NCC191823_NOI Signed Certification_20190916

NCG101 hlotice of Intent (N101) Certificatimi Florin
Directloiris',
Division of Energy, Mineral & Land Resources Storm,water Program
512 N. Salisbury Street, 6" Floor
1612 Mail Service Center
or certification in any application, record, report, plan, or other documentfiled or required to be mointaine
under this Article or a rule implementing e guilty of a Class 2 misdemeanor which may
include a fine not to exceed ten thousand dollars (510,000). 1
Linder penalty of iavv, l certify that (check aH boxes to indicate your agreement),
E am the person responsible for the conStrUction activities of this project, for satisfying the
requirements of this permit, and for any civil or crirninal penalties incurred due to vioations of this
permit.
IM The information submitted in this NU is, to the best of my knowiledge and belief, true, accurate, and
complete based on my inquiry of the person or persons, who manage the systern, or those persons
directly responsible for gathering the information.
[75 l will abide by all conditbns of the NU1,1010000 Generai Perrilfit and the approved Erosion and
Sediment Control Plan.
7x if the approved Erosion and Sediment Control Plan is not compliant with Part 11 (Stormm/ater Pollution
Prevention Plan) of the, N(­((')]�)�)()o Geine� fl,._Flerrr6t, l will nonetheless ensure that all conditions of
Part H of the permit are met on the project at all times.
EN hereby request coverage under the \JCG010000 Geneiral ilerrnit and understand that coverage under
this permit swill constitute the permit requirements for the discharge(s) and is enforceable in the
sw-ne manner, as an individual permit,
Name of Project: Cameron Woods Subdivision, Phase 11
Title of Legailly Res
wm�
'I /
IMPORTANT NOTE: Thisform 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 w ith Part IV, Section 8, Item (6) of the NCG010000 permit.
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