SW7061106_HISTORICAL FILE_20200722

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

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
BRIAN WRENN
Dtrector
Dr. Mark W. Johnson
604 McCarthy Boulevard
New Bern, NC 28562
Dear Dr. Johnson:
NORTH. CAROLINA
Environmental Quality
July 22, 2020
Subject: Stormwater Permit Renewal
Stormwater Management Permit SW7061106
Dr. Mark W. Johnson Office
Craven County
A Division of Energy, Mineral, and Land Resources file review has determined that '
Stormwater Permit SW7061106 for a stormwater treatment system consisting of a wet
detention pond serving an office located at 604 McCarthy Blvd., New Bern, NC expires
on January 24, 2021. This is a reminder that permit renewal applications are due 180
days prior to expiration. We do not have a record of receiving a renewal application.
Please submit a completed permit renewal application along with a $505.00 fee for.
permit renewal. Permit application forms for renewal can be found on our website,at:
https://degnc goylabQgtldiyisjQns/t�nergymineral land resources/energy mineral-land-
rules/stormwater-program/post-construction. North Carolina General Statutes and the
Coastal Stormwater rules require that this property be covered under a stormwater
permit. Failure to maintain a permit subjects the owner to assessment of civil penalties.
If you have questions, please feel free to contact me at [phone]. 1 will be glad to
discuss this by phone or meet with you. If you would like, I came -mail you a copy of the
application form. You can request a copy by e-mailing me at rode' thorpena ncdenrgov.
Sincerely,
Roger,K ;Thorpe
Environmental Engineer
� �Dk �!EE W5'
North Carolina Department of Environmental Qualtty I Dtvislon of Energy, Mineral and Land Resources
Washington Regional Office 1943 Washington Square Mall I Washington. North Carolina 27889
M.946.6481

C) wArF ��ECCUVE® ShIQC II�'y��(P
\O� .�°`�-"e.9QG Michecl F. Easley, Governor
NOV — 6 2006 William G. Ross Jr., Secn:tary
p r North Carolina Department of Environment and Natural Resources
O Y ®gyp/�-� fl /� p� Alan W. Klimek. P.E. Director
Htl VVAR Division of Water Quality
SURFACE WATER PROTECTION SECTION
COASTAL STORMWATER PERMIT NAME/OWNERSHIP CHANGES FORM
I. CURRENT PERMIT INFORMATION: .SW7 O 611 O B J
1. Stormwater Management Permit Number:
2. Permit Holder's name: /JEw 2>E1z"J Adc--2)cAL— DEyr-LyPivMENT—s,LLC
3. Signing official's name: _ Toon 7�,,nak)>i Title: r'✓1n+ A-6E,Z
(person legally responsible for permit)
4. Mailing address: �01, r- V,-✓opo CRCEK -DR- City: Aeiv r
State: ,Jc- ZipCode: Z8562 Phone: 057)633-y73fFAX:
(Area Code and Number) (Area Code and Number)
II. NEW OWNER / PROJECT / ADDRESS INFORMATION
1. This request is for: (please check all that apply)
a. Change in ownership of the property/company (Please complete Items #2,
#3, and #4 below)
✓ b. Name change of project (Please complete Item #5 below)
✓ C. Mailing address change. (Please complete Item #4 below)
d. Other (please explain):
2. New owner's name to be put on permit: DRs Jol,Nsov K?,E-y PTA
3. New owner's signing official's name and title: A4A-z)c vJ JoHy5o^l
7i2c510E u r
(rdle)
4. New Mailing Address:&O'(m `CharH,, 8z.yp City; A/ew 13ca�J
State: ki(- ZipCode: 213562 Phone: [phone] FAX:152.63g 5W
(Area Code and Number) (Area Code and Number)
5. New Project Name to be placed on permit: -DR$ J01-WSu�l E FoA.sy fA-
Page 1 of 2
North Carolina Division of Water Quality Internet: wu%wnacateinuaimn in2 Q�e
Washington,
Washington Square Mall Phone (252)81 N �O� Carolina
Washington, NC 27889 Fax [phone] ati(rally

PERMIT NAME/OWNERSHIP CHANGE FORM
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION OF WATER
QUALITY UNLESS ALL OF THE APPLICABLE ITEMS LISTED BELOW ARE INCLUDED
WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed form.
2. Legal documentation of the transfer of ownership.
3. A copy of therecorded deed restrictions, if required by the permit.
4. The designer's certification, if required by the permit.
5. A signed Operation and Maintenance plan, if a system that requires maintenance will
change ownership.
6. Maintenance records.
CERTIFICATION MUST BE COMPLETED AND SIGNED BY BOTH THE CURRENT PERMIT
HOLDER AND THE NEW APPLICANT IN THE CASE OF A CHANGE OF OWNERSHIP.
FOR NAME CHANGES, COMPLETE AND SIGN ONLY THE CURRENT PERMITTEE'S
CERTIFICATION.
Current Permittee's Certification:
I, I o�,� �fl,,.,cinl attest that this application for a name/ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this application are not completed and that if all required
supporting information and attachments are not included, this application package will be
returned as incomplete.
Signatu
New Applicant's Certification: (Must be completed forall transfers of ownership)
I, ��� W Jo�FrJsorl attest that this application for an ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this application are not completed and that if all required
supporting information and attachments are not included, this application package will be
returned as incomplete/
Signature:
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDRESS:
North Carolina Department of Environment and Natural Resources
Division of Water Quality, SWP
943 Washinton Square Mall
Washington, NC 27889
Page 2 of 2

