SW4110802_HISTORICAL FILE_20111007

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW W4
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
DOC DATE
3OW47
YYYYMMDD

} � � G s ' J\:-3T
f
! / f SAMUEL NEWSOME }
I DB.451 Pia. 2059 i SAMUEL NEWSOME ff /
6902-14-43-9242 y DB.300 PG. 703
DUKE POWER BLANKET EASEMENT 6902-04-53--2221
To AN bVN WE ,' l AIMS 25' RIGHT OF WAY 3 1 ♦� ,�
N 84 59' , " W { / 2O SANITARY SEWER 5.0 SEE NOTE 7 iA„ TIE
PP EASEMENT ,• FP ON INSTALLED LINES ip '47" E PP �A TIE
.34 S ! E 347 5ft S 8"1'47E 2� mac• x
S 85 21 273 25'
! ! x -- - _� ----- __ _ �- _ . - -TIE - ;Q
/ ' / 6 - 5' 8L17G. SETBACK 1 '��" SEE NOTE 7 rx
OV36*48" W
_ 12L4 /lT'-�i ,.1 ..� i•t 4 27'
7 � � '�l1' ,Iirf/ ,f' ✓`': F � * t F
so 12V
L58lz�:!
�•,f��
PERPETUAL •C��/� I�/% o: ire .. t
j �.i /, AY. ACCESS EASEMENT
./ / lam. ,> ��?-� LqB. cn V1 Cl IN
Q� u/
co
/ f/i' LEGEND
CLEl�#CE W. CATER FAMILY LTD PARTNERSHIP RER
` ® N.C.D.O.T. CONCRETE MC3t�It�MENT � i P. IRON PIPE
l�• // :PE#tiI 6�02--04-5�a-�-1668
t .1 F PART OF D8- 556 PG 754 � FIRE HYDRANT
(TOTAL) �. f/�%'� ����, / ,� � ® TELEPHONE PEDESTAL
r. # - PART OF DB. 191 PO. 661 �' P GUY POLE
iaPP ! ! r "~-=6 R--421'9 08' C�`� WATER METER GUY WIRE
1
/ t J
: " r /jGAS VALVE
_ �/! . !/ . f -319 WATER VALVE
DR-N 28' # E ti`vvll/ 61' / �� � STORM MANHOLE
A P ,,O CH .62 / i ?.afi MANHOLE MISC.
! / / &7 •:. / 0' ® CURB INLET SEWER MANHOLE
CONTROL /%*� L27 # LIGHT PULE Q TELEPHONE MANHOLE
""' _ 10 YARD INLET PX NAIL
1 Af1 to / 5' SLOG. SETBACK 1 . �
uk N:3228 r'9.J2 ��/PP
:1 ft14697.41 `;r - _ POWER POLE
sal e A-28is.97' :1/I - /"TEI+�f3ORARY GRADING ~ � `' ��34
R--1187.60' Cs�/ �� ! EASEMENT ��5�,�
�r 0-12'52•48"
' 1O.w 8R-N 51*28'18" W�-
RIGHT OF WAY DEDICATION '" � � � � CFI----266,41" I I '• � � �.
-. N, PERMANENT GRADING c t
3O139.69 Sq. Feet \ � �. 3t�.0 �
! Al ` /.ts NTEW E EASERl NT cq
0.071 Acres ` •'� /Iv �� \ �` �'
62
PERMANENT GRAOIA�G
MAINTENANCE CEMENT
CLARENCE W. CARTER FAMILY LTD PARTNERSHIP ♦a
� `'` 4` C£ T ITRC]L I PIN 6 2-04-°-52--1 fi \ � ^♦ Q �
\. 1�R 'EST ' i s 4 1 PART OF DB. 556 PG 754 ♦ \ "�,� \ � ti
(x 4� At �` `� ', N922703.97 ,e3k' l Ira �1`'a DART Of DW 191 PG. $61 �\ ♦'\:. � `�� ,�
NOTES: F `� h
1. SITE l5 TO ALL EASEMENTS, AHE3 Ac,�NTs "b ` 49f}5.41 i . t t . `,�
OF RE TO THE DATE OF THE �r `. � ` . w � � � � � I i'LIV, ,,(D � \
2. ALL DISTANCES ARE H€ WZONTAL �. LMLESS OTHERWISE NOTED � ��� � � � i � v / � � `` ��r N \
°``
3_ ALL �t € `�`�: '�f\ �fli4#i4 :. 4 f \ ♦,
4. AREA COMPUTEDBY COO�I HATE GEOMETRY_
5.THIS PLAT AND AWY AC�ANYING �*TS ARE ' (j ♦ , i I i I l yt4lI t
/ { U €)1 T 1 L29 5 44113F', 3 ( 52.55'
FURNISHED TO THE PEWSON FTC NAMW t�FL4Nt AND O +�} e � � I 3 l� t �1 i
