SW7120302_CURRENT PERMIT_20120423

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPECURRENT
PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
d%1L�3
YYYYMMDD

��
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Walkid Dee Freeman
Governor Director Secretary
April 23, 2012
Eastern Pride Inc.
Attn: Mr. Barnes Boykin
2405-F Nash Street
Wilson; NC ' 27896--
Subject: Stormwater Permit No SW7120302
Family Dollar Store - Windsor
High Density Stormwater Project
Bertie County
Dear Mr. Boykin:
The Washington Regional Office received your completed application for a
Stormwater Management -Permit on March 12, 2012. Staff review of the plans
and specifications has determined that the subject project will comply with the
Stormwater Regulations set forth in Title 15A NCAC 2H.1000. We are
forwarding Permit No. SW7120302 dated April 23, 2012 for the subject project.
This permit shall be effective from the date of issuance until April 23, 2020, and
shall be subject to the conditions and limitations as specified therein. Please pay
special attention to the Operation and Maintenance requirements in this permit
and in the submitted application. Failure to establish an adequate system for
operation and maintenance of the stormwater management system will result in
future compliance problems.
If any parts, requirements, or limitations contained in this permit are
unacceptable, you have the right to request an adjudicatory hearing upon written
request within thirty (30) days following receipt of this permit. This request must
be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings,
P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demands are made
this permit shall be final and binding.
North Carolina Division of Water Quality Internet: wwwricwaterquality.or
943 Washington Square Mall Phone: [phone]
Washington, NC 27889 >'AX 252-946-9215
An Equal OpportunitylAffirmalive Action Employer — 50% Retycled110% Post consumer Paper
Nne
orthCarolina
Natmrallff

Page 2 of 9
Eastern Pride, Inc
April 23, 2012
Page Two
If you have any questions, or need additional information concerning this matter,
please contact either Bill Moore, or me at [phone],
Sincerely,
- - — ---- - --- - -. _ ..- !-Al Hodge--
Regional Supervisor
Surface Water Protection Section
cc: amlico Engineering Services, PLLC
ertie County Planning/Inspections
Washington Regional Office

Page 3 of 9
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH 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
Eastern Pride, Inc
Mr. Barnes Boykin
Berne County
FOR THE
construction, operation and maintenance of a wet detention system 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 part of this permit for
the Family Dollar Store located off US17 in Windsor, NC.
This permit shall be effective from the date of issuance until April 23, 2020 and
shall be subject to the following specified conditions and limitations:
1. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of
stormwater described in the application and other supporting data.
2. This stormwater system has been approved for the management of
stormwater runoff as described in Section 1.5 on page 4 of this permit.
3. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the
project will be recorded showing all such required easements, in
accordance with the approved plans and permit.
4. The tract will be limited to the amount of built -upon area indicated on page
4 of this permit, and per approved plans. The runoff from all built -upon
area within the permitted drainage areas of this project must be directed
into the permitted stormwater control system.

1
Page 4 of 9
5. The following design criteria have been provided for the construction of
the wet pond system and must be maintained at design condition:
a. Total Site Area: 1.64 acres
b. Impervious Area: 0.79 acres
C. Required Storage Volume: 4348 cf
d. Provided Storage Volume: 9607 cf
e. Provided Surface Area: 5046 sf
f. Design Storm: 1.5-inch
g. Receiving Stream: UT-Cashie River
h. Classification of Water Body: C-SW
II. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of
any built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded
areas of the system will be repaired immediately.
3. The permittee shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater system functions at
optimum efficiency. The approved Operation and Maintenance Plans
must be followed in its entirety and maintenance must occur at the
scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of bypass structure, filter media,
flow spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all
times.
4. Records of maintenance activities must be kept and made available upon
request to authorized personnel of DWQ. The records will indicate the
date, activity, name of person performing the work and what actions were
taken.

Page S of 9
5. The facilities shall be constructed as shown on the approved plans. This
permit shall become voidable unless the facilities are constructed in
accordance with the conditions of this permit, the approved plans and
specifications, and other supporting data.
6. Upon completion of construction, prior to issuance of a Certificate of
Occupancy, and prior to operation of this permitted facility, a certification
must be received from an appropriate designer for the system installed
certifying that the permitted facility has been installed in accordance with
this permit, the approved plans and specifications, and other supporting
documentation. Any deviations from the approved plans and
specifications must be noted on the Certification. A modification may be
required for those deviations.
7. If the stormwater system was used as an Erosion Control device, it must
be restored to design condition prior to operation as a stormwater
treatment device, and prior to occupancy of the facility.
8. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
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 any item shown on the approved plans, including
the stormwater management measures, built -upon area, details,
etc.
b. Project name change.
C. Transfer of ownership.
d. Redbsign or addition to the approved amount of built -upon area or
to the drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the
project area. The project area is defined as all property owned by
the permittee, for which Sedimentation and Erosion Control Plan
approval or a CAMA Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on
the approved plan.
10. The permittee shall submitfinal site layout and grading plans for any
permitted future areas shown on the approved plans, prior to construction.
11. A copy of the approved plans and specifications shall be maintained on
file by the Permittee at all times.
12. 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.

