SW6170901 - Oak Hill Living Center

Angier, NC HARNETT County
Blair Pittman, PE, Bobbitt Design -Build
Oak Hill Living C
© Angier, NC HARNETT
Blair Pittman, PE, Bobbitt C
Application
. x IVSD
'ICP 11 2017
DENR-L41v0 QUpLlry a
)RMwar, ,
Type of application:1 New Permit S 1 Q l
SEP - 5 2017
Only complete application packages will be accepted and reviewed. A complete package includes all of the items in the checklist
below. Add any comments, and indicate the page or plan sheet number where the following information can be found. Please
indicate that you have provided the following required information by initialing in the space provided next to each item.
Part I: Submittal Checklist
Item Notes / Comments Initials
1 Onginal and one copy of this application form (all worksheets) and the permit
application fee. For applications submitted to the DEMLR regular permitting
program, the fee is $505 payable to NCDENR. For Express Review, click on the
link below for information and fee schedule Contact the appropriate regional
office Express Review Coordinator to schedule the required pre -application
meeting.
�—
Click here for Express Permittma info
2 A USGS map identifying the site location. If the receiving stream is reported as
class SA or the receiving stream drains to and is within 1/2 mile of SA waters,
then include the 1/2 mile radius on the map
3 A copy of the most current property deed.
4 Two copies of additional calculations (as needed). Sealed, signed and dated
5 Two sets of sealed, signed, & dated full-sized plans of the entire site at a
readable scale, including.
a. Project name, engineer and firm, revision number and dates.
b. Location map with street names and SR numbers, legend, north arrow,
scale
c. Dimensioned property/project boundary with bearings & distances.
d. The boundaries of all surface waters, regulatory flood zones, and protected
riparian buffers or a note on the plans that none exist
e. The boundanes of all vegetated or protected riparian buffers.
f. Site layout shoving all built -upon areas, drainage features, stormwater
collection systems (inlets, outlets, swales, pipe elevations, slopes and
diameters), and SCMs at ultimate build -out.
g Existing contours, proposed contours, spot elevations, and finished floor
elevations.
h. Existing drainage (including off-site), drainage easements, pipe sizes,
runoff calculations.
L Drainage area boundaries (included in the main set of plans, not as a
�.n4a .inrumwntl
Bobbitt Design Build, Inc.
600 Germantown Road
Raleigh NC 27607
www.bobbitt.com
tRM 711-
Wells Fargo 56-21/530
Raleigh, NC 102611
Pay: **********************************Five hundred five dollars and no cents
TO
THE
ORDER
OF
NCDENR
RALEIGH, NC
DATE 09/01/2017
$ ****505.00

0
Angier, NC HARNETT County
Blair Pittman, PE, Bobbitt Design -Build
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Oak Hill Living Center ®q��
Angier, NC HARNETT County
Blair Pittman, PE, Bobbitt Design -Build NCDENtt '
� -Application
Type of application: New Permit SEP - 5 2017
Only complete application packages will be accepted and reviewed. A complete package includes all of the items in the checklist
below. Add any comments, and indicate the page or plan sheet number where the following information can be found. Please
indicate that you have provided the following required information by initialing in the space provided next to each item.
I ' _ - - - - - Part I: Submittal Checklist
Itom Notes / Comments Initials
1 Original and one copy of this application form (all worksheets) and the permit
application fee. For applications submitted to the DEMLR regular permitting
program, the fee is $505 payable to NCDENR. For Express Review, click on the
link below for information and fee schedule. Contact the appropriate regional
office Express Review Coordinator to schedule the required pre -application
meeting.
Click here for Express Permithna info
2 A USGS map identifying the site location. If the receiving stream is reported as
class SA or the receiving stream drains to and is within 112 mile of SA waters,
then include the 1/2 mile radius on the map.
3 A copy of the most current property deed.
4 Two copies of additional calculations (as needed) Sealed, signed and dated
5 Two sets of sealed, signed, & dated full-sized plans of the entire site at a
readable scale, including.
a. Project name, engineer and firm, revision number and dates.
b. Location map with street names and SR numbers, legend, north arrow,
scale.
c. Dimensioned property/project boundary with bearings & distances.
d. The boundaries of all surface waters, regulatory flood zones, and protected
riparian buffers or a note on the plans that none exist.
e. The boundaries of all vegetated or protected riparian buffers.
f Site layout showing all built -upon areas, drainage features, stormwater
collection systems (inlets, outlets, swales, pipe elevations, slopes and
diameters), and SCMs at ultimate build -out.
g. Existing contours, proposed contours, spot elevations, and finished floor
elevations.
h. Existing drainage (including off-site), drainage easements, pipe sizes,
runoff calculations.
i. Drainage area boundaries (included in the main set of plans, not as a
separate document).
t. Existing and proposed maintenance access routes, utility easements,
drainage easements, public rights-of-way etc
k. A construction sequence that shows how the SCMs will be protected from
sediment until the entire drainage area is stabilized.
6 Two sets of sealed, signed, & dated full-sized plan details of each SCM (or
typical if appropriate) in both plan view and cross-section at a scale of 1" = 30'
or larger, including
a Dimensions, side slopes, length to width ratios and elevations with a
benchmark for clean-out if appropriate.
b. All applicable conveyance devices, including: bypass structure,
pretreatment area, flow distribution device, underdrains, outlet device, outlet
dissipater and level spreader.
c A table of elevations, incremental volumes and accumulated volumes (if
applicable).
d. Specifications for applicable materials, such as planting media, aggregate,
sod, underdrains, outlet devices, etc.
STORM -EZ 8/24/2017
Version 1.4 Application Page 1 of 4

