SW8020432_CURRENT PERMIT_20030716

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO. SWA2a2��Z
� DOC TYPE � CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
� ❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
4 YYYYMMDD

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E„Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
July 16, 2003
Mr. Ron Loftis, Owner
P.O. Box 522
Harkers Island, NC 28531
Subject: Permit No. SW8 020432 Modification
Cape Lookout RV Park
High Density Stormwater Project
Carteret County
Dear Mr. Loftis:
The Wilmington Regional Office received a complete Stormwater Management Permit
Application for Cape Lookout RV Park on July 16, 2003. Staff review of the plans and
specifications has determined that the project, as proposed, will comply with the Stormwater
Regulations set forth in Title 15A NCAC 2H.1000. We are forwarding Permit No. SW8 020432
Modification dated July 16, 2003, for the construction of Cape Lookout RV Park.
This permit shall be effective from the date of issuance until July 16, 2013, and shall be
subject to the conditions and limitations as specified therein. Please pay special attention to the
Operation and Maintenance requirements in this permit. Failure to establish an adequate system
for operation and maintenance of the stormwater management system 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 upon written request within thirty (30) days
following receipt of this permit. This request must be in the form of a written petition,
conforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office of
Administrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demands
are made this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please
contact Laurie Munn, or me at [phone].
Sincerely,
Rick Shiver
Water Quality Regional Supervisor
RSS/:Ism S:IWQSISTORMWATIPERMIT1020432MODJu103
Cc: John McLean, P.E.
Carteret County Building Inspections
Division of Coastal Management
Laurie Munn
Wilmington Regional Office
Central Files
.�
N. C. Division of Water Quality 127 Cardinal Drive Extension [phone] Customer Service
Wilmington Regional Office Wilmington, NC 28405 [phone] Fax [phone] iT 5MR

State Stormwater Management Systemst
Permit No. SWS 020432 Modification
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
Harold Gurganus & Ron Loftis
Cape Lookout RV Park
Carteret County
FOR THE
construction, operation and maintenance of two infiltration basins in compliance with the
provisions of 15A NCAC 2H .1000 (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
hermit.
This permit shall be effective from the date of issuance until July 16, 2013, and shall be subject
to the following specified conditions and limitations:
T. DESIGN STANDARDS
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 on page 3 of this permit, the Project Data Sheet. The stormwater control has
been designed to handle the runoff from 36,156 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated on page 3 of this
permit, and per approved plans. -.
4. All stormwater collection 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.
5. The runoff from all built -upon area within the permitted drainage area of this project must
be directed into the permitted stormwater control system. A permit modification must be
submitted and approved prior to the construction of additional built -upon area from
outside of the approved drainage area.
2

It
State Stormwater Management Systems
Permit No. SW8 020432 Modification
DIVISION OF
WATER QUALITY
PROJECT DESIGN DATA SHEET
Project Name:
Cape Lookout RV Park
Permit Number:
SW8 020432 Modification
Location:
Carteret County
Applicant:
Mr. Ron Loftis, Owner
Mailing Address:
PO Box 522
Harkers Island, NC 28531
Application Date:,
July 16, 2003
Receiving Stream/River Basin/Index #:
White Oak / Back Sound / 21-35-(1.5)
Classification of Water Body:
"SA"
Basin 1 Basin 2
Basin, Depth, feet:
0.95 0.75
Bottom Elevation, FMSL:
8.75 8.95
Drainage Area, acres:
1.57 1.46
Total Impervious Surfaces, ft2:
19,548 16,608
Offsite Area entering Pond, ft2:
none per Engineer
Required Storage Volume, ft3:
5,250 4,530
Provided Storage Volume, ft3:
5,339, 4,551
Temporary Storage Elevation, FMSL:
9.7 9.7
Controlling Orifice:
n/a n/a
Soil Type:
Sand Sand
Seasonal High Water Table:
6.25 6.25
Expected Infiltration Rate:
4" per hour 4" per hour
Time to Draw Down., days:
0.2 0.2
3

State Stormwater Management Systems
Permit No. SWS 020432 Modification
11. SCHEDULE OF COMPLIANCE
I . 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.
Decorative spray fountains will not be allowed in the stormwater treatment system.
6. The facilities shall be constructed as shown on the approved plans. This permit shall
become voidable unless the facilities are constructed in accordance with the conditions of
tliis permit, the approved plans and specifications, and other supporting data.
7. Upon completion of construction, prior to issuance of a Certificate of Occupancy, and
prior to operation of this permitted facility, a certification must be received from an
appropriate designer for the system installed certifying that the permitted facility has been
installed in accordance with this permit, the approved plans and specifications, and other
supporting documentation. Any deviations from the approved plans and specifications
must be noted on the Certification. A modification may be required for those deviations.
S. If the stormwater system was used as an Erosion Control device, it must be restored to
design condition prior to operation as a stormwater treatment device, and prior to
occupancy of the facility.
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. Redesign or addition to the approved amount of built -upon area or to the drainage
area.
e. Further subdivision, acquisition, or sale of all or part 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 Major permit was
sought.
f. Tilling in, altering, or piping of any vegetative conveyance shown on the approved
plan.
4

State Stormwater Management Systems
Permit No, SW8 020432 Modification
10. The permittee shall submit final site layout and grading plans for any permitted future
areas shown on the approved plans, prior to construction. If the proposed BUA exceeds
the amount permitted under this permit, a modification to the permit must be submitted
and approved prior to construction.
11. 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.
12. At least 30 days prior to the sale or lease of any portion of the property, the permittee
shall notify DWQ and provide the name, mailing address and phone number of the
purchaser or leasee. An access/maintenance easement to the stormwater facilities shall be
granted in favor of the permittee if access to the stormwater facilities will be restricted by
the sale or lease of any portion of the property.
13. The permittee must maintain compliance with the proposed built -upon area and ensure
that the rimoff from all the built -upon is directed into the permitted system.
14. The Director may notify the permittec 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.
15. The permittee must maintain the current permitted drainage area. No additional runoff
from outside of the permitted drainage area boundary may enter the permitted stormwater
facilities without first applying for and receiving a permit modification.
III. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the Director. In the
event of a change of owership, or a name change, the permittee must submit a formal
permit transfer request to the Division of Water Quality, accompanied by a completed
name/ownership change form, documentation from the parties involved, and other
supporting materials as may be appropriate. The approval of this request will be
considered on its merits and may or may not be approved. The permittee is responsible
for compliance with all permit conditions until such time as the Division approves the
transfer request.
Failure to abide by the conditions and limitations contained 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.
3. 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) which have jurisdiction.
4. In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Pcrmittee 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.
5. 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.
6. The permit may be modified, revoked and reissued or terminated for cause. The filing of
a request for a permit modification, revocation and reissuance or termination does not
stay any permit condition.

State Stormwater Management System
Permit No. SW8 020432 Modification
7. 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.
8. Approved plans and specifications for this project are incorporated by reference and are
enforceable parts of the permit.
9. The permittee shall notify the Division any name, ownership or mailing address changes
within 30 days.
Permit issued this the 1 bth day of July, 2003.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Alan W. Klimek, P.E., Director
--�v� Division of Water. Quality
By Authority of the Environmental Management Commission

t State Stormwater Management Systems
Permit No. SW8 020432 Modification
Cape Lookout RV Park
Stormwater Permit No. SW8 020432 Modification
Carteret County
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,
(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
SEAL
7

State Stormwater Management Systenis
Permit No. SW8 020432 Modification
Certification Requirements:
1.
2.
3.
4.
5.
6.
7.
8.
9.
14.
The drainage area to the system contains approximately the permitted acreage.
The drainage area to the system contains no more than the permitted amount of
built -upon area.
All the built -upon area associated with the project is graded'such that the runoff
drains to the system.
The outlet/bypass structure elevations are per the approved plan.
The outlet structure is located per the approved plans.
Trash rack is provided on the outlet/bypass structure.
All slopes are grassed with permanent vegetation.
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.
The permitted amounts of surface area and/or -volume have been provided.
Required drawdown devices are correctly sized per the approved plans.
All required design depths are provided.
All required parts of the system are provided, such as a vegetated shelf, and a
forebay.
The overall dimensions of the system, as shown on the approved plans, are
provided.
cc: NCDENR-DWQ Regional Office
Carteret County Building Inspections

t
OFFICE USE ONLY
Dale Receiver)
Pee Paid
Permit Number
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
I. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
Harold Gurganus & Ron Loftis
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
Ron Loftis, Owner
3. Mailing Address for person listed in item 2 above:
P. 0. Box 522
City: Harkers Island State: N.C. zip: 28531
Telephone Number: ( 252 504-3400
4. Project. Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, e(c.):
Cape Lookout RV Park
5. Location of Project (street address):
SR 1335 (Harkers Island Road)
City: Harkers Island County: Carteret
6. Directions to project (from nearest major intersection):
From Harkers Island Bridge, proceed 3.66 miles.
Project is on the NORTH side of SR 1335.
7. Latitude: 34 21 26 Longitude: 76 32 21 of project
8. Contact person who can answer questions about the project.:
Name: John McLean Telephone Number: ( 252 ) 393-2219
II. PERMIT INFORMATION:
1. Specify whether project is (check one): New Renewal X Modii"ication
Form SWU-101 Version 3.99 Page 1 of