1N1�O ALTERATIONS U�t�'F�yUSE �f3�/�t2��yy+�S/�M PPS/' TTEl3(� SURVEYING
-, �`(] � ` - '� ��.� II 1 � - " �.t tc i.. SI r�/ Li S ��Y '.#�°' Ss1 �Sy:��&R' `L.g�T S 39"3�t'2t' E. �4y��3q.1.7
W THOU 7 G. (PIRG.�a� W RI T" CONSENT f O SGROI {.AND :. UR E f ING �. 'i ``\.,* ` \ \ � � t � � I � � T � � � t.«¢ L2 S T,i i � � �-I.SI! a L31 S �' f ��Q" E 16:� F
, ��� } ., 4� '` ,' �''� � .� 1� s 42'��'� E 21, L:�;2 S 3a3�:32- 1= 2.5:21
6, f'�T TRY � NOT UE IN A SKOAL FLOM HAZARD AREA AS BY NC )=L MAP � �� . � l� �. � a� � L4 � ��- 3' ��' E 41,01'
3710690200J , EFFECnVE DATE MAY 16, 2007. � '-. � � 4 �t� i . � L5 N $ " 82. ' . L34 s Q1'4$T7• W It�a�' ����
7. PROPERTY LINE ESTABLISH® BY HEED BOOK 451 PAGE 2059 �Y v I (; t I I t / L6 N 43'3s'37" W 45:'-' L 38 S 2wi �77' W 29.0V
AND SHOWN ON SURVEY BY DEAN SLATE APRIL 3, 2� � � �, I (i j � I � � � I � L7 S 41'13 � .E 19� L36 S 04'45'04" W 44 W'�-
w I �,t f !! L8 N t°"5754' E 60.23' Z37 S 2&'2p'09" W 30.76
s I L9 N 50.12 " E 4,115' L38 14 73'SY48" W 27-60'
,yllilt'�.,i�l�
%David J Sgroi, certify that this plat was dras�n under my supervision from an actual s kyey � �. i � � �TEMPO€IAR Y GRADING L1r� N 47� > 33 L39 N 5� 2933 W 6:7s
made udder my supervision (deed description recorded in t3aolt _, .page 91 � , etc.) �ia�11 i ` , �r � t�� I � � cAS�lEI3TT L11 N 3ts`"E 11 S1` L4L1 N � 16'35" W 58:28'
(other); that the boundaries not surveyed are clearly indicated as drawn from information ♦�.�rBi` �� I;I }��� I LY2 N 1 2�42' t41 1v 7ts1645" +� 9.76"
found in 6txxk. page W that file rcrtia of preeisian as calculated is 1. . that x;�`e •. • " �• �; 1� L 3 N 3 2 23.9 i L42 N 25'SF'37" w fi2.4S3` 1
this plat was .prepared in accordance with G.S 47-30
as m nded. Witness my original = $,•ki�SS a��;� �
signature, registration number and seal this • �_ doy of �, A p., •£d { \, C I
Seat or Stam • \ r=
a
i
Registration NurFer"
\ 1 20,,.0+
4 t
1
0
d. That the survey 1s of another category, such as the recombination of existing parcels, a i27 S 83'1tr " E 33 \ 1 t ,rAt;I-'r
csac€- --ordered survey, or other e�ccion to t de#ireittQn of suhdlvasion; L28 S '1 4 E 74.22'
1
I - r . r� Review Officer of Stokes O.ME FO� AIRC LEr(c1r1 CHQRD %0�4 I 0M..TA X4OtE _C13 -��.� 27.5W 27,17' N z 3s`04" w ' 3Y14'37- I
The IBC Gnd coordinates shown an this plat were derived by uUnzrrig the North I -. -
Carolino Virtual Real Time Kinematic Network Service. The vectors were adjusted Chanty, ceE that the map or plat to which this certificatim is affixed
C1
12;8G'
21.2 4
C2
3a.28'
45 24'
using N.C. V.R.S FIXED/C.0, .S stations (minimum of three), producing a insets ,rtl statutory
requirements for recording.