Page 6 of 9
13. This permit shall be effective from the date of issuance until April 23,
2020. Application for permit renewal shall be submitted 180 days prior to
the expiration date of this permit and must be accompanied by the
processing fee.
III. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the
Director. In the event of a change of ownership, or a name change, the
permittee must submit a formal permit transfer request to the Division of
Water Quality, accompanied by a completed name/ownership change
form, documentation from the 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 such time as
the Division approves the transfer request.
2. Failure to abide by the conditions and limitations contained in this permit
may subject the Permittee to enforcement action by the Division of Water
Quality, in accordance with North Carolina General Statute 143-215.6A to
143-215.6C.
3. 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 agencies (local, state, and
federal) having jurisdiction.
4. In the event that the facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate
corrective action, including those as may be required by this Division, such
as the construction of additional or replacement stormwater management
systems.
5. The permittee grants DENR Staff permission to enter the property during
normal business hours for the purpose of inspecting all components of the
permitted stormwater management facility.
6. 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.
7. Unless specified elsewhere, permanent seeding requirements for the
stormwater control must follow the guidelines established in the North
Carolina Erosion and Sediment Control Planning and Design Manual.
8. Approved plans and specifications for this project are incorporated by
reference and are enforceable parts of the permit. A copy of the approved
plans and specifications shall be maintained on file by the Permittee for
the life of the project.

Page 7 of 9
9. The permittee shall notify the Division of any name, ownership or mailing
address changes within 30 days.
Permit issued this the 23rd day of April, 2012.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number SW7120302

Page 8 of 9
Stormwater Permit No. SW7120302
Wet Detention Pond
Family Dollar - Windsor, NC
Bertie County
Designer's Certification
I, as a duly registered
in the State of North Carolina, having been
authorized to observe (periodically/ weekly/ full time) the construction of the
project,
(Project)
for (Project Owner) hereby state that,
to the best of my abilities, due care and diligence was used in the observation of
the project construction such that the construction was observed to be built within
substantial compliance and intent of the approved plans and specifications.
Note: The checklist on the following page must be included with this
Certification. Any changes or deviations from the approved plans and
specifications must be explained in detail, and may require a permit modification.
The certification forms should be submitted to the Division of Water Quality at the
appropriate Regional office.
SEAL
Signature
Registration Number
Date

Page 9 of 9
Com fete this checklist for each system and include with
Certification:
1. The drainage area to the system contains approximately the
permitted acreage.
2. The drainage area to the system contains no more than the
permitted amount of built -upon area.
3. All the built -upon area associated with the project is graded such
that the runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the
system.
5. The bypass structure elevations are per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the outlet/bypass structure.
8. All slopes are grassed with permanent vegetation.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause
short-circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved
plans.

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Direcror
Eastern Pride, Inc.
Attention: Mr. Barnes Boykin
2405-F Nash Street West
Wilson, NC 27896
Dear Mr. Boykin:
wA(ko
NORTH CAROLINA
Environmental Quality
September 25, 2019
Subject: Stormwater Permit No. SW7120302 Renewal
Family Dollar Store - Windsor, NC
High Density Stormwater Project
Bertie County
A Division of Energy, Mineral, and Land Resources file review has determined that
Stormwater Permit SW7120302 for a stormwater treatment system consisting of a wet
detention pond serving a Family Dollar Store located on US Hwy 17 in Windsor, NC
expires on April 23, 2020. This is a reminder that permit renewal applications are due
180 days prior to expiration. We do not have a record of receiving a renewal application.
Please submit a completed permit renewal application along with a $505.00 fee for
permit renewal. Permit application forms for renewal can be found on our website at:
httos.//dea.nc.eov/about/divisi.ons/enerev.-mineral-land-resources./elierl±v-min(-,i-al-1and-
rules/stormwater-program/post-construction. North Carolina General Statutes and the
Coastal Stormwater rules require that this property be covered under a stormwater
permit. Failure to maintain a permit subjects the owner to assessment of civil penalties.
If you have questions, please feel free to contact me at [phone]. 1 will be glad to
discuss this by phone or meet with you. If you would like, I can e-mail you a copy of the
application forms. You can request a copy by e-mailing me at
[e-mail].
Sincerely,
Roger K. Thorpe
Environmental Engineer
®� North Caroltna Department of Environmental Quallty I DIvlslon of Energy. Mineral and Land Resources
Washingtnn Regional Office ! 943 Washtngton Square Mall j Washington, North Carolina 27889
rnwuurm\ 252.946.6481