t
Z. If this application is being submitted as the result of a renewal or modification to an existing permit, list the -
existing permit number SW8 020432 and its issue date (if'known) 7 / 12 / 02
3. Specify the type of project (check one):
® Low Density X High Density Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
CAMA Major X Sedimentation/Erosion Control _404/401 Permit _NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at.
1-877-6Z3-6748.
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwat.er will he treated. Also attach a detailed narrative
(one to two pages) describing stonnwater management for the project .
Attached
2. Stormwater runoff from this project drains to the White Oak River basin.
3. Total Project Area: 3 • 12 acres 4. Project Built. Upon Area: 2$. 7 26.2.
5. How many drainage areas does the project have? 2
6. Complete the following information for each drainage area. If there are more than two 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 2
Receiving Stream Name
Back Sound
Back Sound
Receiving Stream Class
SA — ORW
SA — ORW
Drainage Area
68,411
63,400
Existing Impervious* Area
1,500 sq. ft .
0
Proposed Impervious*Area
18,048 sq. f t .
16,608 sq. f t .
Impervious' Area (total)
2 8. S—] %
Impervious' Surface Area
Drainage Area I
Drainage Area 2
On -sire Buildings
1,500 sq. f t .
0
On-sileStreets
9,348 sq. ft.
8,508 sq. ft.
On -site Parking
0
0
On -sire Sidewalks
0
0
Other on -sire
8,700 sq. ft.
8,100 sq. ft.
Olr site
0
0
Tolal:19,548 sq. ft.
Total.16,608 sq. ft.
Impervious area is defined as the built upon area Including, but not limited to, buildings. roads, Wr hv#"�
sidewalks, gravel areas. etc. ,�� AR01 �
�aaO
(� EcaMaaccsaryr
\n[�s
•F'or►n 5W11-10I Version 3.99 Page 2 of 4
5631
i
FMCf NE��r� D�

7. How was the off -site impervious area listed above derived? Ny
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
The following italicized deed restrictions and protective covenants are required to be recorded for all
subdivisions, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a table
listing each lot number, size and the allowable built -upon area for each lot must be provided as an attachment.
Try 15 15 067- d PROPE Pr'-' S U B D 1 v t 510 N . -ME?L InaL (5E No oL TT' FARI S,
1. The following covenants are intended to ensure ongoing compliance with state stormwater management permit number
as issued by the Division of Water Quality. These covenants may not be
changed or deleted without the consent of the State.
2. No more than square feet of any lot shall be covered by structures or impervious materials.
Impervious materials include asphalt, gravel, concrete, brick, stone, slate orsimilar material but do not include wood
decking or the water surface of swimming pools.
3. Swales shall not be filled in, piped, or altered except as necessary to provide driveway crossings.
4. Built -upon area in excess of the permitted amount requires a state stormwater management permit modification prior to
construction.
5. All permitted runoff from out parcels or future development shall be directed into the permitted stormwater control
system. These connections to the stormwater control system shall be performed in a manner that maintains the integrity
and performance of the system as permitted.
By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, 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 State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each
BMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the status
and availability of these forms.
For -102
Wet Detention Basin Sup2jlnt
Torrri+SWU--103-Infi�ti lement}orm
SW -ID4
Lowlement
FormSWU-105
Curb Outlet System Supplement
Form SWU-106
Off -Site System Supplement.
Form SWU-107
Underground Infiltration Trench Supplement
Form SWU-108
Neuse River Basin Supplement
Form SWU-109
Innovative Best Management Practice Supplement
Form SWU-101 Version 3.99 Page 3 of 4

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. The complete application package should be
submitted to the appropriate DWQ Regional Office.
Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
• Ori final and one co of the Stormwater Management Permit Application Form
• One copy of the applicable Supplement Form(s) for each BMP (103
• Permit application processing.fee of $420 (payable to NCDENR)
• Detailed narrative description of starmwater treatment/management
• Two copies of plans and specifications, including:
- Development/Project name ✓
-Engineer and firm ✓
- Legend
- North arrow ✓
- Scale ✓
- Revision number & date
-Mean high waterline WA ✓
- Dimensioned property/project boundary
- Location map with named streets or NCSR numbers
- Original contours, proposed contours, spot elevations, finished floor elevations ✓
- Details of roads, drainage features, collection systems, and starmwater control measures'
Wetlands delineated, or a note on plans that none exist NIA WW as RAW-,
Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations
- Drainage areas delineated ✓
- Vegetated buffers (where required)
VII. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section.
Designated agent (individual or firm): 3bFW
Mailing Address: 10(o MPtnlATEE eET
City: %Ape. CAR-TERET State: t`1C Zip: ZS S,8 4-
Phone: ( 2 CjZ ) 393.22.1 ot Fax: ( 2 5 Z ) 3°13 — 244 3
Vill. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in General Informa(ion, item 2) RO tJ W F 1 15
certify that the information included on thisprrmit application form is, to the best of my knowledge, correct and
that the project wil c nstructed in con �ncothe approved plans, that the required deed restrictions
and protective covenan will be recorded dproposed project complies with the requirements of 15A
NCAC 2H .1000.
C
Form SWU-101 Version 3.99 Page 4 of 4
Date:

J
Q�
1

Permit No. S W a 020 c} 3 Z
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name :CA Fe LooKny T- 9 U PAR i<
Contact Person: d6kt S MCLJEA�J. ,GENT• Phone Number: (ZyZ} 3 - Z Z I q
This worksheet applies to: Basin No. 1 in Drainage Area 6614 11 sq.-W.
(as identified on plans) (from Form SWU-101)
11. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type SAND
Infiltration Rate 2. — ( in/hr r cf/hr/sf (circle appropriate units)
SH WT Elevation • 2 s -fa -TAZ fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm inch (1.5 inch event for SA waters, I inch event for others)
Design Volume 5 c.f. A-525C)
Drawdown Time Q• 2 days Me"Uced
Basin Dimensions gQa'm" - -Evan Ca (A,Aii,�
Basin Size 30ft. x 190 ft. _ _ 5GZO sq. ft. (bottom dimensions)
Basin Volume Provided 5339 c.f.
Basin Elevations !
8.75gas�.
Bottom Elevation fmsl f
C.
J
Storage Elevation fmsl I •� �' •��� $'�S �flRr•';,•RE��pp��
Top Elevation fmsl
EAE
Form SWU-103 Rev 3.99 rage I of 3 5631 r
.� pm.,�... '
EPA p,
MC �
All

I

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of 1nvironment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Appiigants Initials
X_T1% a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval has been obtained.
f�0 f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
i. System captures and infiltrates the runoff from the first LO inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
I. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
V�Q n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters). NO OJW_1ZP DW
�d o. Flow distribution mechanism within the basin is provided. !�444Ur FIA W
p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

n�.
e ��
.. k ...
� _ l � i } �

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
l . After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that wili
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads ` q. 5 feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that 1 am responsible for the performance of the five
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.
Print Name and Title: 'RON LOFTIS
Address:P.
___...__�j ZZ
Phone:_
Signature:
R5 ISLAM 1) z8531
Date: MaA 11,_ZQO3 _...
Note: The legally re_vponsibltj_)arty should not be a homeowners association unless more than SO% of the lots have heen sold and a
resident of the subdivision has been named the president. ,,JJ
1, v , a Notary Public for the State of r� ra, County of
6 do hereby certi hat !'� o k !o a - f personally appeared before me this_!t! -
day of Citci+� LO.� 1 . and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
���eeeleeJJJ���r�
. K.F�
� CO t, t����.
<<JJJJI11111ti
My commission expires/e/
_ fit �d0
r
Page 3 of 3

Permit No. 5 �\/ S ©2.043 Z
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
_DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : WS
LOOKOv T'
)�V
PARK
Contact Person: Jo (W
iG LEAN, A%ajT
Phone Number:
This worksheet applies to: Basin No
2.
(as identified on plans)
in Drainage Area 63- ¢100
(from Form 5WU-101)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fxisl).
Soils Report Summary
Soil Type s'AMDY
Infiltration Rate Z — ( /hr r cf/hr/sf (circle appropriate uniu)
SHWT Elevation 5-4- -/16 to • Z 5 fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm -3 inch
Design Volume Ll. c.f.
Drawdown Time 0 • Z days
Basin Dimensions
Basin Size 240 ft. x
Basin Volume Provided 55 c.f.
Basin Elevations !
Bottom Elevation �' fmsl
Storage Elevation fmsl
Top Elevation fmsl
(1.5 inch event for SA waters, I inch event for others)
36 ft. _ 7—sq. ft. (bottom dimensions)
(yteasur�d by c4m14U Ae)
Form SWU-103 Rev 3.99 Page 1 of 3
1: 7- o• rs c
Vy F,.. 1
5631
2
r

im

P��SI�I _42
111. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
J b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
m d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval has been obtained.
N f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way. +A/A
h g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
Y) j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
1
1. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
.ql
m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
Q dense vegetative cover is provided.
n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters). NO 04RF to W
o. Flow distribution mechanism within the basin is provided. 5i36ET_ Ft. W
1'1 p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
YY� r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
M s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

