3400 RIVERFRONT BLVD BASE FILE 2020-07-15

t ' • • Did you know you can submit your NOl electronically using our secure, easy to use online system? www.ecy.wa.gov/programs/wq/stormwater/construction/enoi.html NOTICE OF INTENT(N01) Check if applicable: APPLICATION FORM II Change or Update Permit Information Construction Stormwater General AModification of Permit Coverage DEPARTMENT OF Permit#WAR302222 ECOLOGY Permit State of Washington Please print or type all sections of this application.All fields are required unless otherwise marked.(use[tab]to navigate through fields) I.Operator/Permittee(Party with operational control over plans and specifications or day-to-day operational control of activities that ensure compliance with Stormwater Pollution Prevention Plan(SWPPP) and permit conditions. Ecology will send correspondence and permit fee invoices to the permittee on record.) _ Name:Alaina Robertson Company: Riverfront Commercial, LLC E-mail:alaina.robertson@polygonhomes.com Unified Business Identifier(UBI): 603307071 Business Phone: Ext. (UB1 is a nine-digit number used to identify a business entity. 425.586.7700 Write "none"if you do not have a UBI number.) Cell Phone(Optional): Fax(Optional): Mailing Address: _ 11624 SE 5th St City: State: Zip+4: Bellevue WA 98005-3590 IL Property Owner(The party listed on the County Assessor's records as owner and taxpayer of the parcel[sJ for which permit coverage is requested. Ecology will not send correspondence and permit fee invoices to the Property Owner unless he/she is also the permittee. The Property Owner information will be used for emergency contact purposes.) Name: Riverfront Commercial,LLC Company(if applicable): Riverfront Commercial, LLC Business Phone: Ext. Unified Business Identifier(UBI): 603307071 425.586.7700 (UBI is a nine-digit number used to identify a business entity. Cell Phone(Optional): Fax(Optional): Write"none"if you do not have a UBI number.) E-mail:alaina.robertson@polygonhomes.com Mailing Address: City: State: Zip+4: 11624 SE 5th St Bellevue WA 98005-3590 Ill. On-site Contact Person (Typically the Certified Erosion&Sediment Control Lead or Operator/Permittee) Name: Company: Ron Bown Riverfront Commercial, LLC Business Phone: Ext. Mailing Address: 425.586.7700 11624 SE 5th St Cell Phone(Optional) City: State: Zip+4: Fax(Optional): Bellevue WA 98005-3590 E-mail:ron.bowen@polygonhomes.com IV. WQWebDMR(Electronic Discharge Monitoring Reporting) You must submit monthly discharge monitoring reports using Ecology's WQWebDMR system. To sign up for WQWebDMR, or to register a new site,go to www.ecy.wa.qov/programs/wq/permits/paris/portal.html. If you are unable to submit your DMRs electronically,you may contact Ecology to request a waiver. Ecology will generally only grant waiver requests to those permittees without Internet access. Only a permittee or representative,designated in writing,may request access to or a waiver from WQWebDMR. To have the ability to use the system immediately,you must submit the Electronic Signature Agreement with your application. If you have questions on this process,contact Ecology's WQWebDMR staff at WQWebPortal@ecy.wa.gov or 800-633-6193 or 360-407-7097(local). ECY 020-85(Rev. 12/14) /7-1/K