SW3130304_CURRENT PERMIT_20130510

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW�3
DOC TYPE
CURRENT PERMIT
LJ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
YYYYMMDD

I2U&ENR
North Carolina Department�of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P.E.
Governor Director
April 19, 2013
Mr. Robert S. Hall, Sr. Exec. 'Vice President
State Employees' Credit Union
1000 Wade Avenue
Raleigh, NC 27605
Subject: Stormwater'Permit No. SW3130304
State Employees' Credit Union -- Locust
High Density Commercial Wet,Pond Project,
Cabarrus County
Dear Mr. Hall:
John E. Skvarla, III
Secretary
REGEi` ED
DIVJS,10OF WATER QUALITY
MAy 10 2013
MOORES-ViLLE REGIONAL OFFICE
The Stormwater Permitting Unit received a complete Stormwater Management Perm it.Application for the
subject project on March 28, 2013. Staff review of the plans and specifications has determined that the project,
as proposed, will comply with the stormwater Regulations'set forth in'fitle4SA NCAC 2H.1000 and Session
Law 2006-246. We are forwarding Permit No. SW3130304, dated April•19, 2013, for the construction,
operation and maintenance of the subject project and the stormwater BMPs.
This permit shall be effective from the date of issuance until April 19, 2021 and shall be subject to the
conditions and limitations as specified therein, and does not supersede any other agency permit that may be
required. Please pay special attention to the conditions listed in this permit regarding the Operation and
Maintenance of the BMP(s), recordation of deed restrictions, procedures for changes of ownership,
transferring the permit, and renewing the permit, Failure to establish an adequate system for operation and
maintenance of the stormwater management system, to record deed restrictions, to follow the:procedures fot-
transfer of the permit, or to renew the permit, will result in future compliance problems.
If any parts, requirements; or limitations contained in this.permit are�unacceptable; you have the right to
request an adjudicatory-hearing by filing a written petition with.the Office of Administrative Hearings (OAH).
The written petition must conform to Chapter 150E of the North Carolina General Statutes. Per NCGS 143-
215(e) the petition must be filed with the OAH within thirty (30) days of receipt of phis permit. You should
contact the OAH with.all questions regarding the filing fee (if a filing fee is required) and/or the details of the
filing process at.6714 MaiLService Center, Raleigh, NC 27699-6714, or via telephone at,919-431-3000, or visit
their website at'www.NCOAH-corn. Unless such demands are made this permit shall be final.and.binding.
This project will be kept on file at the Mooresville Regional Office, If you have any questions, or need additional
information concerning this matter, please contact Bill Diuguid at [phone]; or bill.diuguid@ncdenr,gov.
Sincerely,
for Charles Wakild, P.E., Director
Wetlands and Stoimwater Branch
1617,Mail Service Center, Raleigh, North Carolina 27699-1617
LocadDm 512 N. Salisbury St, Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet www rimaterqualily.org
An Equal Gpponunily 1 Affirmative Aclion Employer
[0
NC) ,thC''.] l'A l�ll1t�

Mr. Robert S. Hail, Sr. Exec. VR State Employees' Credit Union
SW3130304 - State Employees' Credit Union —Locust, Cabarrus County
April 19, 2013
cc-' SW3130304 File
cc: Grant.Livengood, P.E. - McKim & Creed, Inc.
Mooresville Regional Office
Page 2 of 2

State Stormwater Permit
Permit No.SW3130304
STATE OF`NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT -AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH:DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
State Employees' Credit Union
State Employees' Credit Union Branch Office
Hwy 24127 and Redbridge Blvd, locust, Cabarrus County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with
the provisions of 15A NCAC 2H .1000 and S.L. 2006-246 (hereafter referred to as the
"stormwater rules" and the approved stormwater management plans and specifications
and other supporting data as attached and on file with and approved by the Division of
Water Quality and considered a part of this permit.
This permit shall be effective from -the date of issuance until April 19, 2021, and shall be
subject to the following specified conditions and limitations;
I. DESIGN STANDARDS:
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2: This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.7 of this permit. The stormwater control has been
designed to handle the runoff from 48,678 square feet of impervious area,
3. The tract will be limited to the amount of built -upon area indicated in Section 1.7
of this permit, and per approved plans.
4. All stormwater coilection and,treatment-systems must be located. in. either
dedicated common areas 'or recorded easements. The final plats for the 'project
will be recorded showing all such required easements, in accordance with the'
approved plans.
51. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
Q., The built=,upon areas associateid..with this pro ect shall be.located at least 30. feet
landward'of�all per`erinial aritl;intermittent suace waters." y
Page 1 of 6

