SW8141106_CURRENT PERMIT_20221205

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 \4\1()�o
DOC TYPE
© CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
2022 1'L C>5
YYYYMMDD

ROY COOPER
Governor
ELIZABETH S. BISER
5ecrerary
DOUGLAS R. ANSEL
Interim Director
December 5`s. 20231`
Hazy's Plaza, LLC.
Attn: Yehezkel Elia, Manager
779 Commerce Place
Myrtle Beach, SC 29577-6541
NORTH CAROLINA
Environmental Quality
Subject: Permit Renewal
Post -Construction Stormwater Management Permit No. SW8141106
Hazy's Plaza
Brunswick County
Dear Mr. Elia:
The Division of Energy, Mineral and Land Resources received a complete 8-year Permit Renewal Application for
the subject permit on December 28t°, 2022. The Division is hereby notifying you that permit SW8141106 has
been renewed, updated; and re -issued on January 51, 2023, as attached. As requested, a copy of the current
operation and maintenance agreement is also enclosed. Please be aware that the renewal and re -issuance of this
stormwater permit does not imply that the site is currently in compliance.
This permit shall be effective until November 25t", 2030 and does not supersede any other agency permit that
may be required. The project shall be subject to the conditions and limitations as specified therein. This permit
does not impose new or increased stormwater control requirements; it clarifies the rules and requirements of this
program to provide you with a better understanding of your obligations under this permit. Failure to comply with
these requirements will result in future compliance problems. Please note that this permit is not transferable
except after notice to and approval by the Division.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request
an adjudicatory hearing by filing a written petition with the Office of Administrative Hearings (OAH). The
written petition must conform to Chapter 150B of the North Carolina General Statutes and must be filed with the
OAH within thirty (30) days of receipt of this permit. You should contact the OAH with all questions regarding
the filing fee (if a filing fee is required) and/or the details of the filing process at 6714 Mail Service Center,
Raleigh, NC 27699-6714, or via telephone at 919-431-3000, or visit their website at www.NCOAH.com. Unless
such demands are made this permit shall be final and binding.
If you have any questions concerning this permit, please contact Aisia Freeman in the Wilmington Regional
Office, at phone [phone] or [e-mail].
Sincerely,
CAQ�� �
,A; Douglas R. Ansel, Interim Director
Division of Energy, Mineral and Land Resources
Enclosures: Attachment A — Designer's Certification Form
Attachment C — Permitting History
copy of the Renewal Application Documents
Copy of the current operation and maintenance agreement
DES/af: \\\Stormwater\Permits & Projects\2014N141106 HD\2023 01 permit.141I06
cc: Wilmington Regional Office Stormwater File
®Ea Q�� North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington, North Carolina 28405
910,790.7215

Post -Construction Stormwater Management
Permit No. SW8141106
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
POST -CONSTRUCTION STORMWATER MANAGEMENT PERMIT
HIGH DENSITY COMMERCIAL 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
Hazy's Plaza, LLC
Hazy's Plaza
Holden Beach Road, Holden Beach, Brunswick County
FOR THE
construction, operation and maintenance of one (1) sand filter in compliance with Session Law 2008-211 and
the provisions of 15A NCAC 2H .1000 (hereafter collectively referred to as the "stormwater rules' as outlined
in the application, approved stormwater management plans, supplement, calculations, operation and
maintenance agreement, recorded documents, specifications, and other supporting data (the "approved plans
and specifications") as attached and/or on file with and approved by the Division of Energy, Mineral and Land
Resources (the "Division" or "DEMLR"). The project shall be constructed, operated and maintained in
accordance with these approved plans and specifications. The approved plans and specifications are
incorporated by reference and are enforceable part of this permit.
This permit shall be effective from the date of issuance until November 251, 2030 and shall be subject to the
following specified conditions and limitations. The permit issued shall continue in force and effect until the
permittee files a request with the Division for a permit modification, transfer, renewal, or rescission, however,
these actions do not stay any condition. 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 for cause as
allowed by the laws, rules, and regulations contained in Title 15A NCAC 2H.1000 and NCGS 143-215.1 et.al.
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater described in the
application and other supporting data.
2. This stormwater system has been approved for the management of stormwater runoff as described in
Section 1.8 of this permit.
3. The runoff from all built -upon area within the permitted drainage area of this project must be directed
into the permitted stormwater control system.
4. The application form, supplement forms, approved plans and specifications for this project are
incorporated by reference and are enforceable parts of the permit.
Page 1 of 5

