46177D - Seamist

?LAMA/ DREDGE & FILL /
3ENERAL PERMIT Previous permit#
I ew LiModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources �� ,E�/�O
:oastal Resources Commission in an ar a of environmental concern pursuant to I 5A NCAC
Ve 4-4 9 t j/,�, /<NCJ7T 1 14taies attached.
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•
BB&T 10974
SEA MIST CAMPING RESORT, INC. Branch Banking and Trust Company
461 DEVANE RD., SW [phone]
P.O. BOX 1481 66-112/531 10 I/o pt,
SHALLOTTE, NC 28459
C
TO THE PAY (��I Q `l
ORDER OF�IC!� `�' 4v0. C)U
DOLLARS
4vvIciLt) JJ(04
VOID AFTER 90 DAYS n
r
MEMO + AUTHORIZED SIGNATURE
1110L0971-o° 1:053LOLL2LI: 529022693911°

1
HIGHFILL
2840 South College Road #412
Infrastructure Engineering,P.C. Wilmington, North Carolina 28412
Tel [phone] Fax [phone]
November 22,2006
Ms. Debra Wilson
Division of Coastal Management
127 Cardinal Drive Extension
Wilmington,NC 28405
Re: Seamist Pump Station and Force Main
Goose Creek Crossing in DOT Right-of-Way
CAMA General Permit Application
Brunswick County
Dear Debbie:
Enclosed for your review are the following for the referenced project:
• Three sets of drawing C-26 and SD-1
• Copies of Property Owner Notifications(2 properties)
• A Check from Seamist Camping Resort for$400 for the Application Fee
• One copy each of DOT Encroachment Agreement, State Stormwater Permit and COE Permit
The purpose of this project is to provide sewer to the Seamist Campground property. The project consists
of installing a wastewater pump station on the Seamist property and a sanitary sewer force main along
state roads to the Sea Trail wastewater treatment plant. These facilities have been planned and designed
in accordance with Brunswick County's master planning documents.
The pump station is not located within an area of environmental concern(AEC)and no construction
activities will take place within an AEC. The force main will cross the AEC associated with Goose Creek
at the point where the creek crosses under Brick Landing Road in two 72"CMP culverts(see attached
drawings). To avoid impact to the AEC,the force main will be installed by directional bore with bore
entry and exit both located outside the AEC in upland areas. The directional bore of approximately 253
linear feet will extend a minimum of 3' below the two culverts and will be located completely within the
NCDOT right-of-way. A copy of DOT encroachment E-010-2006-087 is attached. This project also has
approval from the Army Corps of Engineers under the general permit#198000291 and stormwater
approval per DWQ permit# SW8 060641,copies of both of which are attached. In addition,both
property owners that are adjacent to Goose Creek and the DOT right-of-way in the area of the force main
installation have been notified of the project,and evidence of those notifications is attached.
Based on our field discussions on June 28,we withheld submittal of this package since the general permit
is only valid for 90 days. We now have a schedule from the contractor and the boring subcontractor is to
begin work the week of November 27d'. Based on the tight schedule,anything you can do to expedite
approval will be appreciated. If you have any questions or require additional information please contact
me al 919- 33-8095. Thank you for your assistance.

HlCP
Ms. Geraldine Milliken
Adjacent Riparian Owner Notification
Seamist Pump Station and Forcemain
Seamist Camping Resort, Inc.
September 28, 2006
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
Permit is being applied for by: Seamist Camping Resort,Inc.
I hereby certify that I own the property at I762 Bri klanding Road SW.-The owner applying for the-
referenced CAMA permit has described to me(as shown on the attached drawing)the development they
are proposing and I have no objections to this proposed project.
PropertyOwner Signature
Geraldine Milliken
Print Name
[phone]
Telephone Number with Area Code
/I - '�- off
Date
DCM WILMINGTON, NC
NOV 2 7 2006
RECEIVED

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
i ID. SAW-2006-41235-010 County: Brunswick USGS Quad:
GENERAL PERMIT (REGIONAL AND NATIONWIDE)VERIFICATION
ty Owner Authorized Agent:
3s: Seamist Camping Resort,Inc Highfill Infrastructure Engineering PC
c/o Walter Knott,President J.Ray Cox,P.E.
4616 Devane Road SW 2840 South College Rd#412
Shallotte,NC 28470 Wilmington NC 28412
one No.: 910-367-8269 910-233-8095
id location of property(water body,road name/number,town,etc.): Located on Brick Landing Road, Ocean]
Brunswick County,NC. Longitude: -78.393526 Latitude: 33.9095874
Dtion of projects area and activity: Install-253 linear feet of 14" (12" ID)DR-9 HDPE force main pipe by
onal Bore. Bore will extend from upland to upland,with no impact to waters,wetlands,etc. PURPOSE:
wastewater force main in accordance with Brunswick County's Wastewater Master Plan as described in 1
permit application dated 10-10-06 and the CAMA Major Development Permit Package dated October
ble Law: ® Section 404(Clean Water Act,33 USC 1344)
® Section 10(Rivers and Harbors Act,33 USC 403)
nation: Regional General Permit Number:
Nationwide Permit Number: 12
r work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
ns and your submitted plans. Any violation of the attached conditions or deviation from your submitted plans may subject
e to a stop work order,a restoration order and/or appropriate legal action.
verification is valid until the NWP is modified,reissued,or revoked. All of the existing NWPs are scheduled to be modif.
,or revoked prior to March 18,2007. It is incumbent upon you to remain informed of changes to the NWPs. We will issi
otice when the NWPs are reissued. Furthermore, if you commence or are under contract to commence this activity before
:the relevant nationwide permit is modified or revoked,you will have twelve(12)months from the date of the modificatioi
on of the NWP to complete the activity under the present terms and conditions of this nationwide permit. If, prior to
>n date identified below, the nationwide permit authorization is reissued and/or modified, this verification will remain vs
expiration date identified below, provided it complies with all new and/or modified terms and conditions. The Dist
r may, at any time, exercise his discretionary authority to modify, suspend, or revoke a case specific activity's authorizat
y NWP.
ities subject to Section 404(as indicated above)may also require an individual Section 401 Water Quality Certification. Y
ontact the NC Division of Water Quality(telephone[phone])to determine Section 401 requirements.
ctivities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act(CAM/
)eginning work you must contact the N.C.Division of Coastal Management.
Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Fede
Local approvals/permits.
re are any questions regarding this verification,any of the conditions of the Permit,or the Corps of Engineers regulatory

