NCC233391_Modification Review_20250429

Action History(UTC-05:00)
Submit by Anonymous User 4/25/2025 4:24:08 PM (ADD TO FILE Submittal)
Approve by bethany.georgoulias 4/29/2025 7:03:18 AM (Construction COC ADD TO FILE Review-NCC233391)
• The task was assigned to DEMLR NCG01 MOD Review Team.The due date is:April 30,2025 5:00 PM
4/25/2025 4:24:09 PM
• The task was assigned to bethany.georgoulias by round robin distribution 4/25/2025 4:24:09 PM

Ago Permit for DEQMODIFICATION
Construction0i00
0000
Certificate of NCC233391
Coverage(COC)No.* Enter the Certificate of Coverage Number(Use capital letters)
Initial Permit Fee Status Initial Payment Received
PAID 11/14/2023
(N/A prior to Oct 2020) (N/A prior to Oct 2020)
2020 Annual Fee Status 2021 Annual Fee Status 2022 Annual Fee Status
May be blank if N/A May be blank if N/A May be blank if N/A
2023 Annual Fee Status 2024 Annual Fee Status 2025 Annual Fee Status
May be blank if N/A PAID May be blank if N/A
May be blank if N/A
Information associated with this permit:
Project Name Woodview Estates Lot 31
Address 8727 Maltese Ct., Lewisville, NC
County Forsyth
Latitude 36.0730
Longitude -80.4299
Permittee Listed Third Generation Homes LLC
Legally Responsible Andrew Reece
Individual At the time of Modification Request(not looked up again at review)
NC Reference No. NCG01-2023-3391
E&SC Plan ID EN2300267
Original NOI Tracking 169474
No.*
Date COC Issued* Effective Date at Submittal
04/01/2024
Prior Rescission Date This field will populate only if COC has already been rescinded.
Modification Information:
Reason for Closed-Out Lots/Outparcels in E&SC Plan
Modification* ) Additional Lots/Outparcels Approved-E&SC Revised
J Other Revision(s)to E&SC Plan
0 Legally Responsible Individual and/or Site Contact Has Changed
0 Multiple Reasons(List Below)
0 Other(Describe Below)

Reason for Modification Supporting Doc Name
(ADDL LOTS)
Reviewer Reference Only(Not Visible on Starting Form)
Additional Description/Explanation
More information(e.g.,if lots are being added,please include specific lot numbers.)
Lot Number:38
Address:1379 Ashfield Dr. Lewisville, NC 27023
Parcel ID:5874-78-1369
Permit Number: EN2500090
Site Contact:Jonathan Bottoms,336-840-8125
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).
Supporting Documentation
Upload Supporting Documentation(Revised E&SC Approval,Close-Out Doc,etc.)
WV 38 Approval Letter.pdf 882.14KB
Must be PDF format
Is this project funded with ARPA(American Rescue Plan Act)grant funds?
This pertains to funding distributed by the N.C.Division of Water Infrastructure(DWI)only.
No
Yes
Is this project funded with N.C.Session Law 2023-134 Section 12.2 Earmark funds?
No
Yes
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
Type Name* Alex Mitchell
Title* Project Estimator
Organization* Third Generation Homes LLC

Date* 04/25/2025
Email Address* [e-mail]
Email for confirmation
Telephone Number* 3367828268
Contact number if we need to reach you
Note:Original permittee and site contact are copied on modification correspondence.
Additional Email [e-mail]
(Optional) Additional email for confirmation
Original Permittee [e-mail]
Email
Original Site Contact [e-mail]
Email
Review Date 04/29/2025
Rescinded Since
Submitted?
Current Effective Date Current Expiration Date Permit Version
4/1/2024 3/31/2029 2.00