SW7111009_CURRENT PERMIT_20111128

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO. I SW
DOC TYPE CURRENT PERMIT
L� ROV D APP E PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE IGl l �6
ffiWININ17�

4
North Carolina
Beverly Eaves Perdue
Governor
NCDENR
Department of Environment and Natural Resources
Mr. Cliff Ogburn, Town Manager
Town of Nags Head
PO Box 99
Nags Head, NC 27949
Dear Mr. Ogburn:
Division of Water Quality
Coleen H. Sullins
Director
Dee Freeman
Subject: Stormwater Permit No. SW7111009
Whalebone Park — Town of Nags Head
High Density Project
Dare County
The Washington Regional Office received a complete Stormwater Management Permit
Application for Whalebone Park — Town of Nags Head project on October 25, 2011 and
revised submittal on November 23, 2011. Staff review of the plans and specifications has
determined that the project, as proposed, will comply with the Stormwater Regulations set forth
in Session Law 2008-211 and Title 15A NCAC 2H.1000. We are forwarding Permit No.
SW7111009 dated November 28, 2011, for the construction of the subject project.
This permit shall be effective from the date of issuance unti November 28, 202 , and shall be
subject to the conditions and limitations as specified therein. else pay sp cial 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, 6714 Mail Service Center, Raleigh, NC 27699-6714. 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 Samir Dumpor, or me at [phone].
Meg i0 e tu�kp
Regionalervlsor
Surface Water Protection Section
AH/sd: K:\SD\Permits - Infiltration\SW7111009
cc: David Ryan, PE, Creative Engineering Solutions, PLLC (262 Mother Vineyard
Rd., Manteo, NC 27954)
Pare County Building Inspections
ashington Regional Office
North Carolina Division of Water Quality Intemet: www.ncwaterquality orb
943 Washington Square Mall Phone: [phone]�TOne
Washington, NC 27889 FAX [phone] orthCarollina
An Equal Opportunity/Affirmative Action Employer -50%Recycled/l0% Post Consumer Paper Nafi(yal&

State Stormwater Management Systems
Permit No. SW7111009
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
Town of Nags Head
Whalebone Park
Dare County
FOR THE
construction, operation and maintenance of three infiltration basins, in compliance with the
provisions of Session Law 2008-211 and 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 November 28, 2021, and shall
be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.8 on page 3 of this permit. The stormwater control
has been designed to handle the runoff from total of 27,928 square feet of
impervious area.
3. The tract will be limited to the amount of built -upon area indicated in Section 1.7 on
page 3 of this permit, and as shown on the 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.
6. The built -upon areas associated with this project shall be located at least 50 feet
landward of all surface waters.
7. The following design criteria have been permitted for the infiltration basins and must
be provided and maintained at design condition:
Page 2 of 7

State Stormwater Management Systems
Permit No. SW7111009
INFILTRATION BASINS
#1
#2
#3
a.
Drainage Area, ft2:
9,900
39,632
16,117
b.
Total Impervious Surfaces, ft2:
6,893
11,213
9,593
C.
Design Storm, inches:
1.5"
pre/post
1.5"
d.
Basin Depth,
feet:
1.25
1.50
1.00
e.
Bottom Elevation,
FMS�:
3.50
3.40
3.90
f.
Bottom Surface Area, ft :
678.00
2,598
1,050
g.
Bypass Weir Elevation, FMSI�:
4.75
4.90
4.90
h.
Permitted Storage Volume, ft :
1,194
5,139
1,996
i.
Type of Soil:
Newhan
Corolla
Corolla
j.
Expected Infiltration Rate, in/hr:
12.00
12.00
12.00
k.
Seasonal High Water Table, FMSL:
1.20
1.05
0.97
I.
Time to Draw Down, days:
0.05
0.02
0.05
M.
Receiving Stream/River Basin: Pasquotank River basin/Roanoke
Sound
n.
Stream Index Number:
30-21
o.
Classification of Water Body:
"SA, HQW"
II. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety, vegetated
and operational for its intended use prior to the construction of any built -upon
surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all times provide the operation and maintenance necessary to
assure the permitted stormwater system functions at optimum efficiency. The
approved Operation and Maintenance Plan must be followed in its entirety and
maintenance must occur at the scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of bypass structure, infiltration media, flow
spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and what
actions were taken.
5. 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.
6. 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.
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
Page 3 of 7

