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SW8970415_HISTORICAL FILE_20180724
STORMWATER DIVISION CODING SHEET POST -CONSTRUCTION PERMITS PERMIT NO. I DOC TYPE I ❑ CURRENT PERMIT ❑ APPROVED PLANS HISTORICAL FILE ❑ COMPLIANCE EVALUATION INSPECTION DOC DATE �2 ' (% YYYYMMDD Weaver, Cameron From: Steenhuis, Joanne Sent: Thursday, July 26, 2018 9:51 AM To: Weaver, Cameron Subject: FW: [External] U-5787 - Trade Street Extension Attachments: SW8 970415.pdf; SW8 061125,pdf; SW8 080112.pdf; SW8 921003.pdf From: Morrison, Davin C. [mailttocDavin.Mo-rrisc n@stein cc omJ Sent: Wednesday, July 25, 2018,4:50_PM' To. Steenhuis, Joanne <joanne,steenhuis@ncdenr.gov> Subject: [External] U-5787 - Trade Street Extension Joanne, We are working on the U-5787 Trade Street Extension project for the Town of Jacksonville and NCDOT. There are ponds that we could potentially be impacting / replacing for the project and we have received the existing permits from the Town that they received from your office. We }ust want to inquire and see if there are any record drawings available as well. Is this something you could try and track down for us or point me to the right person? The existing permits are attached. I appreciate the help. Regards,` llavin-Morniso Senior lsngineering Operations Manager ,3. atcr_Resources Group LSTV.Engin6e s,Inc. S L-Ai Cc? p �J 90W. `Trade Street, Suite 715 Charlotte, NC 28202 p F �� O l 1 .. CP_r: 704.816-2528.(direct) U [ 1 Ph: 704-497-9134 (cell) ST Vi- , im Please consider the environment before printing this e-mail Redesigned and rebuilt: visit our new website at www.stvinc.com ' STATE OF NORM CARQLINk Dvartite of Envh oG= w aad Natard Fffqom=s 127 pacdWl Drive Vision Wihn%ngtan, N016 GarDfins 28405 �9fo}��s�rzls - FILE TDEMATR Gnide.�es forAccess: `lie ofming�, Re�.a[ pace is ded�eafed to �a�g publi� recotcls in aIr D odymdiVt &Moto the public for oview arcs oopyltg. 1 e else lave e zespo szb iiy to e public to safeguard thew records and to =7 out oir dad+ -to,* proem abl gafic W. play_ se read care*the folbwmggmdoIi= m$�mgth6 fame: L Aue to fhe karge public did far 0e access, we reds%tt,Wym oL 4 ] asta d# in . �Fance t� �a�scl an. appoi�fzne�.t� xe�zaw�.e e� ��paht�n►�nts �� be seh��uled . een 9:Obara and 3:04 ut, Viavingiiie ids at 4,45pa 4k%n arrtyin [fhq�t �_ om ez pia mew e ies to fhe exEe�t that.fi e and sea s svislag a ai%bk. • �- . . tau merit specify files po�z�ant to �e�ie�r b� �ci�f�'Y name. 7� nam�ber of �fas fat you X.yreViM at oA�iE�e'Mlbe limitedto eve} ' zalse dies of a file �vJfene copier is not its use bytlfo stand tft3me pe. cadpar copy ss t05 oe& NXggl mats be made ky cheek, mo ey ord$r, or cask at e race 6011E des , far 1:4 tofal' SA or maze at 61eneet. 4 I'iI S MtST $E U-PT,W QgDER YD'U FOUND MY, >?r n may notbe fft tom ' . �e o-�cs��`a repave, � defaa�, €Iate, of des�roy�ate�al. inane afthes�fries is a �2k*aartarfor vhfch you catl be &ed.up b t5K00, No b iefoases la 6tote&_et . are - Loig d ine A,€e revievf area. ; S. r aaaadance with. General Saxe 25 M 12, a M-00-processing fee wfl1 be clterged and coliected•fo checls an-Wyohpayb�ahas veep.reascd, and a ass Dad Timm litre oat Pleaxe . Aeh, a 'ass cam t� t " fvrrn , COPIES UA.DB PAID INVOICE S;,�dmi� a aces - - --- FS 5 I'% •r ky- Energy, Min era I and Land Resources ENVIRONMENTAL QUALITY May 11, 2016 Mr. Devin Staley, PE Lowe's Companies, Inc. 1605 Curtis Bridge Rd Wilkesboro, NC 28697 PAT MCCRORY Gonmor DONALD R. VAN DER VAART Secretary TRACY DAVIS Direclor Subject: Request for Permit Name/Ownership Change and/or Renewal SW8 970415: Lowe's Home Improvement Jacksonville (Western Blvd), Onslow County SW8 980429: Lowe's Home Improvement Morehead City, Carteret County SW8 071207: Lowe's Home Improvement Jacksonville (Popp Rd), Onslow County Dear Mr. Staley: The Division received the enclosed Stormwater Management Permit information Update Forms on October 26, 2015, but it appears that the projects are currently not permitted to a Lowe's entity. They are currently permitted to others, and need to be transferred to Lowe's Home Centers, LLC because it appears that Lowe's is the appropriate permittee. This is a different action than the update form because it transfers permit responsibility from one entity to another rather than just changing the corporate name or contact information for an existing permittee (which the Update Form does). On May 10, 2016, the Wilmington Regional