•
ew•STATE.
i 41
kt;
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS LYNDO TIPPETT
GOVERNOR SECRETARY
October 25, 2006
Seamist Camping Resort, Inc. and County of Brunswick Public Utilities
Attention: Walter Knott Attention: Marty Lawing
PO Box 1481 PO Box 249
Shallotte, NC 28459 Bolivia, NC 28422
Dear Sirs:
SUBJECT: Encroachment Agreement on NC 179, SR 1143, 1822, 1279 and NC 904
in Brunswick County (File Number: E-010-2006-087)
Attached for your files is a copy of Right of Way Encroachment contract properly
executed. This contract covers the following:
Sanitary sewer force main to consist of the following project totals: 31,245 LF of 12"
AWWA C900 DR 18 PVC; 1,093 LF of 12"AWWA C150 DIP; 1,190 LF of 14"
AWWA C906 DR 11 HDPE; 647 LF of 18" ASTM A139 grade B steel casing; 19-2" air
release/vacuum relief valves in manholes.
The county has agreed to require their contractor to place the NCDOT on their
contractor's bond and not release the bond until NCDOT has signed off on the project.
This approval is also subject to the attached Special Provisions.
Very t ours,
•
G4)
H. A. Pope,
Division Engineer

Between NCDOT, Seamist Camping Resort, Inc, and Brunswick County •
Construction Materials within NCDOT Encroachment
12"AWWA 12"AWWA 14"AWWA 18"ASTM A139 2"Air Release
In Side C900 PVC DR C150 DIP C906 DR 11 Grade B Steel Valve in Manhole
18 (LF) (LF) HDPE (LF) Casing (Ea.)
t 5881 170 253 74 2
1 21258 595 937 353 16
526 64 0 56 0
h 3135 20 0 0 1
t 445 180 0 164 0
31245 1093 1190 647 19
Bore Schedule Road Schedule
Bored Bore Type Bore Length Plan Sheet Route Common Name
Bore &Jack 26 C-26 SR 1143 Brick Landing Rd
Bore &Jack 48 C-26 NC 179 Beach Rd
c Directional Bore 253 C-26 SR 1279 Lewis Dr
Bore&Jack 64 C-22 SR 1822 Dale Ave
is Rd. Bore &Jack 75 C-21 NC 904 Seaside Rd
c Rd. Bore &Jack 74 C-20 SR 1184 Ocean Isle Beach Road
Rd. Bore &Jack 140 C-17
Directional Bore 227 C-14
Directional Bore 152 C-10
Directional Bore 132 C-9
1 Directional Bore 146 C-8
Dr Directional Bore 133 C-7
Directional Bore 147 C-7
Bore &Jack 56 C-5
Bore &Jack 87 C-3
itrance Bore &Jack 77 C-3

d6/22/2006 15:06 9107548924 BRUNSWICK CO MAINT PAGE 06
D0/D06 -
VERIFICATION OF COMPLIANCE WITH
ENVIRONMENTAL REGULATIONS
(Check Appropriate Box)
❑Permits from the N.C. Department of Environment and Natural Resources and
the U.S. Army. Corps of Engineers are not required for this project. However,
all applicable federal regulations have been followed.
49,-PEamilait4 Ackiwaes thrblE C / 5 A5z-A/ur oti Kri ue`
D The required permits from the Department of Environment and Natural P 4
Resources and the U.S.Arrny Corps of Engineers have been obtained for this &
project. Copies of perrcits and Completion Certificates are attached.
Elit applicable NPDES Stormwater Permit requirements have been met for this
project. (The applicant should contact the N.C. Division of Water Quality in
Raleigh to determine if a storrnwater permit is required)
GThe project is in PP
compliance with all applicable sedimentation and erosion
P
control laws and regulations.
Project Name: ` s r P MP Sr4Z,otti Fried AJ
Township:_ County: ,q5b.!/.0
Project Engineer- J� 2 & K p.6. Phone No. '110-Z.3 -809-
r
Project Contact: Cox c ?fry, 9<0-3<3-<C* /
Airiti';'i" '
Applicants' Name: S cr�v.us1 14 ksozr P_E. SE A
c/o bJ47-t9 Z7 ` '.ram /,,
Date Submitted :
got .

E-010-2006-087(Bru
ENCROACHMENT AGREEMENT
SPECIAL PROVISIONS
y the DOT Highway Maintenance Engineer prior to beginning work and/or backfilling pipe culvert for inspect
and when work is satisfactorily completed. (910-754-6527)
;-Construction conference is required prior to performing any work under this agreement. Please contact(Iris
ombs) at (910-754-6527)to schedule the conference.
(ecuted copy of this encroachment agreement shall be present at the construction site at all times during
ruction. NCDOT reserves the right to stop all work unless evidence of approval can be shown. If safety or trai
lions warrant such action,NCDOT reserves the rights to further limit,restrict,or suspend operations within thf
of way.
rials and workmanship shall conform to the N. C. Department of Transportation's Standards and Specifications
ict the appropriate Utility Company(ies) involved and make satisfactory arrangements to adjust the utilities in
ict with the proposed work prior to construction.
temporary and permanent measures shall be used to control erosion and sedimentation in accordance with roc
and Federal regulations. If any area in excess of one(1)acre will be disturbed, the Encroachee shall submit to
ict Engineer's Office a Sediment and Erosion Control Plan which has been approved by the appropriate regulat
:y or authority prior to beginning any work on the Right of Way. Failure to provide this information shall bi
nds for suspension of operations.
e notify DOT Traffic Engineer one(1)week prior to any excavation within '/2 mile of a traffic interceptor. The
hone number is 910-341-0300.
traffic control devices, signs, etc. shall be installed to insure public safety in accordance with the latest editio
lanual on Uniform Traffic Control Devices and any supplements.
work will be performed within the City Limits,it will be your responsibility to notify the local Municipality p:
ginning work.
1