State Stormwater Permit
Permit No.SW3130304
7, The following. design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a. Drainage Area, sq ft: 97,656
Onsite, W:' 97,656
Offsite, ,ftz:' 0
Total Impervioys Surfaces, ft2:
Buildings ft ;
Roads/Parking, ft2:
Other; ft, -
Qffsite,'ft2'
Pond Depth, feet:
TSS removal efficiency:
Design Storm: -
Permanent Pool Elevation,..FMS�:,
Permitted Surface Area @PP eft
Permitted Storage Volume,,ft
Storage,Elevation, FMSL:
Controlling Orifice:
'Pe�rinahe*nt,Pool',Volume -ft_ J,'.:
Forebay Volume, ft3:
Receiving Stream/River. Basin:
Stream Index Number:
Classification of Water Body:
ll. SCHEDULE OF COMPLIANCE
48,678
8,638
40,040
0,
;0.
5.5
90%
1.O inch
541.50
4,417
5,564 at temporary pool
542.5 at temporarypool
1.25" 0 pipe
9,494
1,992
Teeter Branch 1 Yadkin/Pee Dee
13-17-15
„Cil
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2: During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater system functions at optimum
efficiency. The approved Operation and.Maintenance Plan must be followed in
its entirety and maintenance must occur at the scheduled intervals including, but
not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
c. Mowing and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e, Maintenance of all slopes in accordance.with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device, flow
spreader, catch basins and piping.
;g. Access to the outlet structure must be'available at all times.
4. Records of maintenance activities must be kept and made available upon
request to authorized personnel of DWQ. The records will indicate the date,
activity, name of person performing the work and what actions were taken.
5. The stormwater treatment system shall be constructed in accordance with the
approved plans and specifications, the conditions of this permit, and with other
supporting data.
Page 2 of 6

State Stormwater Permit
Permit No.SW3130304
6. Upon`completionHof cons#ruction,. prior to issuance.s'of 4 Certificate of -Occupancy,
and pnor`to operation of�this permitted facility;.Jpic6 ification; mint be received
from ari,appropnate:de'si ner for the system installed certifying,tli6t the permitted
�-fac.iHty"has:been iristalla�in accordance.with.-this.permit;.the;-approved�plans,and
specifications,•,aWother supporting docurrmentation: An y,deviations-;from the
approved,plans'and'specific,066s must be'noted'';on the;Certification'.
modEfcatiowmay pe.required f6Hhose deviation's: ' `
T. If the stormwater system was used as an Erosion Control device, it.must be
restored to design condition prior to operation ass -a stormwater treatment device,
and prior to occupancy of the facility.
'$;• Access to the stormwater facilities shall be maintained via appropriate
easements at all times,-
9, The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b.: Project name change.
C. Transfer of ownership.
d�. Redesignoraddition to the approvedamount of built -upon area or to the
tlrainag area:.
?e. Further::subdivision; acquisition;. lease.,or.sale,af� all' or`partl'of the;,project
area. The project.area is defined as -all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval or a CAMA
Majnr"p`errnit'w`as `sought,
f. Filling6, alterin or piping of an l.ve etative�conve-ance.sfiown on,tfie'.
� 9, PP 9 y g• Y
approved plan.
10. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
1 1 .. A copy of the approved plans and specifications shall be maintained on file by
the Permittee for a minimum of ten years from the date of the completion of
construction.
42.., The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made.
III. GENERAL CONDITIONS
-1. This permit is not transferable excepVafter notice:to•and approval by the Director,
In the event of a change of ownership,,:era-name,change, the permittee must
submit a completed Name/Ownership Change.form, to the Division of Water
Quality, signed by both parties,"and accompanEed',by supporting documentation
as listed on page 2 of the form. Tf�e'proiect must be in good standing with the
Division. The approval of this request -will., �L- considered on its merits and may or
may not be approved.
2, The permittee. is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request.
Page 3 of 6
1

State Stormwater Permit
Permit No.SW3130304
`3'.. Failure to abide,by the conditions and limitationscontained�in this permit may
subject the Permittee to enforcement action by the. Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
A. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
;5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the'Permittee shall take immediate corrective action,
including those as may be required, by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission.to enter the property during normal
business hours for the purpose of inspecting all components of the permitted .
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing ;of a request for a'p;ermit modification, revocation,and,re-issuanc ;or
termination;does.not stay!any-permit condit►on.
8: Unless specified, elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual;
Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of `this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division of -any name, ownership or mailing
address changes at least 30 days prior to making such changes.
12.The permittee shall submit a renewal request with all -,required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 191h day of April, 2013,
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
,w.
A17LCP
or ar es ail erector '
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No.SW3130304
State Employees' Credit Union -- Locust
Stormwater Permit No. SW3130304
-Cabarrus Count
Designer's Certification
I', , as a duly registered,
in the State of North Carolina, having been authorized,to observe (periodically/ weekly/
full time) the construction of the project,
State Employees' Credit Union -- Locust
(Project)
for (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
Page 5 of 6