Page 8 of 9
Stormwater Permit No. SW7120302
Wet Detention Pond
Family Dollar - Windsor, NC
Bertie County
Designer's Certification
RECEIVED 5M
S P P 1 2 2012
DWQ-WARO
�Marie .0 Peedin , as a duly registered
engineer in the State of North Carolina, having bden
authorized to observe (periodically/ weekly/ full time) the construction of the
project,
Family Dollar Windsor
(Project)
for . Eastern Pride, Inc (Project Owner) hereby state that,
to the best of my abilities, due care and diligence was used in the observation of
the project construction such that the construction was observed to be built within
substantial compliance and intent of the approved plans and specifications.
Note: The checklist on the following page must be included with this
Certification. Any changes or deviations from the approved plans and
specifications must be explained in detail, and may require a permit modification.
The, certification forms should be submitted to the Division of Water Quality at the
appropriate Regional office.
,�,�1l411111///
•v
• SEAL
Signature 20212 ; z M
20212
Registration Number ___ __ 'F''���INE : • Qti
�4� ......• `Ay
Date 9/12/12 soy/I JI a!"%

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Page 9of9
Complete this checklist for each system and include with
Certification:
/ 1: The drainage area to the system contains approximately the
permitted acreage.
�2. The drainage area to the system contains no more than the
/ permitted amount of built -upon area.
r 3. All the built -upon area associated with the project is graded such
that the runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the
system.
5. The bypass structure elevations are per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the outletlbypass structure.
/---'8. All slopes are grassed with permanent vegetation.
9. Vegetated slopes are no steeper than 3:1.
""Do. The inlets are located per the approved plans and do not cause
short-circuiting of the system.
1. The permitted amounts of surface area and/or volume have been
provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved
plans.

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II 'Date Received I Fee Paid I Permit Number . H
Applicable Rules: ' ❑ Coastal SW -1995 ❑ Coastal SW - 2008 0 Ph 11- Post Construction
(select all drat apply) ❑ Non-Coastl SW- HQW/0RW Waters 0 Universal Stormwafer Management Plan
State of North Carolina RECEIVED
Department of Environment and Natural Resources
Division of Water Quality
MAC 1 2 2012
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
77usform may be P&ftcopWfbr use as an original � V V Q "` Y Y /"►
L GENERAL INFORMATION
I. Project Name (subdivision, facility, or establishment name - sb=W be consistent with project name on plans,
specifications, letters, operation and mah !mince agreements, etc.):
Windsor - Fam>7 Dollar
2- Location of Project (street address):
us 17Im
City: Win County:ff!ie zip:
3. Directions to project (from nearest major intersection):
4. Latitude:.35 ° W 20" N Longitude:76 ° 55' 50" W of the main entrance to the project.
IL PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New E Modf cation
b. If this application is being subndtted as the result of a umulifteatio9n to an existing permit;, list the eding
permit number , its issue date (if known _ _ _ , and the status of
construction: ONO Started QPartially Completed' C] Completed* "provide a designer's cae 6feaation
2 Specify the type of project (check one):
[3I.aw Density ®High Density DDrams to an Offsite Stormwater SySteui []Ocher
3. if this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project; if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 14877-623-6748):
DCAMA Major ®Sedimentation/Erosion Control• 1.64 ac of Disturbed Area
❑NPDES Industrial Stormwater 0404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the typeof each permit
Farm S WU-101 Version Mut}2009 Page I of 6
/AA