Post -Construction Stormwater Management
Permit No. SW8141106
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.
The project shall maintain a 50' wide vegetated buffer adjacent to surface waters, measured
horizontally from and perpendicular to the normal pool of impounded structures, the top of banks of
each side of rivers and streams and the mean high water line of tidal waters.
7. All runoff being directed into wetlands shall flow into and through those wetlands at a non -erosive
velocity of 2 fps or less.
8. The following design elements have been approved for this sand filter stormwater facility, and must be
provided in the system at all times.
BMP 1
a.
Draina a Area, acres:
1.03
Onsite, ft :
45,058
Offsite, ft:
0
b.
Total Impervious Surfaces, ft :
45,058
Onsite, ft'
45,058
Future, ft :
0
Offsite, ft :
0
c.
Design Storm, inches:
1.5
d.
Pre -development 1-yr, 24-hr
discharge rate, cfs:
1.30
e.
Sediment Chamber Depth, ft:
8.5
f.
Sediment Chamber Bottom Elev,
fmsl:
20.9
g.
Sediment Chamber Surface Area,
ft2:
1,250
h.
Weir Elevation, fmsl:
22.9
i.
Sand Chamber Bottom Elev, fmsl:
20.9
.
Sand Media Depth, ft:
1.5
k.
Total Sand Chamber Depth ft:
8.5
I.
Sand Chamber Surface Area, ft':
1,250
m
Maximum Head on Filter, ft:
6.5
n.
Top of Ponding Elevation, fmsl:
29.4
o.
Permitted Storage Volume, ft :
16,250
p.
Orifice Diameter, inch:
4.0
q.
Orifice Flowrate, cfs:
0.11
r.
Pump:
Horsepower / volts:
Pump Off, fmsl:
Pump On, fmsl:
High Water Alarm, fmsl:
Goulds SW0311B
1/3 HP / 115 Volt
22.4
23.9
28.0
r.
Time to Draw Down 1.5 storm, hr:
11.0
s.
Seasonal High Water Table, fmsl:
25.5
t.
Receiving Stream/River Basin:
AIWW / Lumber
u.
Stream Index Number:
15-25
v.
Classification of Water Body:
SA, HQW >'/2 mi
Page 2 of 5

Post -Construction Stormwater Management
Permit No. SW8141106
II. SCHEDULE OF COMPLIANCE
No person or entity, including the permittee, shall alter any component shown in the approved plans and
specifications. Prior to the construction of any modification to the approved plans, the permittee shall
submit to the Director, and shall have received approval for modified plans, specifications, and
calculations including, but not limited to, those listed below. For changes to the project or SCM that
impact the certifications, a new or updated certification(s), as applicable, will be required and a copy must
be submitted to the appropriate DEQ regional office upon completion of the modification.
a. Any modification to the approved plans and specifications, regardless of size including the SCM(s),
BUA, details, etc.
b. Redesign or addition to the approved amount of BUA or to the drainage area.
c.Further development, subdivision, acquisition, lease or sale of any, all or part of the project and/or
property area as reported in the approved plans and specifications.
d. Altering, modifying, removing, relocating, redirecting, regrading, or resizing of any component of the
approved SCM(s), the stormwater collection system and/or vegetative conveyance shown on the
approved plan.
e. The construction of any allocated future BUA.
f. The construction of any permeable pavement, #57 stone area, public trails, or landscaping material to
be considered a permeable surface that were not included in the approved plans and specifications.
g. Other modifications as determined by the Director.
Z The permittee is responsible for verifying that the proposed built -upon area for the entire project does
not exceed the allowable built -upon area.
3. 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.
4. 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.
5. During construction, erosion shall be kept to a minimum and any eroded areas of the system will be
repaired immediately. Infiltration systems should not be used as erosion control devices, due to the
potential clogging. 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.
6. 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.
The facilities must be constructed in accordance with the conditions of this permit, the application,
approved plans and specifications, and other supporting data.
Built upon area includes, but is not limited to, structures, asphalt, concrete, gravel, brick, stone, slate,
coquina and parking areas, but does not include raised, open wood decking, or the water surface of
swimming pools.
Page 3 of 5

