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HomeMy WebLinkAboutNCC190182_NOI Signed Certification_20190503 Notice WV Intent Certification r CHEYNEY PHASE 1 I ireCtM<Cns: Print this form,complete,scan and upload to the electronic NOI. Then, mail the original form to the NC DEMLR Stormwater Program at: Division of Energy, Mineral&Land Resources Stormwater Program 512 N.Salisbury Street,6tn Floor 1612 Mail Service Center Raleigh, NC 27699-1612 Per NC General Statute 143-215.6E(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): 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. M 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 p gathering on responsible for atherin the information. e III II_)eu� ii��and the approved Erosion and will abide b all conditions of the INCG _.. Sediment Control Plan. If the approved Erosion and Sediment Control Plan is not compliant with Part II (Stormwater Pollution Prevention Plan)of the NCGO10000 Geneii � II!!Ie nflt, I will nonetheless ensure that all conditions of �,. N times. Part II Y thge permit are uest g et on the project at � m°III Il) u°°u��ii�:and understand that coverage under this permit will constitute the perm t rthe ire requirements ........i .... g p p q i s for the di scharge(s)and is enforceable in the same manner as an individual permit. Legally Responsible Organizational Entity:�MATTAMY CAROLINA CORPORATION...._ * Legally Responsible Person: BRIAN JOHNSON 5/2/2019 Signature: *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. For more information on signatory requirements,see Part IV,Section B, Item(6)of the NCGO10000 permit.