State Stormwater Permit
Permit No-SW3130304
Certification Requirements:
1, The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4: All roof drains are located such that the runoff is directed into the system.
5... The outlet/bypass structure elevations are per the approved plan.
6, The outlet structure is located per the approved plans.
7: Trash rack is provided on the outlet/bypass structure.
$. All slopes are grassed with permanent vegetation.
9.1 Vegetated slopes are no steeper than 3:1.
The inlets are located per the approved plans and do not cause short_.
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided..
..12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
15 The required system dimensions are provided per the approved plans.
Please submit this. Designer's Certification to: Mooresville Regional Office
Surface Water. Protection
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Page 6 of 6

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
Land Quality Section
Tracy E. Davis, PE, CPM
Director
February 20, 2014
State Employee's Credit Union
Attn: Mr. Robert S. Hall, Sr. Exec. Vice President
1000 Wade Avenue
Raleigh, North Carolina 27605
Dear Mr. Hall:
Pat McCrory, Governor
John E. Skvarla, III, Secretary
Subject: Compliance Evaluation Inspection
Stormwater Permit No. SW3130304
State Employee credit Union -Locust
Cabarrus County, NC
Enclosed is a copy of the Compliance Evaluation Inspection (CEI) report for the
inspection conducted at the subject sites on February 19, 2014 by Mr. Samar Bou-
Ghazale and me with the Division of Energy, Mineral and Land Resources.
The enclosed report should be self-explanatory. However, if you have any
questions, comments or need assistance with understanding any aspect of your permit,
please do not hesitate to contact Mr. Bou-Ghazale at [phone].
Sincerely,
S
ahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
Enclosure
cc: MRO-Files
Stormwater — DEM&LR Central Files
Mooresville Regional Office
610 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Telephone [phone] FAX: [phone] • Internet: http://portal.ncdenr.or.q/web/Ir/land-quality
An Equal Opportunity I Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

Compliance Inspection Report
Permit: SW3130304 Effective: 04/19/13 Expiration: 04/19/21 Owner: State Employees' Credit Union
Project: State Employees Credit Union -Locust
County: Cabarrus Hwy 24/27 And Redbridge Blvd
Region: Mooresville
Locust NC 28097
Contact Person: Robert S Hall Title: Phone: [phone]
Directions to Project:
From hwy 24/27 turn onto redbridge blvd project is immediately on the left (western) side of redbridge rd
Type of Project: State Stormwater - General Permit State Stormwater - HD - Detention Pond
Drain Areas:
On -Site Representative(s):
Related Permits:
Inspection Date: 02/19/2014 Entry Time: 10:50 AM
Primary Inspector: Zahid S Khan
Secondary Inspector(s):
Samar E Bou Ghazale
Reason for Inspection: Routine
Permit Inspection Type: State Stormwater
Facility Status: ® Compliant D Not Compliant
Question Areas:
RM State Stormwater
(See attachment summary)
Exit Time: 11:10 AM
Phone:
Phone: [phone] Ext2199
Inspection Type: Compliance Evaluation
Page: 1

Permit: SW3130304 Owner - Project: State Employees' Credit Union
Inspection hate: 02/19/2014 Inspection Type: Compliance Evaluation
Inspection Summary:
This project is still under construction. Completion date will be in May 2014 per Contractor.
File Review
Is the permit active?
Signed copy of the Engineer's certification is in the file?
Signed copy of the Operation & Maintenance Agreement is in the file?
Copy of the recorded deed restrictions is in the file?
Comment: Still Under Construction
Built Upon Area
Is the site BUA constructed as per the permit and approval plans?
Is the drainage area as per the permit and approved plans?
Is the BUA (as permitted) graded such that the runoff drains to the system?
Comment: Still Under Construction
Reason for Visit: Routine
Yes No NA NE
Yes No NA NE
Are the SW measures constructed as per the approved plans? n
n
o
n
Are the inlets located per the approved plans? ®
n
n
n
Are the outlet structures located per the approved plans?
n
n
n
Comment: Still Under Construction
Operation and Maintenance Yes
No
NA
NE
Are the SW measures being maintained and operated as per the permit requirements?
❑
n
n
Are the SW BMP inspection and maintenance records complete and available far review or provided to DWQ n
n
upon request?
Comment: Still Under Construction
Page: 2

Pat McCrory
Governor
at
NCDER
Ntirtn Carolina Departm rof Environment and-Natoral'R sources
May 30, 2014
State Employees' Credit Union
Mr. Robert S. Hall, Sr. Exec. Vice President
1000 Wade Ave
Raleigh, NC 27605
Dear Mr. Hall:
John E. Skvarla, III
Secretary
Subject: State Employee Credit Union -Locust
Hwy 24127 And Redbridge Blvd
State Stormwater Permit No. SW3130304
Cabarrus County, NC
Enclosed is a copy of the Compliance Evaluation Inspection (CEI) report for the
inspection conducted on May 22, 2013 by Chad broadway and Mr. Samar Bou-Ghazale of
this Office.
The report should be self-explanatory; however, should you have any questions
concerning the report, please do not hesitate to contact Mr. Bou-Ghazale at (704) 235-
2199.
Sincerely,
Zahid S. Khan, CPM, CPESC, CPSWQ
Regional Engineer
Land Quality Section
Attachment
Division of Energy, Mineral, and Land Resources
Land Quality Section - Mooresville Regional Office
510 East Center Avenue, Suite 301, Mooresville, North Carolina 28115
Telephone: [phone] FAX; 704-663-6040 • Internet: http:l/portal.ncdenr.org/web/Irlland-quality
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer taper