Office of the Division of Energy, Mineral and Land Resources (DEMLR) conducted file review inspections of the subject projects. The three file reviews found the information listed below for each of the three permits. Items 1-7 listed under each permit are informational, but Item 8 listed under each permit includes a list of items that are needed. Please follow up on these items, and submit them by July 11, 2016. Please note that each project will be inspected on - site in the near future to determine if there are compliance items that need to be addressed. Current Permittees and Property Owners have been ec'd, and their action is needed: 1. All current permit ees (as listed in the cc list at the end of this letter) need to submit a Name/Ownership Change Form (enclosed) to transfer their respective permits to Lowe's Home Centers, LLC if that is their intention. If they do not apply to transfer their permits, they will continue to be responsible for them indefinitely. Only information for the "Current Permittee" is needed from the current permittees. The other information can be left blank. 2. SW8 970415 is located on land owned by VP Jacksonville, LLC. This entity is neither the current permittee nor Lowe's. This may be a leased property. VP Jacksonville, LLC needs to work with Lowe's to determine who the appropriate permittee will be. That entity needs to apply for the Name/Ownership Change as the Proposed Permittee. ' 3. SW9 980429 is located on land owned by Southstar Holdings MHC, LLC, et al. Southstar Holdings MHC, LLC is the current permittee. This may also be a leased property, and so Southstar Holdings MHC, LLC needs to work with Lowe's to determine who the appropriate permittee will be. That entity needs to apply for the Name/Ownership change as the Proposed Permittee. Stale of North Carolina I Environmental Quality I Energy, Mineral and Land Resources 127 Cardinal Drive Extension I Wilmington, NC 28405 910 796 7215 T 1 910 350 2004 F I htiva/oorlal.nedenr orgwe411r/ May 11, 2016 Stormwater Application No. SW8 970415, SW8 980429, SW8 071207 SW8 970415: Lowes of Jacksonville (1255 Western Blvd, Jacksonville, NC 28546) 1. Most Recent Issue Date: 9/3/97 2. Expiration Date: 9/3/07 3. Extension Granted Until: NIA (SL 2009-406 & SL 2010-177 not apply to 1997 permits) 4. Next Expiration Date (after renew): This permit is expired. Since renewal cycle is eight years, it needs to be renewed twice. The first renewal will bring it up through 9/3/15. The second renewal will bring it up through 9/3/23. Each renewal is $505, and so the total for this permit's renewal is $1010. 5. Outgoing Permittee: a. Permitted Name: Crisman Corporation b. Corrected Name: Crisman Corp — The permit was issued to "Crisman Corporation", but it appears that that was a typo. The NC Secretary of State's Office's (SoS) 1997 Annual Report shows that "Crisman Corp" was as the same address as on the permit. A permit transfer from Crisman Corporation to Crisman Corp is not necessary. It will be a correction. c. SoS, Active Corporation? Yes d. SoS, Current Person: i. President: Daniel A. Barrero ii, Vice President: None listed 6. Owner: a. Owner per County GIS: VP Jacksonville LLC b. SoS, Current Person: Two Managers Listed i. VP Blair, LLC (Martin D. Koon is the only manager of this entity) ii. Martin D. Koon Incoming Permitee: Lowe's Home Centers, LLC a. NC Secretary of State (SoS), Active Corporation? Yes b. SoS, Current Person: The Articles of Incorporation show that it is manager -managed. The managers are: i. Ricky D. Damron ii. Robert F. Hull, Jr. iii. Ross McCanless iv. Robert A. Niblock c. Update Form Signed by: M. Devin Staley, PE, Manager — Civil Design Items Needed: Please note that all signatures must be original, and all forms must be signed by an individual with signature authority: a. Renewal Application: Please submit a form signed by Damron, Null, McCanless, or Niblock. Or, submit a letter from one of these individuals delegating authority to Staley if Staley signs the Renewal Application. b. $1010 renewal fee c. Name/Ownership Change Form i. Outgoing Permittee: Please submit a form signed by Barrero. ii. Incoming Permittee: Please submit a form signed by Damron, Hull, McCanless, or Niblock. Or, submit a letter from one of these individuals delegating authority to Staley. iii. $0 transfer fee because this is the first transfer d. Deed (for permit transfer and/or lease