l2
:isting guardrail is disturbed, it shall be reset back to NCDOT Standards and as directed by the District Engineer.
[4
royal of this Encroachment does not include any portion of the work outside The North Carolina Department of
Esportation's Rights of Way.
5
sions shown in RED on attached plan(s).
6
ane closures shall be allowed between the hours of 6:00 am to 9:00 am and 4:00 pm to 7:00 pm. (Peak hours
icted).
9
ane closures or impediment to traffic shall be allowed on state holidays and local events.
0
work requiring equipment or personnel within five (5) feet ten(10'on divided roadways) from the edge of any ti
shall require a lane closure with appropriate tapers.
1
i cut of pavement will not be allowed.
3
1-foot mechanical overlay will be required for the disturbed area(s) only if settlement occurs.
;4
1-foot mechanical overlay will be required for the disturbed area(s)thirty(30)days after pavement repair.
8
one lane closure in each direction
9
:xcavations inside the theoretical 1:1 slope from the existing edge of pavement to the bottom of the nearest trend
shall be made in accordance with the following conditions:
All trench excavation inside the limits of the theoretical 1:1 slope as defined by the policy,shall be completely
)ackfilled and compacted at the end of each construction day. No portion of the trench shall be left open overnig
['he length of parallel excavation shall be limited to the length necessary to install and backfill one(1)joint of pi]
► time.
[raffle shall be moved to a travel lane outside the limits of a theoretical 1:1 slope from the bottom of the nearest
trench wall to the pavement surface.

requires the backfill material to be placed in layers not to exceed six (6) inches loose and compacted to at least 9
of the density obtained by compacting a sample in accordance with AASHTO T99, as modified by DOT.
At the first sign of trench failure, a trench shall be immediately backfilled with materials consisting of A-1,A-3,
I soils or A-4 soils having a maximum of 45%passing a No. 200 sieve and a maximum P.I. of 6. All work shall
pease, the Division Engineer shall be contacted. The Party of the Second Part shall be required to repair any clan
:o the pavement caused by the excavation.
viring and related work shall conform to the latest edition of the National Electrical Safety Code.
2
lit of any part shall be within three (3) feet of edge of pavement or back of curb.
3
nanholes and/or vaults shall be of a pre-approved design. If any proposed structure is not of a design pre-approvf
)OT, the Encroachee shall submit details and design calculations signed and sealed by a Professional Engineer fi
oval prior to construction.
4
proposed manholes shall not be located in the existing ditch line or in a manner that would restrict the maintenar
Dw of the existing ditch line.
5
;ewer clean outs shall be located at the right of way lines.
6
:quipment and materials shall be removed from the right of way when not in use.
encroachment is approved with the understanding that the North Carolina Department of Transportation does nc
antee the right of way on this road, nor will it be responsible for any claim for damages brought by any property
by reason of the installation.
8
)lastic force main pipes shall be SDR 21 or better. ALL GATE VALVES, TEES,AND OTHER MATERIALS
,LL BE TO AWWA STANDARDS.
9
ift stations shall be allowed inside the Rights of Way.
.0
;r boxes, manholes and other appurtenances shall be located outside the Rights of Way or Control of Access righ
line.

44
ated a minimum of seven(7) feet from the nearest part of bridges and culverts, including the toe of wingwalls an
it apron and a minimum of two(2) feet below streambed.
16
Listing guardrail is disturbed, it shall be reset back to NCDOT Standards and as directed by the District Engineer,
17
drainage structure disturbed or damaged shall be restored to its original condition as directed by the District
ineer.
18
access,parking,or material storage shall be allowed along or from Control of Access Highways.
19
Dre areas, pavement settlement and pavement buckling, shall be repaired as directed by the District Engineer. T1
include removal of pavement,patching a fifty feet(50')mechanical overlay,pavement markings etc. as directec
District Engineer.
>0
:ctional drilling methods have not been given statewide approval for use on NCDOT rights of way. Under no
iition shall jetting alone or wet boring with water of utility pipelines be allowed. A cutter head shall be used on
the drill string. Directional boring using jetting with a Bentonite slurry is approved for this installation at a ter,
minimum depth below the surface of the roadway and five(5) feet below the ditch line. Any parallel installatioi
zing the directional boring method shall be placed at a minimum depth of four(4) feel below the ground surface
;pt where the parallel installation crosses another NCDOT maintained roadway. All directional bores shall main
imum distance of five (5)feet from the nearest part of any structure, including but not limited to bridges, footing
culverts, or box culverts. The utility shall be placed a minimum of three (3) feet below any creek bed. Any cha
I be submitted to the District Engineer for approval prior to construction.
overbore shall not be more than two (2") inches greater than the diameter of the pipe encasement. An
rbore exceeding two (2") inches greater than the diameter of the pipe or encasement will be considered if I
roachment includes a statement signed and sealed by a North Carolina Registered Professional Engineer
eating that an overbore in excess of two (2")inches of the pipe or encasement will arch and no damage wi
e to the pavement subgrade. HDPE pipe installed by directional boring shall not be connected to existing
ittings for one(1) week from the time of installation to allow tensional stresses to relax.
55
encroaching party shall comply with all applicable state and federal environmental regulations,and shall obtain
;ssary state and federal environmental permits, including but not limited to,those related to sediment control,
mwater, wetland, streams, endangered species,and historical sites.
56
aching,boring pits, and/or other excavations shall not be left open or unsafe overnight. The contractor shall appl
all North Carolina Department of Transportation's and OSHA requirements and provide a competent person on
ipervise excavations at all times.