r�
Compliance inspection Report
>'grFy�i± 'J�'3130304- - Ei cth�2: ^.4,JP/13 Expiration: 0411-912.1� -- Owner: State Employees' Credit Union
Project: State Employees Credit Union -Locust
County: Cabarrus Hwy 24127 And Redbridge Blvd
Region: Mooresville
Locust NC 28097
Contact Person: Robert S Hall Title: Phone: [phone]
Directions to Project:
From hwy 24/27 turn onto redbridge blvd project is immediately on the left (western) side of redbridge rd
Type of Project: State Stormwater - General Permit State Stormwater - HD - Detention Pond
Drain Areas:
On -Site Representative(s):
Related Permits:
Inspection Date: 05/22/2014 Entry Time: 03:30 PM
Primary Inspector: Samar E Bou Ghazale
Secondary Inspector(s):
Reason for Inspection: Routine
Permit Inspection Type: State Stormwater
Facility Status: ® Compliant D Not Compliant
Question Areas:
EM State Stormwater
(See attachment summary)
Exit Time: 04:10 PM
Phone: [phone]
Ext.2199
Inspection Type: Compliance Evacuation
Page: 1

Permit: SW3130304 Owner - Project: State Employees' Credit Union
IpcFec+ion Dale: C c 2-ti.•:_ 7y,:: _^",;,lance Evaluation Reason fcr Visit: Rcutin;:_
Inspection Summary:
Site was recently constructed and most of the site has been stabilized with ground cover. Please stabilize with ground
cover the downstream slope near the pond. Also, provide this Office with the Engineering certification and a copy of the
deed restrictions.
File Review Yes No NA NE
Is the permit active? n n n
Signed copy of the Engineer's certification is in the file? ❑ ®❑ n
Signed copy of the Operation & Maintenance Agreement is in the file? ® f i ❑ ❑
Copy of the recorded deed restrictions is in the file? ❑ 0.
Comment: Pleaes provide a signed copy of the Engineer certification and a copy of
the recorded deed restrictions.
Built Upon Area Yes No NA NE
Is the site BUA constructed as per the permit and approval plans? ❑ n
Is the drainage area as per the permit and approved plans? ® Q n n
Is the BUA (as permitted) graded such that the runoff drains to the system? [ n n n
Comment:
5W Measures
Yes No
NA
NE
Are the SW measures constructed as per the approved plans?
r n
n
n
Are the inlets located per the approved plans?
D
n
0
Are the outlet structures located per the approved plans?
0 n
n
n
Comment:
Operation and Maintenance Yes No NA NE
Are the SW measures being maintained and operated as per the permit requirements? IR ❑ n ❑
Are the SW BMP inspection and maintenance records complete and available for review or provided to DWQ n n n IM
upon request?
Comment: Construction is completed at this time.
Other Permit Conditions Yes No NA NE
Is the site compliant with other conditions of the permit?
Comment Please provide gorund cover on the downstream slope located near the
pond.
Other WQ Issues
Is the site compliant with other water quality issues as noted during the inspection?
Comment:
n M 0 D
Yes No NA NE
IMnnn
Page: 2

Permit Number:
(to be provided by DIVQ)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
Iog in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
The wet detention basin system is defined as the wet detention basin,
pretreatment including forebays and the vegetated filter if one is provided.
This system (check one):
❑ does ® does not incorporate a vegetated filter at the outlet.
This system (check one):
❑ does ® does not incorporate pretreatment other than a forebay.
Important maintenance procedures:
— Immediately after the wet detention basin is established, the plants on the
vegetated shelf and perimeter of the basin should be watered twice weekly if
needed, until the plants become established (commonly six weeks).
— No portion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
— Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— If the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
— Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected once a month and
within 24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a
Coastal County). Records of operation and maintenance should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate the problem -
The entire BMP
Trash debris is present.
Remove the trash debris.
The perimeter of the wet
Areas of bare soil and/or
Regrade the soil if necessary to
detention basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of
long.
approximatel six inches.
Form SW401-Wet Detention Basin O&M-Rev.4 Page 1 of 4

Permit Number:
(to be provided by DJlV)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
The pipe is clogged.
Unclog the pipe. Dispose of the
swale
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to
Swale.
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible. Remove the sediment and
sediment storage.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional
show that pruning is needed
practices
to maintain optimal plant
health.
PIants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design sediment
possible. Remove the sediment and
storage depth.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over
Consult a professional to remove
50% of the area.
and control the algal growth.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray).
the basin surface.
Form SW401-Wet Detention Basin O&M-Rev.4 Page 2 of 4