C3
301_45'
119.39
weighted least squares adjustment of the [WGS 84 or NAD 83 or other system]
C4
321.83'
12T5.1'
Positions. Coordinates were reported by Topcon Hiper Light reciever serial # Approved �
�� �~ ''�' -_--_ _-
C5
17.25"
2-Wa,3
263-'-0194 and Topcon Topsury data collector Software.
CS
32.ti0'
54AX
C7
t 1'0fHI"
19.29'
�
C8
51.50'
32-SS
This the .---
Day of ---- 2011.
c9
13.27
e if' f I r i_qa by EnLQMgMeDt
C10
saw39.74
C11
91:
62.88'
I hereby certify that the subdivision plat shown hereon has been found to comply with
C12
I112.50'
70.63
the Subdivision Regulations of King, North Carolina, with the exception of such
variances, if any, as noted in the minutes of the Planning Board and recorded on the Certifrco#e Qf
Owners h p_ and Dedication
Plat and that it has been approved for recordinj in the Office of the Register of I (we) hereby'
certify that I (we are) aril the owner(s) of the property
shown and
described
heeds.
hereon and that I (we) hereby adopt this pion of subdivision with
my
(our) free consent.
Ott
{fate � , .^-F-` � �t � l�€
_ __ � _
Enforcement Officer
O
� t-
�'�-- �----
City of KingTHY
Y0J..
CLR�?ENCE W. CARTER i-AMILY LTD PARTNERSHIP
VIVIAN T. CARTER
Rasa*tar i2f Dog atoxao �`0' ' X.
L14
N 37" l9°52" .E
98.26'
L43
N 46P44'34" w
34.78'
456
N 5W38 14 W
10.
L15
N 37'1V " E
48.82'
L44
i 3£3'11z,'35" W
75.1:9'
L57
N 52'01'46' W
66i12
L15
N 01 79W E
27.28'
L4:5
N 4743'33" W
29.91'
138
N S'16'23" W
78-99
L17
N 21 59'32" W
21.42
L46
N 2414'12" E
54.15'
L59
S 79*02*57" W
34-Z'
LIS
s 1 iV' E
83.38'
L47
s &4'41'W E
29.3V
LW
N 6423'54' w
T&'
I.1
s 04 3 E
74,92'
L48
N 8441'59" w
Y&.2
L61
S 64'2354 E
15_ '
L20
5 34 E
15f[,I '
L49
N 65' 12`55" W
159.7v
L62
N 3'2' �7- -E
�F '
L21
S 51'31'4S4' W
13-W
L50
S 25'15'34' W
56.97'
L63
S 85'16'23 E
78-.R9`
L
S 13'39-40 E
' x.1 '
L51
N 509'3S" w
2.1'
U54
S S2"€1f'41i E
71.8W
L23
5 76'Z9" W
20.W
#�
5 5W39 39 E
-&GZt
S S €1 !' E
Siit3
L24
-N I319'4fi W
139.1 a'
L;SS
1i 1:5'S4 E
_
66c97
N 58 7" LY
:57`
L25
N 19-4#° W
191,92'
L54
5 SS'12'55 E
16Fi.2
L1?7
ft 2S1<.41 _23 €
91.77'
L26
N W
14.
L55 I
S $$'3S%'14' E
1i1>93'
L
N 2T 54" E
1 88.76
S 72.47
58" W
95'0447'
C19
4219.08'
IS. '
19-05°
N 2T 39" E
5 &M'59- E
I'Ta Ss"
C20
4219.08'
14.60
14.60'
N. 2754 42" E
5 82'4W28' E
3633'o9'
C21
60.52`
5234'
59.62'
S SW52'34" E
N W53 17" €
1S4LY'4il'
C22
30.95'
48.90,
43,97'
S Q6'24'37" Vd
S 6$ 39 04 E
3T1437'
�3V21
c2z
3a95'
3}.2g'
3 :w
N 77W42 W
S 38'57' 8 E
52'°
C24
60.44
60.00
57.57 1N
04'23'W W
N 4(T3WG4" W I 36 O 20'
C25 I;tW.43' 1 2iK 5' 245.22 N 5(r54 22" W
FINAL PLAT FO t
CLARENCE W. CARTER FAMLY LTD PARTNER
REFERENCES
MOMTAINVIEW
ROAD AND
DART CE
0tD H�� Y 2- .