documentation) e. Designer's Certification (PE Certification): Per Permit Section 11(5) f. Deed Restrictions: NIA, this project is not permitted as a subdivision g. Operation and Maintenance Agreement (O&M): N/A, this document is already on file Page 2 of 6 Ma); 11, 2016 Stormwater Application No. SW8 970415, SW8 980429,SW8 071207 h. Lease: i, if the owner leases the land to another entity and the lease shows that that entity has the responsibility for the items covered by the permit such as the construction of impervious area, then please also submit: 1. The applicable portion of the lease agreement 2. Applications signed by the leasee ii. If the owner does not lease the land to the incoming permittee, please clarify the connection between the owner and the incoming permittee. SW8 980429. Lowes at Morehead Citv (5219 US-70, Morehead Citv. NC 28557 1. Most Recent Issue Date: a. Original Permit: 9/2/99 b. Plan Revision: 3/8106 c. Renewal: 719I13 2.' Expiration Date: 7/12/21 3. Extension Granted Until: NIA (SL 2009-406 & SL 2010-177 not apply to 1998 permits) 4. Next Expiration Date (after renew): NIA, renewal is not needed 5. Outgoing Permittee: a. Permitted Name: Southstar Holdings — Morehead City, LLC b. NC Secretary of State (SoS), Active Corporation? Yes c. SoS, Current Person: Two Managers Listed: i. E. Blanton Hamilton, Jr ii. Scott C. Bortz 6. Owner: ' a. Owner per County GIS: Southstar Holdings MHC, LLC, et al iii. It appears that the County GIS just abbreviated the official corporation name. There is no "Southstar Holdings MHC, LLC" listed on the SoS's website. It does not appear that this is a transfer to a separate entity. iv. If the deed shows that the property is now owned by more than one entity, then please submit a Name/Ownership Change to transfer the permit into all entities' names. b. SoS, Current Person: Same as above Incoming Permitee: Lowe's Home Centers, LLC a. NC Secretary of State (SoS), Active Corporation? Yes b. SoS, Current Person: The Articles of Incorporation show that it is manager -managed. The managers are.- i. Ricky D. Damron ii. Robert F. Hull, Jr. iii. Ross McCanless iv. Robert A. Niblock c. Update Form Signed by: M. Devin Staley, PE, Manager — Civil Design Items ]Weeded: Please note that all signatures must be original, and all forms must be signed by an individual with signature authority: a. Name/Ownership Change Form i. Outgoing Permittee: Please submit a form signed by Hamilton or Bortz. ii. Incoming Permitee: Please submit a form signed by Damron, Hull, McCanless, or Niblock. Or, submit a letter from one of these individuals delegating authority to Staley. iii. $0 transfer fee because this is the first transfer Page 3 of 6 May 11, 2016 Stormwater Application No. SW8 970415, SW8 980429, SW8 071207 b. Deed (for permit transfer and/or lease documentation): Please note that County records show that this land is owned by "Southstar Holdings MHC, I.LC, et a]". if there is more than one owner on the deed please contact me, and we can discuss it further. c. Designer's Certification (PE Certification): NIA, this document is on file (6/10/13) d. Deed Restrictions: Needed per Permit Section II (13), see the 1999 permit e. Operation and Maintenance Agreement (0&M): NIA, his document is already on file (7/6/98) f. Lease: i. If the owner leases the land to another entity and the lease shows that that entity has the responsibility for the items covered by the permit such as the construction of impervious area, then please also submit: 1. The applicable portion of the lease agreement 2. Applications signed by the leasee ii. If the owner does not lease the land to the incoming permittee, please clarify the connection between the owner and the incoming pennittee. SW8 071207: Lowes of Jacksonville 425 Yopp Rd Jacksonville NC 28540 1. Most Recent Issue Date: a. Original Permit: 1/28/08 b. Correction: 1/20/10 2. Expiration Date: 1 /28/2018 3. Extension Granted Until: 12/31/21 (per SL 2009-406 & SL 2010-177- not previously issued) 4. Next Expiration Date (after renew): NIA, renewal is not needed 5. Outgoing Permittee: a. Permitted Name: Jemsite Development, LLC b. NC Secretary of State (SoS), Active Corporation? Yes c. SoS, Current Person: The Articles of Incorporation show that it is manager -managed. The managers are: a. Jeffrey E. Flattery b. James M. Vannoy c. William E. Vannoy 6. Owner: a. Owner per County GIS: Lowes Home Centers Inc. b. Note: It appears that "Lowes Home Centers, Inc." and "Lowes Home Centers, LLC" merged recently and that the LLC was the surviving entity. However, the documentation on the SoS's website is unclear. The Articles of Merger show that "LCI DE, LLC" merged with "Lowes Home Centers, LLC" and that "Lowes Home Centers, LLC" was the survivor. Please clarify and provide documentation that "Lowes Home Centers, Inc." merged into "Lowes Home Centers, LLC". 