Permit Number:
(to be provided by UHVQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate the roblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair. if applicable)
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Division of
damage have occurred at the
Water Quality Regional Office, or
outlet.
the 401 Oversight Unit at 919-733-
1786.
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads 5.5 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 5.5 feet in the forebay, the sediment
shall be removed.
Sediment Removal
Bottom Etc
536.0 1
-----------------
FOREBAV
BASIN DIAGRAM
(fill in the blanks)
1 Volume'
t Min.
Sediment
Storage
Permanent Pool Elevation 541.50
Pool
Sediment Removal Elevation 536.0 Volume
Bottom Elevation
MAIN POND
l -ft n.
Sediment
Storage
Form SW401-Wet Detention Basin O&M-Rev.4
Page 3 of 4

Permit Number:
(to be provided by DJ Q)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:State Employees Credit Union - Locust
BMP drainage area number:
Print name:Robert S. Hall
Title:Sr. Exec. Vice President
Address:1000 Wade Avenue Raleigh, NC 27605
Phone:[phone]}
1 ! I A
Signature:
Date:
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I, Q. Cc-U , a Notary Public for the State of
County of �4%� _, do hereby certify that
personally appeared before me thisQJJ,_
day of O)qg, , ap/ 2 , and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,
R.
�'' 4.�AR1-okp
W �
0
J!�,f.AU B u�
co'?.
SEAL
My commission expires
Form SW401-Wet Detention Basin O&M-Rev.4 Page 4 of 4

Permit No.
(to be provided by DWO)
®TA A3
NC ENR a
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part Ill) must be printed, filled out and submitted along with all of the required information.
Project name State Employees' Credit Unior - Locust
Contact person Grant ❑vengood, PE
Phone number [phone]
Date 26-Aar-13
Drainage area number 1
Ii.qDESIGNIINF,ORMAT10N
Site Characteristics
Drainage area
Impervious area, post -development
% impervious
Design rainfall depth
Storage Volume: Non•SA Waters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5" runoff volume
Pre -development 1-yr, 24-hrrunoff
Post -development 1-yr, 24-hrrunoff
Minimum volume required
Volume provided
Peak Flow Calculations
Is the prefpost control of the lyr 24hr storm peak flow required?
1-yr, 24-hrraWall depth
Rational C, pre -development
Rational C, post -development
Rainfall intensity: 1-yr, 24-hr storm
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
Pre/Post 1-yr, 24-hr peak flow control
Elevations
Temporary pool elevation
Permanent pool elevation
SHWT elevation (approx. at the perm. pool elevation)
Top of 1 Oft vegetated shelf elevation
Bottom of 10ft vegetated shelf elevation
Sediment cleanout, top elevation (bottom of pond)
Sediment cleanout, bottom elevation
Sediment storage provided
Is there additional volume stored above the state -required temp. pool?
Elevation of the top of the additional volume
97,656 fe
48,678 ftz
49.85 %
1.0 in
4,058 ft'
5,564 ft3
ft3
ft3
ft3
ft3
ft3
(Y or N)
2.9 in
0.46 (unitless)
0.76 (unitless)
0.12 inlhr
3.59 It'Isec
2.79 ft'Isec
-0.80 ft'/sec
542.50 fmsl
541.50 fmsl
541.00 fmsl
542.00 fmsl
541.00 fmsi
536.00 fmsl
534.00 fmst
2.00 ft
Y (Y or N)
542.5 fmsl
OK, volume provided is equal to or in excess of volume required.
Insufficient. Check intensity calculation.
`�4441111ffff/
P
oar
OK
f�##f1111444�
Form SW401-Wel Detention Basin-Rev.9-4118112 Parts 1. & IL Design Summary, Page 1 of 2