•' J
IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads 4q , 5 feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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.
Print Name and Title: 16
Address: Pa . &-�kzz Z 6 531
Phone: 252-"G04- 34UU
Signature:
Date: - l I - Z[ao Z
Note: The legally ravj)omsible party shoulXot be, a homeowners association unless more than 50% of the lots have been sold and a
revident of the subdivision hay been named the president.
1, t L ��q
Public for/t/he State of t i : , County of
41)
rvi Id do hereby certify that l� 9�{-: personally appeared before me this
day of A 64- 'U'>3, and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
IL
C) IrLRLlvs 3 )9
My commission expires_A' , /( 7,.,() d�
Page 3 of 3

z: ..f � m:, , r,M-r.OFFICE.LrE ONLY . z.
r� Data Re eived Fee 73Ed Pernit `umber
a 5'
State of :Forth Carolina
Department of Environment and Natural Resources
Division of 'Water Quality
STORMWATER MANAGEMENT P£P.MIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
Harold G r
2. Print Owner/Signing Official's name and tale (person legally responsible for facility and compliance):
Ron Lof ta.s
3. Mailing Address for person listed in item 2 above:
P.Q. Rix 5,27
City: Harkers island. State: N.C. Zip: 28531
Telephone Number: 252 504-3400
Y. Project Name (subdivision, facility, or establishment name -should be consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
Cape Lookout RV Park
5. Location of Project (street address):
SR 1335 (Harkers Tsland Rnnri)
City; Harkers Island County:__ Car terPr _
6. 'Directions to project (from neatest rnajor intersection).
6M T}E LEPT st DZ NORTH! cr R
7. Latitude: 3 4 a 2 i' Z�'� Lonc itude: lipo 3 Z 7, it
of project
S. Contact person who can answer questions about the project:
liar ,e:T John Odom, P.L. S . Telephone Number: (_2 5 2 .1 39 3-21 2 9
H. PMMIT INFOR-MATION:
I. 5pecifs• whether project is (check one) X i.•eh R=_ne%%,Fd Modification
Form SWU-101 Version 3.99 P,,g= 1014

2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing perrrut number A and its issue elate (if known)
3. Specify the type of project (check one):
Low Density __XL High Density Redevelop General Permit 0ltier
4. Additional Project Requirements (check applicable blanks,):
CAMA Nfajor X Sedimentation/Ero;icn Control 404/401 Permit _NPD:S Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-577-623-6743.
M. PROJECT INFOr-uMATION
I. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormw•ater management for the project .
2. Stormwater runoff from this project drains to the W -�11T� � A _ River basin.
3. Total Project Area: �J. �Z acres 4. Project Built Upon Area: (p i
Z$
5. How many drainage areas does the project have? A\14 - 2-7
6. Complete the following information for each drainage area. If there ate more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
:$asiz]�IrtfoEiolty ' i`�
�., Nam.
�i't �3rdit�gAed�.c.
` s; r� Dttriag� A lea 2
Receiving Stream Name
Receiving Stream Class
Drainage Area
I 1 5 CRE.S
• 5 LAG
ExistinE Impervious' Area
I
M
Proposed txn ervious•Area
Q .39 &19ES
Irn er ious• Area (total)
7—G a p
Lei ervrous`;S r#ac Area ;'>
p' ,� :' ' Draz�iaa� area'] R e
z" « Dr' Liiag2 _A'rea l --
On -site Buildings
Q,0 AcoEs
on-site Streets
D. -zt ACRGS
o. Z ACRES
on ;ire Parking
p. Oda J C4ckes
d, 0(o IaG?-ES
On -site Sidew•alk�
o .
o
Other on-3ite RVS b��0
I �} • 2 CCZ�S +�. i Z
Off -site
I o d !
Total: o. 39 ACRES 1 Total: o. 4Z Res
Irnpe-,�iows area is der�—ted as the E,u4iL 4por: a -ea ir,cl adir:a, bu:` no? hm:ted to, bui!dir:gs, roads, parkir:g
gra:;ef areas,
Form 5WU•101 version 3.44 Page 2 of 4

1. 7. HoL•, wa; the off -site impen,'ious area listed above derived? /p,
IV. DEED RESTRiC-nO S AND PROTECTWE COVENANTS
The follo•••,'iing italicized deed restrictions and protective covenants are required to be .recorded for all
subdivision, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a
table listing each lot number, size and the allowable built -upon area for each lot must be provided as an
attachment. T415 r5 NdT A StJBD�Ul51OA�-- 1�5t�R� 1�LILL RjE I�0_
coT PAP, caLS
I. The following cover.-,nis are intended to ensure ongoing compliance with state storrr;water managernyn: permit
numc'r a_ issued by the Division of Water Quality. These covenants may
not be changed or deleted without the consent of the State.
2. No more than square feet of any lot shall be covered by structures or impervious materials.
Imvmious materials include asphalt, gravel, concrete, brick, stone, slate or similar material but do not include wccd
decking or the water surface of swimming pools.
3. Swale; wall not be filled in, piped, or altered except as necessary to provide driveway crossings.
4. BuiIt-upon area in excess of the permitted amount requires a state stormwater management permit modification prior to
construction.
5, Alf permitted runoff from outparcels or future development shall be directed into the permitted stormwater control
system,. These connections to the stormwater control syst--?n shall be performed in a manner that maintains the
integrity and performance of the system: as permitted.
By your signature below•, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, 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 State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FOlUvIS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for
each BLIP specified For this project. Contact the Stormwater and General Permits Unit at [phone] for the
status and availability of these forms.
Form SGtiU-102 Wet Detention Basin Su lement
orm 51ti U 103 Irliiltration Basin 5u leme '
Form 7=rUT Lo« Density Supplement
Fonn Sl^" U-105 Curb Outlet System Supplement
Form 54%U-106 Off -Site System Supplement
Form 5�% a-107 Underground Infiltration Trench Supplement
Form SWU-108 Neuie P: ver Basin Supplement
Form SL%--U-109 lnnovative Best.Ianagement Practice Supplement
Form SWU-101 Vt-rsior. 3.99 Page 3 of—'

VI. SUBMITTAL REQUIRE,tiENTS
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. The complete application package should be
submitted to the appropriate DWQ Regional Office.
I. Please indicate that you have provided the following required information by initialing in the space
pro�-ided next to each item.
• Original and one copy of the Sto-nv.,ater Management Permit Application Form
• One copy of the applicable Supplement Form(s) for each Bti1P
• Permit application proces_ing fee of 5420 (payable to NCDENR)
• Detailed narrative description ostormwater treament/maaementg
• Two copses of plans and specifications, Lncluding:
- Development/Project narne ✓
- Engineer and firm
-Legend �
-North arrow ✓
- Stale i
- Revision number do dated
Mean high water line IJJ A
Dimensioned property/project boundary /
Location map with named streets or NCSR numbers ✓
-Original contours, proposed contours, spot elevations, finished floor elevations
- DetaiIs of roads, drainage features, collection systems, and stormwater control measures
- Wetlands delneated, or a note on plans that none exist N1A No fgE a tj PLANS
-,Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations
- Drainage areas delineated
- Vegetated buffers (where required) N�pr
VII. AGENT AUI-HOMATION
I
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section.
Designated agent (individual or firm): John McLean Engineering Associates
Mailing Address: 106 Manatee Street
City: Cape Carteret State: N.C. Zip: 28584
Phone: ( 252 ) 393-2219 Fax: ( 252 ) 393-2463
VIII. APPLICANT'S CERTIFICATIOti
1, (print or hive rwtn: of Fes, s,)n II: ted in Gen_-ral InfoTrnation,
certify that the information included on this permit application form is, to the best of rTLV knowledge, correct and
that the project will be constructed in confonnance with the approved plans, that the required deed restrictions
and protective cg�ants iti,ill re rded, and that the proposed project complies with the requirernents of 1S a
NCAC 2H .10 �Oe A
5i.- ure:
Form SWU-101 Version 3,99 Page 4 of 4
Date:

Cape Lookout RV Park April 22, 2002
Harkers Island, North Carolina
Cape Lookout RV Park is a proposed development planned on SR 1335
(Harkers Island Road). The size of the tract of land is 3.12 acres. There
is an existing residence on the property which will be used as an office and
a bath house for residents. The proposed street system will be one way
traffic on a 16 foot wide right-of-way. The proposed street will be
constructed in the shape of an inverted crown. The pavement width will be
14 feet.
The tract of land is situated on the north side of SR 1335. The water course
located to the south is Back Sound, classified as SA-ORW. There is no
outlet drainage on this tract.
There will be one way traffic on the street. The street system is set at .5%
grade, with a high point located at the north quadrant point of the street,
set at + 10.5 feet. The adjoining land is higher at this point with spot
elevations exceeding +11 on Lots 11 & 12. Lots 7, 8, 9 & 10 require fill,
but less than a foot in all places.
Fill for the development is available on -site in two areas which will collect
the storm water runoff and treat it with infiltration. The street grade will
remain at .5% for the entire RV Park. Minor fill (less than a foot) will be
necessary on Lots 1 & 2, and Lots 18, 19 & 20.
The owner intends to selectively clear all lots in order to leave as many
trees as possible so the canopy can be left. The only wholesale clearing
will be for the street and the sewer system. The sewer system requires two
parcels be cleared and low pressure lines installed. Only those two land
masses will be cleared, the remaining will be left undisturbed. See map for
clearing notes.
Each infiltration basin has been sized to accept the flow of a 3 inch event.
The western basin is 30 feet wide and 190 feet long. The eastern basin is
30 feet wide and 200 feet long. The volume for storage is based on equal
flow to the basins, and each has a bottom elevation of 8.95 feet. This can
vary as required for more or less storage. The bottom elevation is 9 inches
lower than the inlet elevation. The overall storage is slightly more than
required for the 3 inch event. The bottom of the infiltration basin shall
remain with no silt, no topsoil, only native sand. It is imperative that the
bottom of each basin be left without sealing from ability to infiltrate.