It

III. -CONTACT INFORMATION
1. a. Print Applicant / Signing Offid0s name and tittle (specifecaIIy the developer, property owner, lessee,
designated government official, individual, etc. who owns the 'ect
Applicant/Organization:gastern Pride Inc.
S Official & Title:Harnen kin
b.Corrtact information for person listed in item is above:
Street Address:2405-F Nash Street _ -
City -Willson State:NC zip:rlg9G
Mail g Address (if applicable):
Phone: L252 ) 230.0632
Email
State: Zip:
F,WC ( _ ) • -
c. Please check the appropriate box. The applicant listed above is:
❑ The property owner .(Slap to Contact Information, item 3a)
❑ Lessee' (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
0 Purchaser„ (Attach a copy of the pending sales agreement and complete Contact Information, item 2a, mtd
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owners name and title below, if you are the lessee, purchaser or developer. (IItis is the
person who owns the property that the project is located on):
Property Owner/Organization:RCF Proxy, LLC
Signing Official & Title:Robin Labancz
b. Contact information for person listed in item 2a above:
Street Address.964 Millwood Dr
City:Hartlett State --II. Zip:6010Ci
Mailing Address (if applicable):
CftT-
Phone: ( ) §aLW0-2417
Email
Star Zip:
Fax:
3. a. (Option4 Print the name and title of another contact such as the project's construction supervisor or other
person who can answer guestiorm about the project:
Other Contact Person/Organization ��l}r -Stock aid T tl�__
Signing Official & Title:Selderi Ta E t
b.Contact information for person listed in item 3a above:
Mailing Address:1825 Ave
City:Was n
Phone: 252 ) , 975-5855
Email
State:NC zipmW
Fax: -
4. Local jurisdiction for banding permit$; p2ft Co.
Point of ContartTraci 4Vhi pho -
Form SWU-101 Version 07Jaly2oo9 Page 2 of 6

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IV. , PROJECT INFORMATION
I. In the space provided below, bneft summarize how the skirmwater runoff will be heated.
E!gmwaterrunoff from a low Am
!hw oirefflow-hity the dmM1ggMM1 shall k kmkd bX a wet god
before into a h*u" of Cashke Rhre-x
2- aL lE claiming vested rights, identify the supporting documents provided and the date d" were approved:
❑ Approval of a Site Specific Developmgnt Plan or PUD Approval Date-..
❑ Valid Building Permit Issued Date:
OHM- Date:
b. Identify the regulation(s) the project has been designed in awwdanoe with.
ElCoastal SW - 1995 n Ph H - Post Construction
3. StDrInWater runoff from this project drains to the Roanoke . River basin.
t Total Property Area: 1.64 --ac" 5. Total Coasted Wetlands Area: 0 aQes
6. Total Surface Water Area&—acreff
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Toted Surface Water Area (6) - Total Project
Area*: 1.64 acres
+ Total = area shall be calculated to exclude dzefbllm� the normal pool of nded structum, dir am
between bunks of streamr, and rivers, the area below the L= High gag = line or h1am Hgh Water
(MHK9 line, and coastal wetlands kn&ard ftm ft NHW (or MHVO line. The resultant prpl�ect area is used to
calculate overall percent built upon am (BWA). Non -coastal wetlands landward of the NTW?orAIWM ihw may
be included in the total project area
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 48.54
9 How many drainage areas does the project have?j, (For high density, count I for each proposed engineered
stormwater BMP For low dentsity and other projects, use 1 for the whole property area)
10 Complete the following information for each drainage area identified in Project Information item 9. If thime
are more than four drainage areas in the propM attach an additional sheet with the information for each area
provided in the same format as below.
Rec&,rft Stream Name
Trffi to CaShk
River
Stream Class
C-sw
Stream Index Number
24-2-9
Toted Drainage Area (sf)
71=5
Ile-
On,site Drairap Area (!a_
71225
Off -site DrAreas
0
I Pro!!!o�us Area** (sO
1 34575
I % 4nqMs Area- total1
4834
.Mq=Vio
Area
On -site Buildings/Lots
8"
0
0
On -site Streets
0
On -site E!1k!M M
25405
On -site Sidewalks (sf)
1170
0
Other on -site
0
Futures
0
0
Off -sines
0
0
tin BUA—
0
Total (st):-
M575
- Strearn Class and In&,xVwn*r c= be &&"=wdzk hft.1M."wstate.Mail
Form SWU-101 Version 07JuJy2009 Pap 3 of 6