Permit
(to be provided by DWO)
fl, DESIGN INFORMATION
Surface Areas
Area, temporary pool 6,243 ft'
Area REQUIRED, permanent pool 2,930 ft2
SAIDA ratio 3.00 (unitless)
Area PROVIDED, permanent pool, A,,, rd 4,417 ft` OK
Area, bottom of 1 Oft vegetated shelf, Aw, ,ql 2,980 ft,
Area, sediment cleanout, top elevation (bottom of pond), Ab,_p,, 421 ft`
Volumes
Volume, temporary pool
Volume, permanent pool, Vp._,d
Volume, forebay (sum of forebays if more than one forebay)
Forebay % of permanent pool volume
SAIDA Table Data
Design TSS removal
Coastal SAIDA Table Used?
MountainlPiedmont SAIDA Table Used?
SAIDA ratio
Average depth (used in SAIDA table):
Calculation option 1 used? (See Figure 10-2b)
Volume, permanent pool, Vp„ -P,
Area provided, permanent pool, Ap, P,
Average depth calculated
Average depth used in SAIDA, d,,, (Round to nearest 0.5ft)
Calculation option 2 used? (See Figure 10-2b)
Area provided, permanent pool, AN,m-pcd
Area, bottom of 10ft vegetated shelf, Ab,, ,,,n
Area, sediment cleanout, tap elevation (bottom of pond), Aw_p w
'Depth' (distance b/w bottom of 1Oft shelf and top of sediment)
Average depth calculated
Average depth used in SAIDA, d., (Round to down to nearest 0.511)
Drawdown Calculations
Drawdown through orifice?
Diameter of orifice (if circular)
Area of orifice (if -non -circular)
Coefficient of discharge (CD)
Driving head (Ho)
Drawdown through weir?
Weir type
Coefficient of discharge (C.)
Length of weir (L)
Driving head (H)
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
Storage volume discharge rate (through discharge orifice or weir)
Storage volume drawdown time
Additional Information
Vegetated side slopes
Vegetated shelf slope
Vegetated shelf width
Length of flowpath to width ratio
Length to width ratio
Trash rack for overflow & orifice?
Freeboard provided
Vegetated filter provided?
Recorded drainage easement provided?
Capures all runoff at ultimate build -out?
Drain mechanism for maintenance or emergencies is:
5,564 ft' OK
9,494 ft'
1,992 ft'
21.0% % OK
90 %
N (Y or N)
Y (Y or N)
3.00 (unitless)
N (Y or N)
9,494 ft'
4,417 ft`
ft
ft
Y (Y or N)
4,417 ft`
2.980 ft`
421
5 00 ft
3,27 It
3.0 ft
Need 3 ft min.
OK
Insufficient. Check calculation.
Y (Y or N)
1.25 in
in'
0.60 (unitless)
0.33 It
N (Y or N)
(unitless)
(unitless)
ft
ft
3.59 ft3lsec
2.79 ft3lsec
0.02 ft/sec
2.72 days OK, draws down in 2-5 days.
4 :1
OK
10 :1
OK
10.0 ft
OK
2 :1
Insufficient flow path to width ratio. Must not short-circuit pond.
2.0 :1
OK
Y (Y or N)
OK
5.0 ft
OK
N (Y or N)
OK
Y (Y or N)
OK
Y (Y or N)
OK
Form SW401-Wet Detention Basin-Rev.9-4118l12 Parts I. & II. Design Summary, Page 2 of 2

Application Completeness Review sbl%3/3
❑ First Submittal ❑ Re -submittal Date Received: 3 Z8 I -,Date Reviewed: / 3 By Bill Diuguid
Development/Project Name: 57r C tea_
Receiving strew-n�]] name , T f wiz- .8AA.fC _ Classification: „
River Basin: 1i4•nj/,.,i — 'Pe 'Pe-i-e
For post-codstruction requirements, a program will be deemed compliant for the areas where it,is
IViSiotj pF: WA'+ ER QUALITY
implementing any of the following programs: WS-1, WS-II, WS-III, WS-IV, HQW, ORW, Neuse River Basin
NSW, Tar -Pamlico River Basin NSW, and the Randleman Lake Water Supply Watershed Nutrient MAX 10 2013
Management Strategy.
High Density Projects that require a 401 /404 within an NSW require 85% TSS, 30% TN and 30% DTP removal ( iONAL OFFIC
T&E Species (Goose Creek, Waxhaw Creek or Six Mile Creek Water Sheds): A 1
Latitude and Longitude:_/ - /7_ 4)___ —&0,9 2'7 0 2_W _ _ Jurisdiction oCa S C,v�
Project Address: z z
Engineer name and firm: ,M. `/VAV r,-AD r.. ej /r►,.*:.m d• ce-4
Ptum:, 5 /c ly", a00 - i d..-,d grail: i .g _ Z3 3 - 8 o y'
Is the project cad to be in the State MSI Stormwater Permit jurisdiction? 2Yes or ❑ No
❑ Low Density (no curb and gutter) ❑ Low Density with curb and gutter outlets I -High Density ❑ Other
❑ 401/404 impacts to surface waters, wetlands, and buffers (add language to cover letter and/or add info letter)
Z BUA 41,9. 'S ,,
c4v>eck for $505,00 included
rV' rginal signature (not photocopy) on application
Legal signature (Corporation-VP/higher, Partnership -General Partner/higher, LLC-member/manager, Agent).
Check spelling, capitalization, punctuation: http://www.secretary,state.nc.uslcorporations/thepitge.aspx
If an agent signs the application, a signed letter of authorization from the applicant must be provided which
includes the name, title, mailing address and phone number of the person signing the letter.
❑ For subdivided projects, a signed and notarized deed restriction statement
wrl'Sealed, signed & dated calculations Gst*brr 4,7 , `tV rN &-y off, .A' F—.
Correct supplement and 0&M provided for each BMP on site (check all that were provided & number of each)
❑ Bioretention
❑ Dry Detention Basin
❑ Filter Strip
❑ Grass Swale
❑ Infiltration Basin
❑ Infiltration Trench
❑ Level Spreader
❑ Permeable Pavement
• Restored Riparian Buffer
❑ Rooftop Runoff Management
❑ Sand Filter
❑ Syarmwater Wetland
et Detention Basin
❑ Low Density
❑ Curb Outlet
❑ Off -Site
❑ NCDOT Linear Road
:2/j wo sets of sealed, signed & dated layout & finish grading plans with appropriate details
� Narrative Description of stormwater management provided
iK
oils report, geotech information provided
1hr Wetlands delineated or a note on the plans or in the accompanying documents that none exist on site and/or
adjacent property
�//F]etails for the roads, parking area, cul-de-sac radii, sidewalk widths, curb and gutter;
EY
dimensions &slopes provided
Gr'/Drainage areas delineated ❑ Pervious and impervious reported for each ❑ Areas of high density
MP operation and maintenance agreements provided
Application complete ❑ Application Incomplete Returned: (Date)
Vb[ �V GV+ RCr IO'VII, Qm L"'E'y Ulu