State Stormwater Management Systems
Permit No. SW7111009
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. Access to the stormwater facilities shall be maintained via appropriate easements at
all times.
9. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease 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. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
10. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
11. A copy of the approved plans and specifications shall be maintained on file by the
Permittee at all times.
12. 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 to any person or entity except after notice to and
approval by the Director. In the event of a change of ownership, or a name change,
the permittee must submit a completed Name/Ownership Change form to the
Division of Water Quality, signed by both parties, and accompanied by the
appropriate documentation as listed on page 2 of the form. The approval of this
request will be considered on its merits and may or may not be approved.
2. The permittee is responsible for compliance with all permit conditions until such time
as the Division approves the transfer request.
3. 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.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or
replacement stormwater management systems.
Page 4 of 7 -

State Stormwater Management Systems
Permit No. SW7111009
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
The permit issued shall continue in force and effect until revoked or terminated. The
permit may be modified, revoked and reissued or terminated for cause. The filing of
a request for a permit modification, revocation and reissuance or termination does
not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
controls must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference and
are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit as
allowed by the laws, rules and regulations contained in Session Law 2008-211, Title
15A NCAC 2H.1000, and NCGS 143-215.1 et. al.
11. The permittee shall notify the Division in writing of any name, ownership or mailing
address changes at least 30 days prior to making such changes.
12. This permit shall be effective from the date of issuance until November 28, 2021.
Application for permit renewal shall be submitted 180 days prior to the expiration
date of this permit and must be accompanied by the processing fee.
Permit issued this the 28th day of November, 2011.
NA ENVIRONMENTAL MANAGEMENT COMMISSION
for
Division of Water Quality
By Authority of the Environmental Management Commission
Permit No. SW7111009
Page 5 of 7

State Stormwater Management Systems
Permit No. SW7111009
Whalebone Park — Town of Nags Head
Stormwater Permit No. SW7111009
Dare 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
Page 6 of 7

State Stormwater Management Systems
Permit No. SW7111009
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The bypass structure weir elevation is per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the bypass structure.
8. All slopes are grassed with permanent vegetation.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Dare County Building Inspections
Page 7 of 7

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
O 1 23 II
So'
1 5W7I IUo
AP lic le Rule§: 0 Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater ManageTent an
❑ Other WQ MgmtPlan: S41A<<K (G Zfi I
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This forni may be photocopied for use as an original
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Town of Nags Head -Whalebone Park
2. Location of Project (street address):
7300 S Virginia Dare Trail
City:Naes Head County:C»rriiu`lce tz-+e - Zip:27959
3. Directions to project (from nearest major intersection):
Approximately 1/8 mile north of the intersection of S. Virginia Dare Trail (NC 12) & Cape Hatteras National
4. Latitude:35° 54' 34" N Longitude:75* 35' 52" W of the main entrance to the project.
1I. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) and the status of
construction: ®Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System []Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control:1.51 ac of Disturbed Area
❑404/401 Permit. Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
Form SWU-101 Version 07]un2010 Page I of 6

III. CONTACT INFORMATION
I. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:Town of Nags Head
Signing Official & Title:Cliff Ogburn-Town Manager
b. Contact information for person listed in item 1a above:
Street Address:
Mailing Address (if applicable):P.O. Box 99
City:Nags Head State:NC Zip:27949
Phone: (252 ) 441-5508
Emad:[e-mail]
Fax: (252 ) 441-0776
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official &
b.Contact information for person listed in item 2a above:
Street Address:
City: State: Zip:
Mailing Address (if applicable):
City: State: Zip:
Phone: ( ) Fax:
Email:
3. a. (Optional) Print the name and title of another contact such as the projects construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:Ral ph Bartle -
Signing Official & Title:Deputy Public Works Director
b.Contact information for person listed in item 3a above:
Mailing Address:P.O. Box 99
City:Nags Head State:NC Zip:27959
Phone: (252 ) 4494201
Email:[e-mail]
Fax: (252 ) 441-3350
4. Local jurisdiction for building permits: Town of Nags Head
Point of Contact:Ronnie Ballance Phone #: (252 ) 441-7016
Form SWU-101 Version 07Jun2010 Page 2 of 6
2