Post -Construction Stormwater Management
Permit No. SW8141106
9. The permittee shall at all times provide the operation and maintenance necessary to assure that all
components of the permitted stormwater system function at the design condition. 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 side slopes.
d. Immediate repair of eroded areas.
e. Maintenance of side slopes in accordance with approved plans and specifications.
f. Debris removal and unclogging of filter media, bypass structures, orifice, catch basins and
piping.
g. Access to all components of the system must be available at all times.
10. Records of maintenance activities must be kept and made available upon request to authorized
personnel of DEMLR. The records will indicate the date, activity, name of person performing the work
and what actions were taken.
11. Prior to transfer of the permit, the stormwater facilities will be inspected by DEMLR personnel. The
facility must be in compliance with all permit conditions. Any items not in compliance must be repaired
or replaced to design condition prior to the transfer. Records of maintenance activities performed to
date will be required.
III. GENERAL CONDITIONS
CORRECTIVE ACTIONS REQUIRED. If the facilities fail to perform satisfactorily, the permittee shall
take immediate corrective actions. This includes actions required by this Division and the stormwater
rules such as the construction of additional or replacement on -site stormwater systems. These
additional or replacement measures shall receive a permit from the Division prior to construction.
2. PERMIT RENEWAL. A permit renewal request must be submitted at least 180 days prior to the
expiration date of this permit. The renewal request must include the appropriate application,
documentation and the processing fee as outlined in Title 15A NCAC 02H.1045(3).
3. CHANGES TO THE PROJECT NAME, PERMITTEE NAME OR CONTACT INFORMATION. The
permittee shall submit a completed Permit Information Update Application Form to the Division within
30 days to making any one of these changes.
4. TRANSFER. This permit is not transferable to any person or entity except after notice to and approval
by the Director. Neither the sale of the project and/or property, in whole or in part, nor the conveyance
of common area to a third party constitutes an approved transfer of the permit.
a. TRANSFER REQUEST. The transfer request must include the appropriate application,
documentation and the processing fee as outlined in 15A NCAC 02H.1045(2). This request must
be submitted within 90 days of the permit holder meeting one or more of the following:
i. A natural person who is deceased;
ii. A partnership, limited liability corporation, corporation, or any other business association that
has been dissolved;
iii. A person or entity who has been lawfully and finally divested of title to the property on which
the permitted activity is occurring or will occur through foreclosure, bankruptcy, or other legal
proceeding.
iv. A person or entity who has sold the property, in whole or in part, on which the permitted
activity is occurring or will occur,
V. The assignment of declarant rights to another individual or entity;
vi. The sale or conveyance of the common areas to a Homeowner's or Property Owner's
Association, subject to the requirements of NCGS 143-214.7(c2),
Page 4 of 5