K STREET
CLARE�ICE W. CARTER FAMILY
LTD PARTNERSHIP
PIN # 6902.--04-52-1668
CITY OF KWG
Y DKIN TOWN '
PART OF DB, 556 PG 75
PART OF 0133 191 PG. 8,61
DATE JUNE 22 20 i 1.1 0 1 %JILM I Y,
ri! I ;�T� •� r'il �',�� �! , [T •t I 1,' L=' I te1 I- i1'� .T �
r-,r. �r ] ��. ri YT't - t,.. .. r'-J°r ti _.�,It } r �. r 1 .{.4'I,.L '�F.r .F: t� . •J �.F ... 4 r;
S" _�.
Sa u� U c' ems'
yo. O
Phone J-V-aW-14&
E
c-r
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P.O. Sox $277
High Point, NC 272262

'North Carolina Secretary of State
Page 1 of 1
Ill-orth Caro fi`i2
,fa;n� F.,arshai! PAc�'iEiT Trt-
= tt f S��r ry :�RETARY OF -ram
PO 6ox 2;62a} »316 n, *16C 27626 04522 fg1915C7-2MC
Date: 10/712011
Click here to:
View Document Filings I Sign Up for E-Notifications
PC, PLLC, LP and Non -Profit entities are not required to file annual reports
Corporation Names
Name
Name Type
NC PTM, L.P.
LEGAL
Limited Partnerships Information
SOSID:
0707120
County:
Unknown
Status:
Current -Active
Effective Date:
6/16/2003
Dissolution Date:
Annual Report Due
Date:
Citizenship:
FOREIGN
State of Inc.:
DE
Duration:
PERPETUAL
Registered Agent
Agent Name:
CT CORPORATION SYSTEM
Office Address:
150 FAYETTEVILLE ST., BOX 1011
RALEIGH NC 27601
Mailing Address:
150 FAYETTEVILLE ST., BOX 1011
RALEIGH NC 27601
Principal Office
Office Address:
5700 SIXTH AVE.
ALTOONA PA 16602
Mailing Address: 5700 SIXTH AVE,
ALTOONA PA 16602
Officers
This website is provided to the public as a part of the Secretary of State Knowledge Base (SOSKB) systern. Version:
1116
http:ll�4-%,,tiv.secretary.state.nc.uslcorporations/Corp.aspx'?Pitemld=b 181721 10/7/201 1

North Carolina Secretary of State Page I of•2
rl7ftil Cafoiril
Secretan
Ei TAT
Po 6o.<2�221 =ak;iqn, NC s7626-�0622 ;919`607-20'X
Date: 10/7l2011
Click here to:
View Document Filings I Sign Up for E-Notifications
'� Print apre-populated Annual Report Form I File an Annual Report
Corporation Names
Name
Name Type
NC SHEETZ INC.
LEGAL
Business Corporation Information
SOSID:
0597312
Status:
Current -Active
Effective Date:
7/12/2001
Dissolution Date:
Annual Report Due
Date:
Citizenship:
FOREIGN
State of Inc.:
PA
Duration:
PERPETUAL
Annual Report Status:
CURRENT
Registered Agent
Agent Name: CT CORPORATION SYSTEM
Office Address: 150 FAYETTEVILLE ST., BOX 1011
RALEIGH NC 27601
Mailing Address: 150 FAY ETTEVILLE ST.. BOX 1011
RALEIGH NC 27601
Principal Office
Office Address: 5700 SIXTH AVENNUE
ALTOONA PA 16602
Mailing Address: 5700 SIXTH AVENNUE
ALTOONA PA 16602
Officers
Title: ASSISTANT SECRETARY
Name: STEVEN P AUGUSTINE
Business Address: 110 PETERS LANE
DUNCANSVILLE PA 16635
Title: ASSISTANT SECRETARY
Name: GARY ZIMMERMAN
Business Address: 711 JONES STREET
HOLLIDAYSBURG PA 16648
Title: ASSISTANT SECRETARY
Name: DAVID P HAZELET
Business Address: 133 TIMBERSPRiNGS LANE
INDIANA PA 15701
http://wti4Av.secretary.state.nc.Lislcor-porationsICor-p.asps?Pltemld=5')45086 10/7/201 1

i\lorth Carolina Secretary of State
Page 2 of 2
Title: ASSISTANT SECRETARY
Name: MICHAEL A LACESA
Business Address: 4338 WEBSTER DRIVE
YORK PA 17402
Title: ASSISTANT SECRETARY
Name: TRAVIS T SHEETZ
Business Address: 12 ALLEGHENY DRIVE
HOLLIDAYBURG PA 16648
Title: ASSISTANT TREASURER
Name: THOMAS P LUCIANO
Business Address: RR 4 BOX 179B
ALTOONA PA 16601
Title: CHAIRMAN OF THE BOARD
Name: STEPHEN G SHEETZ
Business Address: 3511 SHAWNEE AVENUE
ALTOONA PA 16602
Title: PRESIDENT
Name: STANTON R SHEETZ
Business Address: 191 SCENIC PINE DRIVE
HOLLIDAYSBURG PA 16648
Title: VICE PRESIDENT
