SW8060305_CURRENT PERMIT_20200910 (2)

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO. I SWg&_e25�6_
� DOC TYPE [CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE 7i la
YYYYMMDD

ROY COOPER
Governor
MICHAEL S. REGAN
secretary
BRIAN WRENN
Director
NORTH CAROLINA
September 10, 2020 Environmental Quality
ABA Mini -Storage, Inc.
Attn: Alan S. Ambrose, President
6635 Gordon Road
Wilmington, NC 28411
Subject: State Stormwater Management Permit No. SW8 060305 MOD
Gordon Road Storage
High Density Project
New Hanover County
Dear Mr. Ambrose:
The Wilmington Regional Office received a complete, modified State Stormwater Management Permit Application for
the subject project on June 25, 2020. Staff review of the plans and specifications has determined that the project, as
proposed, will comply with the Stormwater Regulations set forth in (1995 Rules) as amended by Session Law (SL)
2006-246, Session Law (SL) 2008-211, and subsequently amended on January 1, 2017 (2017 Rules) Title 15A NCAC
2H.1000 effective January 1, 2017. We are forwarding modified Permit No. SW8 060305, dated September 10, 2020,
for the construction, operation and maintenance of the stormwater control measures (SCMs), built -upon areas, as well
as the stormwater collection system and/or vegetated conveyance system associated with the subject project. Please
replace the previously approved plan sheets with the attached modified and approved versions. Please replace the
previous application (SWU--101) and Operation & Maintenance Agreement, with the attached modified versions.
This permit shall be effective from the date of issuance until April 12, 2028 and shall be subject to the conditions and
limitations as specified therein and does not supersede any other agency permit that may be required. Please pay
special attention to the permit conditions regarding the operation and maintenance of the SCMs, stormwater collection
system, and/or vegetated conveyances; the limitation of built -upon area; modification of the project; the procedures for
changing ownership of and/or transferring the permit; and the need to renew the permit. Please also pay attention to the
permit conditions that requires the recordation of deed restrictions and protective covenants, casements, and the
maintenance agreement, which must all be provided along with certification upon completion of the project. Failure to
comply with these requirements will result in future compliance problems.
The following modifications are included and covered by this permit:
• Constructing sidewalks consisting of an additional 440 square feet of built -upon area (BUA), which brings the
total BUA.to 109,640 square feet -
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an
adjudicatory hearing by filing a written petition with the Office of Administrative Hearings (OAH). The written
petition must conform to Chapter 150B of the North Carolina General Statutes and must be filed with the OAH within
thirty (30) days of receipt of this permit. You should contact the OAH with all questions regarding the filing fee (if a
filing fee is required) and/or the details of the filing process at 6714 Mail Service Center, Raleigh, NC 27699-6714, or
via telephone at 919-431-3000, or visit their website at www.NCOAH.com. Unless such demands are made this permit
shall be final and binding.
If you have any questions, or need additional information concerning this matter, please contact Steve Pusey in the
Wilmington Regional Office, at [phone].
Sincerely,
16Brian Wrenn, Direc.Wr
Division of Energy, Mineral and Land Resources
DES/sgp: I11StormwaterlPermits & Pro3ects120061060305 HD12020 09 permit 060305
cc: Phil Tripp, PE — Tripp Engineering
New Hanover County Building Safety Department
New Hanover County Engineering Department
Wilmington Regional Office Stormwater Fife
®� �O North Carolina Department Di Environmental Quality ! Division of Energy. Mineral and Land Resources
` •/ Wilmington Regional Office 1 127 Cardinal Drive Extension E Wilmington, North Carolina 28405
Ncani;:aaq
0-M 910.796.7215

State Stormwater Management Systems
Permit No. SW8 060305 MOD
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
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
ABA Mini -Storage, Inc.
Gordon Road Storage
6631 & 6639 Gordon Rd - New Hanover County
FOR THE
construction, operation and maintenance of a wet detention pond 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 Energy, Mineral and
Land Resources (the "Division" or "DEMLR") and considered an enforceable part of this
permit.
This permit shall be effective from the date of issuance until April 12, 2028 and shall be
subject to the following specified conditions and limitations:
I. 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 1.6 on page 3 of this permit. The stormwater
control has been designed to handle the runoff from 109,640 square feet of
impervious area.
3. The tract will be limited to the amount of built -upon area indicated on page 3 of
this permit, and per approved plans. There is no impervious area available for
future development in this permit.
4. 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.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
Page 2 of 6

