Vista Ridge 3G-PT011015 Mail to; Storm Water Nolice of I nlenliU$ I=PA - ICC Building;1201 ~on~lilulion Ave. NW - Room ?329;~as~ington. DC
THI~ FORU R~P~ PREYIOU~ ~ORU ~10-6 (8-~8) Form Approved. o~ ~o.
See Reverse for lnst~c~ons
NPDES ~ EPA Unit~ Slates Environmental ProtecE~ Agency Washington. DC 2~60
FORM Notice of Intent (NOI) ~r Sto~ Water Dlscha~es Associated with
CONSTRUCTION AC~ Under a NPDES Ge~ral Permit
Submiss~ of ~is Nofi~ of Intent ~nstitutes notice ~at ~e parly idenfifi~ in Section I of this form inten~ to ~ aulhor=ed by a NPDES ~rmit ~s~d
~ storm ~ler d~rg~ ~so~l~ ~th constr~ion ac~ in ~ S~l~n Coun~ Land ~en~d in ~n II ~ this ~rm. Subm~i~ of
of intent abo c~ti~es ~e t~t Ihe ~ iden~ in S~i~ I of this ~rm ~els ~e el~Jbil~ mquiremen~ in Pa~ I.B, of ~e general ~rm~ (including
those relaled to ~ot~ of endangered sped~ de~rmin~ thro~h the p~ur~ in Ad~dum A ~ the ~neral permit), unders~nds ~at ~nfinued
author~ to dis~rge is ~n~ent ~ ~in~ining p~mR el~i~l~y, and ~t imple~ntati~ ~ ~ Storm Waler ~BuU~ ~e~ntion Plan r~uir~ u~er
Part IV ~ the gemini ~ ~11 ~gin at the time the ~rmi~ee commen~s ~rk on the ~ns~on project ~en~ed in S~ion II ~1~. IN ORDER TO
OBTAIN A~HORI~TION, ALL INFORMATION REQUESTED MUST BE INCLUDED ON THIS FORM. SEE INSTRUCTIONS ON BACK OF FORM.
I. OwnerlO~tor (Applicant) In~alion
S~t~ of
Addre~:[~~ I~~l~ I~ ]Sl~Jel 1310101 I I I J I I I ] ~er~pe~t~;
II. Pmjec~Site In~r~fion [ Is Ihe ~dl~ ~t~ ~ I~ian
~unl~ Lands?
Has lhe Storm ~ter ~llut~ P~ent~ Plan (SWPPP) been p~e~r~? Yes ~ ~ ~
Op~nal: Addm~ of lo.lion of
S~PP for ~ng ~ A~ress in ~ct~n I a~ ~ A~r~s in ~n II ab~ ~ Other addre~ (ii kn~)
SWPPP Phone:
City: I ~ ~ ~ ~ I ~ ~ ~ ~ ! ~ ~ { { I ~ ~ I I I I ~ S~te: ~1 ~ ~p~e:J I { ~ I [-{
[t ~ ~ ~ Z ~ 0, ~ [~ 9 ~ 5 ~ ~ ~ 2[ 8~ ~ ~slrudion pr~id~ in Addendum A of the ~rmit,
M~ih O~ ~ ~ Day ~ar ~ere a~ I~t~ ~angemd or ~reatened spas, ~ deg~ated
Esfi~t~ ~tm~ion S/a~ Date EstJ~{~ ~mpiefion Date crit~l habitat in the pmj~t ~ea?
Esti~te~areato~dis~r~[to~aresta~e): I I I I I J 51 ~ ~ No ~ -.
E~imate of Likelih~ of Disc~rge (ch~se onN one): I h~ ~fisfied pe~it ~igibili~ ~ regard to pmt~fi~ of
en~ ~ ~r~h ~e i~i~t~ ~ o~ ~ I.B.3.e.(2)
I ce~ un~r pena~ of law that Ibis U~umem and all aaach~n~ were pre.red under my di[ecti~ or supe~ision in ~o~ance wi~ a system
d~igned to ~sum ~a( q~l~ ~nnel p~ ~r and e~luate the inf~Uon su~. ~d ~ my i~ui~ of ~ ~ ~ ~mo~ w~
~nage this syslem, o~ ~ ~m~ Uirect~ res~nsib~ ~r ga~e~ the )nfo~alion, ~ )n~a~n submi~ is. to ~e ~st of my kn~ge a~
~lieL tree, a~um~, and ~mplete. I am aware that Ihem am ~n~ ~nalUes for submi~ng false inf~t~n, including ~e ~ibil~y o( fine and
im~on~nt ~ k~ng ~atlons.
E~ Fo~ 351~9 re~ac~ ~1~6 (~98)
Date: 10 15 01
I C I
Construction, Inc.
Cary Schmoldt
Project Manager
5485 BELTLINE ROAD
SUITE 300
DALLAS, TEXAS 75240
972-387-0462
FAX 972-387-4022
cschmodlt~icidallas.com
wvw.icidallas.com