9
Loadway signs removed due to construction shall be reinstalled at the end of each day.
vation material shall not be placed on the pavement. Drainage structures shall not be blocked with excavation
-ia1.
>roposed construction shall in no way impede or alter the drainage of the existing roadway. Reshape the shoulde
lopes to allow positive drainage.
compliance with the Policies and Procedures for Accommodating Utilities on Highway Rights of Way Manual s
iuired.
Lct the City of(Ocean Isle Beach) for copies of any and all environmental permits that have been obtained for th
t.
nstruction shall be permitted when shoulders are wet.
ders,ditch slopes, and ditches disturbed as a result of this encroachment, shall be seeded,mulched and restored I
tisfaction of the County Maintenance Engineer.
>suance of this encroachment does not preclude the encroacher from complying with any and all statutes,rules,
itions, or ordinances which may be imposed by other government agencies(local;state,and federal)which have
iction.
time will construction of any kind be performed within the rights of way on a state holiday without prior approv
cess,parking, or material storage shall be allowed along or inside the rights of way line.
All areas disturbed by this encroachment work shall be seeded per the below noted seed detail.
SEED DETAIL
the installation of the utility is complete, the area disturbed in a non-residential are shall be seeded as
(s:

is./acre Tall Fescue Type I
Is./acre Tall Fescue Type II
./acre Centipede
bs./acre Fertilizer
lbs./acre Limestone
I and Type II Tall Fescue shall be separate varieties chosen from the list below:
Adventure Adventure II Amigo Anthem
Apache Apache II Arid Brookstone
Bonanza Chesapeake Chieftain Coronado
Crossfire II Debutante Duster Falcon
Falcon II Finelawn Petite Finelawn Finelawn I
Genesis Grande Guardian Hounddog
Jaguar Jaguar III Kentucky 31 Kitty Hawk
Monarch Montauk Mustang Olympic
Pacer Pixie Pyramid Rebel
Rebel Jr. Rebel II Renegade Safari
Shenandoah Titan Tomahawk Trailblazer
Tribute Wrangler
Lll mixtures:
1-August 31-add 10 lbs./acre Kobe or Korean Lespodeza
:tither 1- April 30-add 10 lbs./acre Rye Grain
5
Environmentally Sensitive Areas:
project is located in an"Environmentally Sensitive Area". This designation requires special procedures to be us
leafing and grubbing,temporary stream crossings, and grading operations within the area identified on the plans.
also requires special procedures to be used for seeding and mulching and staged seeding within the project.

•
iding:
grading operations begin in identified"Environmentally Sensitive Areas", work will progress in a continuous
finer until complete. All construction within these areas must progress in a continuous manner such that each ph
zplete and areas permanently stabilized prior to beginning of next phase. Failure to complete any phase of
struction in a continuous manner in "Environmentally Sensitive Areas"as specified will be just cause for the
lineer to direct the suspension of work in accordance with Section 108-7 of the Standard Specifications.
nporary Stream Crossings:
crossing of streams within the limits of this project must be accomplished in accordance with Section 107-13(b
Standard Specifications.
ding and mulching:
ding and mulching shall be performed in accordance with Section 1660 of the Standard Specifications and veget
er sufficient to restrain erosion shall be installed immediately following grade establishment.
ding and mulching shall be performed on the areas disturbed by construction immediately following final grade
blishment. No appreciable time shall lapse into the contract time without stabilization of slopes,ditches and oth
is within the"Environmentally Sensitive Areas"as indicated on the E.C. Plans.
ze Seeding:
work covered by this section shall consist of the establishment of a vegetative cover on cut and fill slopes as grz
tresses. Seeding and mulching shall be done in stages on cut and fill slopes that are greater than 20 feet in heigh
tter than 2 acres in area. Each stage shall not exceed the limits stated above.

Ar
Shoulder Work
(.5/ - 15' From the Edge of Pavement)
Speed Shoulder
Limit Ta.er (fit)
S
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5�:
rimum
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R rp
4
' A_ Shoulder
� A Taper
y_ A
9
1 500'
_____±*
1 1
Notes:

Ar
Lane Closure on a Two-Lane Road
/Two Flagger Operation)
,
500' ., . .:_X
a
11 I
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200' y
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300' $` :_IOU'
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Speed Buffer • yA `ff (. - 1:
Limit (feet) �;F'l':e
c 220 , f --Buff '
�;- a 50' MIN
to Taper
1 100' MAX
'II
500 :�: 500'
500'
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•
STATE OF NORTH CAROLII
SR 1143, NC 179, PROJECT Seamist Pump COUNTY OF Brunswick
P 9, SR 1822, Station & Force Main
NC 904 5R I Z?9
gRTMENT OF TRANSPORTATION ,-t ^ r , , THREE PARTY RIGHT OF WAY
h l v I `-% ENCROACHMENT AGREEMENT ON
-AND-
Seamist Camping Resort, Inc. PRIMARY AND SECONDARY SYSTEM
7x iy8/1 s I# LL.oTTC-- ,N.c. Zgy59
(�� J `j
-AND- 9/V- 361-g2(09 L- c _ UC • V 1{1 t t
Brunswick County
2Y9/ aoL./v/A /1/".Z. Zf3YZ1
t - 25-3-Za+oc,
AGREEMENT, made and entered into this the 351t. day of , 20 O(p , by and between the Depa
)rtation, party of the first part; and Seamist Camping Resort, Inc.
party of the second part; and Brunswick County
party of the third part,
WITNESSETH
-IAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designate
SR 1143, NC 179, SR 1279, SR 1822, NC 904 , located Beginning on SR 1143 approx. 250 If north of
n with SR 1155. On the west side of 1153 from start point to NC 179, then on the north side of NC 179 to SR 127
east side of SR 1279 to SR 1822, then on the south side of SR 1822 to NC 904, then on the west side of NC 9C
instruction and/or erection of: Sanitary Sewer force main to consist of the following project totals: 31,245 If 12"
)00 DR 18 PVC; 1,093 If 12"AWWA C150 DIP; 1,190 If 14"AWWA C906 DR 11 HDPE; 647 If 18"ASTM A139 (
(sing; 19 2"Air release/vacuum relief valves in manholes. For detailed breakdown per route see Attachment A.
HEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the part)
rt in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits o'a
y as indicated, subject to the conditions of this agreement;
)W, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the
3e to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which a
rt hereof upon the following conditions, to wit:
at the installation, operation, and maintenance of the above described facility will be accomplished in accordance with the party of
,t part's latest POLICIES AND PROCEDURES FOR ACCOMMODATING UTILITIES ON HIGHWAY RIGHTS-OF-WAY, and such
ns and amendments thereto as may be in effect at the date of this agreement. Information as to these policies and procedures
obtained from the Division Engineer or State Utility Agent of the party of the first part.
ie said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe and proper
on that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper maintenance
f, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways and structures
vary due to installation and existence of the facilities of the party of the second part, and if at any time the party of the first part shall
the removal of or changes in the location of the said facilities, that the said party of the second part binds himself, his successors
signs,to promptly remove or alter the said facilities, in order to conform to the said requirement,without any cost to the party of the
rt.
,.a ... �..- a- • • -