Name: W. DANIEL MCMAHON
Business Address: 521 SUMMIT STREET
GALLITZIN PA 16641
Title: VICE PRESIDENT
Name: RANDALL A SHEETZ
Business Address: RD 2 BOX 352
HOLLIDAYSBURG PA 16648
Title: VICE PRESIDENT
Name: STEPHANIE DOLIVEIRA
Business Address: 731 FAIRFIELD DRIVE
DUNCANSVILLE PA 16635
Title: VICE PRESIDENT
Name: JOSEPH S SHEETZ
Business Address: 309 CARDINAL DRIVE
HOLLIDAYSBURG PA 16648
This website is provided to the public as a part of the Secretary of State Knowledge Base (SOSKB) system Version:
1116
http://ww-,%-.secretary .state.nc.LislcorporationsICorp.aspx?Pltemld=5345086 10/7/2011

0620
1032 BK: C0620 PGA 032
APPROVED BY FILED
STOKES COUNTY ASSESSOR STOKES COUNTY
KATHY YOUNG
REGISTER OF DEEDS
FILED Jul 28, 2011
AT 12:59 pm
BOOK OC620
START PAGE 1032
Srokr County 07-28-2011
:�OR'r1i C.�ROLUNA END PAGE 1033
INSTRUMENT # 03569
$1..,30 ao
NORTH CAROLINA SPECIAL WARRANY DEED
Excise Tax:$1430.00
Parcel Identifier No. portion ofG 02-04-52.1663 Verified by County on the day of 2011
By: -- ---- - -
Maib'13os to: PTM. L.P.. C/O Sheetz, Inc„ 5700 Si,mli Avenue, Altoona, PA 16602
This Instrument was prepared J. Tyrone Browder. Attorney, P. Q. Box 550, Kh1s. NC S7021
Brief Description for the Index: _2.097 acres
TH[S DEED made this Z day of_1 1 2011, by and between
GRANTOR
CLARENCE W.CARTER
FAMILY LIMITED PARTNERSHIP
(a North Carolina Limited Partnership)
P. 0. Box 441
Icing. NC 27021
GRANTEE
PTM, L.P.
(a Delaware Limited Partnership)
00 SHEETZ, INC.
5700 Sixth Avenue
Altoona, PA 16602
Enter in appropriate block for each party: name, address, and if appropriate, character of entity, e.g. corporation or partnership.
The designated Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and sha)i include
singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged,
has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land
situated in the City of _King Yadkin Township, _Cokes____ County, North Carolina and more particularly
described as follows',
Being Lot I containing 2.087 acres as shown on Plat for P'P�1, L. P, dated June 22, 2011, prepared by Sgroi Land Surveying and
recorded in Plat Book -J-4—, Page - Stokes County Register of Deeds.
The foreguing property does not include the primary residence of the Grantors.

0620
1033
BK O0620 °G:1033
The property hereinabove described was acquired by Grantor by instrument recorded in Rook 556, Page754 and Book 191. Page
351.
A map shut%in-, the above described property is recorded in Plat Book" , page��,
TG HAVE ANO TO HOLD aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging �o tho Grantee in
fee simple.
And the Granlur covenants with the Grantee, that Grantor has nothing to impair such title as Grantor received, and Grantor will
warrant and defend the title against the lawful claims of all persons claiming by, under and through Grantor, other that the
following exceptions'.
Easements ai=d restrictions of record, if any.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
Corporate Name
By:
Title:
By:
Title:
B y.
Title:
SEAL-STANIP
�Z�o-
¢ g
rya19
i�L
° n
z°
CLARENCE W. CARTER FAMLY
LIMITED PARTNERSHIP
BY:
V1V1AN T. CARTER, GENERAL PARTNER
11)
EAL)
State of North Carolina- County of Stokes
1, the undersigned Notary Public of the County and State aforesaid, certify that Viviaa T.
Carter. Generaj_Parcner personally appeared before me this day and
acknowledged the execution of the foregoing inslrutpent for the purposes therein expressed.
Witness by hand and Notary stamp or sea{ this as day of � iu o01f .