IV. PROJECT INFORMATION
1. In the space provided below, bn'efly summarize how the storrnwater runoff will be treated.
ink bFNri�
Stormwater will sheet flow over paved surfaces to permeable grid pavers and (3) separate bioretentiorrcetls
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
® Coastal SW -1995 ❑ Ph R - Post Construction
3. Stormwater runoff from this project drains to the Pasquotank River basin.
4. Total Property Area:1.51 acres 5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area':1.51 acres
Total project area shall be calculated to exclude thefollowing: the normal pool of iin ounded strictures, the area
between the banks of streams and rivers, the area below the Normal H�iggh Water (NM line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or NH line. The resultant project area is used to
calculate overall percent built upon area (BLIA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 38.93 %
9. How many drainage areas does the project have?3 (For high density, count 1 for each proposed engineered
stornwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drainage Area 1
Drainage Area 2
Drainage Area 3
Drainage Area _
Receiving Stream Name
Roanoke Sound
Roanoke Sound
Roanoke Sound
Stream Class *
SA-HQW
SA-HQW
SA-HQW
Stream Index Number *
30-21
30-21
30-21
Total Drainage Area (sf)
9900
39632
16117
On -site Drainage Area (sf)
9900
39632
16117
Off -site Drainage Area (sf)
0
0
0
Proposed Imervious Area** (so
6893
11214
9593
% Impervious Area'* total
69.6
28.3
59.5
Impervious' Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area 3
Drainage Area _
On -site Buildings/Lots (sf)
-
960
On -site Streets (sf)
-
-
On -site Parking (so
5210
8721
9092
On�ite Sidewalks (so
635
1533
501
Other on -site (sf)
-
-
Future (sf)
Off -site (sf)
-
Existing BUA*** (so
1048
229
Total (so:
6893
11213
9822
* Stream Class and Index Number can be determined at: lit!p.-,*ortal.iicdenr.orgtlzuebAvqlpslcstilclassiflcatiopis
** ImppeTous area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sldewniks, gravel areas, etc.
*** Report only that amount of existing BLIA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new BUA.
Form SWU-101 Version 07Jun2010 Page 3 of 3

11. How was the off -site impervious area listed above determined? Provide documentation. N/A
Projects in Union County: Contact DWO Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that maybe subject to more stringent stormwater requirements as per NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from hqp://portal.ncdenr.org/web/wq/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklistsareavailablefromhttp://portal.ncdenr.org/,web/wq/ws/su/"statesw/forms does. Thecomplete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at http://portal.ncdenr.org/web/wq/ws/su/mals.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http:/ /portal.ncdenr.org/web/wq/ws/su/statesw/forms does.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. bMr-
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants LI/A
Form. (if required as per Part V11 below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http://www.envhelp.org/pages/onestopexpress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within t/ mile of the site boundary, include the'/z
mile radius on the map.
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
in. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
bmr
DMr-
b91?
DMrL
DAAM
Form SWU-101 Version 07Jun2010 Paee 4 of 6

9. Copy of any applicable soils report with the associated SHWT elevations (Please identify M2
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xll" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verifij the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 1781/1784 Page No: 61&61 /393 DMfz
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC N�/k
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per NCAC 2H.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http://,Alww.secretaEy.state.nc.us/Corr)orations/CSearch.asRx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
hn://portal.ncdenr.org/web/wq/ws/su/states•/forms does. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer:David M. Ryan, P.E.
Consulting Firm: Creative Eneineering Solutions, PLLC
Mailing Address:262 Mother Vineyard Rd
City:Manteo
Phone: (252 ) 473-5566
Email:[e-mail]
State:NC Zip:27954
Fax: (252 ) 473-5566
IX. PROPERTY OWNER AUTHORIZATION (if Contact Itnfor cation, item 2 has been filled out, complete this
section)
I, (print or hjpe name of person listed in Contact Information, item 2a) certify that I
own the property identified in this permit application, and thus give permission to (print or hjpe tame of person
listed in Contact Information, itenn 1 a) with (print or hjpe nante of organization listed in
Contact Information, item In) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 07Jun2010 Page 5 of 6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on thew
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
a Notary Public for the State of
do hereby certify that
before me this _ day of
County of
personally appeared
. and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission
X. APPLICANT'S CERTIFICATION
I, (print or hype name of person listed in Contact Information, item ln) CIi fOgburn
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 covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 2H .1000, SL 2006-246 (Ph. II - Post Construction) or SL 2008-211.
/1 _
io --G-H
lT COY QU/ a Notary Public for the State of N C . County of
yl1VP do hereby certify that Q I tt QQ IOUfn personally appeared
before me this �0411ay of 6&t'111/W✓ 240 U and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, L- YUA> f I I L , 0J q-2( A t .
OTARV-
U811G I
���41ti Bitty
SEAL
My commission expires Q- 27-1 c
Form SWU-101 Version 07Jun2010 Page 6 of

