SW6140505_Application_20140529

-- — --
DWQ USE ONLY -- —
Dole Received
___
Fee Paid
Permit Number
S - 2-9 . Z O / </
t� soS.
S ),A/ 4. i5 0
Applicable Rules: ❑Coastalr9W-1995 ❑Coastal SW-2008 II- Post Constl'nCtiOn
(select all that apply) U Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ Mgmt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopier( far use as an original
1. 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.):
I
If I'1 Motor Pool Expansion at Fort Bragg
2. Location of Project (street address): FEB 1 0 2015
Pratt Street
Cilya_ort Bragg _._. C.�nmty:C:umbo_rland — Zi It: _8310
i
3. DirecHons to project (from nearest major intersection):
The project is located on the northern side of Pratt Street approximately 1100 feet east of the intersection of
Pratt Street and Lewis Street in
4. Latitude:350 09' 26" N Longitude:790 00' 54" 4V of the main entrance to the project.
IL PERMIT INFORMATION
1. a.Specify whether project is (check one): NNew ❑Modification ❑ Renewal w/ Niodificationt
TRom,05 with modifications also requires SWtI-102 - Renmal Appluntion form
b.lf 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 cerli ication
2. Specify the type of project (check one): I
❑Low Density NFfigh 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; uiformation on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑LAMA Major NSedimentation/Erosion Control:1.3 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑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:
5. Is the project located within 5 miles of a public airport? NNo ❑Yes
Ifyes, .see S.L. 2012-200, Part Vf:httl2:/il2ortal.iicdenr.org/web/wQ/ws,'sLitstatesw/­rule.q laws
Fonn 8 W U-101 Version MAug'_013 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 oroiect):
Applicant/Organization:NC National Guard -_—____—
Signing Official & Title:Cul. Toni L. Coats
b.Contact information for person listed in item la above:
Street Address:
Mailing Address (if �plicabfe 1:
Phone:
Fax:
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 agreementand 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. (Phis is the
person who owns the property that the project is located on):
Property Uwner/Urganizatimr:De artmentofDefense
Signing Official & Title:Dave Heins. DPW - Water Management Branch
b.Contact information for person listed in item 2a above:
Sheet Address:Buildine 3-1631 Butner Road
City:FortBrAM.___ State:NC Zip:28310
Mailing Address (ifapplicable):__
Phone: [phone] Fax:
[e-mail]]
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:NC National Guard____
Signing Official & Title:_—
b.Contact information for person listed in item 3a above:
Mailing Address:___
City: _—_-- — State:__ --
Phone: ( 'I Fax:
A. Local jurisdiction for building permits:
Point of Contact:Hector Cruz ._. Phone #: (910 _)- 432A'l1 I
Form SWU-101 Version 06Aug2012 Page 2 of

11. How was the off -site impervious area listed above determined? Provide documentation.
Projects in Union County: Contact DPo'Q Central Office Wo fto check if tho project is located within a Threalemd J.
Cndongered S'pecles watershed that nmy be z uhjecl to more stringent stoprnnvater requirements as per I5A NCAC 026 0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) furms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http,//portal.iicdenr.or•r/web/wq/ws/su/bmp-manual.
VL SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ),
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from hnt Ri//oortalncdenrorg/web/wq/ws/su/statesw/forms dots. The complete
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/mans.).
Please indicate that tlLe following required informatiun have been provided by_initialine in the space provided
for each item. All original documents MUST be signed anti initialed in blue ink. Download the latest versions
for each submitted application package from http:/ /portal ncdenr ore/web/wq/ws/sulstatesw/forms dots.
Initials
1. Original anti one copy of the Storm water Management Permit Application Form. _
2. Original anti one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if retluired as per Part V11 helmn)
3. Original of the applicable Supplement Fornn(s) (scaledLiglred and dated) and O&M
agreement(s) for each B1vfP.
4. Permit application processing fee of $505 pnynble to NCDLNI?. (For an Express review, refer to
n:t,/www envhel�rg/pages/onestopexprtss'hmnl for information on the Express program
rind 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 USCS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the'h
mile radius on the map'.
7. Sealed, signed and dated calculations (one copy). ___—__......
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 M}IW 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 anti dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. 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).
Form SWU-101 Version 06Aug2012 Page 4 nl G