�CQ¢F�p Michael F. Easley, Governor
�O ^�'t v William G. Ross, Jr., Secretary
' j�' r North Carolina Department of Environment and Natural Resources
V+✓ U —i
Alan W. Klimek, P.E. Director
`x Division of Water Quality
SURFACE WATER PROTECTION SECTION
COASTAL STORMWATER PERMIT RENEWAL APPLICATION FORM
I. CURRENT PERMIT INFORMATION:
1. Stormwater Management Permit Number: 5W 79 (0 100 (o — LoT
2. Permit Holder's name: 17y25 �toi}rJsorJ g �oiy 7A
3. Signing official's name: M�KK W 4otl_)V50N Title: _PkEs7/�E!Ni
(person lega8y responsible for pertnit)
4. Mailing address: 7o � rvl `C,ti2, �Y atxU City: N16W 34-;Pw
State:,Jc ZipCode: 28562 Phone: Z6'2 63g(o177 FAX:
(Area Code and Number) (Area Code and Number)
5. Project Name: �Zs iU7W1y5oW 5� %>6y -FA
6. Location of Project: (street address)_ 60`{ tO'CA FHY aLV/>
7. Directions to Project (from nearest major intersection) _FkQoA �iY%�12SCC %�W or Z�R MLkIW(v J2
&Y 1) (U5HWy/7) At40 MC44k-r FI/ 6.L.Yn /0/L-1 ONTO n/l���vH4 6LVo (T,:i, 7Aic7ETT)
fMflRo�cIMA-Y7�zy �� �l•.N(�f i-,?JM
l�vi'��ts'rCTioAJ
II. PERMIT INFORMATION /
1. Specify the type of stormwater treatment (wet pond, infiltration, etc.): WET :1�c%TEui/oAJ 3A6)n/
2. List any changes (from project that was originally approved, attach additional pages if needed) NODE
n � 'Z T��� o vrNe2sN-1 P
3. Do you have a copy of the original Operation and Maintenance Agreement? Yes No
Applicant's Certification:
I, (print) lt�r4i@KY �taliNSQA/ certify that the information included on this
-permit renew I ap lic do , s t the best of my knowle correct and compete.
Signature: Date:
Submit this completed fo4 along with an application fee of $420.00 and a copy of the
designer's certification to the address listed below.
North Carolina Division of Water Quality 943 Washington Square Mall Phone [phone] Customer Service 1-877$23-6748
Washington Regional Office Washington, NC 27889 FAX [phone] Internet h2o.enr.state.nc.us Otte
No Caro/l/ina
An Equal OpporNnitytfim� /Aative Action Employer- 50%RegGed/10%Post Consumer Paper Naturally j�

St i .t ure Repairs and R placement Ownershall replace all deteriorated inlet/outlet
works and decant orifice structure and pipe riser works when deterioration from use
and age causes them to fail and function properly. Owner shall be responsible for
all costs incurred with their replacement. Replacement shall be in accordance with
original plans and specifications.
2. Sediment Removal Owner shall be responsible for the removal of excess
accumulated sediment in the pond when the storage capacity is significantly
reduced from the design capacity due to the properly designed and functioning
stormwater retention pond. Owner shall be responsible for all incurred costs of
removal and proper disposal of the sediment in accordance with all local, state, and
federal regulations. Sediment removalldean out cycle for stormwater retention pond
is recommended on a ten to twenty year cycle. Owner shall every five (5) years
measure the depth of sediment above design grade to determine rate of
accumulation and to establish a time line for sediment removal.
Owner shall be responsible for all annual costs of routine maintenance and for any and all non -
routine maintenance costs as they occur throughout the life of each of the stormwater retention
ponds.
Name & Title:
Signature:
Notary Public: Jblic: I, e-6- -k F /�SYI�CN , a Notary Public for the State of
No'4 l 'D (1nA County of _hrau/ eta , do hereby certify that
44-k, d. 1awson personally appeared before me this
&dcy of &-hier. , 20—&, and acknowledged the due execution of the
foregoing stormwater system maintenance requirements. Witness my hand
and official seal.
•
p7A ff y'•: �z SEAL
Notary blic
rUa Q l C: My commission expires: J7u eZ4 a 44V
44or SubdAIS n 7 RUC No: 96136SW