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
The drainage area will be carefully managed to reduce the sediment load to the
infiltration basin.
Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basin is established, it will be inspected once a quarter and within
24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
Swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Form SW401-Infiltration Basin O&M-Rev.3
Page 1 of 3
U

BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred or
Provide additional erosion
riprap is displaced.
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticides are used, wipe
them on the plants rather than
treatment area I A visible layer of sediment
has accumulated.
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP. Replace any media that
was removed in the process.
Revegetate disturbed areas
Water is standing more than
Replace the top few inches of filter
5 days after a storm event.
media and see if this corrects the
standing water problem. If so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Weeds and noxious plants are
Remove the plants by hand or by
growing in the main
wiping them with pesticide (do not
treatment area.
spray).
The embankment
Shrubs or trees have started
Remove shrubs or trees
to grow on the embankment.
immediately.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-infiltration Basin O&M-Rev.3
Page 2 of 3
IS

Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:Town of Nags Head Whalebone Park
BMP drainage area
Print name:C lift Ogburu
Title:Nags Head Town Manager
Address:P.O. Box 99, Nags Head, NC 27959
Phone:[phone]
Signature:
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I, f v \Ion IL- 4 �� , a Notary Public for the State of
Qnn� , County of Dim , do hereby certify that
G�I//��
t �O bt�1
(/i1) personally appeared before me this 1%t)
day of , 2o(� , and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires Q12-71 i_sS
Form S W401-Infiltration Basin O& M-Rev.3
Page 3 of 3
14�

,XWO&M, r,t
,'.`mil
cl r�
'e.. r..r•�� CJ C

Permit Number:
(10 be provided by DWQ)
Drainage Area Number: 2
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the
infiltration basin.
— Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
— No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
— The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basin is established, it will be inspected once a quarter and within
24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Form SW401-infiltration Basin O&M-Rev.3
Page 1 of 3
17

BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred or
Provide additional erosion
riprap is displaced.
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticides are used, wipe
them on the plants rather than
spraying.
The main treatment area
A visible layer of sediment
Search for the source of the
has accumulated.
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP. Replace any media that
was removed in the process.
Revegetate disturbed areas
immediately.
Water is standing more than
Replace the top few inches of filter
5 days after a storm event.
media and see if this corrects the
standing water problem. If so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Weeds and noxious plants are
Remove the plants by hand or by
growing in the main
wiping them with pesticide (do not
treatment area.
spray).
The embankment
Shrubs or trees have started
Remove shrubs or trees
to grow on the embankment.
immediately -
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-Infiltration Basin O&M-Rev.3
Page 2 of 3

Permit Number:
be provided by DWQ)
I acknowledge and agree by my signature below that 1 am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:Town of Nays Head Whalebone Park
BMP drainage area man
Print name:Cliff Ogbum
Title:Nags Head Town Manager
Address:P.O. Box 99, Nags Head, NC 27959
Date: / / - / % - /l
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I, I P�1P �C l �QU a Notary Public for the State of
County of do hereby certify that
C�I 1-0
QQ �py r ✓) personally appeared before me this 17*
day of N O i _, and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
sib{ } .. '
SEAL �Ml..l
My commission expires �f 27 15
Form SW401-Infiltration Basin O&M-Rev.3
Page 3 of 3
a

Permit Number:
(to be provided by DWQ)
Drainage Area Number:___
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the
infiltration basin.
— Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
— No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
— The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basin is established, it will be inspected once a quarter and within
24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin
erosive gullies have formed,
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Form SW401-Infiltration Basin O&M-Rev.3
Page 1 of 3
PWJ

BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred or
Provide additional erosion
riprap is displaced.
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. if pesticides are used, wipe
them on the plants rather than
spraying.
The main treatment area
A visible layer of sediment
Search for the source of the
has accumulated.
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP. Replace any media that
was removed in the process.
Revegetate disturbed areas
immediately.
Water is standing more than
Replace the top few inches of filter
5 days after a storm event.
media and see if this corrects the
standing water problem. If so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Weeds and noxious plants are
Remove the plants by hand or by
growing in the main
wiping them with pesticide (do not
treatment area.
spray).
The embankment
Shrubs or trees have started
Remove shrubs or trees
to grow on the embankment.
immediately.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-Infiltration Basin O&M-Rev.3
Page 2 of 3
21

Permit Number:
(to be provided by DIVQ)
I acknowledge and agree by my signature below that 1 am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project nanie:Town of Nags Head Whalebone Park
BMP drainage area
Print
Title:Nags Head Town Manager
Address:P.O. Box 99, Nags Head, NC 27959
Date: / / .f / � 1 l
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
1, , Akn ( t/V)CL10- _+ Gl( , a Notary Public for the State of
ham% Countyof DOLM do hereby certify that
C�I IV(�6Uf n personally appeared before me this 17111
day of �J b V , 26 /1 , and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
�t JMAQIO A
's-7• �V�{.1C 4.
SEALqwj�p 7Y
My commission expires Q'271L
Form SW401-Infiltration Basin O&M-Rev.3
Page 3 of 3
Z2

G

Project Narrative
Project Name: Whalebone Park
Address: 7300 S. Virginia Dare Trail (NC 12)
Nags Head, NC 27949
Acres in Affected Area: 1.51 ac.
Proposed Disturbed Acreage: 1.51 ac.
11404" Wetland Acreage: 0 ac. (No determined jurisdictional wetlands)
Proposed Wetland Impacts: None
Ownership: Town of Nags Head c/o Cliff Ogbum, Town Manager
P.O. Box 99
Nags Head, NC 27959
Description of Development Proposal:
The intent of this application is to provide recreational, parking & drainage infrastructure
improvements to service the proposed Town of Nags Head Whalebone Park. /
Improvements will primarily consist of asphalt drives with (73) permeable pavement
parking spaces in support of recreation elements for development of a municipal park.
Access to the site is accommodated by an existing "shared entrance" with the west side
parking area servicing the Jennette's Pier Aquarium. Concrete sidewalks are proposed
internally within the project limits in association with walkway improvements along S.
Virginia Dare Trail to support pedestrian connectivity to adjoining properties.
Drainage improvements will consist of (3) separate infiltration basins to temporarily store
and treat runoff generated from the planned improvements. To coincide with the
infiltration basins, (3) separate tributary drainage areas have been delineated which
describe the rainfall runoff directed to each of the three BMP's.
Existing surface drainage is provided with a minor collector ditch located along the
northern property line in conjunction with an intersecting primary drainage ditch
transecting the property on the western portion of the site. The manmade ditches drain to
unnamed tributaries and conveyed, via a cross culvert pipe, with an outlet to the
Roanoke Sound (Classification 30-21 SA:HQW). The subject property is restricted by
minimal topography and high water table conditions.
The existing drainage features are integral to the operation of the adjoining wastewater
disposal system servicing Jennette's Pier. The peripheral drainage acts as a "line sink" or
groundwater lowering measure, maintaining the water surface elevations within the
existing infiltration basin. In an effort to maintain the existing hydraulic conditions, a
combination of subsurface perforated and solid drainage pipes will replace the existing
open channels. The proposed perforated piping along the northern property line will aid
in maintaining groundwater levels in and around the project area.
The proposed discrete pipe collection system alignment will be extended to the eastern
portion of site in an attempt to provide drainage relief adjacent to the existing "shared"
entrance drive. All proposed discrete drainage inlets have been integrated into the
stormwater management system design to serve as outlet structures to the planned
infiltration basins.
The intent is to proceed with a "phased" approach for the development of this project.
The grading, drainage, & parking improvements will be installed initially with the
recreational and building improvements constructed intended for future development.
This proposal attempts to account for all proposed future improvements.
24