My Commission Expires: 1 I D' _ �X�c a , 16Lk_
Notary Public
SEAL-STANIP State of
County of
1, tht undersigned Notary Public of dw County and State aforesaid, certify that
___.-rpersonally appeared before me this day and
acknowledged that he is the of
a corporation, limited liability coin panylgeneraI partnership
(strike Through the inapplicable), and that by authority duly given and as the act of each
entitled. _he signed the forgoing instrument in its name on it s behalf as its act and deed.
Witness by hand and Notary stamp or seal this day of , 20.
My Commission Expires:
Notary Public

timm
601 N. Trade Street
Suite zaa
Winston Salem, NC
Landscape Architecture
27101-2916
Civil Engineering
stimmei Associates, PA Land Planning
P:336.723.1067
F: 336.723.1069
attn: Robert Patterson
to: NCDENR DWQ
date: 101712011 job #: 10-139
project: Sheetz - King, NC
letter of transmittal
512 N. Salisbury St.
Raleigh, NC 27604
919-807-6375
sent Via: 67 Attached
C` Under Separate Cover
U.S. Mail By Hand
I✓i Over Night Service r.-- For Pick -Up
r Fax#
# of pages total = 1
We are sending you the following items:
r1 Prints Calculations Base Drawings
r Reproducibles r Information r Correspondence
fJ Originals ( Specifications r Change Order/Addendum
r Diskette/CD
L Email with Attachments
F
copies
sheet
dated
description
2
C-3.0
10/5/2011
Grading Plan
2
C-3.1
10/5/2011
Stormwater Management Plan
2
C-4.0
101512011
Erosion Control Plan
2
Stormwater Management Permit Application Form
2
Deed & Plat
2
USGS Map
2
Document from NC Secretary of State
remarks, comments, & details:
These are the supplementary submittals requested, including the current SWU-101.
Thanks Robert for your assistance!
K noted enclosures are not received, please notify us.
copies to. File
1&9(r-z'2n'q
L� �
OCT 1 0 201,
ft DENR- WATER QUALITY
WD.SAW STpRftjE W H
by: Bob Young

Patterson, Robert
From: Tim Jennings [[e-mail]]
Sent: Tuesday, October 04, 2011 1:03 PM
To: Patterson, Robert
Subject: RE: SW4110802 - Sheetz - King - Additional Information Request
Yes Robert Sam Smith is no longer with Stimmel Associates, P.A. and yes we will be able to address the email below
within the next week or so. Thank you for your understanding and flexibility.
Tim Jennings, RLA, ASLA
flennings(ci�stimmelpa. com
v: 336.72 3.106 7 ext. 101
From: Patterson, Robert f mailto:[e-mail]
Sent: Tuesday, October 04, 2011 8:38 AM
To: Tim Jennings
Subject: FW: SW4110802 - Sheetz - King - Additional Information Request
Mr. Jennings,
Please see the additional information request below. Let me know if you think you can submit this in the next week or
two; otherwise I'll need to return it as incomplete. I understand that Mr. Smith is no longer with Stimmel.
Thanks
Robert D. Patterson, PE
Environmental Engineer
NCDF:NR I DWQ I SLormwater Perrnitutig
1617 Mail Service Ceriter, Raleigh, NC 27699- 16 17 Mail 1 512 N. Salisbury St, Raleigh, NC 27604 1 91h Floor Location h-, Pnrc:clS
[phone] Phone [phone] Fax I Robert. Pattersonuncdenngov F.mail I http://porLal.ncdenr.org/webywp/wsysu Websit(,,
h,A Belixc printing this email. please eunsider your budget and the environment,
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties unless the content is
exempt by statute or other regulation.
From: Patterson, Robert
Sent: Thursday, September 01, 2011 3:03 PM
To: [e-mail]
Cc: [e-mail]; Homewood, Sue
Subject: SW4110802 - Sheetz - King - Additional Information Request
Dear Mr. Smith:
The Division of Water Quality Central Office received a Stormwater Management Permit Application for the subject
project on August 25, 2011. A preliminary review of that information has determined that the application is not
complete. The following information is needed to continue the stormwater review:
The application was submitted on an outdated version of SWU-101. Please complete and submit the
original of the latest version available at http://I)ortal.ncdenr.org/web/wcl/ws/sulstatesw/forms _dots.
The person that signs the application for a corporation must a principal executive officer of at least the level
of vice-president, or his authorized representative. Mr. John Maxwell is not shown as such on the 4C
Secretary of St:1te's website.

3. Any wetlands and surface waters must be shown on the plans; or provided a note that non exist, if that is the
case.