417-A BROAD STREET
P.O. BOX 3486
NEW BERN, NORTH CAROLINA, 28564-UN
ROBERT M. CHILES, P.E.
ENGINEERS, CONSULTANTS
8
MARINE SURVEYORS
June 22, 1998
Mr. William Moore
North Carolina Department of Environment & Natural Resources
Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
Dear Mr. Moore:
BUSINESS: 252.837.4702
NIGHTS: 252-83&2346
FAX: [phone]
I ",'"I
,'"I
JUN 2 3 1998
WASNINGTON REGIONAL OFFICE
Enclose please find the Designer's Certification for the Storrnwater Permit No SV 7961000 or Naw Rarn
Medical Developments,1LC. This certification is only for the wet detention pond on of No. 3 in this project.
Please note that the required wording of Designer's Certification found in the approved permit has been
typed on our letterhead.
As required by the permit, upon completion of the detention ponds for each of the ponds, the remaining
certifications will be forwarded to your office. I have also included a copy of the certification sent to the Chief
Building Inspector's office for the City of New Bern for your files.
If you have any questions concerning this certification please do not hesitate to call.
Yours Very Truly,
ZaD. Francis
96136SW StateCert1-ot31tr.doc
MECHANICAL, CIVIL, AND MARINE EP
MARINE HYDROGRAPHIC AND LAND SURVEYS
COMMERCIAL, INDUSTRIAL, MARINE AND RAILROAD Y
FACILITIES DESIGN
FORENSIC ENGINEERING AND FAILURE ANALYSIS
BOUNDARY SURVEYS AND MAPPING SERVICE

nli

ti
ROBERT M. CHILES, P.E.
ENGINEERS, CONSULTANTS
8
417-A BROAD STREET MARINE SURVEYORS
P.O. BOX 34e6
NEW BERN, NORTH CAROLINA 285843488
June 22, 1998
Mr. William Moore
North Carolina Department of Environment & Natural Resources
Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
BUSINESS: 252-637-4702
NIGHTS: 252-638-2348
FAX: 252-837J100
PROJECT: New Bern Medical Developments, LLC - attn: Mr. Todd H. Rankin Manager
Lot No. 3, Drs. Secosky and Johnson, PA (General Partnership)
604 McCarthy Blvd., New Bern, Craven County, NC
Stormwater Permit No. SW7961006
Dear Bill:
Designer's Certification
I, Robert M. Chiles , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe periodically the construction of the project, New Bern
Medical Developments. LLC - Lot No. 3 for Drs. Secosky and Johnson. PA , 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.
Signature:
Registration Number:
S�:e1
Date: Id (Nc 2,Z. l0%
BDF/bdf
cc: Drs, Secosky and Johnson, PA
New Bern Medical Developments, LLC
Bridge & Lee
City Inspedtlons Dept.
File
96136SW StateCe rtLot3ltr. doc
MECHANICAL, CIVIL, AND MARINE ENGINEERING
qN CARO�j^:
SEAL'
NLF'���
M.
COMMERCIAL, INDUSTRIAL, MARINE AND RAILROAD
FACILITIES DESIGN
MARINE HYDROGRAPHIC AND LAND SURVEYS
FORENSIC ENGINEERING AND FAILURE ANALYSIS
BOUNDARY SURVEYS AND MAPPING SERVICE

417-A BROAD STREET
P.O. BOX 3496
NEW BERN, NORTH CAROLINA 28564-3496
June 22, 1998
ROBERT M. CHILES, P.E.
ENGINEERS, CONSULTANTS
8
MARINE SURVEYORS
Mr. Johnny Clark, Chief Building Inspector
Mr. Lenwood Toler, Inspector
City of New Bern Planning & Inspections Department
City of New Bern
P.O. Box 1129
New Bern, NC 28560
BUSINESS'. 252-637-4702
NIGHTS'. 252-638-2348
FAX: [phone]
PROJECT: New Bern Medical Developments, LLC - attn: Mr. Todd H. Rankin Manager
Lot No. 3, Drs. Secosky and Johnson PA (General Partnership)
604 McCarthy Blvd., New Bern, Craven County, NC
Stormwater Permit No. SV 7961006
Dear Johnny /Lenwood:
Designer's Certification
I, Robert M. Chiles , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe periodically the construction of the project, New Bern
Medical Developments, LLC - Lot No. 3 for Drs. Secosky and Johnson PA , 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.
Signature
Registrati
Date:
BDF/bdf
Cc: Ors. Secosky and Johnson, PA
New Bern Medical Developments, LLC
Brydge & Lee
File
95136SW CityC ertLot3ltr.doc
MECHANICAL, CIVIL, AND MARINE ENGINEERING
COMMERCIAL, INDUSTRIAL, MARINE AND RAILROAD
FACILITIES DESIGN
MARINE HYCROGRAPHIC AND LAND SURVEYS
FORENSIC ENGINEERING AND FAILURE ANALYSIS BOUNDARY SURVEYS AND MAPPING SERVICE