State Stormwater Management Systems
Permit No. SW8 060305 MOD
0
The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a. Drainage Area, acres:
Onsite, ft2:
Offsite, ft2:
b. Total Impervious Surfaces, ft2:
C. Design Storm, inches:
d. Pond Depth, feet:
e. TSS removal efficiency:
f. Permanent Pool Elevation, FMSL:
g. Permanent Pool Surface Area, ft2:
h. Permitted Storage Volume, ft3:
i. Temporary Storage Elevation, FMSL
j. Controlling Orifice:
k. Permitted Forebay Volume, ft3:
I. Receiving Stream/River Basin
m. Stream Index Number:
n. Classification of Water Body
II. SCHEDULE OF COMPLIANCE
4.07
177,289
0
109,640
1
6.0
90%
41.6
8,111
11,251
42.8
1.25" O pipe
3,912
Smith Creek I Cape Fear
18-74-63
"C; Sw"
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 the design
condition. The approved Operation and Maintenance Plan 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 outlet structure, orifice device, flow
spreader, catch basins and piping.
g. Access to the outlet structure must be available at all times.
Page 3 of 6

State Stormwater Management Systems
Permit No. SW8 060305 MOD
4. Records of maintenance activities must be kept and made available upon
request to authorized personnel of DEMLR. The records will indicate the date,
activity, name of person performing the work and what actions were taken.
5. Decorative spray fountains will be allowed in the stormwater treatment system,
subject to the following criteria:
a. The fountain must draw its water from less than 2' below the permanent
pool surface.
b. Separated units, where the nozzle, pump and intake are connected by
tubing, may be used only if they draw water from the surface in the
deepest part of the pond.
c. The falling water from the fountain must be centered in the pond, away
from the shoreline.
d. The maximum horsepower for a fountain in this pond is 1/8 horsepower.
7. 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.
8. The facilities shall be constructed, operated and maintained in accordance with
the provisions of this permit, the approved plans and specifications, and the
supporting documents attached to this permit and on file with the Division.
8. 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.
9. No person or entity, including the permittee, shall alter any component shown in
the approved plans and specifications. Prior to the construction of any
modification to the approved plans, the permittee shall submit to the Director, and
shall have received approval for modified plans, specifications, and calculations
including, but not limited to, those listed below. For changes to the project or
SCM that impact the certifications, a new or updated certifcation(s), as
applicable, will be required and a copy must be submitted to the appropriate DEQ
regional office upon completion of the modification.
a. Any modification to the approved plans and specifications, regardless of
size including the SCM(s), BUA, details, etc.
b. Redesign or addition to the approved amount of BUA or to the drainage
area.
c. Further development, subdivision, acquisition, lease or sale of any, all or
part of the project and/or property area as reported in the approved plans
and specifications.
d. Altering, modifying, removing, relocating, redirecting, regrading, or resizing
of any component of the approved SCM(s), the stormwater collection
system and/or vegetative conveyance shown on the approved plan.
e. The construction of any allocated future BUA.
f. The construction of any permeable pavement, #57 stone area, public
trails, or landscaping material to be considered a permeable surface that
were not included in the approved plans and specifications.
g. Other modifications as determined by the Director.
Page 4 of 6

State Stormwater Management Systems
Permit No. SW8 060305 MOD
11. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
12. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
13. A copy of the approved plans and specifications shall be maintained on file by
the Permittee for a minimum of ten years from the date of the completion of
construction.
14. 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.
III. GENERAL CONDITIONS
Current Permittee Name or Address Changes: The permittee shall submit a
completed "Permit Information Update Application Form" (available on the
Division website) to the Division within 30 days to making any one or more of the
following changes:
a. A name change of the current permittee;
b. A name change of the project;
c. A mailing address change of the permittee;
2. This permit is not transferable to any person or entity except after notice to and
approval by the Director. The permittee shall submit a completed and signed
"Permit Transfer Application Form" (available on the Division website)
accompanied by the required fee and supporting documentation as listed on the
form, to the Division at least 60 days prior to any one or more of the following
events:
a. The sale or conveyance of the project area in whole or in part, except in
the case of an individual lot sale that is made subject to the recorded deed
restrictions and protective covenants-
b. Dissolution of the partnership, corporate, or LLC entity, subject to NCGS
55-14-05 or NCGS 57D-6-07 and 08;
c. Bankruptcy;
d. Foreclosure, subject to the requirements of Session Law 2013-121;
3. Any individual or entity found to be in noncompliance with the provisions of this
stormwater management permit or the requirements of the Stormwater rules is
subject to enforcement procedures as set forth in NCGS 143 Article 21,
4. 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.
5. 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.
6. The permittee grants DEQ Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
Page 5 of 6

