Loading...
HomeMy WebLinkAboutNCC220864_NOI Signed Certification_20220223NCGO1 Notice of Intent (N41) Certification Form DVV0kww Prim M4 farm. Compiat■, sun Oro wpinad to Vw ele twk hO1 Then. mall tr! Orval fort to tlra NC DtMLA SW Pra(r&rrt l.Ati 5]Po cfMci ll0ors"4"drtc&] +T' ONision of (narp, IVinerai 6 tand Mww[+s Stamswit/r Peorsm $12 N. Sa igbwY Street, f l Ftoor 1OW9 r 64%) 1612 ltrail Sew" Cgmtf Raleigh. NC 17691-11W DO NOT MAIL THIS FORM OR PAY101NT UNTU YOUR APPUCATIDM HAS "th At Cf PIID AS COVPtt TV TW FVRM YOU MAR MUST SE COFifKMD VRTW AN OR$ MilAt Wt"TURt (NOT DoGTAs) 140 CFR 122-Ul !v• 1K Grrvr&srraeute 141-2115.0 GL onypmori who kftw *TP1F'wlwv mrt'nC •rtrrre'notbrt dr [err terra• ;n any AWicotbr4 reeds report &m or omen docio Krt fW Of reyuetd :a tar m+ntOh[4 :r+drr Ines AnOe tr a rinse implemtn" this Art•tk ox%ybt puny c/o Crasf 2 M4.* 'r<'o''+dr rdI►Ch evy r r*.dr a Tww ncl rn t.kceed era 0%*A sddo*rs (3IQ0w) l rder Penany of tare, I CM?fY tr•,t ui*utt of tows to inacate your averment l: 0 I am the person reWe sibie fors the 0Qr4U', [1k>n Wtrifles of tNa ptOWI, Iw ""Styeg the re" oe tt+ts permit, and &W arry (MI oe co, ^e as pen4M41 oXW'ed &0 to vlptatians Co tha Pwrit Q The r.Aon &taw s,rte-.tied in thn NOI Is. to IhP best of my tr4w4rd9! and be}.et True, *cc ara*, and Corr Plette based on r,Y1f rryritV of the Perw", Of gemDns Ktfd maNQe the SyLtein, or IhQse Puns drre[T1y eeip4rrtrW }M lathered the hfoern&Tion. Q r will abide ay f1 condAbns or V+t �rtPral it a Sr and Tine kA;wv ed tiresron ar`d SrtJ we+t ContrdT P11n Q if Ztw &➢Proved Erosion and WrNent CCnYrol Plan 1 wrsn none lsmt sdth pjrr l (S rrrw tCf PoloubonR H e' Ow Prevveniort Plana of Ihar NCGdl{+�74Ses�i Permit are rret on the Peo^t at as simes- r❑ I [sere" request twrer4w ur4er the �rrgia0oa G_enrral QYr!R i ar d "efstarrd iho cowaFe Un6rr WS Perm it"oon&IItem the W-ml tea uirtmtmfor the drscnargPls'i and 11,enfcere4blc In the same manner &tan individual perm t. prDkct Name ,n;,fimotrhAla : Heritage Pointo - Lot 35 SwAlc Lot Numbers (meat march +t2_ 6}� Peirri"te (must r wCh 811: V114H TAN tr s: Ref n Uble t�rrson P%usr emfch 62 & 93)- V1NH TAN risibPe+amml83a : OWNER tda Re e u Nafrle 6 Title of Sagntd df Authorized Indiv,dutl VINH TAN DRfers from Leib sicW. rtsibir PeKO Phone Wunder. 9193296789 — !� ?z S#mture of LePly Resararvtle PerSPn orAu':hceired in&Odal r ■ giMWAIIfTAIplL 11,,s 1La ' Tait rbe volr9 &Y d respCe 401* cc'rw'Jlt otter trot averts a• apCdtts :he ACRfL LCTK^ so* as 0Pfe&tbq mere!ary. C•rawnef, Cr rste �^i. a• a m,,-no�rr T'+Cr;s outr+wtrtd;n n[tardorsu w�lA PITIi rr, 5rtfbn Mw(QV/VwN=0wxr-T -d