7. Incoming Permiee: Lowe's Home Centers, LLC. a. NC Secretary of State (SoS), Active Corporation? Yes b. SoS, Current Person: The Articles of Incorporation show that it is manager -managed. The managers are: iii. Ricky D. Damron iv. Robert F. Hull, Jr. v. Ross McCanless vi. Robert A. Niblock c. Update Form Signed by: M. Devin Staley, PE, Manager — Civil Design Page 4 of 6 May 11, 2016 Stormwater Application No. SW8 970415. SW8 980429. SW8 071207 Items Needed: Please note that all signatures must be original, and all forms must be signed by an individual with signature authority: a. Name/Ownership Change Form i. Outgoing Permittee: Please submit a form signed by Flattery, J. Vannoy, or W. Vannoy. ii. Incoming Permittee: Please submit a form signed by Damron, Hull, McCanless, or NTiblock. Or, submit a letter from one of these individuals delegating authority to Staley. iii. $0 transfer fee because this is the first transfer b. Deed (for permit transfer and/or lease documentation) c. Designer's Certification (PE Certification): NIA, this document is on file (1/28/08) d. Deed Restrictions: NIA, this document is on file (BK 3159/ PG 384-387) e. Operation and Maintenance Agreement (O&M): NIA, this document is on file (1/31/14) Lease: i. If the owner leases the land to another entity and the lease shows that that entity has the responsibility for the items covered by the permit such as the construction of impervious area, then please also submit: 1. The applicable portion of the lease agreement 2. Applications signed by the leasee ii. If the owner does not lease the land to the incoming permittee, please clarify the connection between the owner and the incoming permittee. Any individual or entity found to be in noncompliance with the provisions of a stormwater management permit or the stormwater rules is subject to enforcement procedures as set forth in NCGS 143 Article 21. Failure to provide the requested information, or to respond to this letter by the due date, may initiate enforcement action including the assessment of civil penalties. Additionally, for your records, effective August 1, 2013, the State Stormwater program was transferred from the Division of Water Quality (DWQ) to the Division of Energy, Mineral and Land Resources (DEMLR). All previous references to DWQ will remain in older stormwater permits issued prior to August ], 2013 until they are modified. Please note that this letter references DEMLR as the Division responsible for issuance of the permit. Additionally, the department was renamed from the Department of Environment and Natural Resources (DENR) to the Department of Environmental Quality (DEQ). Please reference the State assigned application number on all correspondence. If you have any questions concerning this matter, please feel free to call me at (910) 796-7215 or email me at kelly.p.johnson@licdenr.gov. Si ly Johns'bn 'Ironm ntal Engineer GDSTni: \\\Stormwater\Permits & Projects\] 997\970415 HD\2016 05 addinfo 970415 \\\Stormwatcr\Permits & Projects\1998\980429 HD\2016 05 addinfo 980429 \\\Stormwater\Permits & ProJects\2007\071207 HD\2016 05 addinfo 071207 Page 5 of 6 May 11, 2016 Stormwater Application No. SW8 970415, SW8 980429, SW8 071207 enc : All Three Permits: Name/Ownership Change Form SW8 970415 Permit Update Form, 10/26/15 SW8 970415 Permit SW8 970415 Onslow County GIS, ownership data 5/10/16 SW8 970415 NC Secretary of State Documentation SW8 980429 Permit Update Form, 10/26/15 SW8 980429 Permits Original Permit: 9/2/99 Plan Revision: 3/8/06 (unsigned only, original lost from file) Renewal: 7/9/13 SW8 980429 Carteret County GIS, ownership data 5/10/16 SW8 980429 NC Secretary of State Documentation SW8 071207 Permit Update Form, 10/26/15 SW8 071207 Permit, 1/20/10 SW8 071207 Onslow County GIS, ownership data 5/10/16 SW8 071207 NC Secretary of State Documentation cc: SW8 970415 Current/Outgoing Permittee: (w/ SW8 970415 attachments) Daniel A. Barreiro, President, Crisman Corp. 4967 Brushy Mountain