Post -Construction Stormwater Management
Permit No. SW8141106
TRANSFER INSPECTION. Prior to transfer of the permit, a file review and site inspection will be
conducted by Division personnel to ensure the permit conditions have been met and that the project
and the on -site stormwater system complies with the permit conditions. Records of maintenance
activities performed to date may be requested. Projects not in compliance with the permit will not be
transferred until all permit and/or general statute conditions are met.
5. COMPLIANCE. The permittee is responsible for compliance with the terms and conditions of this
permit until the Division approves the transfer request.
a. APPROVED PLANS AND SPECIFICATIONS. A copy of this permit, approved plans,
application, supplement, operation and maintenance agreement, all applicable recorded
documents, and specifications shall be maintained on file by the permittee at all times.
b. DIVISION ACCESS. The permittee grants Division Staff permission to enter the property during
normal business hours to inspect all components of the permitted project.
c. ENFORCEMENT. Any individual or entity found to be in noncompliance with the provisions of a
stormwater management permit or the requirements of the stormwater rules is subject to
enforcement procedures as set forth in NCGS 143 Article 21.
d. ANNUAL CERTIFICATION. The permittee shall electronically submit to the Division an annual
certification completed by either the permittee or their designee confirming the projects
conformance with permit conditions
e. OBTAINING COMPLIANCE. 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
modified plans and certification in writing to the Director that the changes have been made.
OTHER PERMITS. The issuance of this permit does not preclude the permittee from complying
with and obtaining any other permits or approvals that are required for this development to take
place, as required by any statutes, rules, regulations, or ordinances, which may be imposed by
any other Local, State or Federal government agency having jurisdiction. Any activities
undertaken at this site that cause a water quality violation or undertaken prior to receipt of the
necessary permits or approvals to do so are considered violations of NCGS 143-215.1, and
subject to enforcement procedures pursuant to NCGS 143-215.6.
Permit renewed, updated, and reissued this the 5'h day of January 511, 2023.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
(Wtt6a UY
�,-, Douglas R. Ansel, Interim Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Page 5 of 5

Post -Construction Stormwater Management
Permit No. SW8141106
Hazy's Plaza Page 1 of 2
Stormwater Permit No. SW8 141106
Brunswick 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 are a part of this Certification.
Noted deviations from approved plans and specifications:
Signature
Registration Number
Date
SEAL
Page 1 of 2

Certification Requirements:
Post -Construction Stormwater Management
Permit No. SW8141106
Page 2 of 2
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 sand filter elevations are per the approved plan.
6. The sand filter is located per the approved plans.
7. A trash rack is provided on the outlet/bypass structure.
8. For open sand filters, 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. Required drawdown devices are correctly sized and located per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf, a forebay, and the
vegetated filter.
15. The required dimensions of the system are provided, per the approved plan.
cc: NCDENR-DEMLR Regional Office
Brunswick County Building Inspections
Page 2 of 2

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Permit Number: _5ff` / llzo
(m be provided by DWQ)
Drainage Area Number: ( .
Sand Filter 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 sand filter.
— The sedimentation chamber or forebay will be cleaned out whenever sediment depth exceeds
six inches.
— Once a year, sand media will be skimmed.
— The sand filter media will be replaced whenever it fails to function properly after maintenance.
The sand filter will be inspected quarterly 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:
Potential problem:
How I will remediate the problem:
Entire BMP
Trash/debris is present.
Remove the trash/debris.
Adjacent pavement (if
Sediment is present on the
Sweep or vacuum the sediment as soon as
applicable)
pavement surface.
possible.
Perimeter of sand filter
Areas of bare soil and/or erosive
Regrade the soil if necessary to remove the
gullies have formed.
gully, and then plant a ground cover and
water until it is established. Provide lime
and a one-time fertilizer application.
Vegetation is too short or too long.
Maintain vegetation at an appropriate
height.
Flow diversion structure
The structure is clogged.
Unclog the conveyance and dispose of any
sediment offsite.
The structure is damaged.
Make any necessary repairs or replace if
damage is too large for repair.
Forebay or pretreatment area
Sediment has accumulated to a
Search for the source of the sediment and
depth of greater than six inches.
remedy the problem if possible. Remove
the sediment and stabilize or dispose of it
in a location where it will not cause
impacts to streams or the BMP.
Erosion has occurred.
Provide additional erosion protection such
as reinforced turf matting or riprap if
needed to prevent future erosion
problems.
Weeds are present.
Remove the weeds, preferably by hand. If
a pesticide is used, wipe it on the plants
rather than spraying.
Form S W401-Sand Filter O&M-Rev.4 2009Sept 17
CEEEVE:
NOV 17 2014
Page I of 3

