NCC215549_NOI Application_20211006

Action History (UTC-05:00) Eastern Time (US & Canada)
Subrrit by Anonymous User 10/5/2021 10:12:45 AM (NCG01 NOI Submission)
Approve by Broussard, Brooklyn C 10/5/2021 10:23:13 AM (Review- Construction NOI 67900)
• The task was assigned to Broussard, Brooklyn C by round robin distribution 10/5/2021 10:13 AM
The task was assigned to DEMLR NCG01 NOI Review Team. The due date is: October 7, 2021 5:00
PM 10/5/2021 10:13 AM
Submit by Evans, Shaundra M 10/6/2021 8:55:02 AM (Payment Verification for NCC215549)
* Jerry Ricciardi
• Evans, Shaundra M assigned the task to Evans, Shaundra M 10/6/2021 8:54 AM
The task was assigned to DEMLR NCG01 Payment Team. The due date is: November 16, 2021 5:00
PM 10/5/2021 10:23 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 67619
NOI No.
Prior Reviewer Brooklyn Broussard
Name
1a. Project Name* 400H
1 b. Specific Lot This field may be used to list specifc lot numbers.
Numbers Lot 1 (block of Harrington, Hillsborough, West and Edenton St)
1 c. Parcel ID List all RW associated w ith this project.
Number(s) (PIN) 1703592333, 1703592431, 1703591364, 1703591364, 1703591476,
1703591309,1703592436
2. County* Wake
3. Highway or Street 400 Hillsborough Street
Address* Street name only is acceptable if no address number assigned yet
4. City or Township* Raleigh
5. State * NC
6. Zip Code * 27603
7. Latitude* Enter the latitude in decimal degrees
35.7810
8. Longitude * Enter the longitude in decimal degrees (M-STbe negative)
-78.6454
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* 09/16/2021
Estimated Construction Project Start Date
10. Date to End* 09/15/2023
Estimated Construction Project End Cate

11. SIC (Primary)* Commercial (1542)
Standard Industrial Classification for Development
12. Acres to be 2.08
disturbed* (including off -site borrow and waste areas)
13. Total site area 1.10
(acres) *
14. Post- 1.25
construction (Estimated)
impervious area
(acres) *
Project Tracking ID NCC-WAKE-2021-400H
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 Pigeon House Branch
Waterbody* Name of waterbody into which stormwater runoff will discharge
15b. Waterbody 27-33-18
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
BR Hillsborough LLC
It pernittee is an individual, enter first and last narre in this field. Ctherwise, 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 Faegistered Agent First Wre
3. Last Name* Sandreuter
It Corporation, enter Pbegistered Agent Last %rre
3b. Title Member Manager
4. Permitee E-mail [e-mail]
Address*
5. Permittee 919-460-9786
Telephone No.*
6. Permittee Mailing Street Address
Address* 104 Lake Cliff Ct.
Address Line 2
City
Cary
Fbstal / Zip Code
27513
Check box if the
street address the
same as mailing
address
7. Permittee Street
Address*
V Yes
Street Address
104 Lake Cliff Ct.
Address Line 2
city
Cary
Fbstal / Zip Code
27513
State / Frovince / Fbgion
NC
Country
us
State / Frovince / Faegion
NC
Country
us
8. Type of Ownership 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
Rose
Contact - Last
Name *
3. Title
Senior Project Manager
4. Site Contact E-
[e-mail]
mail Address*
5. Site Contact
919-896-5257
Telephone No.
6. Organization
Barnhill Contracting Company
Name
7. Site Contact
Street Address
Mailing Address*
400 Hillsborough Street
Address Line 2
City
Raleigh
Postal / Zip Code
27603
8. Consultant Name
(Optional)
Joe Puckett
First and Last nacre
9. Consultant E-mail
[e-mail]
This person will be copied on all correspondence.
10. Consultant
919-866-4829
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
202-436-2524
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 09/16/2021
Approved *
2. E&SC Plan Project SPR-0007-2020
Number/ID * Assigned by agency or local program
3. E&SC Plan
Approved by*
4. Local Program*
f State DEQ Office
r 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 Grading Permit.pdf 119.21 KB
Approval letter or Mast beRDFformat
Grading Permit
6. Signed FRO Financial Pesponsibility/Ownership Form
FinancialResponsibilityOwnership_BRHillsborough_... 404.58KB
FinancialResponsibilityOwnership_TieOneLLC_sig... 444.67KB
Mist be RDFfon-rat
7. Site Location Map Mist be RDFforrret (lint 201VB)
69d231 dedac348a981 e82a5d82c37fbf.pdf 602.98KB
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.
Comment #1: The latest FRO form, signed February 24, 2020 lists
Greg Sandreuter/BR Hillsborough LLC as the legally responsible
party. Barnhill Contracting Co/Randy Fichera aren't listed on either
FRO forms.
Comment #1 Response: Gregg Sandreuter with BR Hillsborough
has signed the NOI Certification and is now listed on Section B
Comment #2: Al2. The acres approved for disturbance on your
grading permit are 0.00. The total acres to be disturbed between
your two FRO forms is 2.08. Al says 2.10. Three different
disturbed acreage amounts can't be used
Comment #2 Response: The All value has been revised to match
total listed in FRO from original permitting with City of Raleigh to
2.08. The grading permit does show 0.0 and 1.9 but we cannot edit
these values and are unclear why the City didn't match the 2.08
from the FRO and our plans. The 2.08 was rounded to 2.1 for
calculation of fee per Raleigh direction, but for this propose we
have revised to 2.08 in as many places as we are able.
9. NOI Certification Untitled.pdf 88.69KB
Form Mist be R Yformat

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 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* Gregg Sandreuter
Title Member Manager
Organization Legally Pesponsible Entity
BR Hillsborough LLC
Date * 10/05/2021

F. Tracking and COC Info
NOI Tracking No. 67900
NC Reference No.
NCG01-2021-5549
Uses 'count_nurrber' variable (increrrented by SP)
Certificate of
NCC215549
Coverage (COC)
Uses 'count_nurrber' variable (increrrented by SP)
No.*
Count Number 5549
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. NCC215549-2021
Invoice Due Date 11/4/2021
Initial Fee $ 100.00
Invoice Status OPEN