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
7J , 6
)
Applicable Rules: ❑ Coastal SW - 1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- 1-IQW/ORW Waters ❑ Universal Storm water Management Plan
❑ Other WQ M rmt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
State Emolovees' Credit Union - Locust
2. Location of Project (street address):
Hwv 24/27 and Redbridee Blvd
City:Locust County:NC (.
3. Directions to project (from nearest major intersection):
Arl� CS Zi
4. Latitude:35* 15' 17" N Longitude:-80° 27' 37" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
iRenn,als with nnodifications also rcquires SWU-102 — Reneznal Application Form
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) , and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ®Sedimentation/Erasion Control: 3.46 ac of Disturbed Area
❑NPDES Industrial Stormwater 0404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:Erosion Control: State Employees' Credit Union - Locust, CABAR-2013-
045, March 18, 2013
5. Is the.project located within 5 miles of a public airport? ®No ❑Yes
If yes, see S.L. 2012-200, Part Vl: htti2://12ortal.ncdenr.org/web/`wq/ws/su/statesw/rules laws
Form SWU-101 Version 06Aug2012 Page 1 of 6

III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns theproject):
Applicant/Organization:State Em to ees' Credit Union
Signing Official & Title:Robert S. Hall, Sr. Exec. Vice President
b.Contact information for person listed in item 1a above:
Street Address:1000 Wade Avenue
City:Raleigh State:NC Zip:27605
Mailing Address (if applicable): P.O. Box 37665
City:Ralei
Phone: [phone]
Email:
State:NC
Zip:27605
Fax: [phone]
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Address:
City: State:
Mailing Address (if applicable):
City: State:
Phone: ( } Fax:
Email:
Zip:
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/ Organ ization:McKim & Creed, Inc.
Signing Official & Title:Grant Livengood, PE (Project Manager)
b.Contact information for person listed in item 3a above:
Mailing Address:1730 Varsi Drive Suite 500
City:Ra
Phone: (919 ) 233-8091
Email:glivengood©mckimcreed.com
State:NC
Zip:27606
Fax: (919 ) 233-8031 _
4. Local jurisdiction for building permits: City of Locust
Point of Contact:Administration Department Phone #: (704 ) 888-5260
Form SWU-101 Version 06Aug2012 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
The stormwater runoff will be treated using a wet detention basin.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW - 1995 ❑ Ph If - Post Construction
3. Stormwater runoff from this project drains to the Yadkin -Pee Dee River basin.
4. Total Property Area: 3.35 acres 5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: acres
7. Total Property Area (4) -Total Coastal Wetlands Area (5) -Total Surface Water Area (6) = Total Project
Area+:3.35 acres
+ Total project area shall be calculated to exclude the followin the norinal pool of impounded structures, the area
between the batiks of streams and rivers, the area below the Norinal High Water (NNW) lime or Mean High Water
(MHW) lime, and coastal wetlands landward front the NNW (or MHW) lure. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of file NHW (or MHW) lure ruay
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / 'Total Project Area) X 100 = 49.8
9. How many drainage areas does the project have?2 (For high density, count I for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drainage Area 1
Drainage Area _
Drainage Area _
Drainage Area _
Receiving Stream Name
Teeter Branch
Stream Class *
C
Stream Index Number *
13-17-15
Total Drainage Area (so
97,656
On -site Drainage Area (so
97,656
Off -site Drainage Area (so
Proposed Impervious Area** (so
48,678
% Impervious Area** total
49.8%
Impervious- Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
On -site Buildings/Lots (so
8,638
On -site Streets (so
On -site Parking (so
40,040
On -site Sidewalks (so
Other on -site (so
Future(so
Off -site (sf)
Existing BUA*** (so
Total (so:
48,678
* Stream Class and index Nunnber call be determined at: Irttp://portal.ncdenrr.orgAiyeb%zc)r47s/csrr/classi icatiorrs
lin pervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
***Report only that arnormt of existing BUA that will remain after development. Do not report any existing BUA that
is to be removed and winch will be replaced by new BUA.
Form SWU-101 Version 06Aug2012 Page 3 of 6