The proposed project development activities have been designed in accordance with low
impact development practices. Techniques implemented include compact design,
maintaining natural hydrology, minimizing impervious surfaces, treating runoff at the
source, and maximizing infiltration to create a hydrologically functional project.
The infiltration basins proposed with this application have been designed in the
accordance with all requirements as specified in Chapter 16 Infiltration Devices of the
2007 NCDENR Stormwater BMP Manual. The in -situ soils within the subject consist of
Newhan & Corolla fine sands with soil permeability rates documented in excess of 20
in/hr. On -site soils investigations were conducted confirming minimum vertical separation
and soil permeability rate requirements being met.
The Town of Nags goal with the development of Whalebone Park is to incorporate low -
impact development techniques to coincide with those elements that currently exist on
the Jennette's Pier Aquarium site. The intent is to develop a demonstration project with
sustainable design elements for the development of an education outreach program.
The Town has requested assistance through the Coastal Studies Institute to aid in
achieving this effort in the form of grant assistance and educational outreach
opportunities may also be included in the support services provided by CSI.
Please note that a permeable pavement section is provided with this application without ,�
any "managed grass" credit being sought.
Existing Permits: None
Existing Development Activities: Portions of existing access drives, impervious parking
areas and existing drainage improvements.
Project Funding: Municipal, Local & State Grants
River Basin: Pasquotank-30-21-SA:HQW
Proposed Impervious Coverage: 42.2%
Proposed Treatment Measures: (3) Infiltration basins
Buffer Requirements: 1 00'minimum
Buffer Provided: 100' plus
Off -site runoff: Discrete Pipe Collection Bypass Provided
Site Soils: Newhan/Corolla Fine Sands
Construction: A contractor for this job has yet to be determined. It is anticipated that the
same contractor conducting the land -disturbing activities will also be responsible for waste
related activities and disposal due to pavement removal. Once a contractor is selected for
this application, the related off -site disposal facility name and location will be forwarded to
NCDENR-LQS.
Maintenance Contact: Ralph Bartle, Deputy Public Works Director, Town of Nags Head -
252-449-4205
25

Map for Whalebone Park
Location of Site
1:12,000 i ry
Roanoke Island NE re
7.5-minute Quadrangle
Index map
NC SPCS E: 916629.4, N:244815.2 meters (NAD83)
Long:-75.5977778 W, tat 35.9094444 N (NAD83)

Permit No
(to be provided by DWQ)
�A
IRA STORMWATER MANAGEMENT PERMIT APPLICATION FORM
NCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information.
Project Name
Contact Person
Phone Number
Date
Drainage Area Number
11/27/2011
�OF W A rEq
O�
a
II. DESIGN INFORMATION
Site Characteristics
Drainage area
9,900.00
le
✓
Impervious area
6,893.00
f?
✓
Percent impervious
69.63
%
Design rainfall depth
N10
in
[/
Peak Flow Calculations
1-yr, 24-hr rainfall depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr discharge
Post -development 1-yr, 24-hr discharge
Pre/Post 1-yr, 24-hr peak flow control
Storage Volume: Non -SA Waters
Minimum design volume required
Design volume provided
Storage Volume: SA Waters
1.5' runoff volume
Pre -development 1-yr, 24-hr runoff volume
Post -development 1-yr, 24-hr runoff volume
Minimum required volume
Volume provided
Solis Repoli Summary
Soil type
Infiltration rate
SHWT elevation
Basin Design Parameters
Drawdown time
Basin side slopes
Basin bottom elevation
Storage elevation
Storage Surface Area
Top elevation
Basin Bottom Dimensions
Basin length
Basin width
Bottom Surface Area
3.Pu in
4.61 inthr
0.70 ft'/sE
0.70 ft'/sE
0.00 ft'/sf
847.00 ft' t/
1,808.00 ft' ✓
1,854.00
ft9
1,194A0 'ff OK
Newhan
00 In/hr (wA6F-b 113'y '50�10
1.20 crVAL
fmsl IAMEeEMEs�
v t/ 0.05 days OK
3.00 :1 OK
3.50 fmsl OK
4,75 fmsl
V 1,232.00 ftz
4.75 fmsl
53.50 it
31.00 it
678.00 le
Form SW401-Infdtrason BaSln-Rev.5 11Ap2011
Parts I a II. Design Summary, Page 1 of 2
7