WITNESSETH
HAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designate
SR 1143, NC 179, SR 1279, SR 1822, NC 904 , located Beginning on SR 1143 approx. 250 If north of
)n with SR 1155. On the west side of 1153 from start point to NC 179, then on the north side of NC 179 to SR 12
ie east side of SR 1279 to SR 1822, then on the south side of SR 1822 to NC 904, then on the west side of NC 9
onstruction and/or erection of: Sanitary Sewer force main to consist of the following project totals: 31,245 If 12"
900 DR 18 PVC; 1,093 If 12"AWWA C150 DIP; 1,190 If 14"AWWA C906 DR 11 HDPE; 647 If 18"ASTM A139
asing; 19 2"Air release/vacuum relief valves in manholes. For detailed breakdown per route see Attachment A.
/HEREAS, it is to the material advantage of the party of the second part to effect this encroachment, and the part
art in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits c
)y as indicated, subject to the conditions of this agreement;
OW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the
?ge to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which
art hereof upon the following conditions, to wit:
eat the installation, operation, and maintenance of the above described facility will be accomplished in accordance with the party of
st part's latest POLICIES AND PROCEDURES FOR ACCOMMODATING UTILITIES ON HIGHWAY RIGHTS-OF-WAY, and such
D n s and amendments thereto as may be in effect at the date of this agreement. Information as to these policies and procedures
ie obtained from the Division Engineer or State Utility Agent of the party of the first part.
he said party of the second part binds and obligates himself to install and maintain the encroaching facility in such safe and proper
lion that it will not interfere with or endanger travel upon said highway, nor obstruct nor interfere with the proper maintenance
)f, to reimburse the party of the first part for the cost incurred for any repairs or maintenance to its roadways and structures
;sary due to installation and existence of the facilities of the party of the second part, and if at any time the party of the first part shall
e the removal of or changes in the location of the said facilities, that the said party of the second part binds himself, his successors
ssigns, to promptly remove or alter the said facilities, in order to conform to the said requirement, without any cost to the party of the
art.
eat the party of the second part agrees to provide during construction and any subsequent maintenance proper signs, signal lights,
=n and other warning devices for the protection of traffic in conformance with the latest Manual on Uniform Traffic Control Devices
-eets and Highways and Amendments or Supplements thereto. Information as to the above rules and regulations may be obtained
he Division Engineer of the party of the first.
eat the party of the second part hereby agrees to indemnify and save harmless the party of the first part from all damages and
for damage that may arise by reason of the installation and maintenance of this encroachment.
eat the party of the second part agrees to restore all areas disturbed during installation and maintenance to the satisfaction of the
)n Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable precaution during
uction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes, reservoirs, other water
ndments, ground surfaces or other property; or pollution of the air. There shall be compliance with applicable rules and regulations
North Carolina Division of Environmental Management, North Carolina Sedimentation Control Commission, and with ordinances
!gulations of various counties, municipalities and other official agencies relating to pollution prevention and control. When any
ation or maintenance operation disturbs the ground surface and existing ground cover, the party of the second part agrees to
e and replace the sod or otherwise reestablish the grass cover to meet the satisfaction of the Division Engineer of the party of the
art.
at the party of the second part agrees to assume the actual cost of any inspection of the work considered to be necessary by the
>n Engineer of the party of the first part.
at the party of the second part agrees to have available at the construction site, at all times during construction, a copy of this
Went showing evidence of approval by the party of the first part. The party of the first part reserves the right to stop all work unless
ice of approval can be shown.
)vided the work contained in this agreement is being performed on a completed highway open to traffic;the party of the second part
;to give written notice to the Division Engineer of the party of the first part when all work contained herein has been completed.
specifically requested by the party of the first part, written notice of completion of work on highway projects under construction will
required.
at in the case of noncompliance with the terms of this agreement by the party of the seco y th fi ° .a efrON
ht to stop all work until the facility has been brought into compliance or removed from the h nn ct n t�' narc/del tut