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Impemim area is defined as the built upon area including; but not limited to, buildings, roads, parking areas,
shlewalb, gravel areas, etc.
Report only that amount gf'aishng BUA that will remain after dwdW=enL Do not report any existing BUA that
is to be removed and whkh wiU be mq&md by new BUA.
11. How was the off -site impervious area listed above determb d? Provide documentation. NA
Prt►fset$ in Uuigg County: Contact DWQ Central Office staff to cheek f Ox project Is located within a Tk aterrad &
Endangered Species watershed that may be subject to more sMngerrt stormivater repmerrrents as per NC4C 02B .0600
IIVyJ;X 'Illy,
The applicable state stormwater managemerd permit supplement and operation and mainteuanm (O&M) forms
must be submitted for each BMP specified for this project The latest versions of the forms can be downloaded
from h=.//h2o.enr-statp-nc.us/sn/`hmR fnTans.hW
VI. SUBMITTAL REQUIREMENTS
Only c mpletse application packages will be awepted and reviewed by the Division of water Quality WWQ,).
A o mplete package includes all of the fbems listed below. A detailed application hutruction sheet aad B?"
checklists are available from htty� / /h2 ,SflXAtate.nc.usZsulbmp forms.htm. The complete application
package should be submitted in the appropriate DWQ Office. (The appropriate office may be found by locating
project on the interactive online map at httmLLh2o.enrstatenc.us/su/ msi_mamim.)
Please indicate that the following required information have been provided by initialing in the space provided for
each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions for
each submitted application package from h h2o.enr tage.nC.us su bm fo
1. Original and one copy of the Stormwater Management Permit Application Form.
2 Original and one copy of the signed and nohwized Deed Restrictions & Protective Covenants
Form. {if requirrd as per Fart irII below}
3. Original of the applicable Supplement Form(s) (sealed, gWMd and datedl and O&M agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR (For an Express review, refer to
hft:/ ImnnY.oyhelR.oK& IRUM JgMMhWgxRMsELhtml for information on the Express program
and the associated fees. Contact the appropriate regional office Express Perma Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwat m treatment/managemefti for V
6. A USGS map identifying the site locatim if the receiving scream is reported as class SA or the
receiving stream drains to class SA waters within 1h mile of the site boundary, include the %
mile radius on the map.
7. Sealed, signed and dated calculations.
8. Two sets of plans f9lded W 8.F x 14" (sealed, signed, & dated), including-.
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g Revision number and dates.
h Ideattify all surface waters on the plans by defines g the normal pool eleva&m of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Dethumte the vegetated buffer landward from the normal pool elevation of impounded
struchires, the banks of streams or rivers, and the MHW (or NHW) of tidal wagers.
L Dimensioned property/ project boundary with bearings & distances.
j. Site Layout with all BUA ideri ied and dimensioned.
k. Existing contours, proposed commas, spot elevations, finished floor elevations.
L Details of roads, drainage features, collection systems, and stormwater control measures.
in. Wetlands delineated, or a note on the plans that none eidst. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the ppl1an
n- Existing drainage (including adf�e, drainage easements, pipe sizes, runoff calculatiom
Form S WU-101 Version Muly2009 Page 4 of 6 _ /

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o. Drainage areas delineated (included in the retain set of plams, not as a separate document).
p. Vegetated buffers (where required).
9 Copy of any applicable sails report with the associated SI1{ T elevatiom (Please identify !
elevations in addition to depths) as well as a map of the boring locatiom with the existing
elevations and boring logs. Include an S.Y'xlr copy of the NRC5 County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(bfiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book M Page No: S61
11. For corporations and limited liability corporations gLCj: Pmvide document ion from the NC
Secretary of State or other official documentation, which supports the titles and pins held
by the persons listed in Contact Information, item la, 2a, and/or 3a per NCAC 2111003(e). The
corporation or LLC must be listed as an active corporation is good standing with the NC
Secretary of State, otherwise the application will be rebaoated.
hut-!/www.seard"; .statencus/CQrparatians/C r+ch.aspx
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development; fire appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot If lot sizes vary sJA `cantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable budt-upon area must be
provided as an attachment to the completed and notarized deed won form. The appropriate deed
restrictions and protective covenants farms can be downloaded from
ht#}�J/1�2a.enr state n&, g forms.htmideed restrictions. Download the latest versions for each submittal
In the instances where the applicant is different than the property owner, it is the respor>sibiMty of the property
owner to sign the deed restrictions and protective covenants form whole the applicant is responsible for emmft
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holders) certify that the recorded property restrictions and
eve covenants for this project, if required, shall include all the items required in the pe a dt and hftd
on the farm available on the website, that the covenants will be binding on all parties and persons cl
under them, that they will ran with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ, and that they will be recorded prior to the sale of any lot
VIIL CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing regmm for additional information).
Consulting Engirreer:Marie U. Peedin, PE
Consulting Firm: Pamlico En¢irtieOM Sery , PLI
Mailing Address:M Abbgy Lance„ .
City:Was n Stater, _ . . Zip: - - -
Phone: (PZ I. 2I 2983 Fax (252 ) W44-7618
IX PROPERTY OWNER AUTHORIZATION (of Contact homnatian, inert 2 has been filtad out o n*k this
section)
ZQ� t I, (print or type name of person Iistrd in Contact Infor»ruhian, item 2a) 66 � �' C ,certify that I
own the property identified in this permit application, and thus give permission to (print or type name of pensmi
listed irc Contrrrt In%rntation, item 1a) Barry Botdan _ _ with (print or type name of agwuration fisted fn
Contact InPnnation, item 1b) Easkm Pride Inc. - _ to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maird etunce of the stormweter system.
Form SW-101 Version 071ul 2009 Page 5 of 6