At the entrance of both basins, on both ends of both basins, a temporary
sediment basin has been designed to handle 1,800 cf/acre disturbed in the
construction. The temporary basins are 25 feet square, 2 feet deep.
These temporary sediment traps will eventually be filled when construction
is complete and vegetation has been established.
The owners of the tract are
Ron Loftis
P.O. Box 522
Harkers Island, N.C. 28531
Tel: [phone]
and Harold Gurganus
2036 Hollow Pond Road
Williamston, N.C. 27892
Tel: [phone]
The approximate acreage of disturbed land will be 2.75 acres
The surveyor is:
The engineer is:
Prestige Surveying
c/o John Odom, PLS
501 W. B. McLean Boulevard
Cape Carteret, N.C. 28584
John P. McLean, P.E.
106 Manatee Street
Cape Carteret, N.C. 28584
Tel: [phone]
There are no wetlands being affected by clearing/construction on this
project. A topographic survey has been prepared by Prestige Surveying.
The FEMA classification for flood hazard is shown on the attached map.
ADJACENT PROPERTY:
The property on the west has been cleared and a residence has been built.
On the north and east side there are native woodlands (not cleared).

SOIL CONDITIONS:
The property has been evaluated by Land Management Group, Inc. (Larry
Baldwin, CPSS. A copy of his report has been included herein. Soil types
Seabrook and Mandrin-dry phase were identified in an area planned for
infiltration basin # 1 (West). Mandrin and Leon -dry phase were, identified
for infiltration basin # 2 (East). The seasonal high water table was
identified as being from 35" to 55" below the surface of the ground.
Permeability has been set at 2-6 inches per hour.
DEVELOPMENT NOTES:
The owner intends to obtain Carteret County Planning Board Approval in
May. There will be no work done until DENR permits are obtained from
Land Quality and Water Quality. The Carteret County Environmental
Health Division has evaluated the land for septic permits. There will be
two large systems which collect the effluent and dispose of it through low
pressure pipe systems.
A DOT entrance permit will be obtained for access to SR 1335 across an
existing driveway to the existing residence which will be used as an office
and bath house.
Water supply for the Cape Lookout RV Park is being requested from Harkers
Island Water Corporation.
The owners plan to selectively clear for RV sites, Although clearing is
necessary for the street, the owners plan to save as may oak trees as they
can be carefully selecting sites. The septic system requires two active
sites and two repair sites. The repair sites will NOT be cleared, but left with
a canopy from existing trees as much as possible.
Excavation, Filling and Roadway construction. As much as possible, all
material to be excavated will be used in areas noted on plans to build up
adjoining lots. The owners have been extremely cautious with respect to
wholesale clearing. All work will be monitored carefully to ensure no clear
cutting is done. The construction of the infiltration basins will be monitored
to make certain no topsoil or silt is allowed to be placed in the basins. It is
imperative that sandy soil is the medium in the bottom of the basins.

PLANNED SEDIMENTATION & EROSION CONTROL PRACTICES:
1. Construction Entrance
See detail on drawing. Clean washed rock will be used in the
entrance.
2. Temporary Sediment Retention Basins (4)
See details on drawing. There is at least one basin at each corner of
each infiltration basin. The Temporary Basins are to be 2 feet deep,
25 feet square.
3. Rock Check Dams
Rock check dams are provided at the four corners of the infiltration
basins as detailed on the drawings.
4. Silt Fences
A silt fence will be used to protect adjoining property. It will be
erected as shown on the drawings.
5. Driveway pipe: None. The DOT has no roadside ditch along SR 1335.
MAINTENANCE MEASURES:
The rock check dams require monitoring for sediment accumulation. If
evidence of silt is found at the check dam areas it shall be removed.
Grass is a critical measure for all sediment control. If grass is found to be
ineffective, other temporary measures shall be used to control sediment.
These additional temporary measures could be more check dams or
additional silt fence. When ground cover is established, the siltation will be
controlled.
It is equally important to monitor the temporary sediment basins for
accumulation of sand/silt. When it becomes obvious that at least 20% of
the temporary basins are filled, they will be excavated and graded to
original construction conditions.
NAME OF RECEIVING WATERS
There is no outlet from this project to adjoining wetlands, marsh, water,
streams, etc.
TEMPORARY BENCH MARK
There shall be a temporary bench mark set in each basin at the north and
south end with the elevation of +9.5 clearly marked. When this elevation
is reached, it is time to remove the sediment.
File: Caaelooxou[Rvseda.zl.zooz

Permit No. Sty 020 2r
(to be provided by DtivQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORNMATER NLANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form maybe photocopied for use as an original
D`4� 51onwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name: CAPE LOOKOUT RV PARK
Contact Person: ROK LIOF`RS Phone Number: (Z52) So 4 -34o n
J0AN MC LEf_"N, PE: 2 5 Z _:Y13 • Z Z 19
This worksheet applies to: Basin No. in Drainage Area I.5 AcgcS
(at Uenrlfisd oK plans) V vm Form SWU-101)
II. DESIGN INFORNLMON - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable
source of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type SAND
Infiltration Rate 2—CD in/hr or cf/hr/sf (circle appropriate units)
SKWT Elevation 4p.255.4Z fMS1 (Seasonal High Warer Table elevarion)
Id-- 4-S"+-S-S- "
Basin Design Parameters
Design Storm 3 inch (1.5 inch event far 5A waters, I inch event for others)
Design Volume 4 37S c.f.
Drawdown Time . o(' -TD - 14 days
Basin Dimensions
Basin Size _ 4 ft. x ft. = S700sq. ft. (bottom dimensions)
Basin Volume Provided 4 Zn7a c.f.
Basin Elevations
BotromElevation S•g5f fmsl
Storage Elevation .70 fmsl
Top Elevation `i .70 _ - fmsl
Form SWU-103 Rev3.99 page 1of3

b4*W # I
IIL. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Nlanual
(N.C. Department of Environment. Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008,
Initial in the space provided to indicate that the following design requirements have been met and zupporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
a.
b.
C.
d.
e.
ND f.
System is located 50 feet from class SA waters and 30 feet from other surface waters.
System is located at least 100 feet from water supply wells.
Bottom of system is at least 2 feet above the seasonal high water table.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
System is not sited on or in fill material or DWQ approval has been obtained.
System is located in a recorded drainage easement for the purposes of operation and N/A
.maintenance and has recorded access easements to the nearest public right-of-way. (!�
Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
3.a
i. System captures and infiltrates the runoff from the first 1. iR2 of .rainfall (1.5 inch event
for areas draining to SA waters ). Design volume and infiltration calculations attached.
System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
1. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches
or dense vegetative cover is provided.
n. Vegetated filter is provided for overflow and detail is shown on plans (Re wired,mu nimum
length is 50 feet for SA waters, 30 feet for other waters). NO OVGf QW
o. Flow distribution mechanism within the basin is provided. 't)4 -l~T FLOW
p. A benchmark is provided to determine the sediment accumulation in the pretreatment
device.
0
Runoff in excess of the desitrn volume bypasses off-line systems (bypass detail provided)
System is designed to draw dov,n the design storage volume to the proposed bottom
elevation under seasonal high wwtr conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
Plans ensure that the installed ;,.stem will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Pat: 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEIIIENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved
design specifications,
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or wheq
depth in the pretreatment unit is reduced to 75117b of the original design depth. The system shall be restore_ d
to the original design depth without over -excavating. Over -excavating may cause the required water
table separation to be reduced and may compromise the ability of the system to perform as designed.
Removed sediment shall be disposed of in an appropriate manner and shall not be handled in a manner
that will adversely impact water duality (i.e. stockpiling near a stormwater treatment device or stream,
etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads'I 9•5 feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin,
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design £unction, other stormwater
control devices as allowed by NCAC 2H A000 must be designed, approved and constructed.
1 acknowledge and agree by my signature below that l am responsible for the performance of the five
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.
Print Name and Title: 1�N LOB-1 ( 5
Address: PC. BO 6?Z ADZ Y-CF,S 15LAkID, KC 7_'1531
Phone: 2CJz - 3 Date: i
Signature:
Nate: The legally responsible party should not be a homeoxvners association unless more than 50% of the lots have been sold and
a )resident of the subd is,ision has been named the president.
a Noocary Public for the State of 4, r �c� w .h. County of
do hereby certify char iC o.o _ Z_ _ 1� S personally appeared before me this
day of and acknowledge the due execution of the forgoing infiluarion basin maintenance
requirements, Witness my hand and official seal,
$ FA .t...
Form SWU-103 fiLv 3.99
My commission expires / ';cr.. , 441."j
Page 3 of 3