ti within one(1)year from the date of authorization by the party of the first part unless written waiver is secured by the party of the
ld part from the party of the first part.
uring the performance of this contract, the second party, for itself, its assignees and successors in interest(hereinafter referred to a:
;ontractor"), agrees as follows:
Compliance with Regulations: The contractor shall comply with the Regulations relative to nondiscrimination in Federally-
assisted programs of the U. S. Department of Transportation, Title 49, Code of Federal Regulations, Part 21, as they may be
amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and
made a part of this contract.
Nondiscrimination: The contractor, with regard to the work performed by it during the contract, shall not discriminate on the
grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials
and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by
Section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B
of the Regulations.
Solicitations for Subcontracts, including Procurements of Materials and Equipment: In all solicitations either by competitive
bidding or negotiation made by the contractor for work to be performed under a subcontract, including procurements of
materials or leases of equipment, each potential subcontractor or supplier shall be notified by the contractor of the
contractor's obligations under this contract and the Regulations relative to nondiscrimination on the grounds of race, color,
or national origin.
Information and Reports: The contractor shall provide all information and reports required by the Regulations, or directives
issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its
facilities as may be determined by the Department of Transportation or the Federal Highway Administration to be pertinent to
ascertain compliance with such Regulations or directives. Where any information required of a contractor is in the exclusive
possession of another who fails or refuses to furnish this information, the contractor shall so certify to the Department of
Transportation, or the Federal Highway Administration as appropriate, and shall set forth what efforts it has made to obtain
the information.
Sanctions for Noncompliance: In the event of the contractor's noncompliance with the nondiscrimination provisions of this
contract, the Department of Transportation shall impose such contract sanctions as it or the Federal Highway Administration
may determine to be appropriate, including, but not limited to,
(1) withholding of payments to the contractor under the contract until the contractor complies, and/or
(2) cancellation, termination or suspension of the contract, in whole or in part.
Incorporation of Provisions: The contractor shall include the provisions of paragraphs"a"through"f"in every subcontract,
including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued
pursuant thereto. The contractor shall take such action with respect to any subcontract or procurement as the Department
of Transportation or the Federal Highway Administration may direct as a means of enforcing such provisions including
sanctions for noncompliance: Provided, however,that, in the event a contractor becomes involved in, or is threatened with,
litigation with a subcontractor or supplier as a result of such direction, the contractor may request the Department of
Transportation to enter into such litigation to protect the interests of the State, and, in addition, the contractor may request
the United States to enter into such litigation to protect the interests of the United States.
iat when title to the subject that constitutes the aforesaid encroachment passes from the party of the secor
ests in the party of the third part, the party of the third part agrees to assume all responsibilities and rights
II obligations as agreed to herein by the party of the second part.
V (166) : Party of the Second Part certifies that this agreement is true and accurate copy of the form
V (166) incorporating all revisions to date.
WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the da'
ibove written.
DEPARTMENT O�PORTATION

may determine to be appropriate, including, but not limited to, J
t1) withholding of payments to the contractor under the contract until the contractor complies, and/or
(2) cancellation, termination or suspension of the contract, in whole or in part.
Incorporation of Provisions: The contractor shall include the provisions of paragraphs"a"through"f'in every subcontract,
including procurements of materials and leases of equipment, unless exempt by the Regulations, or directives issued
pursuant thereto. The contractor shall take such action with respect to any subcontract or procurement as the Department
of Transportation or the Federal Highway Administration may direct as a means of enforcing such provisions including
sanctions for noncompliance: Provided, however,that, in the event a contractor becomes involved in, or is threatened with,
litigation with a subcontractor or supplier as a result of such direction, the contractor may request the Department of
Transportation to enter into such litigation to protect the interests of the State, and, in addition,the contractor may request
the United States to enter into such litigation to protect the interests of the United States.
iat when title to the subject that constitutes the aforesaid encroachment passes from the party of the secor
jests in the party of the third part, the party of the third part agrees to assume all responsibilities and rights
II obligations as agreed to herein by the party of the second part.
N (166) : Party of the Second Part certifies that this agreement is true and accurate copy of the form
N (166) incorporating all revisions to date.
I WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the da
above written.
DEPARTMENT OF PORTATION
BY: ��— DIV ION ENGINEER
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CORPORA I E -�'
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ILU'ITM 4 IT riesuiumu• Print your name and address on the reverse Xo b 1 Gst,.^- T) 0 Addressee
so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery
• Attach this card to the back of the mailpiece, �I D _ d C44
or on the front if space permits.
D. Is delivery address different from Item 1? ❑Yes U
1. Article Addressed to: If YES,enter delivery address below: ❑No Z
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Registered ❑Return Receipt for Merchandise
❑insured Mali 0 C.O.D. E
4. Restricted Delivery'?ip+ c 0 Yes C.)
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2. Article Number II 7006 0100 0003 3486 1928
(Transfer from service label) l • "
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
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HIGHFILL
2840 South College Road #412
Infrastructure Engineering,P.C. Wilmington, North Carolina 28412
Tel [phone] Fax [phone]
CER I'IHED MAIL—RETURN RECEIPT REQUESTED ,
1
September 28,2006 Z
Mr.E.Ross Lewis 6 1A)
PO Box 264
Bladenboro,NC 28320
Re: Seamist Pump Station and Force Main
Adjacent Property Notification(1790 Brick Landing Road, Shallotte,NC) ono- 8(3-3
Brunswick County
Dear Mr.Lewis:
This letter serves as adjacent riparian property owner notification for the submittal of a Coastal Area
Management Act(CAMA)permit for the construction of the Seamist Pump Station and Force Main
project. The project consists of the installation of a wastewater pump station at the existing Seamist
Campground property and the installation of an underground forcemain(pipeline). The forcemain will be
installed along Brick Landing Road,within the NCDOT right-of-way in front of your property.
The CAMA permit is required because the line will cross under Goose Creek. A directional bore will be
utilized so that Goose Creek and adjacent wetland areas will not be disturbed during construction. You
can see the extents of the directional bore in the attached figure. The remaining forcemain shown will be
installed in an open trench,and the ground above the pipeline will be returned to its pre-construction
state. All work will be accomplished within the NCDOT right-of-way adjacent to Brick Landing Road,
and the pump station and forcemain will be owned and operated by Brunswick County. Please review the
attached Seamist Pump Station and Force Main Project Layout Map for better understanding of the
proposed project.
Also attached you will fmd two copies of the Adjacent Riparian Property Owner Statement. Please fill
out one copy and return it to us by October 6,2006,if possible. In fact,we are happy to meet with you to
answer any questions,and you can give the form to us directly. The second copy is for your records.If
you have any questions or concerns,or if you would like for us to meet with you on site,please contact
me at(910)313-1516 or on my mobile phone at(910)233-8095. Thank you so much for your assistance.
Sincerely,
„—
HEW-WILL INFRASTRUCTURE ENGINEERING,P.C.