BMP element:
Potentialproblem:
How I will remediate theproblem:
Filter bed and underdrain
Water is ponding on the surface for
Check to see if the collector system is
collection system
more than 24 hours after a storm.
clogged and Flush if necessary. If water
still ponds, remove the top few inches of
filter bed media and replace. If water still
ponds, then consult an expert.
Outlet device
Clogging has occurred.
Clean out the outlet device. Dispose of the
sediment offsite.
The outlet device is damaged
Repair or replace the outlet device.
Receiving water
Erosion or other signs of damage
Contact the NC Division of Water Quality
have occurred at the outlet.
401 Oversight Unit at 919-733-1786.
Form S W 401-Sand Filter O&M-Rev.4 2009Sept 17
�EOVF
NOV t 7 20%
Page 2 of 3

Permit Number:
(to be provided by DIVA)
I acknowledge and agree by my signature below that I am responsible for the performance of the
maintenance procedures listed above. 1 agree to notify DWQ of any problems with the system or prior
to any changes to the system or responsible party.
Project name:
BMP drainage area number:
Print name:
Title: Managing Member, Flazy's Plaza, LLC
Address: 779 Commerce Street, Myrtle Beach, SC 29577
Signature:
Date:
Note: The legally responsible party should not be a homeowners association unless more than 50%of the lots have been
sold and a resident of the subdivision has been named the president.
1, V e II P CL a Notary Public for the State of
L County of r✓' do hereby certify that
C, personally appeared before me this day of
{ , c�, and acknowledge the due execution of the forgoing sand filter
maintenance requirements. Witness my hand and official seal,
� 1
SEAL
My commission expires a'A\J
I NOV 17 2014
Form SW401-Sand Filter O&M-Rev.4 2009Septl7 Page 3 of 3

UtMLH USt UNLY
Date, Rerc�eyved
Fee Paid
Permit Number
NC DEQ Division of Energy, Mineral and Land Resources
STATE STORMWATER:
PERMIT RENEWAL APPLICATION FORM
In accordance with 15A NCAC 2H.1045(3), the current permit holder shall renew their high density permit 180 days
prior to its expiration. Renewed permits are valid for a period of 8 years per Session Law 2011-398 (SB 781)
Section 60. (c). This application form is for permit renewals only.
A. PROJECT INFORMATION
1. State Stormwater Permit Number
2. Project name: s
3. Project e t ddr a Q
City: County: lslfwnsylZIP : 2
4. What, if any, changes have been made to the project as permitted? —4L,02
If the project has changed from the original approved plans, please complete SWU-101 fora Major
Modification or Minor Modification Application form available at: https://deg.nc.gov/about/divisions/energy-
mineral-land-resources/energy-mineral-land-rules/stormwater-program/post-construction.
B. PERMITTEE INFORMATION
If changes to the permittee or project name have been made, please complete either the Permit Update form
or the Permit Transfer form available at: https://deg.nc.gov/abouUdivisions/energy-mineral-land-
resources/energy-minera l-land-rules/stormwater-program/post-construction. State Stormwater Permits do not
automatically transfer with the sale of the property. n/�
1. Current Permit Holder's Company Name/Organization: Zy Fz "Z,A, z1 e
2. Signing Official's Name: _yezf7—f%�/ �Z
3. Signing Official's Title: � %'/
4. Mailing A ress: za wirJ
City: !4�"64State: =ZIP:
5. Street Address:
City: _
6. Phone: lys_) y -Y29Z Email:
DEC 2 0 2022
BY:
IAIM
Stormwater Permit Renewal Form Page 1 of 3 May 11, 2018