Permit No.
(to be provided by DWQ)
State of North Carolina
Department of Environmeht and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN'SUPPLEMENT
This form may be photocopied for use as an original
DWO Stomwater Mana em n n Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration' basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : CA LOO Ko V 12il�
Contact Person: IRDN I Phone Number: Z -34400
D t� WLID, PC Z5z 393- ZZ lq
This worksheet applies to: Basin No. 'Z in Drainage Area 1,7 ' &gE'S
(as fdenulfeed on plans) (from Form SWU-1 D1)
II, DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable
source of soils information. All elevations shall be in feet mean sea level (fmsl),
Soils Report Summary
Soil Type SANDI(
Infiltration Rate iQ in/hr or ef/hrlsf (circle appropriate units)
Si- WT Elevation S.4 To ta.7S fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Borrom Elevation
Storage Elevation
Top Elevation
inch
4,S—T5 c.f.
0.e6 a. H days
(1.5 inch eventfor SA waters, 1 inch event for others)
2W ft. X 30
fmsl
fmsl
q• %!� � fnzs]
ft. _ _ �Cda Sq. ft. (bottom dimensions}
Form SlA`U-t03 Rev 3.99 Page 1 of 3

III. REQUIRED.ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Adnunistrative Code:
Section: 15 A NCAC 2H .1008.
lrt Gal in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Farm, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval has been obtained.
NO . f. System is located in a recorded drainage easement for the purposes of operation and ` + n
maintenance and has recorded access easements to the nearest public right-of-way. l
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
3.
i. System captures and infiltrates the runoff from the fM rich of rainfall (1.5 inch event
for areas draining to SA waters ). Design volume and nfiltration calculations attached.
j, System is sized to take into account the .runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
1, A pretreatment device such as a catch basin, grease trap, filter strip, grassed Swale or
sediment trap is provided.
m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches
AV or dense vegetative cover is provided.
n. Vegetated filter is provided for overflow and detail is shown on pl s (Required minimum
length is 50 feet for SA waters, 30 feet for other waters). Na tW r FO W
M o. Flow distribution mechanism within the basin is provided. .59EET` 1FLOW
p. A benchmark is provided to determine the sediment accumulation in the pretreatment
device.
NJ q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system wi11 meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIS` OPERaTIOti AND 'NIAINTENANCE AGREENT_ENT
I. .After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2, Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved
design specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or wheri
depth in the pretreatment unit is reduced to 7517a of the original design depth. The system shall be restored
to the original design depth without over -excavating. Over -excavating may cause the required water
table separation to be reduced and may compromise the ability of the system to pdrform as designed.
Removed sediment shall be disposed of in an appropriate manner and shall not be handled in a manner
that will adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream,
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the desfgu depth reads+6f.S feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H A000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system orprior to any
changes to the system or responsible party.
Print Name and Title! DON I ().F1 IS
Address: 2-0. 8 Gz- R4-EF—S 6-AQD �I.Z,$53l
Phone: 2,52 d4 Date: 1l _ `-, u2
Signature:
Note: The legally responsible party should nor be a homeox•rers association unless more than 50% of the fors have been sold and
a residear of the subdivision has been named the president.
yy �
a Notary Public for the Sme of O.r �i: �} „�, County of
L rLO do hereby certify that ��' �l �.� . ^S personally appeared before me this Zc
day of -20v2— . and acknowledge the due execution of the forgoing infiltration basin maintenance
requirernents. Witness my hand and official seal,
SEAL, ��ty commission expire;
Force S r,- -103 Rcv 3.99 Pagc 3 of 3

-------- -- -
CAPE LOOKOUT R.V. PARK 1005
252.504-3400
1491 ISLAND RD.
HARKERS ISLAND, NC 28531
DATE 02201
PAY
TO THE
ORDER OF_ Z2En //V I$ did
AMR
BIB&T
OAAN CH BANKM a AND TRUST COM PAN Y
FOR ABEAUFORT, NORTH CAROLINA
#-Apt
so b- --)

(/Il/Z=Gtf%7?/I7LFl7LfQr% [:l/1Z3000tQ/ILafl
n/ e7� Ogle, /gac 2/J22
d Jc/. 9/0-452-0001
��� �Ypi[/l�f!!nT'✓��G e[Jfin
�, Ciae� Jtl�nCe
DATE: February 28, t99-7
Yule P
_qw-nt,y /`_3,a��nzA //Cg,,e Ad
,Jsoj
WWMi,Z,&t. ✓t,' z403
SUBJECT: Land & soils evaluation of the proposed Cape Lookout RN Park Tract (--3.0 acres)
to determine usability with infiltration stormwater treatment usage. Tract located
on the north side of Harkers Island Rd (NCSR 1335), -0.41 miles past NCSR 1424,
Harkers Island east area, Carteret County, North Carolina.
TO: - Mr. Ron Loftis & Mr. Harold Gurganus -... ` Mr. John McLean, PE
Cape Lookout RN Park McLean Engineering Company
P.O. Box 1478 106 Manatee Street
Washington, NC 27889 - 1478 Cape Carteret
[phone] Swansboro, NC 28584
cc: Mr. John Odum, Prestige Surveying [phone]
The•land & soils within the proposed Cape Lookout RN Park Tract (-3.0 acres) were evaluated
to determine potential suitability for on -site stormwater treatment usage. NCDEH&NR "Stormwater
Runoff Disposal" rules and regulations (NCAC 15-2H-.1000) were used as guidelines in making
this evaluation.
The proposed project is greater than 1 acre in size, proposes >25% impervious surfaces, drains
to Class SA or ORW Waters, and is within 112 mile of class SA-ORW Waters. If the development
project is within 112 mile of and drains to Class SA-ORW Waters or their unclassified tributaries,
then stormwater must be treated by infiltration basins or an equivalent alternative method. The
tract has previously been determined to be geographically located within 112 mile of Class SA-
ORW Waters to the south, thus stormwater is to be treated through infiltration basins. This tract
has broad sandy ridgetops, that gently slope (-1-3%) to poorly drained flats.
Principle soil and site requirements for an infiltration system are: ---the infiltration system's bottom
must be 2 ft or greater from the seasonal high water table; ---must be capable of complete draw -
down within 5 days; ---the soil's hydraulic conductivity must be >0.52 inlhr (<115 min/in);
---recent fill (>1977) material is not usable. The enclosed land & soils map shows the various
land/soil types found (see map). The following are brief descriptions of these land & soil types
for stormwater infiltration usage:
The "Yellow' Areas are well to moderately well drained, deep sandy soils. These soils have an
estimated seasonal high static water table +45 to 55 inches from the surface, based upon soil
wetness indicators. Estimated permeability is <10 - 20 min/in (+3-6 inlhr) to +48" depths. Soils
may have a non-restrictive spodic horizon between +30-50" depths. These soil types should be
considered as usable for shallow placed infiltration stormwater systems with basin bottoms <2-3
ft into the present ground surface. These usable soil areas should not be significantly excavated
or altered. Soil types found are Seabrook and Mandarin -dry phase.

