NCC240176_MODIFICATION Supporting Docs (LOT 628)_20240214

NCG01 Coverage Lot 628 Brookberry EN2400039
Ronnie Holbrook <[e-mail]>
Tue 2/13/2024 2:58 PM
To:Justin Reece <[e-mail]>
Hi Justin,
The plan for Lot 628 Brookberry EN2400039 has been approved as noted. Before the Grading/Erosion Control Permit
can be issued you must provide documentation that you have obtained coverage under the NCG01 Construction
Stormwater Permit(NPDES). Please obtain coverage under the permit at the following website
(https://edocs.deg.nc.gov/Forms/NCG01-NOI). Once coverage is obtained please upload a copy to the project
documents for this project in IDT. The Grading/Erosion Control Permit will not be issued until proof of coverage under
NCG01 is provided. Erosion Control Reviews can be approved on Building Permit application once this uploaded and the
Grading Permit fee is paid.We will need to schedule an on-site precon before work begins.
Thanks,
Ronnie D. Holbrook
Erosion Control Inspector
Office: 336-734-1299
Fax: [phone]
Mobile: [phone]
City Of Winston Salem
Field Operations Department
Erosion Control Division
100 E. First Street, Suite 328
Winston Salem, NC 27101
City of Winston-Salem
ONE TEAM
Committed to Excellence
All e-mails including attachments sent to and from this address are subject to being released to the media and the public in accordance with the North
Carolina Public Records Law.

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zn�'""'Ogs►f (t Bryce A.Stuart Municipal Building
hor y�c Suite 328
4 Single-Family Dwelling µilLtil„MNim 100 E. First Street
INSPECT DNS
City of Winston-Salem Winston-Salem, NC 27101
DIVISION Field P.O. Box 2511
Excellence lhravgh Semce Erosion Control P e r m i t Application pP Operations Winston-Salem, NC 27102-2511
Please use this form when the Developer and Builder are not the same Phone:311 or(336)747-7453
financially responsible party/person and will be less than one (1) acre of Fax: [phone]
land disturbance on any one (1) lot.
Lot(s)to be Developed Information (� —t— / r
Site Address: 17 O 7 �4 d;q0 8 t n ky,q C I w, J I,- S G /e�., �l� ��l C�t5
(� I v
Subdivision Name: B roA �j eery Falw
Anticipated Dates of Construction Activity: Start:-- OQ Ild 190 D y Completion: / o7O D q
***Complete the LOT INFORMATION TABLE for each lot to be developed;ensure that the appropriate drainage pattern type is
denoted. Attach a corresponding, existing platted survey for each lot with your application,please. If not,your permit
application may not be accepted for review.***
Financially Responsible Party/Person
Name: 7),� e eoecdo" In vo4es LL II
Address: n / S Ale 0-doe1" � S4 700
City/State/Zip: Office Phone:L33 90 ! -oao)
r'
Mobile Phone:(3 36) 0,2- y 7 Email Address: I'Pe c e H i,� genera u a+ho�es. C o Ak
My signature hereto signifies I am the owner/financially responsible party for job site compliance with the Erosion Control Ordinance
as outlined in Chapter, Section 8.4 of the Unified Development Ordinances(UDO)of the City of Winston-Salem/Forsyth County or
Article IV of the UDO of the Village of Clemmons, Town of Lewisville,or Town of Walkertown. I hereby acknowledge that the Best
Management Practices annotated on the attached sketch plan must be properly installed and maintained to retain soil within the
constructed lot.
I understand that if the total disturbed area for any reason becomes greater than one acre on any one(1)lot, a professionally designed
and sealed Erosion Control Plan will be required to be submitted and approved before the start of the land disturbing activity on the lot. I
further acknowledge that City Inspection's staff may refuse to make building inspections and the Erosion Control Division may issue
Notices of Violation, Stop Work Orders and/or Civil Penalty Assessments for failure to comply with Erosion Control requirements.
�s ��, ece- T614 l
e- G !-)
Print Name of Financially Responsible Person Sign a of Financially Responsible Person
TO BE COMPLETED BY CITY STAFF ONLY:
Date of Application Submittal:
Permit Number:

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