C. SUBMITTAL REQUIREMENTS
Submit the application package to the appropriate DEMLR Regional Office (Coastal, SA Waters) or DEMLR
Central Office (Urbanizing Areas Ph 2, USMP, Non -Coastal HQW/ORW). Only applications packages that
include all required items listed below will be accepted and reviewed.
Init at each item below to indicate that the required information is provided in the application package:
1. A permit application processing fee of $505.00 payable to NCDEQ.
2. One original signed hard copy and one electronic copy of this completed form. The signing official
named on this application to represent the current permitlee must meet one of the following:
a. Corporation — a principle executive officer of at least the level of vice-president;
b. Limited Liability Company (LLC) — a manager or company official as those terms are defined
in G.S. 57D "North Carolina Limited Liability Company Act;'
c. Public Entity — a principal executive officer, ranking official, or other duly authorized employee;
d. Partnership or limited partnership — the general partner;
e. Sole proprietor; or
f. Letter of authorization signed by one of the signatories noted in a — e above authorizing the
n signature of another entity.
3. One hard copy and one electronic copy of recorded documents required by the original permit that have
not yet been received by DEMLR, including: deed restrictions, protective covenants,
condominium/planned community declaration and easements. If the project has been built, include
documentation that the maximum BUA per lot or maximum total BUA has not been exceeded. If
the project has not been built, include a signed agreement that the final recorded deed restrictions
1 and protective covenants will be submitted at a later date.
4. O&M Agreements, Please select one:
❑ I have a copy of the current recorded O&M Agreement for all SCMs, and I will continue to
keep this on file with the permit; or
do not have a copy of the current recorded O&M Agreement for all SCMs and am
requesting a copy be sent to me. I agree to keep this on file with the permit.
5. Design Certifications, Please select one:
A copy of the certification(s) confirming that the project was built in accordance with the
approved plans have been previously provided to the Division; or
❑ A copy of the certification(s) confirming that the project was built in accordance with the
approved plans are enclosed; or
❑ The project has not yet been built.
6. [IF APPLICABLE] If the project has been built, one original hard copy and one electronic copy of a
signed, sealed, and dated letter from a licensed professional stating that the SCMs have been
nspected, and that they have been built and maintained in accordance with the permit.
7. [IF APPLICABLE] When the permittee is a corporation or a limited liability corporation (LLC): Provide
onehard copy and one electronic copy of documentation from the NC Secretary of State, or other
official documentation, which supports the titles and positions held by the persons listed in Section
C.2 per 15A NCAC 2H. 1043(3)(b).
https://www.sosnc.gov/online services/search/by title/ Business Registration
QC 3o I� ®'�•
DEC 2 8 20?2
By:_�
Stormwater Permit Renewal Application Form Page 2 of 3 May 11, 2018

D. PER�JMITTEE'S CERTIFICATION
I, , the person legally responsible for the permit, certify that I have
a copy of the Permit and O&M Agreement on site (or I will obtain a copy and it will be kept on site), that I am
responsible for the performance of the maintenance procedures, and the site has been and will be maintained
according to the O&M Agreement and approved plans. I agree to notify DEMLR of any problems with the SCMs
or built -upon area and to submit the proper forms to modify or transfer the permit prior to any changes to the
project, SCMs, or ownership. All information provided on this permit renewal application is, to the best of my
knowledge, correct
�and complete. /►
Signature: // y�G /� Date: /eX 27
NOTARIZATION
I, I.1 A "14 99 , a Notary Public for the State of
Sou ' - , County of t-6� , do hereby certify
that 42z')Pic' II11 personally appeared before me
this the ,( 1S day of uRGP—M 41, 201P_Q and acknowledge the due
ex,6yJj4i)pf the forgoing instrument.
;/ ••'•{vo�ry�i�$ature�„�t,l��� jiG
'�,�olitRlisslfi 1,e�c Aires
Witness my hand and official seal,
/1111111100 NY CRAWFORD
F.NataryPublic, State of South Carolina Commission Expires 09/10/2030
DEC 2 8 1022
Stormwater Permit Renewal Application Form Page 3 of 3 1
May 11, 2018

CAROLINA
SITE DESIGN, INC.
ENGINEERING O PLANNING
Hazy's Plaza I
Stormwater Permit No. SW8 141 106
Brunswick County
Designer's Certification
I, Arnie S. Drucker, as a duly registered engineer in the State of North Carolina, having been
authorized to periodically observe construction of the project,
Hazy's Plaza (Project)
for Hazy's Plaza, LLC (Project Owner) hereby state that, to the best of my abilities, due care and diligence
was used in the periodic 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 specifications:
A grassed swale has been added by the contractor across the rear of the property to direct runoff from the
NCDOT culvert under Holden Beach Road to the existing ditch near the midpoint of the rear property
line. This was the ultimate receiving water body for the approveddesigndrawing.
rCEIVIE,E6 12 2016
SEAL
Signature���
Registration Number
Date March 23, 2016
843-280-5870 Post Office Box 538 843-280-5870
Office North Myrtle Beach, SC 29597 Facsimile