State Stormwater Management Systems
Permit No. SW8 060305 MOD
7. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request. Neither the sale of the project,
in whole or in part, nor the conveyance of common area to a third party
constitutes an approved transfer of the stormwater permit.
8. The permit issued shall continue in force and effect until the permittee files a
request with the Division for a permit modification, transfer, renewal, or
rescission; however, these actions do not stay any permit conditions.
9. 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.
10. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
11. A permit renewal request must be submitted at least 180 days prior to the
expiration date of this permit. The renewal request must include the appropriate
application, documentation and the processing fee as outlined in Title 15A NCAC
02H.1045(3).
12. The permittee shall notify the Division any name, ownership or mailing address
changes within 30 days.
Permit modified and reissued this the 10th day of September 2020.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
z brjan Wrenn, Uirector
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Page 6 of 6

�DEI
ILR,USE ONLY
' Date Re eived
Fee Paid
Permit Number
5 o
301.
v&o a
Applicable Rules:
In Coastal SW -1995
❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply)
❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina C�
Department of Environment and Natural Resources t r,
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT APPLICATION FORMY:_ --
Thus forte stray be photocopied far use as an original
1. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Gordon Road Storage
2. Location of Project (street address):
Gordon Road
City:Wilmington County:New Hanover Zip:28411
3. Directions to project (front nearest major intersection):
Apprex 2800 If northwest of the intersection of US Hwy 17 and Gordon Road (SR 2048).Site is on the right.
4. Latitude:34° 15' 59" N Longitude:77° 50' 13" W of the main entrance to the project.
H. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ❑New ❑Modification ® Renewal w/ Modificationt
tRenezoals With modifications also requires SW11-102 - Reneroal Application Fornt
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numberSW8 060305 , its issue date (if known)04/12/2006 _, and the status of
construction: ❑Not Started ❑Partially Completed* ® Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
If this application is being submitted as the result of a previously returned application or a letter from
DEMLR 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 1-877-623-6748):
❑CAMA Major ®Sedimentation/Erosion Control: 4.1 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:Erosion Control #22-06, 06/05/2006
5. Is the project located within 5 miles of a public airport? ❑No
If yes, see S.L. 2012-200, Part VI: litti2:Hi2oi-tal.iicdenr.org/web/Ir/rLIIL-s-aiid-rOgL]lati
- E
I JUN 2 5 2020
BY:
Form SWU-101 Version Oct. 31, 2013 Page I of

III.' CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:ABA Mini -Storage. Inc.
Signing Official & Title:Alan S. Ambrose, Vice President _
b.Contact information for person listed in item I above:
Street Address:6635 Gordon Road
City:Wilmington State:NC Zip:28411
Mailing Address (if applicable).
City: State: Zip:
Phone: (910 ) 612-9409 _ Fax:
Email: wa a [e-mail]
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the Iease agreement and complete Contact information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Address:
City: State: Zip:
Mailing Address (if applicable):
City: State: Zip:
Phone: (_ _- ) Fax:
Email:
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:
Signing Official & Title:
b.Contact information for person listed in item 3a above:
Mailing Address:
City: State:
Phone:
Email:
4. Local jurisdiction for building permits:
Fax:
Point of Contact: Phone #:
Form SWU-101 Version Oct. 31, 2013 Page 2 of
Zip:
BY.

