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HomeMy WebLinkAboutNCC215505_NOI Application_20211006Action History (UTC-05:00) Eastern Time (US & Canada) Subrrit by Anonymous User 10/1/2021 8:49:28 AM (NCG01 NOI Submission) Approve by Broussard, Brooklyn C 10/4/2021 8:19:06 AM (Review- Construction NOI 67641) • The task was assigned to Broussard, Brooklyn C by round robin distribution 10/1/2021 8:50 AM The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 5, 2021 5:00 PM 10/1/2021 8:50 AM Submit by Evans, Shaundra M 10/6/2021 8:11:46 AM (Payment Verification for NCC215505) * Ryan Jackson • Evans, Shaundra M assigned the task to Evans, Shaundra M 10/6/2021 8:10 AM The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 15, 2021 5:00 PM 10/4/2021 8:19 AM .• SThF� '; 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 66752 NOI No. Prior Reviewer Brooklyn Broussard Name 1a. Project Name* Bridle Run 1 b. Specific Lot This field may be used to list specifc lot numbers. Numbers 1 c. Parcel ID List all R% associated w ith this project. Number(s) (PIN) 0782474590, 0782477601, 0782572676 2. County* Wake 3. Highway or Street 4505 Tryon Rd, 4525 Tryon Rd, 2301 Dover Farm rd Address* Street name only is acceptable if no address number assigned yet 4. CityorTownship* Raleigh 5. State * NC 6. Zip Code* 27606 7. Latitude* Enter the latitude in decimal degrees 35.7484 8. Longitude * Enter the longitude in decimal degrees (MJSTbe negative) -78.7127 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* 09/30/2021 Estimated Construction Project Start late 10. Date to End * 05/27/2022 Estimated Construction Project End late 11. SIC (Primary)* Residential, Single Family Houses (SFE) (1521) Standard Industrial aassification for Developrrent 12. Acres to be 16.80 disturbed* (including off -site borrow and waste areas) 13. Total site area 16.77 (acres) * 14. Post- 5.03 construction (Estirrated) impervious area (acres) * Project Tracking ID NCC-WAKE-2021-Bridle Run Assigned autorratically (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 Unamed Tributary to Swift Creek (Yates Mill Waterbody* Pond) Bane of waterbody into which stornwater runoff will discharge 15b. Waterbody 27-43-5(1.5) Index No.* NCWaterbody Index Nirrber 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 CND -Bridle Run, LLC 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 * Ryan If Corporation, enter Faegistered Agent First Wre 3. Last Name* Jackson It Corporation, enter F;bgistered Agent Last %rre 3b. Title Land Manager 4. Permitee E-mail RJackson@dwhomes.com Address* 5. Permittee 919-659-1502 Telephone No.* 6. Permittee Mailing Street Address Address* 1901 North Harrison Ave Address Line 2 Suite 200 City State / Ffovince / Fbgion Cary NC Fbstal / Zip Code Country 27513-2410 UA Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* 1901 North Harrison Ave Address Line 2 Suite 200 City State / Frovince / Region Cary NC Fbstal / Zip Code Country 27513-2410 ILIA 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 Ryan Contact - First Name * 2. Primary Site Jackson Contact - Last Name * 3. Title Land Manager 4. Site Contact E- RJackson@dvvhomes.com mail Address* 5. Site Contact 919-659-1502 Telephone No. 6. Organization CND -Bridle Run, LLC Name 7. Site Contact Street Address Mailing Address* 1901 North Harrison Avenue Address Line 2 Suite 200 city Cary Postal / Zip Code 27513-2410 8. Consultant Name (Optional) Arnaldo Echevarria First and Last narre 9. Consultant E-mail aechevarria@uvithersravenel.com This person will be copied on all correspondence. 10. Consultant 9194693340 Telephone No. 11. Billing E-mail (For Annual Fee correspondence) RJackson@d\Athomes.com Default is legally responsible person e-rrail 12. Billing (For Annual Fee correspondence) Telephone 919-659-1502 Default is legally responsible person telephone State / Rovince / Region NC Country us D. E&SC Plan Part D. ^ Erosion & Sediment Control (E&SC) Ran Approval Information ...................................................................................................................................................................................................................................................................................................................................... 1. Date E&SC Plan 09/23/2021 Approved * 2. E&SC Plan Project LDG-007976-2021 Number/ID * Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by* r Local Program 4. Local Program* City of Raleigh 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 letter or Grading Permit 6. Signed FRO LDG-007976-2021-Bridle Run.pdf Mast be RDFforrrat 112.92KB Financial Pesponsibility/Ownership Form BridleRun_SPR_FinancialResponsibilityOwnership... 767.82KB Mast be RDFforrral 7. Site Location Map Mast be FDFfornat (lirrit 20IVB) SPR-0227-2019 APPROVED REV-1 BRIDLE- 14.19MB RUN Cover_Erosion.pdf Rease do not upload entire set of E&SC plans. 8. Notes (Optional) Frovide any additional information that night help the reviewer better understand how uploaded docurrents support the application. Include additional waterbodies if necessary. 9. NOI Certification Bridle Run NOI V.pdf 516.26KB Form Mast 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 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 r- Type Name* Ryan Jackson Title Land Manager Organization Legally Ibsponsible Entity CND -Bridle Run. LLC Date * 10/01 /2021 F. Tracking and COC Info NOI Tracking No. 67641 NC Reference No. NCG01-2021-5505 Uses 'count_nunber' variable (increrrented by SP) Certificate of NCC215505 Coverage (COC) Uses 'count_nurrber' variable (increrrented by SP) No.* Count Number 5505 Sequential nunber for subnittal 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. NCC215505-2021 Invoice Due Date 11/3/2021 Initial Fee $ 100.00 Invoice Status OPEN