Page 2.
Cape Lookout RN Tract, Soils & Stormwater Usability
The "Brown" Areas are moderately well drained, deep sandy soils. These soils have an
estimated seasonal high static water table +35 to 45 inches from the surface, based upon soil
wetness indicators. Estimated permeability is <10 - 30 min/in (+2-6 inlhr) to +45" depths. Soils
may have a non-contiguous restrictive spodic horizon between +35-55" depths. These soil types
should be considered as usable for ultra -shallow placed infiltration stormwater systems with basin
bottoms <1.0 - 1.5 ft into the present ground surface and/or with sidewail berms. These usable
soil areas should not be significantly excavated or altered. Soil types found are Mandarin and
Leon -dry phase.
The "Pink" Areas are somewhat poorly to poorly drained sandy soils. These soils have an
estimated seasonal high static water table +12 to 25 inches from the surface, based upon soil
wetness indicators. Estimated permeability is <20 - 40 min/in (1.5 - 3.0 inlhr). Soils may have
a non-contiguous restrictive spodic horizon between +30-50" depths. These soil types should be
considered as unsuitable infiltration stormwater systems, unless fill and site improvements can be
constructed.-, These natural soil areas should not be significantly excavated or altered. Soil types
found are Leon and Lynn -Haven.
The tract is relatively uniform within the respective soil groups delineated on the enclosed map.
The major variations are depths to seasonal high water table indicators and depths to non-
restrictive or restrictive spodic horizons, which are typcially non-contiguous. The better sites for
stormwater infiltration system usage are on the higher elevations above —10-10.5 ft elevations,
with marginal sites being above —9.5-10 ft elevations. Unsuitable sites are typically found at —8.5
to <9.5 ft lower elevations. Careful planning and design should be exercised to insure gravity flow
to usable soil areas, and that usable soils are reserved for stormwater infiltration treatment in their
natural state. Otherwise, the usable soil areas could be degraded to an unsuitable status for
stormwater infiltration basins. Soil logs can be provided upon request.
Larry F. Baldwiin, CPSSISC
ARCPACS #2183; NCLSS #1040

LAND & SOILS MAP OF THE PROPOSED CAPE LOOKOUT RN PARK FOR ON -SITE STORMWATER INFILTRATION USAGE
Harkers Island East Area - Carteret County - North Carolina
— _ - rr
Moderately well to well drained sandy soils with an estimated seasonal high static water table +45-55" from the
present ground surface. Soils may have a non-restrictive spodic horizon between +30-50" depth. Estimated
permeability <10-20 min/in (>3-6 in/hr). Seabrook and Mandarin -dry phase soil types. Suitable for shallow
infiltration basins with bottoms <2-3 ft into present ground surface.
Moderately well drained sandy soils with an estimated seasonal high static water table +35-45" from the present
•, ground surface. Soils may have a non-contiguous restrictive spodic between +35-55" depths. Estimated
SCALE: 1 Inch = 60 Feet permeability <10-30 min/in (+2-6 in/hr). Mandarin -dry phase and Leon-dryphase soil types. Suitable for
ultra -shallow infiltration basins with bottoms <1 - 1.5 ft into present ground surface and/or sidewall berms.
(all lines paced & approx) Somewhat poorly to poorly drained sandy soils with an estimated seasonal high static water table 12-25" from
the present ground surface. Soils may have a noncontiguous restrictive spodic between 30-50" depths. Estimated
FEBRUARY - 2002 permeability 20-40 minlin (+1.5-3 in/hr). Leon and Lynn -Haven soil types. Unsuitable for infiltration basins unless filled.
IL' fd s-_I_j _ a
rw
Land Management Group, Inc.

State Stormwater Management Systems
Permit No. SW8 970241 Modification
The Boardwalk RV Park Page 1 of 2
Stormwater Permit No. SW8 970241 Modification
Carteret County
Designer's Certification
1, J 0 914 VIe LEAtJ , as a duly registered P oIF£SS Io W A� 1- CN6l0Z
the State of North Carolina, having been authorized to observe (periodically/weekly/full time) the
construction of the project,
I'Ar= 'E66RDw6u�- Fq Pv�K (M�D��rC�rtoN
(Project)
if&m C-A-AEvALD &opewne-5. LL.C.
for LLG (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 acid intent of the
approved plans and specifications.
The checklist of items on page 2 of this form are a part of this Certification.
Noted deviations from approved plans and specifications:
'V4ERC- /XII,t KIO DEV1ATI6M5 C'�M ME AprrzavF� FLAQ5 4`5'PECS .
Signature l
Registra 00nHumber 5631
Date !" 16-LA 0 t ZQQ J
SEAL
0096 g GA
L
A
S• r
M
5631
r h
FNG11���4 0�
✓ --*game"
0

State Stormwater Management Systems
Permit No. SW8 970241 Modification
Certification Requirements:
9
61
a
Page 2 of 2
The drainage area to the system contains approximately the permitted acreage.
The drainage area to the system contains no more than the permitted amount of
built -upon area.
All the built -upon area associated with the project is graded such that the runoff
drains to the system.
The outlet/bypass structure elevations are per the approved plan.
The outlet structure is located per the approved plans.
Trash rack is provided on the outlet/bypass structure.
All slopes are grassed with permanent vegetation.
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.
The permitted amounts of surface area and/or volume have been provided.
Required drawdown devices are correctly sized per the approved plans.
All required design depths are provided.
All required parts of the system are provided, such as a vegetated shelf, a forebay,
and the vegetated filter.
r_!/ 14. The dimensions of the system, as shown on the approved plan, are provided.
cc: NCDENR-DWQ Regional Office
Carteret County Building Inspections
10

0� wAT, Rq —
� r
4 -c
Mr. Ron Loftis, Owner
Harold Gurganus R. Ron Loftis
PO Box 522
Barkers Island, NC 28531
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
July 24, 2002
Alan W. Klimek, P.E., Director
Division of Water Quality
Wilmington Regional Office
Subject: Permit No. SW8 020432
Cape Lookout RV Park
High Density Stormwater Project
Carteret County
Dear Mr. Loftis:
The Wilmington Regional Office received a complete Stormwater Management Permit
Application for Cape Lookout RV Park on July 12, 2002. Staff review of the plans and
specifications has determined that the project, as proposed, will comply with the Stormwater
Regulations set forth in Title 15A NCAC 2H.1000. We are forwarding Permit No. SW8 020432
dated July 24, 2002, for the construction of Cape Lookout RV Park.
This permit shall be effective from the date of issuance until July 22, 2012, and shall be subject
to the conditions and limitations as specified therein. Please pay special attention to the
Operation and Maintenance requirements in this permit. Failure to establish an adequate system
for operation and maintenance of the stormwater management system 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 upon written request within thirty (30) days following
receipt of this permit. This request must be in the form of a'written petition, conforming to
Chapter 150B of the North Carolina General Statutes, and filed with the Office of Administrative
Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demands are made this
permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please contact
Noelle Lutheran, or me at [phone].
Sincerely,
Rick Shiver
Water Quality Regional Supervisor
RSS/nml: S:1WQSISTORMWATIPERMIT1020432.JUL
cc: John McLean, P.E.
Carteret County Building Inspections
Division of Coastal Management
Noelle Lutheran
Wilmington Regional Office
Central Files
N.C. Division of Water Quality 127 Cardinal Drive Extension Wilmington, N.C. 28405 [phone] Fax [phone]
*A
NCDENR
Customer Service
800-623-7748

--�•- y � --�- �., x»,_ �, _ ,_4 ;... __�. .. ...�_ . .•_ ,�}�. ... "ti-ro K_y._. _.. '�i.-. ,.. - .vex Js''-- i �_d_p_.� -,^, .'.s;a-
State Stormwater Management Systems .
Permit No. SW$ 020432 '
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
H1GB 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
Harold Gurganus & Ron Loftis
Cape Lookout R V Park
Carteret County
FOR THE
construction, operation and maintenance of two infiltration basins in compliance with the
provisions of 15A NCAC 2H .1000 (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 July 22, 2012, and shall be subject
to the following specified conditions and Iimitations:
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 on page 3 of this permit, the Project Data Sheet. The stormwater controls have
been designed to handle the runoff from 35,000 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated on page 3 of this
permit, and per approved plans.
4. All stormwater collection 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.
5. The runoff from all built -upon area within the permitted drainage area of this project must
be directed into the permitted stormwater control system. A permit modification must be
submitted and approved prior to the construction of additional built -upon area from
outside of the approved drainage area.
2

_ _ ... - -• - - - - - _,..-. " _. t.- _:i
... <; :ice.: �." _ b _ _,.v.z^1-• * w:.. �=� r��a't .... '.3� r f r•:-... -� 4Fa ,.'. _
State Stormwater Management Systems
e
Permit No. SW8 020432
DIVISION OF
WATER QUALITY
PROJECT DESIGN
DATA SHEET
Project Name:
Cape Lookout RV Park
Permit Number:
SW8 020432
Location:
Carteret County
Applicant:
Mr. Ron Loftis, Owner
Mailing Address:
Harold Gurganus & Ron Loftis
PO Boa 522
Harkers Island, NC 28531
Application Date:
July 12, 2002
-- Receiving Stream/River Basin/Index 9:
White Oak I Back Sound 121-35-(1.5)
Classification of Water Body:
"SA"
Basin 1 Basin 2
Basin, Depth, feet:
0.75 0.75
Bottom Elevation, FMSL:
8.95 8.95
Drainage Area, acres:
1.5 1.5
Total Impervious Surfaces, ft2:
16,750 18,250
Offsite Area entering Pond, ft'
none per Engineer
Required Storage Volume, ft3:
4,475 4,275
Provided Storage Volume, ft3:
4,500 4,275
Temporary Storage Elevation, FMSL:
9.7 9.7
Controlling Orifice:
n/a
Soil Type:
Sand Sand
Seasonal High Water Table:
6.25 6.25
Expected Infiltration Rate:
4" per hour 4" per hour
Time to Draw Down, days:
0.125 0,125
3