IV.- PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
tention basin
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW - 1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area: 4.07 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area*:4.07 acres
Total project area shall be calculated to exclude the following the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Norinal High Water (NHW) litre or Meat High Water
(MHW) line, and coastal zvetlauds laradzvard from the NHW (or MHW) lure. The resrrltafrt project area is used to
calculate overall percent built upon area (BUA). Non -coastal Wetlands landward of the NNW (or MHW) litre may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 61.8 %
9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered
stornrzvater BMP. For lozv density and other projects, use I for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
'Bashi Information
'Drainage Area 1
Drainage Area
Drainage Area _
Drainage Area
Receiving Stream Name
Smith Creek
Stream Class *
CSW
Stream Index Number *
18-74-63
Total Drainage Area (sf)
177,289
On -site Drainage Area (so
177,289
Off -site Drainage Area (so
-
Proposed Impervious Area** (so
109,640
% Impervious Area** total
61.8%
Impervious" Surface. Area
Draina e.Area.1
Draina e-Area'"
Drainage Area
Drainage Area '
On -site Buildings/Lots (so
76,675
On -site Streets (so
-
On -site Parking (so
32,232
On -site Sidewalks (so
733
Other on -site (so
-
Future (so
-
Off -site (SO
-
Existing BUA*** (so
-
Total (so,.
109,640
Stream Class and Index Number can be determined at: httl�://pnrtal.ncdcnr.ar /zuclJ/rnrl[ps/csu/class rations _�,i _
Imppervious area is defined as the built upon area including, but not limited to, buildings, roads, parkrng'areas;LE
shT7valks, gravel areas, etc. '
JUN 2 5 2020
Form SWU-101 Version Oct. 31, 2013 Page 3 of BY.

-***Report only that ainount of existing BUA that will remain after development. Do not report any existing BUA that
is to be renioaed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. NA
Projects in Union County: Contact DEMI,R Central Office staff to check if the project is located within a Threatened c&
Endangered Species watershed that niay be subject to more stringent stormwater requirements as per 15A NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http:Z/portal.ncdenr.org/web/wq/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
httki:/Zportal.iicdeiir.org/N%,ebLwgLwsZsu/statesw/fornis does. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map at http:Z/Vortal.iicdejir.oi-g/web/wq/ws/su/iiiaps.)
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 httPJ/portal.ncdenr.org/web/wq/ws/su/statesw/forms does.
II i
1. Original and one copy of the stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants h10
Form. (if required as per Part V11 below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M �?
agreement(s) for each 13MP.
4. Permit application processing fee of $505 payable to NCD,ENR. (For an Express review, refer to
littp://www.envhelp.org/pages/onestopexi2ress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/ management for
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the N lk`
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the'/z
mile radius on the map.
7. Sealed, signed and dated calculations (one copy)._
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including: —�
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSIZ numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/ project boundary with bearings & distances. (y"�
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations. i
I. Details of roads, drainage features, collection systems, and stormwater control measures. JUN 2 2020
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a 9
qualified person. Provide documentation of qualifications and identify the person who BY.
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
Form S W U- l 0 l Version Oct. 31, 2013 Page 4 of 6

P. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify nil(�
10
11
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x11" copy of the NRCS 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.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DEMLR to verify the SHK7 prior
to subinittal, [phone].)
A copy of the most current property deed. Deed book: 5051 Page No: 172
For corporations and limited liability corporations (LLC)•. Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item 1a, 2a, and/or 3a per 15A NCAC 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http:/ /www.secretary.state.ilc.us/Corporations/CSearch.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be
provided as an attachment to the completed and notarized deed restriction form. The appropriate deed
restrictions and protective covenants forms can be downloaded from httt):f/f/portaLncdenr.org/web/Ir/state-
stormwater-forms does. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and Iisted
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMLR, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/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 requests for additional information).
Consulting Engineer: Phil] i p G. Tripp,P.E.
Consulting Firnijripp Engineering
Mailing Address:419 Chestnut Street
City: W ilmington
Phone: [phone]
EmaiI:office©trippengineering.coni
State:NC Zip:28401
Fax: (910 ) 763-5631
IX. PROPERTY OWNER AUTHORIZATION (if Contact biformatioi, item 2 has been filled out, complete this
section)
I, (print or type mmte of person listed in Contact Information, item 2a) � _ , certify that I
own the property identified in this permit application, and thus give permission to (print or type naive of person
listed in Contact Information, item Ia) with (print or type name of organization listed In
Contact btfornnation, item M) 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 titre operation and maintenance of the stormwater system.
k
Form SWU-101 Version Oct. 31, 2013 Page 5 of 6 BY.