WAT
�\0 31 RECEIVED Michael F.Easley,Govt
William G.Ross Jr.,Seen
JUL 'n North Carolina Department of Environment and Natural Resot
411N Alan W.Klimek,P.E.Dirt
Division of Water Qu
July 21, 2006
Mr. Walter Knott, President
Seamist Camping Resort, Inc.
114 W. Moore Street
Southport, NC 28461
Subject: Permit No. SW8 060641
Seamist Pump Station & Force Main
Low Density Stormwater Project
Brunswick County
)ear Mr. Knott:
The Wilmington Regional Office received a complete Stormwater Management Permit
\pplication for Seamist Pump Station & Force Main on June 29, 2006. Staff review of the plat
Ind specifications has determined that the project, as proposed, will comply with the
itormwater Regulations set forth in Title 15A NCAC 2H.1000. We are forwarding Permit No.
;W8 060641 dated July 21, 2006, for the construction of the subject project.
-his permit shall be effective from the date of issuance until rescinded and shall be subject to
le conditions and limitations as specified therein, and does not supercede any other agency
Permit that may be required.
any parts, requirements, or limitations contained in this permit are unacceptable, you have
ie right to request an adjudicatory hearing upon written request within sixty (60) days
)flowing receipt of this permit. This request must be in the form of a written petition,
onforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office c
,dministrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demanc
re made this permit shall be final and binding.
you have any questions, or need additional information concerning this matter, please
ontact either Linda Lewis or me at [phone].
incFy;'
j6v2_cc (_3„Le-c__
dward Beck
egional Supervisor
urface Water Protection Section
KID G'.\tAI# c'%f+T/1f1AA\AIAT%r—• r%••,T,i.e..... . . • ....

State Stormwater Management Systems
Permit Number SW8 C60641
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
LOW 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
Walter Knott & Seamist Camping Resort, Inc.
Seamist Pump Station & Force Main
4616 Devane Road, SW, Shallotte, Brunswick County
FOR THE
construction, operation and maintenance of a low density development in compliance
with the provisions of 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 pall UI UIIJ permit.
The Permit shall be effective from the date of issuance until rescinded and shall be
subject to the following specific conditions and limitations:
I. DESIGN STANDARDS
1 . This permit covers the construction of 3,000 square feet of new built-upon area
for the pump station site only. The drainage area contains 68,600 ft2 of existing
BUA (dirt roads and temporary housing).
2. The overall tract built-upon area percentage for the project must be maintained at
25%, as required by Section .1005 of the stormwater rules.
3. Approved plans and specifications for projects covered by this permit are
incorporated by reference and are enforceable parts of the permit.
4. The only runoff conveyance systems allowed will be vegetated conveyances
such as swales with minimum side slopes of 3:1 (H:V) as defined in the
stormwater rules and approved by the Division.
Nn nininn is annul/PH PxrPnt that minim)Im amni Int naraccani to riirPrt n rnnff

•
State Stormwater Management Systems
Permit Number SW8 060641
II. SCHEDULE OF COMPLIANCE
1. Projects covered by this permit will maintain a minimum 30 foot wide vegetative
buffer between all impervious areas and surface waters.
2. The permittee is responsible for verifying that the proposed built-upon area 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.
5. Alteration of the drainage as shown on the approved plans may not take place
without the concurrence of the Division of Water Quality.
6. Construction of additional built-upon area in excess of the permitted 3,000
square feet within the 7.8 acre project area will require a permit modification.
7. Construction of additional impervious areas such that low density requirements
are no longer met must be submitted to DWQ and a permit modification must be
issued prior to construction. An suitable engineered system will be required to
collect and treat the runoff from all built-upon area associated with the project,
including that area permitted under the low density option. This may or may not
be permitted, depending on the suitability of the soils for infiltration.
8. Filling in or piping of any vegetative conveyances (ditches, swales, etc.)
associated with this development, except for average driveway crossings, is
strictly prohibited by any persons.
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 the approved plans, regardless of size.
b. Project name change.
c. Transfer of ownership.
d. Redesign or addition to the approved amount of built-upon area.
e. Further subdivision, acquisition, or sale of the project area. The project
area is defined as all property owned by the permittee, for which
Sedimentation and Erosion Control Plan approval was sought.
f. Filling in, altering or piping any vegetative conveyance shown on the
approved plan.
10. Swales and other vegetated conveyances shall be constructed in their entirRty_

•
State Stormwater Management Systems
Permit Number SW8 060641
14. The permittee shall at all times provide the operation and maintenance
necessary to operate the permitted stormwater management systems at optimum
efficiency to include:
a. Inspections
b Sediment removal.
c. Mowing, and revegetating of the side slopes.
d. Immediate repair of eroded areas.
e. Maintenance of side slopes in accordance with approved plans and
specifications.
III. GENERAL CONDITIONS
1. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to an enforcement action by the Division of Water Quality,
in accordance with North Carolina General Statutes 143-215.6A to 143-215.6C.
2. The permit issued shall continue in force and effect until revoked or terminated.
3. 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.
4. 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 Title 15A of the North
Carolina Administrative Code, Subchapter 2H.1000; and North Carolina General
Statute 143-215.1 et. al.
5. This permit is not transferable except after notice to and approval by the Director.
The Director may require modification or revocation and reissuance of the permit
to change the name and incorporate such other requirements as may be
necessary. A formal permit request must be submitted to the Division of Water
Quality accompanied by the appropriate fee, documentation from both parties
involved, and other supporting materials as may be appropriate. The approval of
this request will be considered on its merits, and may or may not be approved.
The permittee is responsible for compliance with all permit conditions until the
Director approves the transfer.
6. The permittee grants permission to DENR Staff to enter the property for the
purpose of inspecting all components of the stormwater management facility.
7. The permittee shall notify the Division of any name, ownership or mailing address
changes within 30 days.
8. 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 aaencies (local. state and federall which haves iiiricrlicrinn