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As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
Iease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
1 S-e-
Date• `a"'� t�
Aa Notary Public for the State of County of
do hereby certify that J >A AAA) C 2 - personally appeared
before me this day of and aAnoitfledge the 7due execution of the application for
a stormwater permit. Witness my hand and official seal, w wja�
win
OFFICIAL SEAL
DENISE A HAYES
NOTARY PUBLIC - STATE OF RIMOis
MY COMMISSION WIRES-.12W2
X. APPLICANT'S CERTIFICATION
SEAL
My commission expires ) a - d "-
I, (print or type name of person listed in Contact Information, item 2) Barnes Boykin
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 2H .1000, SL 2006-246 (Ph. II - Post Construction) or SL 2008-211.
Signature: Date.
a Notary Public for the State of . County of
do hereby certify that personally appeared
before me this _ day of . and acknowledge the due execution of the application for
a stormwater permit Witness my hand and official seal,
SEAL
My commission expires
Form SWu-101 Version 07Ju1y2009 Page 6 of 6

r
sf

X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 2) Barnes Boutin _ ,
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormw r rules under 15A CAC 2H .1000, SL 2006-246 (Ph. H -Post Construction) or SL 2008-211,
Signature-, Date: 21,;? l�
L I LX a N Public for late ofOAA&&--�County of
do1heby certify that f.2Q _, a personally appeared
before me y oand acknowledge the due execution of the application for
a stormwater permit. Witness my hand a�6 official seal, 19 a 120 ! 1--
SEAL
My commission expires
Form S WU-101 Version 07Ju1y2009 Page 7 of 7

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Permit Nurnber:
(to he provided by Dtl'O)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
1 will keep a maintenance record on this BMP. ]'his maintenance record will be kept in a
log in a known set location. Any deficient BMP elements notes{ in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
The wet detention basin system is defined as the wet detention basin, P%ECEIVED
pretreatment including forebays and the vegetated filter if one is provide
This system (check one): MAR 1 2 2012
❑ does ® does not incorporate a vegetated filter at the outlet. `��
This system (check one): D �l ►� Qr Y ►t`nJ
ARC
® does ❑ does not incorporate pretreatment other than a forebay.
Important maintenance procedures:
— Immediately after the wet detention basin is established, the plants on the
vegetated shelf and perimeter of the basin should be watered twice 'meekly if
needed, until the plants became established (commonly six weeks).
— No portion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
— Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— If the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
— Once a year, a darn safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected once a month and
within 24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a
Coastal County). Records of operation and maintenance should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How 1 will remediate theproblem:
The entire BMP
"Trash/debris is present.
Remove the trash/debris.
The perimeter of the wet
Areas of bare soil and/or
Regrade the soil if necessary to
detention basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of
long.
approximaMy six inches.
Forrn SW401-Wet Detention Basin O&M-Rev.4
Page 1 o I' 4

Permit Number:
(ro he provided by DfVO)
Drainage Area NUmbe[':
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
The pipe is clogged.
Unclog the pipe. Dispose of the
Swale
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the Seale if necessary to
Swale,
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible. Remove the sediment and
sediment storage.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
)erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than s ravin .
The vegetated shelf
Best professional practices
Prune according to best professional
show that pruning is needed
practices
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessaa.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying,
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design sediment
possible. Remove the sediment and
storage depth.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over
Consult a professional to remove
50% of the area.
and control the algal growth.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray).
the basin surface.
Norm SW40I-Wct Dctention Basin O&M -Rev. } .l'agc 2 of 4

