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i° ' � i . • �QAQjE��of�� °'��.4 NOTICE OF INTENT � �� ' �'��'� , NPDES GENERIC PERMIT FOR STORMWATER � 4 FI.O �A DIS CHARGE FROM LARGE AND SMALL � _ _ _ _ _ _ _ _ _ _ _ CONSTRUCTION ACTIVITIES ; (RULE 62-621.300(4), F.A.C.) You must submit this completed Notice of Intent(NOI)form to the Department to get coverage under the Generic Permit for Stormwater Discharge from Large and Small Consiruction Activities provided in subsection 62-621.300(4),F.A.C. The Generic Permit document[DEP Document 62-621.300(4)(a)]tells you what construction activity qualifies for coverage,how you obtain and terminate coverage,what you must do to minimize poIlution from your construction site,and what conditions apply to your project to use the generic permit. You must submit the appropriate generic permit fee, as specified in paragraph 62-4.050(4)(d),F.A.C.,with this NOI Form to obtain permit coverage. You must read and understand the requirements of the generic permit document and the attached instructions before completing this NOI form. Please print or type information in the appropriate areas below. For construction activities also requiring an Individual Environmental Resource Permit(ERP),under Chapter 62- 330,F.A.C.: If your construction activities are already authorized by a valid Individual ERP issued by the Denartment,Water Mana�ement District or a Delegated Local Government, you may also eiect to use this NOI form to provide the required notice of commencement of construction, in Iieu of Form 62-330.350(1) ("Construction Commencement Notice"). Do you wish to also provide notice of commencement of construction activities authorized under an Individual ERP permit throagh the use of this form? ❑Yes ❑No I. IDENTIFICATION NUMBER: A.Facility ID(if renewing coverage): FLR20AK26-002 B.ERP Pemut Nvmber*(if applicable): C.ERP Permitting Agency(if applicable): *Tf the ERP permit authorizes phased construction,please also indicate which phase. II. STORMWATER POLLUTFON PREVENTION PLAN(SWPPP)DEVELOPED AND READY TO BE IMPLEMENTED: �Yes ❑No *If No,you mav not submit your NOI at this time. III. APPLICANT INFORMATION: i A. OperatorName: The Keamey Campanies ' *BRP Permittee Name(if different than"Operator"),if applicable: B.Operator Status: p C.Address: 9625 Wes Kearney Way D.City: Rivarview E.State: FL F.Zip Code: 33578 0506 G.Responsible Authority: Brian Seeger ' I Pa e 1 of 6 I g DEP Form 62-621.300(4)(b) Effective Date: 02/10/2015