Angier, NC HARNETT County�� igq ��'®? 7 x-17 9 9
Blair Pittman, PE, Bobbitt Design -Budd
Part II: General Project and Applicant Information
Project Name: Oak Hill Living Center Date: 24 -Aug -17
Protect Street Address 9767 NC 210 Lat 3551
City Angier I Zip 127501 Long -78.73
Directions to Project 0.3 miles east of the intersection of NC 210 and N Hickory St County HARNETT
(from nearest intersection) NON -COASTAL
Project Applicant: JBS's Company, LLC
(identify the corporation, organization, property owner, designated
government official, etc. which owns the oroiect.) �� CC 1
Owner/ Signing Offical's Name:
Title:
Address
City:
State -
Zip
Phone
Fax
Email
JeffreyStephenson
Manager
8200-1004 Renaissance Parkway
Durham
NC
27713
919 572-1702
Status of applicant: Owner
River Basin Cape Fear
Receiving Stream(s). Black River
Stream Class(es) Supporting, Sw
Surface Water Area (ac) 0 Coastal wetland area (ac) 0
Total property area (ac) 1246 Total protect area (ac) 2.06
Goals/charactenstics NO Volume Matching (LID) NO Drains to an offsite stormwater system
YES Low Density NO Within 575' of Saltwater ORW
NO High Density NO Within 5 miles of a public airport
Briefly summarize how the stormwater runoff will be treated
New impervious surfaces from protect area will drain to a Bioretention Cell.
( Part 111: Permit Information
Status of construction INot Started
Other permits needed YES Sedimentation & erosion control NO 404 Permit/ 401 Certification
NO CAMA Major Permit NO Isolated Wetlands Permit
NO Threatened & Endangered Species NO NPDES Industrial Stormwater Permit
If an application for this project has been previously returned, provide the original project number and previous name of the project,
Provide the permit type, number and issue date for any permits that have
for
If claiming vested rights, then identify (and attach) the supporting documents and approval dates
Approval of a site-specific development plan or PUD Approval date
Valid building permit Issue date -
Other Date -
Not Started
Point of Contact
Phone number
STORM -EZ 8/24/2017
Version 1 4 Application Page 3 of 4

(Optional) Additional Contact
Person / Orgmization
Signing Official & Title.
Street address
City, State, Zip
Phone number(s).
Email
Angier, NC HARNETT County
Blair Pittman, PE, Bobbitt Design -Budd
Part IV: Additional Contact Information
Tim Stephenson
9767 NC 210
Angier, NC 27501
[phone] x4
will(a?oakhitlliving com
(Note: Person/Organization noted above may be contacted for additional project information if applicant
cannot be reached.)
I Part V: Consultant Information 1
Complete this section if you wish to designate authority to another individual or firm so that they may provide information on your
behalf for this project (such as addressing requests for additional Information).
Consultant
Firm
Street address
City, State, Zip.
Phone number(s):
Email
Blair Pittman, PE
Bobbitt Design -Budd
600 Germantown Road
Raleigh, NC 27607
919-851-1980
bodtma n(a?bobbitt.com
G Part VI: Property Owner / Applicant Certification f
I, (the Owner & Applicant fisted above), ��E;Q�� S�EPr{r:,Jsor���, certify that the information included
on this permit applicant form is, to the best of my knowiladge, correct and that the project will be constructed in conformance with the approved
plans, that the required deed restnctusion and protective covenants will be recorded, and that the proposed protect complies with the
requirements of the applicable stat or ater rules and requirements.
Date- `2 L '�,' 11
I, r( r� . . \ 0 \ , a Notary Public for the to of
County of A rl- do 4parby certify tat -e
personally appeared before me this ay of
and acknowledge the due execution of ap He do f r a rn water permit.
Witness my hand and official seal,
LE FIS A KELLY
NOTARY PUBLIC
Johnston County
North Carolina l ar l l
y commission expires
Seal
STORM -EZ 8/24/2017
Version 1.4 Application Page 4 of 4

-r • z
4
X 14
Click Here To:
North Carolina
Elaine F. Marshall DEPARTMENTOF THE
Secretary _ ECRETARY ®F STATE
PO Box 29522 Raleigh,NC 27626-0622 [phone] Account
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Create
View Document Filings File an Annual Report Amend a Previous Annual Report
Print a Pre -Populated Annual Report form
Corporate Names
Legal: JBS'S Company, LLC
Limited Liability Company Information
Sosld:
Status:
Annual Report Status:
Citizenship:
Date Formed:
Fiscal Month:
Registered Agent:
Corporate Addresses
0802305
Current -Active
Current
Domestic
9/13/2005
December
Stephenson, Jeffrey Barnes
Mailing:
8200-1004 Renaissance Parkway
Durham, NC 27713-6698
Principal Office:
8200-1004 Renaissance Parkway
Durham, NC 27713-6698
Reg Office:
8200-1004 Renaissance Parkway
Durham, NC 27713-6698
Reg Mailing:
8200-1004 Renaissance Parkway
Durham, NC 27713-6698
Company Officials
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Manager: Jeffrey Barnes Stephenson
8200-1004 renaissance parkway
durham NC 27713
Account