11. How was the off -site impervious area listed above determined? Provide documentation.
Proiects in Union County: Contact DWQ Central Office staff to check if the project is located within a Threatened &
Endangered Species Watershed that may be subject to more stringent stormttiiater• regrtirements as per 15A NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
'File applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http://poria[.ncdcnr.orl;/►�ch/ti�q/ws/su/I}ml}-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from http://portal.iiccleiir.org/web/-.vq/ws/su/states=/forms_docs. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project out the interactive online map at 1'octal.�trcienr.nr�,It�eb/1�i�_ti�S/su nut is.)
Please indicate that the following required information have.been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from hR[)://13artal.ncclL_n_rxl;/W(!I)/WO/H•s%sLz/slirtesti.•/f0r,ms- dins.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. G%tt1L
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants---"`lA_
Form. (f required as per Part VIl below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
hgpJ/www.envhelp.org/pay,,es/onestopexpress.litml for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
the project, `Phis is required in addition to the Brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location, If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within r/z mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 85" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend,
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the M14W or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NI-IW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, coliection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans drat none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
a M i,
__On MIL
�1M �
E►1" � V
Form SWU-101 Version 06Aug2012 Page 4 of

9. Copy of any applicable soils report with the associated SHWT elevations (Please identify (-2�
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x11" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to W1RO: Schedule a site visit for DWQ to verifiy the SHVa' prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 10172 Page No: 0269
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
ht!p:/ / www.secretary.state.nc.us/Corporations/CSearch.aspx
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
lltt ): ortal.ncderlI'.oi' y web/wq/ws/su/statesw/forms flocs. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ and that they will be recorded prior to the sale of any lot.
Vlll. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer:Grant ! ivengood, PE T
Consulting Firm: McKim & Creed, Inc _
Mailing Address:1730 Varsi Drive Suite 500
City:RaIeigh State:NC Zip:27606
Phone: (919 ) 233-8091 Fax: (919 L233-8031
Eniail:glive�ood tr_ mc_kimcreed.com
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
1, (print or hjpe name of person listed in Contact Information, item 2a) certify that 1
own the property identified in this permit application, and thus give permission to (print or hjpe narne of person
listed in Contact Information, item 7a) with (print or hype rrarrre of organization listed in
Contact Information, item 7a) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 06Aug2012 Page 5 of

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature:
a Notary Public for the State of
do hereby certify that
Date:
County of
personally appeared
before me this _ day of and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 7a) Robert S. Hall ,
certifv that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater iY-1QS' under 85A KA)Zpi-t .1000 and any other applicable state stormwater requirements.
Signatu
�} pDate: 7 0
11_. }T S : i`3 cad , a NPL Public for the State of N C— , County of
wLY f' - , do hereby certifyC
that J' i personally appeared
before me this -2 day of FtV)-C��1L, atd 7 nowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,r_J
�4'+'OTACaL
1 umr "nv\ r--
SEAL
My commission expires
Form SWU-101 Version 06Aug2012 Page 6 of6

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Permit No.
(to be provided by DWQ)
Jill. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Page/ Plan
Initials
Sheet No.
1. Plans (1" - 50' or larger) of the entire site showing:
- Design at ultimate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Basin dimensions,
- Pretreatment system,
- High flow bypass system,
Maintenance access,
Proposed drainage easement and public right of way (ROW),
Overflow device, and
Boundaries of drainage easement.
G J1
2. Partial plan (1" = 30' or larger) and details for the wet detention basin showing:
Outlet structure with trash rack or similar,
Maintenance access,
Permanent pool dimensions,
Forebay and main pond with hardened emergency spillway,
Basin cross-section,
Vegetation specification for planting shelf, and
Filter strip.
3. Section view of the wet detention basin (1" = 20' or larger) showing:
Side slopes, 3:1 or lower,
Pretreatment and treatment areas, and
Inlet and outlet structures.
ic,l/1+1 L
4. If the basin is used for sediment and erosion control during construction, clean out of the basin is specified
on the plans prior to use as a wet detention basin.
L
5. A table of elevations, areas, incremental volumes & accumulated volumes for overall pond and for Forebay,
to verify volume provided.
G12(72.
6. A construction sequence that shows how the wet detention basin will be protected from sediment until the
entire drainage area is stabilized.
7. The supporting calculations.
8. A copy of the signed and notarized operation and maintenance (O&M) agreement,
L
9. A copy of the deed restrictions (if required).
11�
C& C
10. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. County
12jOO
soil maps are not an acceptable source of soils information.
Form 5W401-Wet Detention Basin-Rev.9-4118112 Part III. Required Items Checklist, Page 1 of 1