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
lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR 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.
Signature: Date:
I, 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 seat,
SEAL
My commission expires
X. APPLICANT'S CERTIFICATION
1, (print or type name of person listed in Contact Information, item 1a) Alan 5. Ambrose
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 and any other applicable state stormwater requirements.
Date: �] :� —)-0
c j�!^(1�r a Notary Public for ther State of CAA County of
APn( { do hereby certify that A101) 5,475k) ! nXt_ personally appeared
before me this 2— day of AAj and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
,�pTAJ?-
#611B1.NG
SEAL
My commission expires_ 10—%S'2 % _
JUN Y N
51010 ; ,
BY:
Form SWU-101 Version Oct. 31, 2013 Page 6 of

Operation & Maintenance Aareement
Project Name:
Project Location:
Gordon Road Storage
6635 Gordon Road
Maintenance records shall be kept on the following BMP(s). This maintenance record shall be kept in a log in a known set locatio
Any deficient BMP elements noted in the inspection will be corrected, repaired, or replaced immediately. These deficiencies can
affect the integrity of structures, safety of the public, and the pollutant removal efficiency of the BMP(s).
The BMP(s) on this project include (check all that apply & co
Bioretention Cell
Quantity:
Dry Detention Basin
Quantity:
Grassed Swale
Quantity:
Green Roof
Quantity:
Infiltration Basin
Quantity:
Infiltration Trench
Quantity:
Level SpreaderNFS
Quantity:
Permeable Pavement
Quantity:
Proprietary System
Quantity:
Rainwater Harvesting
Quantity:
Sand Filter
Quantity:
Stormwater Wetland
Quantity:
Wet Detention Basin
Quantity:
Disconnected Impervious Area
Present:
User Defined BMP
Present:
O&M tables will
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
i Rear of site I
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed for
each BMP above, and attached O&M tables. I agree to notify NCDENR of any problems with the system or prior to any changes to
the system or responsible party.
Responsible Party. -
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Email:
Alan S. Ambrose
President, ABA Mini -Storage, Inc.
6635 Gordon Road
Wilmington, NC 28411
910-612-9409
[e-mail]
Signature: II Date:
�� `�`���
I, .ell a� _ ( a Notary Public for the State of �JQA C'rrD��n�
County of do Nearby certify that Mm S, kmo,bise,
personally appeared before me this 2- day of jVj aTZQ 0 and
acknowledge the due execution of the Operations and Maintenance Agreement.
Witness my hand and official seal, ;) ,&4 Imo. 6=d
w
��•o •• p�lBI..�G
JUG!
BY:
Seal ''++ii+i�uu{,u10
STORM-EZ
Version 1.4
Ay commission expires
O&M Manual
3/2/2020
Page 1 of 4

' A 70

Wet Detention Pond Maintenance Requirements J
Thd wet detention basin system is defined as the wet detention basin, pretreatment including forebays and the vegetated filter if one
is provided.
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 weekly if needed, until the plants become 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 dam 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:
Potential problem:
How I will remediate the problem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the BMP
Areas of bare soil and/or
Regrade the soil if necessary to remove the gully, and then plant a
erosive gullies have formed.
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 approximately six inches.
long.
The inlet device
The pipe is clogged.
Unclog the pipe. Dispose of the sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to smooth it over and provide erosion
swale.
control devices such as reinforced turf matting or riprap to avoid future
problems with erosion.
Stone verge is clogged or
Remove sediment and replace with clean stone.
covered in sediment (if
applicable).
The forebay
Sediment has accumulated to
a depth greater than the
Search for the source of the sediment and remedy the problem if
possible. Remove the sediment and dispose of it in a location where it
original design depth for
will not cause impacts to streams or the BMP.
sediment storage.
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 spraying.
The vegetated shelf
Best professional practices
Prune according to best professional practices
show that pruning is needed
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the problem: soils, hydrology, disease, etc.
dying.
Remedy the problem and replace plants. Provide a one-time fertilizer
application to establish the ground cover if a soil test indicates it is
necessary.
Weeds are present.
Remove the weeds, preferably by hand. If pesticide is used, wipe it on
the plants rather than spraying
111,010
' l
4
JUN 2 n
BY:
STORM-EZ 2/28/202
Version 1.4 O&M Manual Page 2 of