State Stormwater Management Systems
Permit No. S W 8 141 106
Certification Requirements:
C'�> 1. The drainage area to the system contains approximately the permitted acreage.
0-A> 2. The drainage area to the system contains no more than the permitted amount of built -upon area.
Per "Hazy's Plaza Drainage As -Built Holden Beach, NC", by Bobby M. Long & Associates, dated
March 23, 2016
fAP —3. All the built -upon area associated with the project is graded such that the runoff drains to the system.
_(s�L4. All roof drains are located such that the runoff is directed into the system.
Gi�5. The sand filter elevations are per the approved plan.
Per "Hazy's Plaza Drainage As -Built Holden Beach, NC", by Bobby M. Long & Associates, dated
March 23.2016
_�6. The sand filter is located per the approved plans.
1�. 7. Trash rack is provided on the outlet/bypass structure. ` s
mECEI
En
6*8. For open sand filters, all slopes are grassed with permanent vegetation. q
9
(4 _9. Vegetated slopes are no steeper than 3:1. nrC
BY:._---
_l0. The inlets are located per the approved plans and do not cause short-circuiting of the system.
I. The permitted amounts of surface area and/or volume have been provided.
�_I2. Required drawdown devices are correctly sized and located per the approved plans.
(I3. All required design depths are provided.
fl)_14. All required parts of the system are provided, such as a vegetated shelf, a forebay, a
vegetated filter, and level spreader.
_CQ_15. The required system dimensions of the system are provided per the approved plans.

-1
Permit Number: m I I13(0
(robe provided by DWQ)
VA
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
SAND FILTER SUPPLEMENT
This form must be filled out on line, printed and submitted with all of the required information.
Make sure to also fill out and submit the Required Items Checklist (Section ///) and the l&MAgreement (Section 10
I. �P,ROJECTONFORMATION !
Project name IHarjs.Plaza.._
Contact name IAmie Drucker PE''.
Phone number `843-280-5870 '
Date 111/222014; Revised 1124114
Drainage area number )1 * • -
II.1tDES IGNiINF,ORMAT_ION
Site Characteristics
Drainage area (AD)
45,058.001, ft' OK
Impervious area
1 45,058.00 ft2
% Impervious (I,,)
100.0% %
Design rainfall depth (Rc)
j _ 1:50'in
Peak Flow Calculations
1-yr, 24-hr runoff depth
i- 3.91 .,. ' ';.m
1-yr, 24-hr intensity
I - 6.31 -,,,' ,:iin/hr
Pre -development 1-yr, 24-hr runoff
! - 1.30 :ft3/sec
Post -development 1-yr, 24-hr runoff
I 6.20 , .ft3/sec
Pre/Post 1-yr, 24-hr peak control
4.90 ft3/sec
Storage Volume
Design volume (WOV)
( J' 5328:00'ft3
Adjusted water quality volume (WOVE)
3,996.00 ft3 OK
Volume contained in the sedimentation basin and on top of the sand filter
- 16;256.00'fi3
Top of sand filter/grate elevation
( -� 31 . -., . ,ft amsl
Weir elevation (between chambers)
,25.el 23,E 047'ftamsl
Ca
Maximum head on the sedimentation basin and sand filler (hR,,,r;r,,-)
(_ .'6.50'ft Iflsafi�ieRt-�ep
Average head on the sedimentation basin and sand filler (h,J
{. _ 3.251ft OK
Runoff Coefficient (Rv)
0.95 (unitless)
Type of Sand Filter
Open sand filter? - ;'`-.-N..T-; YorN
SHWT elevation I ' '.ftamsl
Bottom of the sand filter elevation i .ft amsl
Clearance (ds,,v,) ('.
Closed/pre-cast sand filler? i, r Y:... Y or N
SHWT elevation {. :25.50 It amsl
Bottom of the sand filter elevation i. .20.40!ft amsl
Clearance (ds,,v,) I -5.101
If this is a closed, underground closed sand filter. The clearance between 1
the surface of the sand filter and the bottom of the roof of the underground �`.; �7.50 ft
structure (ds.)
Form SW401-Sand Filter -Revs 2009Sept17 Parts 1 and II. Project Design Summary, Page 1 of 2