State Stormwater Management Systems
Permit No. SW8 020432 '
II. SCHEDULE OF COMPLIANCE
I. The stormwater management system shall be constructed in it's 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.
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 ofslopes 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 'ai 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. Decorative spray fountains will not be allowed in the stormwater treatment system.
6. The facilities shall be constructed as shown on the approved plans. This permit shall
become voidable unless the facilities are constructed in accordance with the conditions of
this permit, the approved plans and specifications, and other supporting data.
7. Upon completion of construction, prior to issuance of a Certificate of Occupancy, and
prior to operation of -this permitted facility, a certification must be received from an
appropriate designer for the system installed certifying that the permitted facility has been
installed in accordance with this permit, the approved plans and specifications, and other
supporting documentation. Any deviations from the approved plans and specifications
must be noted on the Certification. A modification may be required for those deviations.
8. If the stormwater system was used as an Erosion Control device, it must be restored to
design condition prior to operation as a stormwater treatment device, and prior to
occupancy of the facility.
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 Iimited 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. Redesign or addition to the approved amount of built -upon area or to the drainage
area.
e. Further subdivision, acquisition, or sale 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 Major permit was sought.
f. FiIling in, altering, or piping of any vegetative conveyance shown on the approved
plan.
4

~State Stormwater Management Systems
Permit No. SW8 020432
10. The permittee shall submit final site layout and grading plans for any permitted future
areas shown on the approved plans, prior to construction. if the proposed BUA exceeds
the amount permitted under this permit, a modification to the permit must be submitted
and approved prior to constriction.
11. A copy of the approved plans and specifications shall be maintained on file by the
Pcnmittee for a minimum of ten years from the date of the completion of construction.
12. Prior to the sale or lease of any portion of the property, the permittee shall notify DWQ
and provide the name, mailing address and phone number of the purchaser or leasee. An
access/maintenance easement to the stormwater facilities shall be granted in favor of the
permittee if access to the stormwater facilities will be restricted by the sale or lease of any
portion of the property.
13. The permittee must maintain compliance with the proposed built -upon area and ensure
that the runoff from all the built -upon is directed into the permitted system.
14. 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
This permit is not transferable. In the event there is a desire for the facilities to change
ownership, or there is a name change of the Permittee, a formal permit request must be
submitted to the Division of Water Quality accompanied by an application fee,
documentation from the parties involved, and other supporting materials as may be
appropriate. The approval of this request will be considered on its merits and may or may
not be approved. Responsibility for compliance with all permit conditions remains with
the Permittee until such time as the Division approves the formal permit request.
2. Failure to abide by the conditions and limitations contained 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.
3. 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) which have jurisdiction.
4. 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.
5. 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.
6. The permit may be modified, revoked and reissued or terminated for cause. The filing of
a request for a permit modification, revocation and reissuance or termination does not
stay any permit condition.
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.
5

8
9
State Stormwater Management Systems
Permit No. SW8 020432 ,
Approved plans and specifications for this project are incorporated by reference and are
enforceable parts of the permit.
The permittee shall notify the Division any name, ownership or mailing address changes
within 30 days.
Permit issued this the 24th day of July, 2002.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
i
Alan W. Klimek, P.E.,'Directbr
Division -of Water Quality -
By Authority of the Environmental Management Commission
O

State Stormwate'r Management Systems
Permit No. SW8 020432
Cape Lookout RV Park
Stormwater Permit No. SW8 020432
Carteret County
Desibner's Certification
as a duly registered
in the State of North Carolina, having been authorized to
observe (periodically/weekly/full time) the construction of the project,
(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
SEAL
7

State Stormwater Management Systems- ,
Permit No. SW8 020432
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. The outlet/bypass structure elevations are per the approved plan.'
5. The outlet structure is located per the dpproved plans.
6.... Trash rack is provided on the outletlbypass structure.
7. All slopes are grassed with permanent vegetation.
8. Vegetated slopes are no steeper than 3:1.
9. The inlets are located per the approved plans and do not cause short-circuiting of
the system.
10. The permitted amounts of surface area and/or volume have been provided.
11. Required drawdown devices are correctly sized per the approved plans.
12. All required design depths are provided.
13. All required parts of the system are provided, such as a vegetated shelf, and a
forebay.
14. The overall dimensions of the system, as shown on the approved plans, are
provided.
cc: NCDENR-DWQ Regional Office
Carteret County Building Inspections

a.QFFIC£;i35E:ONLY
' 3:
Date Received Fee Paid Permit Number
Y Zv OUP
® State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied far use as an original
1:. GEN]ERAL INI FORMATION
1. Appbcasrts name (specify the name of the corporation, individual, etc. who owns the project):
Harold Gurpanu,-z_ &. Ron T,nffi G
2. Print Owner/Signing official's name and title (person legally responsible for facility and compliance):
Ron Loftis , Qwnd
3. Mailing Address for person listed in item 2 above:
_P-0 , Box 522
City: Harkers Island State: N.C._ Zip: 28531__.
Telephone Number: f 252 504-3400 _
4. Project Name (subdivision, facility-, or establishment name -should be consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.);
Cape Lookout RV Park
5. Location of Project (street address):
SR 1335 (Harkers Island Road)
City: Harkers Island County, _GartPrPt.
6. Directions to project (from nearest major intersection).
�� Tel o�> ,59 t — P9oc-1_D 3 . &L
b M Tip E L.EFT S t D E NORTH �= R I
o + I+
7, Latitude: '1J 4 2 Z% Longitude:--- 3 Z 2 4 of project
6. Contact person who can answer questions about the project:
Narne: John Odom P.L. S. Telephone Number; ( 252 ) 393-2.1 29
11. PERMIT INFOR-MATION:
1. Specify;n•hether project is (check: one) X New Rene"val Modification
• Form 5wU-101 Version 3.99 Page 1 of 4

2 If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit munber N / A _ and it, issue date (if known)
3. Specify the type of project (check one):
Low Density X High Density Redevelop General Pezty"t Other
® 4. Additional Project Requirements (check applicable blanks):
_CAMA Major X Sedimentation/Erosion Control _404/4a1 Permit _NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
M. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormµ•ater management for the project .
2, Storrnwatet runoff from this project drains to the W AITE: QAK River basin.
3 Total Project Area: acres 4. Project Built Upon Area: z(p ZS
5. How many drainage areas does the project have? 2 A\14 - z-7
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
•
Basulitfo� '�A
Area 2
Receiving Stream Name
��
$AC _S6UiJC>
Receiving Stream Class
Drainage Area
,15
rj
Irra ervious' Area
-Existing
Proposed Lm ervious'Area
Q . 39 AcgEs
a .
Impervious* Area (total)
7—G a p
-ram i� �� • � -�
.leer ei'�ous. f;S•tlr�at� Area. `
�Y
�'�',�� � ~�`,•Draufage�rea�] ,� ' � rr
� �. �,c�� '� Drainage E1zei12`;,' �'�":
On -site Buildings
Q ,O c-S
On -site Streets
Q- 2t
0. 2. ( A cize5
On -site Parking
o, Q{O AC, -e5
O!a ACF-ES
On -site Siderval.lcs
Q
Other on -site V1 *46
O. 1 Z A cRe->
O I Z
Off -site
Qd
Total: 0.39 GiZES
Total: o.4z QES
Imper-vrous area is defined a; the built upon area including, but not limited to, buildings, roads, parking arms,
sidewalk:,, gravel areas, etc.
0 Form SwU-10l version 3.99 Page 2 of 4

E.
u

7. How was the off -site impervious area listed above derived? dI_Ar
. IV. DEED RESTRICTION5 AND PROTECTIVE COVENANTS
The following italicized deed restrictions and protective covenants are required to be recorded for all
subdivisions, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a
table listing each lot number, size and the allowable built -upon area for each lot must be provided as an
attachment. T� rs 15 w6 T A 1503 A51o� — 11kV_RT-_ W kLL FEE Mb
c T PARCELS -
I. The following covenants are intended to ensure ongoing compliance with state stormwater management permit
number as issued by the Division of Water Quality. ne5e covenants may
not be changed or deleted without the consent of the State.
2. No more than square feet of any lot shall be cowered by structures or impervious materials.
ma
terials aterials include asphalt, gravel, concrete, brick, stone, slate or similar material but do not include wood
decking or the water surface of swimming pools.
3. Swales shall not be filled in, piped, or altered except as necessary to provide driveway crossings:
4. Built -upon area in excess of the permitted amount requires a state stormwater management permit modification prior to
construction.
5. All permitted runoff from outparcels or future development shall be directed into the permitted stormwater control
system. These connections to the stormwater control system shall be performed in a manner that maintains the
integrity and performance of the system as permitted.
• By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, 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 State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for
each BMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the
status and availability of these forms.
Form S1V'U 102
WgDu�iioBasin Su lenient
orm SWU-103
In Su lemeForm
hpplement
Form SWU-103
Curb Outlet System Supplement
Form 5WU-106
Off -Site System Supplement
Form SWU-107
Underground Infiltration Trench Supplement
Form S14U-108
Neuse River Basin Supplement
Form SWU-109
Innovative Best Management Practice Supplement
0 Form SWU-101 V-ersion 3.99 Page 3 of a