Please note that this request for additional information is in response to a preliminary review. The requested
information should be received by this Office prior to September 30, 2011, or the application will be returned as
incomplete. The return of a project will necessitate resubmittal of all required items, including the application fee.
If you need additional time to submit the information, please mail or fax your request for a time extension to the
Division at the address and fax number at the bottom of this letter. The request must indicate the date by which you
expect to submit the required information. The Division is allowed 90 days from the receipt of a completed application
to issue the permit.
The construction of any impervious surfaces, other than a construction entrance under an approved Sedimentation
Erosion Control Plan, is a violation of NCGS 143-215.1 and is subject to enforcement action pursuant to NCGS 143-
215.6A.
All revised original signed documents must be returned or new originals must be provided. Copies are not acceptable.
Any revised calculations or plans must be sealed, signed, and dated; and have a revision date shown. Please reference
the State assigned project number SW4110802 on all correspondence. If you have any questions concerning this matter
please feel free to call me at [phone], or at [e-mail]_.
Sincerely,
Robert D. Patterson, PE
Environmental Engineer
NCDENR I DWQ I Stormwater Permitting
1617 Mail Service Center, Raleigh, NC 27699-1617 Mail 1 512 N. Salisbury St, Raleigh, NC 27604 1 91h Floor Location &, Parcels
[phone] Phone; 1 [phone] Fax 1 Robert. Patterson(mcdenr.�ov Email I htt :/ 1portal.ncdenr.org/web/w ws/su Website
`A Before printing this email, please consider your budget and the environment.
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties unless the content is
exempt by statute or other regulation.

I
Stimmel
Landscape Architecture
Civil Engineering
Stimmel Associates, PA Land Planning
601 N. Trade Street date: 8/22/2011 job #:
Suite 200
Winston Salem, NC project: Sheetz -King, NC
27101-2916
R336.723.1067
F: 336.723.1069
letter of transmittal
attn: NCDENR
to: 585 Waughtown Street
Winston-Salem, NC 27107
sent via:(-. Attached
C Under Separate Cover
r U.S. Mail ry By Hand
r Over Night Service r For Pick -Up
r Fax #
# of pages total = 1
We are sending you the following items:
rl Prints r Calculations r Base Drawings
Reproducibles Information r Correspondence
r Originals r- Specifications r Change Order/Addendum
r Diskette/CD
r Email with Attachments
r°
copies
sheet
dated
description
2
Complete set of Civil Drawings
2
Stormwater Management Permit Application
2
Bioretention O&M Agreement
2
Stormwater Management Binder with CalIcs., etc
remarks, comments, & details:
RECFIVED
AUG 2 3 2011
wu:
Rogional office
AUG 2 5 2011
"ETUWOS AND STORMWATER BRANCH
K noted enclosures are not received, please notify us.
copies to: File by: Bob Young

r✓First Submittal ❑ Re -submittal
Develop men UProject Name: S44
Receiving stream name M w4Q
River Basin: u . a01-
ie��-�
A-10+,WX f1i 44t. r.
Application Completeness Review
Date Received: S z �, Date Reviewed: V!�4
4j, By Bill Diuguid
� - k,� g .c , , rAlC.
Classification: e
For post -construction rerquirements, a program will be deemed compliant for the areas where it is
implementing any of the following programs: WS-I, WS-II, WS-lil, WS-IV, HQW, ORW, Neuse River Basin
NSW, Tar -Pamlico River Basin NSW, and the Randleman take Water Supply Watershed Nutrient
Manaqement Strateqv.
High Density Projects that require a 401/404 within an NSW require 85% TSS, 30% TN and 30% TP removal.
T&E Species (Goose Creek, Waxhaw Creek or Six Mile Creek Water Sheds): N
Latitude and Longitude: 3G Z 1 SG A( - so 3 3 g 0 W Jurisdiction S o C x C
Project Address: iul-A,- s rz crlbr,/ OF kiuG sTKxe r % oc A -u . !i:. )4 f G--d �/,,4��) 4-- mowu fa►
Engineer name and firm: S g - G o oAU ie .
Phone: Email: s ssm;-rx %...ram L,.�, c a^_
Is the project confirmed to be in the State MSI Stormwater Permit jurisdiction . R'Yes or ❑ No �P ��
❑ Low Density (no curb and gutter) ❑ Low Density with curb and gutter outlets i h Densit
-a^ 401/404 impacts to surface waters, wetlands, and buffers (add language tocoverletter and/or add info letter;
m," BUA 7S Pte6Jd ov-d /, Z 0 )1, r µAJ
51- Check for $505.00 included
R'' Original signature (not photocopy) on application
R'�' Legal signature (Corporation-VP/higher, Partnership -General Partner/higher, LLC-member/manager, Agent).
