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HomeMy WebLinkAboutNCC190182_NOI Application_20190503 Action History (UTC-05:00) Eastern Time(US&Canada) Submit by Anonymous User 5/3/2019 9:33:03 AM(NCG01 NOI Submission) Approve by Morman,Alaina 5/6/2019 10:53:05 AM(Review-Construction NOI 10644) • The task was assigned to Morman,Alaina by round robin distribution 5/3/2019 9:33 AM • The task was assigned to DEMLR NCG01 NOI Review Team.The due date is: May 7,2019 5:00 PM 5/3/2019 9:33 AM Submit by Morman,Alaina 5/6/2019 10:54:16 AM(Payment Verification-NCG01-2019-0182) • The task was assigned to Morman,Alaina.The due date is: May 7,2019 5:00 PM 5/6/2019 10:53 AM E, • 1 • • 1 III • 1 1 sees �' � ••. -• i •• i i• i IY sell NORTH CAROLINA Environmental QUII A. Project Information Part A. Project Location and Waterbody Information 1. Project Name* Cheyney Phase 1 2. County* Mecklenburg 3. Highway or Street 10230 Arthur Davis Rd. Address* Street narra only is acceptable if no address nurrber assigned yet 4. City or Township* Charlotte 5. State* NC 6.Zip Code* 28269 7. Latitude* Enter the latitude in decirral degrees 35.3600 8. Longitude* Enter the longitude in decirral degrees(MJSTbe negative) -80.8100 If you do not know the latitude and longitude coordinates for this project,you can search the location on this map of North Carolina. Look for the coordinates in the bottom left corner. 9. Date to Begin* 05/06/2019 Estimated Construction Project Start Date 10. Date to End* 05/07/2021 Estimated Construction Project End Date 11. SIC(Primary)* Residential, Single Family Houses(SFE) (1521) Standard Industrial aassification for Developrrant 12.Acres to be 32.50 disturbed* (including off-site borrow and waste areas) 13.Total site area 45.20 (acres)* 14. Post- 12.12 construction impervious area (acres)* NCC Project NCC-MECKL-2019-Cheyney Phase 1 Tracking ID Assigned automatically Below you must enter waterbody information for surface waters affected by this project. Please consult DWR's Surface Water Classifications Map Viewer to find waterbody name and corresponding index number. You may enter up to 3 waterbodies. 15a. Receiving Clarks Creek Wate rbody* Nacre of waterbody into which stormvwater runoff will discharge 15b.Waterbody 13-17-5-2 Index No.* NCWaterbody Index camber Stormwater fJ No discharges will flow r Yes to additional wate rs* 16a.Is this project F Yes subject to the NC r No, not subject to NC SPCA Sediment Pollution Control Act?* B. Permittee Information Part B. Perrrittee Information-Legally Responsible Entity and Individual ..................................................................................................................................................................... Important:The person who signs the NOI Certification Form and signs the Certification in Section E of this application form should be the same person as listed in THIS SECTION, or an authorized responsible individual within the same organization. That person must be a responsible corporate officer who 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. 1.Organization Mattamy Carolina Corporation Name* 2. First Name* Brian ff Corporation,enter Registered Agent First l\b e 3. Last Name* Johnson ff Corporation,enter Registered Agent Last Barre 4. Permitee E-mail BA.johnson@mattamycorp.com Address* 5. Permittee 7045077547 Telephone No.* 6. Permittee Mailing Street Address Address* 2025 Ayrsley Town Blvd. Address Line 2 Su ite 1104 City State/Province/Region Charlotte NC Fbstal/Zip Code Country 28273 United States of America Check box if the V Yes street address the same as mailing address 7. Permittee Street Street Address Address* 2025 Ayrsley Town Blvd. Address Line 2 Suite 1104 City State/Province/Region Charlotte NC Postal/Zip Code Country 28273 United States of America C. Site Contact Information Part C. Project Site Contact Information .................................................................................................................... 1.Type of Non-Government Ownership* 2. Primary Site Brian Contact-First Name* 3.Primary Site Johnson Contact-Last Name* 4.Title Director of Land Development 5.Site Contact E- BA.Johnson@mattamycorp.com mail Address* 6.Site Contact 7045077545 Telephone No.* 7.Organization Mattamy Carolina Corporation Name 8.Site Contact Street Address Mailing Address* 2127 Ayrsley Town Blvd. Address Line 2 Suite 201 City State/Province/Pegion Charlotte NC Fbstal/Zip Code Country 28273 United States of America D. E&SC Plan Part D. Erosion&Sediment Control(E&SC)Ran Approval Information ....................................................................................................................................................................................................................................... ............................................................................................. 1. Date E&SC Plan 05/02/2019 Approved* 2. E&SC Plan Project LDGPR-2019-00085 Number/ID* Assigned by agency or local program 3. E&SC Plan f State DEQ Office Approved by r Local Program 4. Local Program* City of Charlotte Documentation of E&SC Plan approval and the signed Notice of Intent(NOI)Certification Form is required for a complete application. 5. E&SC Plan Cheyney Phase 1 -City of Charlotte Grading Letter Approval 27.96KB of Approval.pdf letter/documentation Mist be R7F format 6. NOI Certification Cheyney Phase 1 -NOI Certification Form.pdf 61.96KB Form Mist be RDFfornat This is an Express r No Review Project* r Yes E. Certification North Carolina General Statute 143-215.6B(1)provides that: Anyperson who knowinglymakes any false statement,representation,or certification in anyapplication,record,report,plan,or other documentfiled or required to be maintained under this Article or a rule implementing this Article;or who knowinglymakes 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 deice or method required to be operated or maintained under this Article or rules of the Commission implementing this Article shall be guiltyofa Class 2 misdemeanor which mayinclude a fine not to exceed ten thousand dollars($10,000). Under penalty of law, I certify that: rJ 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. * rJ 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. * I7 I will abide by all conditions of the NCG010000 General Permit and the approved Erosion and Sediment Control Plan. * rJ If the Erosion and Sediment Control Plan approved by the delegated program is not compliant with Part II(Stormwater Pollution Prevention Plan)of the NCG010000 General Permit, I will nonetheless ensure that all conditions of Part II of the permit are met on the project at all times. * I7 I hereby request coverage under the NCG010000 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. Specify if you are:* r The Responsible Person named on this Notice of Intent r Authorized Responsible Person* Important:The person who signs this Certification above and signs the NOI Certification Form should be the same person(or authorized responsible person within the same organization)as listed in Section B(Permittee Information) of this form. *An authorized individual is a responsible corporate officer who 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 Z Type Name* Brian Johnson Date* 05/03/2019 F. Tracking and COC Info NOI Tracking No. 10644 NC Reference No. NCG01-2019-0182 Uses'count_nunber variable(incremented by SP) Certificate of NCC190182 Coverage (COC) Uses'count_nunber'variable(increrrented by SF) No.* Count Number 182 Sequential nunber for subrrittal that is increrrented by Stored Procedure COC Year 2019 Year of date reviewed,used to assign YY digits after"NOC'in OOC no.)