OFFICE USE ONLY
Date Received Fee Paid Permit Number
45-f'7 2C:v' 5�v ' C c 4/
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Applicants name (specify the name of the corporation, individual,etc.who owns the project):
<)01-Ml57- (11-41Pfiv4 e Gs r lnkc
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
44i--rr✓n- W_Ato T T
3. Mailing Address for person listed in item 2 above:
1/4 HI Mac 57
City: .SOD -?,02( State: A/G Zip: 7646/
Telephone Number: ( G)lQ ) 36,7- ,Z(o
4. Project Name (subdivision, facility,or establishment name-should be consistent with project name on plans,
specifications, letters,operation and maintenance agreements, etc.):
vusz NMI) S:ro -rwAG AND 24-C Nll}tN
5. Location of Project (street address):
1lo Dcv6.45
City: <44 12.0- 1 County: jiJ5/ /C/C.
6. Directions to project (from nearest major intersection): /`�.,�-
1 N r17� � jZ
CreAGD) b Sp.Ir!43 (11/464/9WI IN4 )41) /24v0 . .°74/
Attvt4 Sacii—i,44044 IZD L.-VA-NC. ZD. LgFT ei/Deo' T 1 brry.
o I' o l
7. Latitude: ,35 S4 Z Z Longitude: 7{� 2 5 Z°7 of project
8. Contact person who can answer questions about the project:
Name: •J ZA.y 7\ P.L. __ Telephone Number: (_a)(G ) 233-

2. If this application is being submitted as the result of a renewal or modification to an existing permit,list the
existing permit number and its issue date (if known)
3. Specify the type of project(check one):
Low Density High Density Redevelop General Permit Other
4. Additional Project Requirementsui (check applicable blanks):
CAMA Major ✓ Sedimentation/Erosion Control 404/401 Permit NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
III. PROJECT INFORMATION
1. In the space provided below,summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project.
1M�
Cis c 1 ;� CF r►vl �r� �ri�l oF,! M �Mo S a to�N tM =rNi ov c - /l u `/ L;
/A 10 ci/ �, ON AMP SZ{i cN icz D/L Srh:,.3.r R 1 447,, argEN7
2. Stormwater runoff from this project drains to the L-f444 'e_ River basin.
3. Total Project Area: . acres 1 4. Project Built Upon Area: z/, 1
( 1NA4e-Ihtta Cc.c�) ploP�2Zt' l$ LI,264a¢aS•1 -.
5. How many drainage areas does the project have?
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project,attach an additional sheet with the information for each area provided in the same format as below.
SE bjas • —r (-ZS
Basin Information Drainage Area 1 Drainage Area 2
Receiving Stream Name 60 i;
Receiving Stream Class 4 j {Q
Drainage Area —3 O}05O p,z
Existing Impervious`Area (pa Gov r-r• Z
Proposed Impervious#Area 000 tZz
%Impervious`Area (total) 2 1„l qa
Impervious`Surface Area Drainage Area 1 Drainage Area 2
On-site Buildings 43 COO 719AP• g )
On-site Streets ZS;(ax.4S= 027 /1,,,u&l.
On-site Parking
On-site Sidewalks

7. How was the off-site impervious area listed above derived? N/A
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS /VA — 742'.0Pgrell AIOT 7veovi
UTtcr>r�jP2ofeccr Gal
The following italicized deed restrictions and protective covenants are required to be recorded for all
subdivisions,outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a table
listing each lot number,size and the allowable built-upon area for each lot must be provided as an attachment.
1. The following covenants are intended to ensure ongoing compliance with state storm water management permit number
as issued by the Division of Water Quality. These covenants may not be
changed or deleted without the consent of the State.
2. No more than square feet of any lot shall be covered by structures or impervious materials.
Impervious materials include asphalt,gravel,concrete, brick,stone,slate or similar material but do not include wood
decking or the water surface of swimming pools.
3. Swales shall not be filled in,piped,or altered except as necessary to provide driveway crossings.
4. Built-upon area in excess of the permitted amount requires a state storm water management permit modification prior to
construction.
5. All permitted runoff from outparcels or future development shall be directed into the permitted stormwater control
system. These connections to the storm water control system shall be performed in a manner that maintains the integrity
and performance of the system as permitted.
By your signature below,you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, 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 State,and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each
BMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the status
and availability of these forms.
Form SWU-102 Wet Detention Basin Supplement
Form SWU-103 Infiltration Basin Supplement
''Form SWU-104 Low Density Supplement
Form SWU-105 Curb Outlet System Supplement
Form SWU-106 Off-Site System Supplement
Form SWU-107 Underground Infiltration Trench Supplement
Form SWU-108 Neuse River Basin Supplement

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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. The complete application package should be
submitted to the appropriate DWQ Regional Office.
1. Please indicate that you have provided the following required information by initialing in the space provid(
next to each item.
Initials
• Original and one copy of the Stormwater Management Permit Application Form (ev
• One copy of the applicable Supplement Form(s)for each BMP
• Permit application processing fee of$420(payable to NCDENR) 544/ .,
• Detailed narrative description of stormwater treatment/management
• Two copies of plans and specifications, including:
- Development/Project name
- Engineer and firm
- Legend
- North arrow
-Scale
- Revision number & date
-Mean high water line
-Dimensioned propel ty/plojeLt boundary
- Location map with named streets or NCSR numbers
-Original contours, proposed contours, spot elevations, finished floor elevations
-Details of roads,drainage features, collection systems,and stormwater control measures
-Wetlands delineated, or a note on plans that none exist
- Existing drainage (including off-site), drainage easements, pipe sizes, runoff calculations
-Drainage areas delineated
-Vegetated buffers (where required)
VII. AGENT AUTHORIZATION
f you wish to designate authority to another individual or firm so that they may provide information on your
>ehalf, please complete this section.
)esignated agent(individual or firm): Highfill Infrastructure Engineering,P.C.
Mailing Address: 2840 S.College Road #412
=ity: Wilmington State: NC Zip: 28412
'hone: ( 910 ) 313- 1516 Fax: ( 919 ) 882-9762
✓III. APPLICANT'S CERTIFICATION
, (print or type name of person listed in General Information, item 2) Walter Knott
.ertify that the information included on this permit application form is, to the best of my knowledge, correct anc
hat the project will be constructed in conformance with the approved plans, that the required deed restriction!