Check spelling, capitalization, punctuation: http://www.secretary.state.nc.us/corporations/thepage.aspx
If an agent signs the application, a signed letter of authorization from the applicant must be provided which
includes the name, title, mailing address and phone number of the person signing the letter.
❑ ,For subdivided projects, a signed and notarized deed restriction statement
&' ealed, signed & dated calculations
Correct supplement and O&M provided for each BMP on site (check all that were provided & number of each)
a,"'Bioretention
❑ Dry Detention Basin
❑ Filter Strip
❑ Grass Swale
❑ Infiltration Basin
❑ Infiltration Trench
❑ Level Spreader
❑ Permeable Pavement
❑ Restored Riparian Buffer
❑ Rooftop Runoff Management
❑ Sand Filter
❑ Stormwater Wetland
❑ Wet Detention Basin
❑ Low Density
❑ Curb Outlet
❑ Off -Site
❑ NCDOT Linear Road
Two sets of sealed, signed & dated layout & finish grading plans with appropriate details
m,- Narrative Description of stormwater management provided
Ll" Soils report provided
-a—Wetlands delineated or a note on the plans or in the accompanying documents that none exist on site and/or
djacent property
Details for the roads, parking area, cul-de-sac radii, sidewalk widths, curb and gutter;
a-imensions & slopes provided
Y Drainage areas delineated ❑ Pervious and impervious reported for each ❑ Areas of high density
a," BMP operation and maintenance agreements provided
Application complete ❑ Application Incomplete Returned: (Date)
Comments 09
Rd,
May 5, 2071 Revision, Bill Diuguid

Permit No'. -5k*1-0%bZ
(to be assigned by DWQ)
Ill REQUIRED. ITEMS _CHEG!([IST �`-
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Pagel Plan
Initials Sheet No.
K9 1. Plans (1" - 50' or larger) of the entire site showing:
Design at ultimate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Cell dimensions,
Pretreatment system,
High flow bypass system,
Maintenance access,
Recorded drainage easement and public right of way (ROW),
Clean out pipe locations,
Overflow device, and
Boundaries of drainage easement.
Rts 6-3.1 2. Plan details (1" = 30' or larger) for the bioretention cell showing
Cell dimensions
Pretreatment system,
High flow bypass system,
Maintenance access,
Recorded drainage easement and public right of way (ROW),
Design at ultimate build -out,
Off -site drainage (if applicable),
Clean out pipe locations,
Overflow device, and
Boundaries of drainage easement.
Indicate the P-Index between 10 and 30
2� C — 3•
3, Section view of the bioretention cell (V = 20' or larger) showing:
Side slopes, 3:1 or lower
Underdrain system (if applicable), and
Bioretention cell layers [ground level and slope, pre-treatment, ponding depth, mulch depth, fill media
depth, washed sand, filter fabric (or choking stone if applicable), 957 stone, underdrains (if applicable),
SHWT level(s), and overflow structure]
KKJ5 RPT.
4. A soils report that is based upon an actual field investigation, sail berings, and infiltration tests. The
S 1A P.
results of the soils report must be verified in the field by DN1Q, by completing & submitting the soils
p Pi
investigation request form. County soil maps are not an acceptable source of soils information. All
elevations shall be in feet mean sea level (fni Results of soils tests of both the planting sail and the in
situ soil must include
Soil permeability,
Soil composition (% sand, % fines, % organic), and
L^ I + Z
P-index.
5 A detailed planting plan (1" = 20' or larger) prepared by a qualified individual showing:
A variety of suitable species,
Sizes, spacing and locations of plantings,
Total quantity of each type of plant specified,
A planting detail,
The source nursery for the plants, and
Fertilizer and watering requirements to establish vegetation.
t-�
6. An assurance that the installed system will meet design specifications upon initial operation once the
project is complete and the entire drainage area is stabilized.
)QZ d C ` f ,0
7 A construction sequence that shows how the bioretention cell will be protected from sediment until the
entire drainage area is stabilized.
APT
3. The supporting calculations (including Underdrain calculations, if applicable).
l� KPT
9. A copy of the signed and notarized inspection and maintenance (I&M) agreement.
li
10. A copy of the deed restriction.
Form SW401 Bioretention-Rev,7 Part H. Page 1 of 1