HomeMy WebLinkAboutNCC221463_NOI Signed Certification_20220413NCG01 Notice of Intent (NOI) Certification Form
Directions:
Print this form, complete, scan and upload to the electronic NOI.
Then, mail the original form to the NC DEMLR Stormwater Program (with $100 check if paying by check) at:
Division of Energy, Mineral & Land Resources Stormwater Program
S12 N. Salisbury Street, 6,1 Floor (Office 640K)
1612 Mail Service Center
Raleigh, NC 27699-1612
DO NOT MAIL THIS FORM OR PAYMENT
UNTIL YOUR APPLICATION HAS BEEN REVIEWED AND ACCEPTED AS COMPLETE
Per NC General Statute 143-215.6B (i), any person who knowingly makes any false 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 ... shall be guilty of a Class 2 misdemeanor which may include a fine not to
exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that (check all boxes to indicate your agreement):
d 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.
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.
f� I will abide by all conditions of the NCGO10000 General Permit and the approved Erosion and Sediment Control
Plan.
If the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution
Prevention Plan) of the NCGO10000 General Permit, I will nonetheless ensure that all conditions of Part II of the
permit are met on the project at all times.
I hereby request coverage under the NCGO10000 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.
Name of Project (must match Ala): Townes at Stonecrest
Specific Lot Numbers (must match Alb): See attached
Legally Responsible Organizational Entity (must match B1): D.R. Horton, Inc
Legally Responsible Person (must match B2 & B3): Debra Green
Title of Legally Responsible Person (must match B3b): City Manager
Name & Title of Signed if Authorized Individual
Differs from Legally Responsible Person:
Phone Number: 843.455.4995
ature of Legally Responsible Person or Authorized Individual
Date
* IMPORTANT NOTE: This form must be signed by a responsible corporate officer that 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 NCGO10000 permit.
Stonecrest Townhomes PIN Numbers- D.R. Horton
Unit 208:
9660-90-5621
Unit 209:
9660-90-5519
Unit 210:
9660-90-5517
Unit 211:
9660-90-5505
Unit 212:
9660-90-5503
Unit 213:
9660-90-5309
Unit 214:
9660-90-5317
Unit 215:
9660-90-5325
Unit 216:
9660-90-5333
Unit 217:
9660-90-5331
Unit 218:
9660-90-5267
Unit 219:
9660-90-5285
Unit 220:
9660-90-5294
Unit 221:
9660-90-6212
Unit 222:
9660-90-6231
Unit 223:
9660-90-6149
Unit 283:
9660-90-6665
Unit 284:
9660-90-6652
Unit 285:
9660-90-6650
Unit 286:
9660-90-6548