Rd, Moravian Falls, NC 28654 SW8 970415 Property Owner: (w/ SW8 970415 attachments) Martin Koon, Manager, VP Jacksonville, LLC & VP Blair, LLC 128 Oakwoods Trace, Wilkesboro, NC 28697 SW8 980429 Current/Outgoing Permittee: (wl SW8 980429 attachments) Blanton Hamilton & Scott Bortz, Managers, Southstar Holdings — Morehead City, LLC 2820 Selwyn Ave, Suite 425, Charlotte, NC 28209 SW8 071207 Current/Outgoing Permittee: (w/ SW8 071207 attachments) Jeffrey Flattery, Manager, Jemsite Development, LLC 2874 Chestnut Grove Rd, Sparta, NC 28675 James Vannoy and William Vannoy, Managers, Jemsite Development, LLC PO Box 635, Jefferson, NC 28640 Wilmington Regional Office Stormwater Permit File SW8 970415 Wilmington Regional Office Stormwater Permit File SW8 980429 Wilmington Regional Office Stormwater Permit File SW8 071207 Page 6 of 6 State of North Carolina Department of Environment and Natural Resources Division of Water Quality STATE STORMiWATER PERMIT NAME/OWNERSHIP CHANGE FORM I. CURRENT PERMIT INFORMATION 1. Stormwater Management Permit Number: ��? onc)L v 2. Project Name: 3. Current Permit Holder's Company Name/Organization: 4. Signing Official's Name: .5. Mailing Address: City: 6. Phone: () Title: State: Zip: Fax: ( ) II. PROPOSED PERMITTEE / OWNER 1 PROJECT 1 ADDRESS INFORMATION This request is for: (please check all that apply) ❑ Name change of the owner (Please complete Items 1, 2 and 3 below) ❑ Name change of project (Please complete Item 5 below) ❑ Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below) ❑ Mailing address I phone number change. (Please complete Item 4 below) ❑ Other (please explain): 1. Proposed permittee's company name/organization: 2. Proposed permittee's signing official's name: 3. Proposed permittee's title: 4. Mailing Address: City: Phone:(_) 5. New Project Name to be placed on permit: State: Zip: Fax: Please check the appropriate box. The proposed permittee listed above is: ❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a recorded easement for all areas that contain stormwater system features. Print name of HOA or POA in #1 above and provide name of HOA/POA's authorized representative in #2 above) ❑ The property owner [] Lessee (Attach a copy of the lease agreement and complete Property Owner Information on page 4) ❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be granted upon receipt of a copy of the recorded deed) ❑ Developer (Complete Property Owner Information on page 4) SSW NIO Change Rev24Sept2012 . Page 1 of 4 III. REQUIRED ITEMS A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all of tha-applicable required items listed below are included with the submittal. Failure to provide the listed items may result in processing delays or denial of the transfer. 1. This completed and signed form�This certificat�pn must be completed and signed by both the currertitpermif;halder�and,the newapplicant tf this fs,a change a# ownership: 2. Legal documentation of the property transfer to a riew owner. 3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit. 4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from each DWQ Regional office), if required by the permit and if not already submitted to DWQ. 5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability company, or other corporate entity, provide documentation showing the authority of the named representative to act on behalf of the proposed permittee. 6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing fee is not required. Subsequent ownership transfers will require the $40.00 processing fee. IV. CURRENT PERMITTEE'S CERTIFICATION Please check one of the following statements and fill out the certification below that statement.- [:] Check here if the current permittee is only changing his/her/its name, the project name, or mailing address, but will retain the permit. I, , the current permittee, hereby notify the DWQ that I am changing my name and/or I am changing my mailing address and/or I am changing the name of the permitted project. I further attest that this application for a name/ownership change is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed or if all required supporting information and attachments listed above are not included, this application package will be returned as incomplete. ❑ Check here if current permittee is transferring the property to a new owner and will not retain ownership of the permit. I, _ , the current permittee, am