Permit Number:
(Nt be prodded by /AVQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs re Eair. if applicable)
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of -
Contact the local NC Division of
damage have occurred at the
Water Quality Regional Office, or
outlet.
the 401 Oversight Unit at 919-733-
1786.
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads 4 • feet in the main pond, the
sediment shall be removed.
When the permanent pool depth reads _ feet in the forebav, the sediment
shall be removed.
13ASIN DIAGRAM
(fill in the blanks)
Scdimcnt Removal IE . t.0 Pe manen\
Volume
Bottom lElevatiot 3 -� - --
- -tt Min.
Sediment
Storage
FOREBAY
Form SW401-Wct Detention Basin O&M-Rcv.4
Permanent Pool Elevation -7'137-
Pool
Sediment Removal I levation 3 Volume
1------------
Bottom (Elevation
MAIN POND
Page 3 of 4
Sediment
Storage

Permit Number:
(to be provielcei by D)VO)
acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project nome:Family Dollar Windsor
BW clraintige cn•eu nunther:
Print name:Barnes Boykin
Title: jit,—".4 -'a
Address:2405 -F Nash Street, Wilson, NC 27896
Phone: 41S,;7 --;230 -d <3 .2 _...,
Signature: L-�—i
Date: S2-�R�Z, Z7
Note: The legally responsible party should not be a homeo,,%,ricrs association unless more than 50% of
the lots have heen sold and a resident ol'thc subdivision has been named the president.
I. a Notary Public for the State of
County of do hereby certify that
D ersonally appeared before me this
day of a�,a , and acknowledge the due ezccution ofthe
forgoing wet detention asin maintenance requirements. Witness my hand and official
seal,
���•�A F Wlf �i,�.
9'1�ll'; 1 CO a�
IIIW4%a
SEAL
My commission expires
Form SW401-Wet Detention Basin O&M-Rev.4
i,age 4 of 4

Permit No.
(to be provided by DW4)
F� _QaoF w a r�,gQG
NCDENR a
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be filled out, printed and submifted.
The Required Items CheckW (Part 110 must be printed, filled out and submitted along with an of fhe required imkxma6on.
I. PROJECT INFORMATION
Project name Family Dollar - Windsor
Contact person Marie U Peedin, PE
Phone number 252-945.2983
Date
Drainage area number 1
II. DESIGN INFORMATION
Site Characteristics
E4 GtG
Drainage area
Impervious area, post -development
71,225 1e
34,575 fe
% impervious
48.54 %
Desgn rainfall depth
1.5 in
Storage Volume: Non -SA Waters
Minimum volume required
4,348 ft3
OK
Volume provided
9,607 ft'
OK; volume provided is equal to or in excess of volume required.
Storage Volume: SA Waters
1.5' runoff volume
ft3
Pre -development 1-yr, 24-hr runoff
ft3
Post -development 1-yr, 24-hr runoff
ft3
Minimum volume required
fe
Volume provided 113
Peak Flow Caicutations
Is the prelpost control of the 1yr 24hr storm peak flow required?
1-yr, 24-hr rainfall depth
Rational C, predevelopmerd
Rational C, post -development
Rainfall intensity:)-yr, 24-hr storm
Pr"evelopment 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
PrafPost 1-yr, 24-hr peak flow control
Elevations
Temporary pool elevation
Permanent pool elevation
SHWT elevation (approx. at the perm. pool elevation)
Top of 10ft vegetated shelf elevation
Bottom of 10111 vegetated shelf elevation
Sediment deanout, top elevation (bottom of pond)
Sediment deanout, bottom elevation
Sediment storage provided
Is there additional volume stored above the state -required temp. pod?
Elevation of the top of the additional volume
Y (Y or N)
3.1 in
0.35 (unitless)
0.44 (unitless)
0.13 inlhr
0.07 831sec
0.10 ft )sec
0.03 fP/sec
Insufficient. Check intensity calculation.
RITIsl 8 - 'Y--
7.50 fmsl
7.50 fmsl
8.00 fmsl
7,00 fmsl
3,00 fmsl
2.00 furs!
1.00 ft
Y (Y or N)
9.0 irnsl OK
RECEIVED
MAR 1 2 2012
oW4-waRo
Form SW401-Wet Detention Besiri-Rev.8-9/17109 Parts I. a II. Design Summary, Page 1 of 2