Permit Number:
(to be provided by DWQ)
Sedimentation Basin
Surface area of sedimentation basin (As)
't 1,250.00 ff'
OK. Meets minimum, but may need to be increased to
Sedimentation basin/chamber depth
! 6.50,ft
Sand Filter
Surface area of sand filler (At)
_ _-
1,250.00.ftZ
OK. Meets minimum, but may need to be increased to
Top of sand media filler bed elevation
22.90.It amsl
Bottom of sand media filter bed/drain elevation
( - 21.40 It amsl
Depth of the sand media filter bed (dF)
1.50 It
Coefficient of permeability for the sand filter (k)
3.50 (ft/day)
Outlet diameter
; 4.00 in
Outlet dischargelflowrate
0.11 ft3/sec
Time to drain the sand filter (t)
I 11.00 hours
OK, Submit drainage calculations.
Time to drain the sand filter (t)
0.46 days
Additional Information
Does volume in excess of the design volume bypass the sand filter? (
:µ r' Y 4
Is an off-line flow -splitting device used? I
N
If draining to SA waters: Does volume in excess of the design volume Flow I
Y
evenly distributed through a vegetated fillet?
What is the length of the vegetated filter? I
21
Does the design use a level spreader to evenly distribute flow?
` Y
Is the BMP located at least 30ft from surface waters (50ft if SA waters)? !
N/A
If not a closed bottom, is BMP located at least 100ft from water supply wells? (
.., ;N/A,
Are the vegetated side slopes equal to or less than 3:1 �'
`.',�..Y'
Is the BMP located in a recorded drainage easement with a recorded access
-, - ;
N
easement to a public Right of Way (ROW)? {
'
What is the width of the sedimentation chamber/forebay (W,e,,)? !
6.25 ft
What is the depth of sand over the outlet pipe (dpipe)? t
-1.50 ft
Y or
OK
Y or N
Insufficient flow splinter.
YorN
OK
Y or N
OK
Y or N
Enter Data
Y or N
Enter Data
YorN
OK
Y or N
Insufficient ROW location.
OK
OK
Form SW401-Sand Filler-Rev.5 2009Sept17 Paris I and II. Project Design Summary, Page 2 of 2

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.
Initials Page/ Plan
Sheet No.
C-1 1. Plans (1" - 50' or larger) of the entire site with labeled drainage area boundaries
- System dimensions (length, width, and depth) for both the sedimentation chamber and the filter
chamber,
- Maintenance access,
- Flow splitting device,
- Proposed drainage easement and public right of way (ROW),
- Design at ultimate build -out,
- Off -site drainage (if applicable), and
- Boundaries of drainage easement.
-WW_ C-3 2. Plan details (1" = 30' or larger) for the sand filter showing:
- System dimensions (length, width, and depth) for both the sedimentation chamber and the filter
chamber,
- Maintenance access,
- Flow splitting device,
- Vegetative filter strip dimensions and slope (if SA waters),
- Proposed drainage easement and public right of way (ROW),
- Design at ultimate build -out,
- Off -site drainage (if applicable), and
- Boundaries of drainage easement.
C-3 3. Section view of the sand filter (1" = 20' or larger) showing:
- Depth(s) of the sedimentation chamber and sand filter chamber,
- Depth of sand filter media,
- Connection between the sedimentation chamber and the sand filter chamber and weir elevation,
- SHWT elevation,
- Outlet pipe, and
- Clearance from the surface of the sand filter to the bottom of the roof of the underground structure (if
applicable).
N/A 4. 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.
r^D SWIM RPT 5. Supporting calculations (including drainage calculations)
ojo 6. Signed and notarized operation and maintenance (0&M) agreement
N/A 7. A copy of the deed restrictions (if required).
cEC'EIVE .
NOV 17 2014
BY:
Form SW401-Sand Filter-Rev.5 2009Sept17 Part III, Page 1 of 1