control and Diversion Ditch Plans
3.15MB
Rev 041619- SEALED.pdf
Rease do not upload entire set of E&SC plans.
8. Notes (Optional) Provide any additional information that night help the reviewer better understand how uploaded documents support
the application. Include additional w aterbodies if necessary.
9. NOI Certification Hwy 3 LCID Landfill Notice of Intent Stormwater
Form 440.04KB
signed.pdf
Mast be RDFfornat
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* Bradley Mills
ale owner
Organization Legally Pesponsible Entity
Bradley W. & Nicole R. Mills
09/04/2021

F. Tracking and COC Info
NOI Tracking No. 64178
NC Reference No.
NCG01-2021-5040
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC215040
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5040
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. NCC215040-2021
Invoice Due Date 10/7/2021
Initial Fee $ 100.00
Invoice Status OPEN