IV. PROJECT INFORMATION
1. In the space provided below, brief[ summarize how the stormwater runoff will be treated.
The stormwater runoff will be treated by routing it through a grassed swale that drains to a dry detention
basin before being outlet to another grass swale
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: --,-----__--_—, Date:---____--
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW - 1995 ® Ph If - Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area:1.33 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': 1.33 acres
Total project ores shall be calculated to exclude the fallondog the normal pool of iwpounded structures, the area
behveen the bwrks of streams and rivers, the area bclouo the Norranl High Water (NHW) line or Menu High Wnter
(MHWJ litre, and coastal metlwnis lm+droard from the NHW for MHW) lice. The resulhvN project area is nserl to
caladn to overall percent built uporr area (BUA). Non -coastal wetlands lnudrnnrJ of the NHW(or MHIh') line nrny
he included on the total project area.
8. Project percent of impervious area: (Total Impervious Area /'rota) Project Area) X 100 = 60.91 %
9. How many drainage areas does the project have?l (For high density, count I for each proposed engineered
,stornmmter BMP. For low density and other projects, use 1 for the mlrole property nren)
10. Complete the fallowing information for each drainage area identified in Project Information item 9. If there
are more than four drainage. areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drainage Area 1
Drainage Area _
Drainage Area
Drainat>,e_reeaa
Receiving Stream Name
Tank Creek
Stream Class '
C
Stream Index Number
18-23-27
Total Drainage Area (so
50966
_
On -site Drainage Area (st)
50966
Off -site Drainage Area (so
0
Proposed Impervious Area (sf)
35302
% Impervious Area" (total)
6927%
Impervious'- Surface Area
Drainage Area I
Drainage Area _
Drainage Area _
Drainage Area _
On -site Buildings/Lots (so
On -site Streets (so
On -site Parking (so
35302
On -site Sidewalks (sf)
Other nn-site (sf)
Future (so
Off -site (so
Existing BUA'"' (so
Total (sf):
35302
Stremn Class and holey Number can br determined at: hilp:/l n,rlul_urrtr.err.nrg[mrl!inr�l(ps/�xu/,:Innsifinitinns
`» Impervious area is d+jined as the built upon nren including, but rot limited to, baildingc, roads, parting areas,
sidewalks, gravel arena, etc.
Report only that amount of existing BUA that toill remain afh'r development. Do not report nay misting BUA that
is to be removed and which will be replaced by nc-to BUA.
Forst S W U-11)1 Version 06Au.�2012 Page 3 uf6

9. Copy of any applicable soils report with the associated S! UVT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 9 9"xl 1" copy of the NRC9 County Soils map with the
project area clearly delineated for projects with infiltration Mips, the report should also
Include the soil type, expected infiltration rate, and the method of determinuig the infiltration rate
(Infiltration Devices submitted to MRO:4hedtrle a cite otsif fr OWQ) to cenj); the SHVITprior
to submittal, (91)) 796-7378.1
10. A copy of the most current property deed. Deed book. n/_aPage No: nya
11. hor corporations and limited liability corporations (LLC): Provide documentation from the NC:
Secretary of State or other ofricial dMitnentation, which supports the titles and positions held
by the persons listed in Contact Information, item Ia, 2a. and/or 3a per 15A NCAC 2f-1.1003(e).
The corporation or LLC most be listed as an active corporation in good standing with the NC
Secretary of State. otherwise the application will be returned.
http:/ / www.secretwv state, nc us/Corporaffims/CSearch.asp
VTI. DEED RESTRICTIONS ANT.) PROIFCTTVECOVENANTS
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 Lable 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 •
Lttp:; , portal.!icdenr.or�,i rreb%w/_</ sit/statc:sw/ lotnu d=cs. 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 lot ensuring
that the steed 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/orfirm (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).
Consultinglingineer:Scott I.Leiter_7,P•_£-
Consulting Firm. ms consultants, iiic
------
.Mailing Address:222"I Schrock Road
CiWCOluml+us- State:OH Zip 43229
014
Phone: (nl<!Eax:.. _... _-1 39F-rliii) _..._._ ._. •, _,:.�_. ,,r
1•.mail:slt!itu_dn)niscunsultants.com_
tX. PROPERTY OWNER AUTHORIZATION ftfCcr.tnct laf'orinaliwr, item i h,is been%ifled out, coniptete His
,echon)
L (print y type nave o/persmr h>ted in Cowan bib)nnnhmt, Item 2a) fort Bragg DRVV I Dare Hemp , certify that t
oa,n the property i,tentiliccl in the permit •yrplica lion, and th�.0 give I+elm is.cion to im,ni :)r h/pr �cu�c.�l tenon
ti52dLl i" 1 00IIlit t'I�'YLlriliJq. Il_L JIl c. Jf. 1 ✓If, I. Udti _._ wid, LYp'. :yTY �6pq t
to develop: the prujc_cl as csirently ptopoaed A copy of
the lease agreement ri pending ptooei(v Talcs conLiact.. has been provided •-:Stir tile s•.ibrnjtlal, which Indicates dic
perlV responsible Ini the opUiatl„n and main L°i Sauce of the Storm roMQt Systern.