V1. SUBMTTTAI. REQUIREMENTS
40
`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. The complete application package should be
submitted to the appropriate DWQ Regional Office.
1. Please indicate that ,you have provided the following required information by initialing in the space
provided next to each item.
• Original and one copy of the Stormwater Management Perzrdt Application Form
• One copy of the applicable Supplement Form(s) for each BMP
• Permit application processing fee of $420 (payable to NCDENR)
• Detailed narrative description of stormwater treatment/management
• Two copies of plans and specifications, including:
-Development/Project name ✓
- Engineer and firm
- Legend v
-North arrow
- Scal
e i
- Revision number & dated
- Mean high water line N( A ✓
- Dimensioned property/project boundary /
-Location map with named streets or NCSR numbers
-Original contours, proposed contours, spot elevations, finished floor elevations
- Details of roads, drainage features, collection systems, and stormwater control measures
- Wetlands delineated, or a note on plans that none exist WIA NofE oil P1,AN5
- Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations
- Drainage areas delineated
-Vegetated buffers (where required) NJk
VII. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section.
Designated agent (individual or firm): John McLean Engineering Associates
Mailing Address: 106 Manatee Street
City: Cape Carteret State: N.C. Zip: 28584
Phone: 3 3-221.9 Fax: [phone]
VIII. APPLICANT'S CERTIFICATION /� C
I, (print or type name of person li;:ed in General Information, item: 2) l o O ► �J „_
certify 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 c ants wilt re rdecl, and that the proposed project complies with the requirements of I5A
NCAC 2H .100,
Si�tature:
Form SWU-101 Version 3.99 Page 4 of 4
Date:
li z-

0-4
.1 •

Permit No. _5� zDq S Z
(to be provided by DIvQ)
State of North Carolina .
Department of.Enyironmeitt, and Natural Resources
Division of Water Quality
'STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ &,unwaterManagerrtent Plan Review:
A complete stormwater management plan submittal includes a stormwater management pertrdt application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name: CAPE LOOKOUT RV PARK
Goncact Person: RON' LOFTIS Pk►one Number: 252 Soo -34o a
393 • zz lq
This worksheet applies to: Basin No. in Drainage Area l 5 AC_QES
(as tdewr flied an plans) (from Form SWU-101)
11. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are no[ an acceptable
source of soils information. All elevations shall be in feet mean sea level (fmsi).
Soils Report Summary
Soil Type
lnfiltxation Rate
SHWA' Elevation
Id— 45"+oYy "
Basin Design Parameters
SANy`(
,a— Ca in/hr or cf(hrlsf (circle appropriate units)
�p. 5 '}G 5.42 frnsl (Seasonal High Water Table elevation)
Design Storm J inch (1.5 inch event for SA waters, I inch event for others)
Design Volume a,3JG ,— c.f.
Drawdown Time .04'm • tR days
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
O ft. x 1 ft. = S700 sq. ft. (bottom dimensions}
4 L- _ c.f_
.70 fmsl
--176) fmsl
Form SWU-103 Rev 3.99 Pa-e t of 3

1

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements, per the Stormwater Best Management Practices Manual.
(N.C. be'parm"e'nr''of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H, �1008.' '
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
,. ... .-Application Form, the agerfvmay initial below. Attach justification if'a requirement has not, been met.
Applicants Initials
a.
b.
c.
d.
e.
System is located 50 feet from class SA waters and 30 feet from other surface waters.
System is located at least 100 feet from water supply wells.
Bottom of system is at least 2 feet above the seasonal high water table.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
System is not sited on or in fill material or DWQ approval has been obtained.
D f. System is located in a recorded drainage easement for the purposes of operation
maintenance and has recorded'access easements to the rieaiest public right-of'`way:
g. Drainage area for the device -is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
1.
J•
k.
l .
M.
Na n.
o
p
q
r.
s
3.0
System captures and infiltrates the runoff from the first 1. the of rainfall (1.5 inch event
fof azeas draining to SA waters ). Design volume and infiltration calculations attached.
System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V). �,.
A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches
or dense vegetative cover is provided.
Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters). No Cd1�O
Flow distribution mechanism within the basin is provided. 454E-GT FLOW
A benchmark is provided to determine the sediment accumulation in the pretreatment
device.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw down calculations are attached.' -
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
1=orm SWU-103 Rev 3.99 Page 2 of 3

IV, INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved
design specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when
depth in the pretreatment unit is reduced to 757o of the original design depth. The system shad be restored
to the original design depth without over -excavating. Over -excavating may cause the required water
table separation to be reduced and may compromise the ability of the system to perform as designed.
Removed sediment shall be disposed of in an appropriate manner and shall not be handled in a manner
that will adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream,
etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads* 9.5 feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H A000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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.
print Name and Title: NON
Address: P& 5ok622 J ARkEF—S i5LAMD, KC zBS31
Phone_ ZGJZ
Signature:
r�
. fir_ ./ r♦
Note: The legally responsible patty should nor 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.
a Notary Public for the State of 404t CC d ik , County of
do hereby certify that, IC a ram_ O_f J�- S personally appeared before me this Z-�
day of r ' Zrav y , and acknowledge the due execution of the forgoing infiltration basin maintenance
requirements. witness my hand and official seal,
SFA _1
Form S►vU-103
/ILL/
r
F,�v 3,99
My commission expires C
Page 3 of 3

'�. .
f' � r
r ^ � ti.
.ti
t'
^•'� j
;�
, ,,-

Permit No. 45 v
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
nis form may be photocopied for use as an original
D)YQ 51QCmwater Manage er►LQI�n Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name: (W: LeoKoUT 2V. PMi, T
Contact Person: ON Rhone Number: LZ2Z__) 504- 3400
D 41r N jC.LFAI , PE' ZSz 393— Z Z I q
This worksheet applies to: Basin No. z in Drainage Area I-V &
(as ldeniifed on plans) (from Form SWU-1 t)1)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable
source of soils information. All elevations shall be in feet mean sea level ffmsl),
Soils Report Summary
Soil Type SANDY
Infiltration Rate inft or eflhrlsf (circle appropriate units)
SHWT Elevations LA To -6.2S fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
inch
AS—TS c.f.
O.C% - b. 19 days
(1.5 inch event for SA waters, I inch event for others)
2W ft. x 30
B•�S fmsl
�•�0 frnsl
�•%D fmsl
ft. Z-- (0Cdd sq. ft. (bottom dimensions)
Form SWU-103 Rev 399 Page I of 3

..
.. .��� �
4
i

Ill. REQUIRED.ITEMS CMCKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manuai
(N.C. Department of Environment. Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Storruwater Management Permit
Application Form, the agent may initial below. Attach ,justification if a requirement has not been met.
Applicants Initials
g
System is located 50 feet from class SA waters and 30 feet from other surface waters.
System is located at least 100 feet from water supply wells.
Bottom of system is at least 2 feet above the seasonal high water table.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
System is not sited on or in fill material or DWQ approval has been obtained.
System is located in a recorded drainage easement for the purposes of operation and ���
maintenance and has recorded access easements to the nearest public right-of-way.
Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
3
i. System captures and infiltrates the runoff from the firs rich of rainfall (1.5 inch event
for areas draining to SA waters ). Design volume and nfiltration calculations attached.
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
1. A pretreatment device such as a catch basin, grease trap, filter strip, grassed Swale or
sediment trap is provided.
in, Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches
or dense vegetative cover is provided. "
n. Vegetated filter is provided for overflow and detail is shown on plans Re uired minimum
length is 50 feet for SA waters, 30 feet for other waters). No 6 E3 w
o. Flow distribution mechanism within the basin is provided. 5Ef. ' Flow
1!i
A benchmark is provided to determine the sediment accumulation in the pretreatment
device.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided)
System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-1o3 Rev 3,99 Page 2 of 3

f

',,_-IV. INTILTRATION BASIN OPERATION AND MAINTENANCE AGREEINTENT
l . After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2, Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockade and deterioration. Remove any blockage and repair the structure to approved
design specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when,
depth in the pretreatment unit is reduced to 75110 of the original design depth. The system shall be restored
to the original design depth without over -excavating. Over -excavating may cause the required water
table separation to be reduced and may compromise the ability of the system to perform as designed.
Removed sediment shall be disposed of in an appropriate manner and shall not be handled in a manner
that will adversely impact water quality (i,e. stockpiling near a stormwater treatmentm
device or strea,
etc).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used
to determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the desfgn depth reads+�s feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
S. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
1 acknowledge and agree by my signature below that 1 am responsible for the performance of the five
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.
Print Name and Title:
Address: 1"• S.�ZAZ
Phone_
Signature:
Note: The legally responsible party' should nor be a homeowners association unless more than 50% of the lots have been sold and
ll a resident of the subdivision has been named the president.
t. Ill .•� J� '01:4rt it k _ a Notary Public for the State of 4t 612 ' County of
aw do hereby cerfify , �a l��'`• S personally appeared before me this &7 x
day of r, and acknowledge the due execution of the forgoing infiltration basin maintenance
requirements. Witness my hand and official seal,
�EAi C. �c--.k
Form SWii-l03 Rev 3.99
/t—/INIY commission expires1��-�T_//
Page 3 of 3