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HomeMy WebLinkAboutNCC205305_Modification Review_20240129 Action History (UTC-05:00)Eastern Time(US&Canada) Submit by Anonymous User 1/26/2024 7:53:52 AM (ADD TO FILE Submittal) Approve by bethany.georgoulias 1/29/2024 1:24:42 PM (Construction COC ADD TO FILE Review-NCC205305) • The task was assigned to bethany.georgoulias.The due date is:January 31,2024 5:00 PM 1/26/2024 7:53:53 AM Ago Permit for DEQMODIFICATION Construction0i00 0000 Certificate of NCC205305 Coverage(COC)No.* Enter the Certificate of Coverage Number(Use capital letters) 2020 Annual Fee Status 2021 Annual Fee Status 2022 Annual Fee Status May be blank if N/A PAID PAID May be blank if N/A May be blank if N/A 2023 Annual Fee Status 2024 Annual Fee Status PAID May be blank if N/A May be blank if N/A Information associated with this permit: Project Name NCC-GUILF-2021-Contract 2018-051A, Davie Street Streetscape Improvements Address 200 N.to 339 S. Davie Street,Greensboro, NC County Guilford Latitude 36.0718 Longitude -79.7891 Permittee Listed City of Greensboro Legally Responsible Jason Geary Individual At the time of Modification Request(not looked up again at review) NC Reference No. NCG01-2020-5305 E&SC Plan ID GUILF-2021-003 Original NOI Tracking 36479 No.* Date COC Issued* 12/02/2020 Prior Rescission Date This field will populate only if COC has already been rescinded. Modification Information: Reason for Modification* Closed-Out Lots/Outparcels in E&SC Plan Additional Lots/Outparcels Approved-E&SC Revised Other Revision(s)to E&SC Plan Legally Responsible Individual and/or Site Contact Has Changed Multiple Reasons(List) Addional Explanation More information(e.g.,new Site Contact details).If lots are being added,please include specific lot numbers. The previous erosion control permit had expired.A new erosion control permit has been obtained. You must upload supporting documentation below. Do not upload E&SC Plans unless specific plan sheets are the only documentation with approval for revised acres of disturbance, etc. (only upload applicable sheets). For changes to the legally responsible individual, you must upload this form. Supporting Documentation Upload Supporting Documentation(Revised E&SC Approval,Close-Out Doc,etc.) 2018-051A_Approval_with_Modifications-Contractor copy.pdf 806.84KB Must be PDF format Is this project funded with ARPA(American Rescue Plan Act)grant funds? No Yes This question was added to the eNOl on 2/3/2023 and will not be answered in applications submitted prior to that date. North Carolina General Statute 143-215.613(1)provides that: 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;or who knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article;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 Article shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars($10,000). * I hereby request modification to coverage under the NPDES Stormwater Permit for the subject project site. I am familiar with the information contained in this request and to the best of my knowledge and belief such information is true,complete and accurate. Specify if you are:* The Legally Responsible Individual Authorized Responsible Person' 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 NCG010000 General Permit. For more information on signatory requirements,see Part IV,Section B, Item (6)of that permit. Signature cTJ s miff Type Name* Jason S. Geary, PE Title* Deputy Director, Engineering&Inspections Organization* City of Greensboro Date* 01/26/2024 Email Address* Jason.Geary@greensboro-nc.gov Email for confirmation Telephone Number* (336)373-2302 Contact number if we need to reach you Note:Original permittee and site contact are copied on modification correspondence. Additional Email Guy.ingle@greensboro-nc.gov (Optional) Additional email for confirmation Original Permittee jason.geary@greensboro-nc.gov Email Original Site Contact Melinda.King@greensboro-nc.gov Email Review Date 01/29/2024 Rescinded Since Submitted?