submitting this application for a transfer of ownership for permit # . I hereby notify DWQ of the sale or other legal transfer of the stormwater system associated with this permit. I have provided a copy of the most recent permit, the designer's certification for each BMP, any recorded deed restrictions, covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved operation and maintenance agreement, past maintenance records, and the most recent DWQ stormwater inspection report to.the proposed permittee named in Sections II and V of this form. I further attest that this application for a name/ownership change is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed or if all required supporting information and attachments listed above are not included, this application package will be returned as incomplete. I assign all rights and obligations as permittee to the proposed permittee named in Sections II and V of this form. I understand that this transfer of ownership cannot be approved by the DWQ unless and until the facility is in compliance with the permit. Signature: Date: a Notary Public for the State of , County of , do hereby certify that personally appeared before me this the day of , 20 , and acknowledge the due execution of the forgoing instrument. Witness my hand and official seal, (Notary Seal) Notary Signature SSW N/O Change Rev24Sep12012 Page' 2 of 4 V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the Proposed Permittee for all transfers of ownership) I, , hereby notify the DWQ that I have acquired through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted stormwater management system, and, if applicable, constructing the permitted system. acknowledge and attest that I have received a copy of: (check all that apply to this permit) 8 the most recent permit the designer's certification for each BMP ❑ any recorded deed restrictions, covenants, or easements ❑ the DWQ approved plans and/or approved as -built plans [] the approved operation and maintenance agreement ❑past maintenance records from the previous permittee (where required) DWQ stormwater inspection report showing compliance within 90 days prior to this transfer I have reviewed the permit, approved plans and other documents fisted above, and I will comply with the terms and conditions of the permit and approved plans. I acknowledge and agree that I will operate and maintain the system pursuant to the requirements listed in the permit and in the operation and maintenance agreement. 1 further attest that this application for a name/ownership change is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed or if all required supporting information and attachments fisted above are not included, this application package will be returned as incomplete. Signature: County of Date: a Notary Public for the State of do hereby certify that personally appeared before me this the day of , 20 , and acknowledge the due execution of the forgoing instrument. Witness my hand and official seal, (Notary Seal) Notary Signature Additional copies of the original permit and the approved Operation and Maintenance agreement can be obtained from the appropriate Regional Office of the Division of Water Quality. This completed form, including all supporting documents and processing fee (if required), should be sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural Resources, Division of Water Quality, as shown on the attached map. Please note that if the Proposed Permittee listed above is not the property owner, the property owner must complete and sign page 4 of this document. Both the lessee / developer and the property owner will appear on the permit as permittees. SSW N/O Change Rev24Sept2012 Page 3 of 4 VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION If the Proposed Permittee listed in Sections If and V of this form is not the Property Owner, the Property Owner must provide his/her Contact Information below and sign this form. - Printed Name: Organization: Title within the Organization: Street Address: City: Mailing Address: City: State: (if different from street address) State: Phone: Fax: Email Zip: Zip: I certify that I own the property identified in this permit transfer document and have given permission to the Proposed Perm ittee.listed in Sections II and V to develop and/or, lease the property. A copy of the lease agreement or other contract, which indicates the party responsible for