Permit No.
(to be provided by DWD)
Additional Information
Maximum runoff to each inlet to the basin?
0.12
ac-in
OK
Length of vegetative filter for overflow
33.00
ft
OK
Distance to structure
33.00
ft
OK
Distance from surface waters
500.00
ft
OK
Distance from water supply well(s)
100.00
If
OK
Separation from impervious soil layer
2.00
ft
OK
Naturally occuring soil above shwt
2.00
ft
OK
Bottom covered with 4-in of clean sand?
Y
(Y or N)
OK
Proposed drainage easement provided?
Y
(Y or N)
OK
Capures all runoff at ultimate build -out?
Y
(Y or N)
OK
Bypass provided for larger storms?
N
(Y or N)
Must provide bypass for larger flows
a
VOLUME 1 ZOV IbpD
Pretreatment device provided
GRASSED FILTER STRIP
Fdtz I0-`(i- 57oQN1
Form SW401-InfiItrabon Basin -Rev 5 11Apr2011 Parts I. a It. Design Summary, Page 2 of 2

Permit No.
(to be Provided by DWQ)
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
NCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part Ill) must be printed, filled out and submitted along with all of the required information.
Project Name
Contact Person
Phone Number
Dale
Drainage Area Number
II. DESIGN INFORMATION
Site Characterisfics
Drainage area
39,632.00
ft'
✓
Impervious area
11,213.00
le
✓
Percent Impervious
28.29
%
✓
Design rainfall depth
1.50
in
Peak Flow Calculations
1-yr, 24-hr rainfall depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr discharge
Post -development 1-yr, 24-hr discharge
Pre/Post 1-yr, 24-hr peak now control
Storage Volume: Non -SA Waters
Minimum design volume required
Design volume provided
Storage Volume: SA Waters
1.5' runoff volume
Pre -development 1-yr, 24-hr runoff volume
Post -development 1-yr, 24-hr runoff volume
Minimum required volume
Volume provided
Soils Report Summary
Soil type
Infiltration rate
SHWT elevation
Basin Design Parameters
Drawdown time
Basin side slopes
Basin bottom elevation
Storage elevation
Storage Surface Area
Top elevation
Basin Bottom Dimensions
Basin length
Basin width
Bottom Surface Area
s.zu in
4.61 in/hr
3.20 ft'/SE
3.60 ft'/sec
040 ft/sec
1510.00
ft' V
2,075.00
ft' /
3,764.00
ft'
1689.00
It"
5,139.00
ff31 / OK
Corolla
12.00 m/hr (,(b� B`! 50� FiwR4
1.05 fmsl V ACTVAL ri&tt M VAr-UQr-MVNT6%
0.02 days V OK
3.00 :1 OK
3.40 fmsl PK
4.90 fmsl
4,253.00 flz
4.90 fmsl
168.00 it
26.00.00 it
2,598.00 ft'
Form SW401-InfiHrabon Basin -Rev 5 11Ap2011
Parts 1.811 Design Summary, Page 1 of 2
I

Permit No.
(to be pmvrded by b;v )
Additional Information
Maximum runoff to each inlet to the basin?
Length of vegetative filter for overflow
Distance to structure
Distance from surface waters
Distance from water supply well(s)
Separation from impervious soil layer
Naturally occudng soil above short
Bottom covered with 4-in of clean sand?
Proposed drainage easement provided?
Capures all runoff at ultimate build -out?
Bypass provided for larger stones?
Pretreatment device provided
10
ac-m
OK
00
ft
Filter is too short, must be > 30-ft
.00
ft
OK
I.00
If
OK
1.00
ft
OK
00
ft
OK
00
It
OK
(
(Y or N)
OK
f
(Y or N)
OK
f
(Y or N)
OK
V
(Y or N)
Must provide bypass for larger flows
Form SW401-Infiaratwn 8asmAev.5 11Apr2011
Pans 1. & H. Design Summary, Page 2 or 2
a