Permit No.
00 be provided by DWQ)
1
II. DESIGN INFORMATION
Surface Areas
Area, temporary pool 7,764 ftZ
Area REQUIRED, permanent pool 2,977 ft2
SAIDA ratio 4.18 (unitless)
Area PROVIDED, permanent pool, A,.r,,,_ ,q
5,046 ft
OK
Area, bottom of 1 Oft vegetated shelf, Ab ,,,a
3,607 e
Area, sediment deanout, top elevation (bottom of pond), Abrya„ d
1,921 ft`
Volumes
Volume, temporary pool
9.607 it
OK
Volume, permanent pod, VP—JXKA
11,056 ft3
Volume, forebay (sum of forebays if more than one forebay)
2,000 ft3
Forebay % of permanent pool volume
18.1 % %
OK
SAIDA Table Data
Design TSS removal
90 %
Coastal SAIDA Table Used?
Y (Y of N)
Mountain/Piedmont SAIDA Table Used?
N (Y or N)
SAIDA ratio
4.18 (unitless)
Average depth (used in SAIDA table):
Calculation option 1 used? (See Figure 10-2b)
N (Y or N)
r
Volume, pemianent pool, Vpem-pad
11,056 ft,
Area provided, permanent pool, Ap rm_pw
5,046 W
Average depth calculated
2.07 ft
Need 3 0 min.
Average depth used in SAIDA, dN, (Round to nearest 0.5ft)
4.0 ft
Insufficient. Check calculation.
Calculation option 2 used? (See Figure 10.2b)
y (Y or N)
Area provided, permanent pool, A, ,m_pw
5,046 ft`
Area, bottom of 10ft vegetated shelf, AbLdw
3,607 ft
Area, sediment cleanout, top elevation (bottom of pond). Abo_,w
1,921 fe
'Depth' (distance btw bottom of 1 Oft shelf and top of sediment)
4.00 ft
Average depth calculated
4.00 ft
OK
Average depth used in SAIDA, d. (Round to nearest 0.511)
4.0 It
OK
Drawdown Calculations
Drawdown through orifice?
Y (Y or N)
Diameter of orifice (tl circular)
1.50 in
Area of orifice (if -non -circular)
in'
Coefficient of discharge (Co)
0.60 (unitless)
Driving head (Ho)
0.50 fl
Drawdown through weir?
N (Y or N)
Weir type
(unilless)
Coefficient of discharge (C.)
(unidess)
Length of weir (L)
ft
Driving head (H)
ft
Pre -development 1-yr, 24-hr peak flow
0.07 R31SK
Post -development 1-yr, 24-hr peak flow
0.10 ft3lsec
Storage volume discharge rate (through discharge orifice or weir)
0,02 ft3lsec
Storage volume drawdown time
2.00 days
OK, draws down in 2-5 days.
Additional Information
Vegetated side slopes
Vegetated shelf slope
Vegetated shelf width
Length of flowpath to width ratio
Length to width ratio
Trash rack for overflow & orifice?
Freeboard provided
Vegetated filter provided?
Recorded drainage easement provided?
Capures all runoff at ultimate build -out?
Drain mechanism for maintenance or emergencies is:
3 :1
OK
10 :1
OK
10.0 it
OK
3 :1
OK
2.0 :1
OK
Y
(Y or N)
OK
Y It
OK
N
(Y or N)
OK
n
(Y or N)
Insufficient. Recorded drainage easement required.
Y
(Y or N)
OK
Sump pump
Form SW401-Wet Detention Basin-Rev.8-9117r09 Parts I. & II. Design Summary, Pape 2 of 2

Permit No.
,► (to be provided by DWQ)
III. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found, An incomplete submittal package will
result in a request for additional Information. This wilt 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.
Paget Plan
ATSheet No.
C-amz
C_60 3
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),
- Basin dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROW),
- Overflow device, and
- Boundaries of drainage easement.
2. Partial plan (1" = 30' or larger) and details for the wet detention basin showing:
- Outlet structure with trash rack or similar,
- Maintenance access,
- Permanent pool dimensions,
- Forebay and main pond with hardened emergency spiltway,
Basin cross-section,
Vegetation specification for planting shelf, and
- Filter strip.
3. Section view of the wet detention basin (1" = 20' or larger) showing:
- Side slopes, 3:1 or lower,
- Pretreatment and treatment areas, and
- Inlet and outlet structures.
4. If the basin is used for sediment and erosion control during construction, clean out of the basin is specified
on the plans prior to use as a wet detention basin.
` - v r4- 5. A table of elevations, areas, incremental volumes & accumulated volumes for overall pond and for forebay,
to verify volume provided.
-a o3 6. A construction sequence that shows how the wet detention basin will be protected from sediment until the
entire drainage area is stabilized.
� n
•4!' 7. The supporting calculations.
8. A copy of the signed and notarized operation and maintenance (O&M) agreement.
9. A copy of the deed restrictions (if required).
_ 'dv 10. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. County
soil maps are not an acceptable source of soils information.
Form SW401-Wet Detention Basin-Rev.8-9117109 Part Ill. Required Items Checklist, Page 1 of 1