NCC190453_NOI Signed Certification_20190603

NCGO1 Notice of Intent (NOI) C IIrfi' j j aIIIi ",I
Wlre t i 1111 :
Print this form,complete,scan and upload to the electronic NOL
Then,mail the original form to the NC DEMLR Stormwater Program at:
Division of Energy, Mineral&Land Resources Stormwater Program
512 N.Salisbury Street,61'Floor
1612 Mail Service Center
Raleigh, NC 27699 1612
Per NC General Statute 1 ®21 (i), any person who knowingly makes any false statement, representation,
or certification in any application,record,report,plan, or other documentfiled or required a 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( 1 , .
I.,hider penalty of Ilaw, I c,ertlfy that (dl'iueck all boxes to indicate your agreement):
I airr the Iper.sou'ri for the construction activities oft is project,for satisfy1ing thnr
recquiu°emeruts of finis q,.nei rrrniit, and for any civil or criminal penalties incurred due to viioladoirns of tll°nis
p e n°rirn it w
_111rue lurdoir'nriation subirnitted in this NU iis, tote best of my knowledge and belief,trule, ac,cu.,cri te, arnn:l
conrn�plle'lte (based on rruy inquiry of the eu°son or persons who mainage the system,oir°tilruose peirsons
chirlectly responsible foir°gathering the iinformation.
I will abicie by a111l conditiioirni,of the rnnd tlliue aI Iprovelrl IEirosiiriiru airud
Sedlunent Control Pllainw
If the all::npiroved Il:wrosiiou°u and Sediment (.rou°utrr.nf II:'llarn lis not cr irnnll,rlliaint With (Bart III (Stonnrnwater IPollln,ution
f)u°eventioi n IIDl.ain'Q of the E jig nip r oaf{ [)ei o Ju,. II M111 noii,i tJliieMllee�,s nuv�slu e'�:Ilnat�allll coins°.litiiou'ris of
Part II@ oftlhe Il::neir•rnrlit are rrnet on the! proiect at aIIII tinges.
I hierrallry request coveria e urndieur the C fig (;o➢r li['10r1 I P� r ni-iu q and unideirstarnd tlmi�t�cloveiralgie under
NNNN, NNNN NNNN NNNN.
this pierrnit wH1 ci nrmstitUte tl1hme ,peirnrnk recqu'iireirneirruts fcuirtlree dii^sclharge(s) and is enfoirceall::lle irrn the
sa rm� manner as aindividualn pernit.
Name of Project: Erwin-Selma 230kV Transmission Line Switch Installations and Access Roads
Legally Responsible Organizational Entity: Duke Energy Progress
Legally Responsible Person: Rodney Hutcherson
l
Title of Legally o rso irc r o rns mission Duke r Progress
Signature, at e
*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 NCG010000 permit.
For more information on signatory requirements,see Part IV,Section B, Item(6)of the NCG010000 permit.