Permit No.
(to be provided by DWQ)
�AA
*/�
O?0, WA 7,g.9
STORMWATER MANAGEMENT PERMIT APPLICATION FORM o
NCDENR
401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part 1/1) must be printed, filled out and submitted along with all of the required information.
Contact Person
Phone Number
Date
Drainage Area Number
II. DESIGN INFORMATION
Site Characteristics
Drainage area
16,117.00
ftz ✓
Impervious area
Percent impervious
9,593.00
59.52
f? /
s/e {r
Design rainfall depth
1.50
in l/
Peak Flow Calculations
1-yr, 24-hr rainfall depth
3.20
in
1-yr, 24-hr intensity
4.61
infllr
Pre -development 1-yr, 24-hr discharge
1.30
ft'/sec
Post -development 1-yr, 24-hr discharge
1.60
ft'/sec
Pre/Post 1-yr, 24-hr peak flow control
0.30
ft'/sec
Storage Volume: Non -SA Waters
Minimum design volume required
ft'
Design volume provided
it,
Storage Volume: SA Waters
1.5' runoff volume 1180.00 ft' ✓
Pre -development 1-yr, 24-hr runoff volume 874.00 It,
Post -development 1-yr, 24-hr runoff volume 2,028.01 ft'
Minimum required volume 1180.00 ft' ✓? 5L`�"t`"
Volume provided 1,996.00 ft' ✓ OK
Soils Report Summary
Soil type
Corolla
Infiltration rate
12.00
in/hr
(, Qtsbt Eb BY 505a
SHWT elevation
0.97
fmsl
FROM AC-TUAI
!F=1 Et,6 ^Al 6ASIJ (zEMSNTS
Basin Design Parameters
Drawdown time
0.05
days
OK
Basin side slopes
3.00
:1
OK
Basin bottom elevation
3.90
fmsl
OK
Storage elevation
4.90
fmsl
Storage Surface Area
2,942.00
fl'
Top elevation
4.90
fmsl
Basin Bottom Dimensions
Basin length
250.00
it ✓
Basin width
12.00
It V
Bottom Surface Area
1,050.00
it,
Fonn SW401-Infflratwn Basin-Rev.5 11Ap2011 Pans I. a II. Design Summary, Page 1 of

Permit
(to be Provided by DWQ)
Additional Infomletion
Maximum runoff to each inlet to the basin?
Length of vegetative filter for overflow
Distance to structure
Distance from surface waters
Distance from water supply well(s)
Separation from impervious soil layer
Naturally occuring soil above shwt
Bottom covered with 4-in of dean sand?
Proposed drainage easement provided?
Capures all runoff at ultimate build -out?
Bypass provided for larger storms?
Pretreatment device provided
10
ac-in
OK
00
ft
Filter is too short, must be > 30-ft
.00
ft
OK
).00
It
OK
)00
It
OK
00
ft
OK
00
ft
OK
Y
(YorN)
OK
Y
(YorN)
OK
Y
(YorN)
OK
V
(Y or N)
Must provide bypass for larger flows
:D FILTER STRIP
Fom1 SW401-IMambon Basm-Rev.5 11Ap2011
Pans I a II. Design Summary, Page 2 or 2
12

Permit No.
(to be provided by DWQ)
III. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Pagel Plan
Initials
Sheet No.
bMt7—
1. Plans (V - 50' or larger) of the entire site showing:
- Design at ultimate build -out,
- Off -site drainage (if applicable),
- Delineated drainage basins (include Rational C coefficient per basin),
- Basin dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROW),
- Overflow device, and
- Boundaries of drainage easement.
blINAIZ_
pp oo
2. Partial plan (1" = 30' or larger) and details for the infiltration basin showing:
- Bypass structure,
- Maintenance access,
- Basin bottom dimensions,
- Basin cross-section with benchmark for sediment cleanoul,
- Flow distribution detail for inflow,
- Vegetated filter, and
- Pretreatment device.
bMIL
a
P8/ /
3. Section view of the infiltration basin (1" = 20' or larger) showing:
- Pretreatment and treatment areas, and
bMIZ
�� - Inlet and outlet structures.
'Tl`w/46 4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided.
bM12-
64 - 65
5. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWQ, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information.
bM2
P4/7
6. A construction sequence that shows how the infidration basin will be protected from sediment until the
entire drainage area is stabilized.
bmR -
30-53
7. The supporting calculations.
DM 2
f 6�19 22
8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
bM Z
9. A copy of the deed restrictions (if required).
P- bagi 6NATES R-AXI,&t6ET
Form SW401-Infiltration Basin-Rev.4
Page 1 of 1 Pad III Required Items Checklist, Page 1 of 1
13