r, Wet Detention Pond Maintenance Requirements Continued I
Thar main treatment area
Sediment has accumulated to
Search for the source of the sediment and remedy the problem if
a depth greater than the
possible. Remove the sediment and dispose of it in a location where it
original design sediment
will not cause impacts to streams or the BMP.
storage depth.
Algal growth covers over 50%
Consult a professional to remove and control the algal growth.
of the area.
Cattails, phragmites or other
Remove the plants by wiping them with pesticide (do not spray).
invasive plants cover 50% of
the basin surface.
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and consult a professional to remove
beaver activity is present.
beavers.
A tree has started to grow on
Consult a dam safety specialist to remove the tree.
the embankment.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair. (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 Department of Environment and Natural
damage have occurred at the
Resources Regional Office.
outlet.
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.
JUN 2 5 2020
BY•
STORM-EZ 2I28I2020
Version 1.4 O&M Manual Page 3 of 4

i Wet Detention Pond Design Summary 1
Wet Pond Diagram
WET POND ID FOREBAY
MAIN POND
1
Permanent Pool El.
41.6
Permanent Pool El.
41.6
Temporary Pool El:
42.8
Temporary Pool El:
42.8
Pretreatment other No
Clean Out Depth:
2.25
Clean Out Depth:
4.5
than forebay?
Sediment Removal El:
39.35
Sediment Removal El:
37.1
Has Veg. Filter? Yes
Bottom Elevation:
38.6
Bottom Elevation:
35.6
.:}
JUN 2 9 2020
BY.•
STORM-EZ 21281242
Version 1.4 O&M Manual Page 4 of

TE 05130
Gordon Road Storage
Stormwater Project No. SW8 060305
New Hanover County
Engineer's Certification
State Stormwater Management Systems
Permit No. SW8 060305
E EBVE
MAR
I, Phillip G. Tripp , as a duly registered Professional Engineer in the
State of North Carolina, having been authorized to observe (periodically/we
/
time) the construction of the project,
Gordon Road Storage
(Project)
for _ ABA Mini -Storage, 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.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specifications:
Signature
Registratic
Date �W
SEAL
\ CA R p
SEAL. �
-ti 17374 ;ate
GINV-
,, R j i off, `,`�.
EGEWE" ,
JUN 2 5 2020
BY:

1�
State Stormwater Management Systems
Permit No. SW8 060305
Certification Requirements: Page 2 of 2
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 outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. 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. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf, a
forebay, and the vegetated filter.
15. The required system dimensions are provided per the approved plan.
JUN 2 5
W
BY:

Date Received
Fee Paid
Permit Number
-2S- Z c
Vi c3(_ D o
Applicable Rules: ❑ CoastaI SW -1995 ❑ Coastal SW -- 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt PIan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Gordon Road Stora e
2. Location of Project (street address):
on
City:Wilmington _ County:New Hanover Zip:28411
3. Directions to project (from nearest major intersection):
Approx 2800 If northwest of the intersection of US Hwy 17 and Gordon Road (SR 2048). Site is on the right. _
4. Latitude:340 15' 59" N Longitude:77° 50' 13" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ❑New ❑Modification ® Renewal w/ Modificationt
tRenewals with niodif cations also requires SWU-102 - Renewal Application Form
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numberSW8 060305 , its issue date (if known)04/12/2006 , and the status of
construction: []Not Started ❑Partially Completed* ® Completed* *provide a designer's certification
Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from
DEMLR 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 1-877-623-6748):
❑CAMA Major
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 4.1 ac of Disturbed Area
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 type of each permit:Erosion Control ##22-06 06 05 2006
5. Is the project located within 5 miles of a public airport? []No ®Yes
If yes, see S.L. 2012-200, Part VI: littp://12ortal.ticdenr.org/web/Ir/rules-aiidiEe ulati
W V 7 .. !
JUN 2 5 2020 '
BY
Form SWU-101 Version Oct. 31, 2013 Page l of 6
C a P4

III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:ABA Mini -Storage, Inc.
Signing Official & Title:Alan S. Ambrose V-W@-President
b.Contact information for person listed in item 1a above:
Street Address:6635 Gordon Road
City:Wilmington _ T State:NC Zip:28411
Mailing Address (if applicable):
City:
State:
Phone: [phone] Fax:
Emaii:[e-mail]
Zip:
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official & Title:
b. Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if applicable):
City:
State: Zip:
State: Zip:
Phone: i y Fax:
Email:
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization.
Signing Official & Title:
b. Contact information for person listed in item 3a above:
Mailing A
City:
Phone: (
Email:
4. Local jurisdiction for building permits:
Point of Contact:
State,
Fax:
Phone #: (
Zi
Form S V U-101 Version Oct. 31, 2013 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Wet detention basin
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development PIan or PUD Approval Date:
[] Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW - 1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area: 4.07 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) -- Total Surface Water Area (6) = Total Project
Area+.4.07 acres
t Total project area shall be calculated to exclude thefollowing: the norinaI pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHW) Iine or Mean High Water
(MHW) line, and coastal wetlands landward front the NNW (or MHM line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 61.8 %
9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density 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 there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
.•
Basin.informahon , , ,. _.... r,,;
,Drama e' Area l'
_
Draina e Area",
Draina e Area _
'Drama e`Area _
Receiving Stream Name
Smith Creek
Stream Class
C;SW
Stream Index Number *
18-74-63
Total Drainage Area (sf) 1
177,289
On -site Drainage Area (so
177,289
Off -site Drainage Area (so
-
.Proposed Impervious Area"* (so
109,640
% Impervious Area" total
61.8%
Ini ervious"?.Surface Area r a ,''
-Drama -e Aiea'1
.Drains � e A_iea'=
Drains e Area"
,Draiiia e`Area
On -site Buildings/Lots (so
76,675
On -site Streets (so
-
On -site Parking (sf)
32,232
On -site Sidewalks (so
733
Other on -site (so
-
Future (so
-
Off -site (sf)
-
Existing BUA*** (sf)
-
Total (so:
109,640
* Stream Class and Index Number can be determined at: littp.Z&ortal.ncdenr.orgAi)ebA(7a[ps/csu/classi tic,?tiotcs
�rt Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version Oct. 31, 2013 Page 3 of 6

***Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? provide documentation. NA
Proiects in Union County: Contact DEMLR Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15A NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from htt ortaIncdenr.org/web/wgZws/su/btiip-iiianual,
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
httll. /_portal.ncdenr.org/web/wq/ws/su/statesw/forms_docs. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map at htW://jZoLrtal.i)cdeiir.org/web/wq/ws/su/maps.)
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 Litt :://portalmcdennorg/web/wq/ws/su/statesw/forms does.
I itials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants LIA
Form. (if required as per Part V11 below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
h Jwww.envhelp.org/ pages onesto ex ress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management
6. A USGS map identifying the site Iocation. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within'/2 mile of the site boundary, include the 1/2
mile radius on the map.
7. SeaIed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n, Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
Form SWU-101 Version Oct. 31, 2013 Page 4 of 6
for r�

p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify an Al
elevationsin addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x11" copy of the NRCS 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.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DEMLR to verifij the SHWT prior
to submittal, [phone].)
A copy of the most current property deed. Deed book: 5051 Page No: 172'
For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 21-1.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http:/ /www.secretary.state.nc.usZCorl2orationsZCSearch.asRx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be
provided as an attachment to the completed and notarized deed restriction form. The appropriate deed
restrictions and protective covenants forms can be downloaded from htt):/Iportal.i-icdenr.org/`web/irstate-
stormwater-forms does. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMLR, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/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 requests for additional information).
Consulting Engineer:Phillip G. Tripp, PEE.
Consulting Firm: TrippEngineering
Mailing Address:419 Chestnut Street
City:Wilmington
Phone: [phone]
[e-mail]
State:NC Zip:28401 _
Fax: (910 ) 763-5631 _
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) , certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, Item 1a) with (print or type name of organization listed in
Contact Information, item 1a) 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 maintenance of the stormwater system.
Form S WU-101 Version Oct. 31, 2013 Page 5 of 6

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
lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR 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.
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
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, itein Ia) Alan S. Ambrose
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 and any other applicable state stormwater requirements.
Signature: _�' /!. l/1— _ Date:
C' . & 1�,(j a Notary Public for the State of �Ao4h l Il b1l County of
ien(yir __, do hereby certify that Alan 5, �mt personally appeared
before me this 2— day of _jc�rLC W and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,�r�C _
o.: • OTAR
y:
w
SEAL
My commission expires /0_-6-Z]
Form SWU-101 Version Oct. 31, 2013 Page 6 of