the construction and/or operation and maintenance of the stormwater system, has been provided with the submittal. As the legal property owner I acknowledge, understand, and agree by my signature below, that I will appear as a permittee along with the lessee/developer and I will therefore share responsibility for compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify DWQ by submitting a completed Name/Ownership Change Form within 30 days of procuring a developer, lessee or purchaser for the property. I understand that failure to operate and maintain the stormwater treatment facility in accordance with the permit is a violation of NC General Statute (NCGS) 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 of the property owner County of Date: a Notary Public for the State of do hereby certify that personally appeared before me this the day of , 20 , and acknowledge the due execution of the forgoing instrument. Witness my hand and official seal, Notary Signature (Notary Seal) SSW N/O Change Rev24Sept2012 Page 4 of 4 LoWE't ENGINEERING & CONSTRUCTION 1605 Curtis Bridge Road, Wilkesboro, NC U.S.A 28697 October 19, 2015 Georgette D. Scott Stormwater Supervisor Division of Energy, Mineral, and Land Resources 127 Cardinal Drive Extension Wilmington, NC 28405 RE: Permit Information Update Forms Lowe's Home Centers, LLC Dear Ms. Scott: Enclosed you will find executed Permit Information Update Forms for the following Lowe's projects.; o /Lowe's of Cape Carteret, NC— v Lowe's of Morehead City, NC -' !`% 4, a ,/Lowe's of Shallotte, NC G-1-9 T Fi ,) O Lowe's of Jacksonville, NC (Yopp Road) --5 o Vowe's of Southport, NC -•- �' 3 pf{� o VILowe's of Wilmington, NC -- S F C 06 5.;2, j �- v "Lowe's of Jacksonville, NC (Western Boulevard) -- . 6 •�OG� f �� If you have any questions, or need additional information concerning this matter, please contact me at 336-658-4347. Kindest Regards, M. Devin Staley, PE Lowe's Companies, Inc. FFSSt 1Jj!' yam__- �� I:f J�l, l•'r � S OCT 2 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENERGY, MINERAL AND LAND RESOURCES STORMWATER MANAGEMENT PERMIT INFORMATION UPDATE FORM This form is only to be used by the current permittee to: 1) change the Point of Contact (signing official) for the current permittee (LLC, Corporation, HOA or POA); 2) change the mailing address, phone number or email address of the current permittee; 3) change the name of the project; and 4) change the legal corporate name as documented by a Name Change filed with the NCSOS. For all transfers of the permit to a NEW OWNER (including dissolution of the current permittee corporation or LLC and the transfer of assets to a new corporation or LLC), please complete the "Permit Transfer Form". I. CURRENT PERMIT INFORMATION 1. Stormwater Management Permit Number: SW8 970415 2. Project Name: Lowe's of Jacksonville NC Western Boulevard 3. Current / Previous Corporation Name: _ Lowe's Home Centers, Inc. 4. Current Permit Holder's Company Name/Organization: Lowe's Home Centers, LLC -_ 5. Signing Official's Name: Stewart Scott _ _ Title: VP - Engineering/Construction Phone: ( 336 ) - Fax:( - II. NEW PERMIT INFORMATION Request the following information be updated: (Please check all that apply, If more than one,point-of contact,or.ma.iling address is being changed, please attach a separate sheet.). ' ❑ Project Name — (Complete Item 9 below) I''tr. x Corporation Name — Com lete Item 2 below and provide the Name Change filed: v0th the 'NC50S) ❑ Point of Contact (i.e., Signing Official, Property Owner, LLC Manager, HOAIPOA president/manager) — lL' (Complete Items 3 & 4 below and provide a copy of supporting documentation suclt`as NCSOS-filiragj ❑ Mailing Address 1 Phone Number/ Email Address — (Complete Item 5, 6, or 7 below, as applicable) 1. New Project Name: _ 2. New Corporation Name: Lowe's Home Centers LLC 3, New Point of Contact Name: M. Devin Staley, PE 4. New Point of Contact Title: _ManagQr - Civil Design 5. New Mailing Address: Apt.iSuite# City: State: Zip: 6. New Phone:(_) 7. New Email Address: devin.d.staley &-lowes.com New Fax: ( ) III. CURRENT PERMITTEE'S CERTIFICATION I, Stewart Scott the current permittee, hereby notify DEMLR that I am making the above noted changes as listed i ecti II. I further attest that this application for an update to the permit information currently on file is accurate c lete tot best of my knowledge. Il fl"��t] Signature: w` Date: l - ZD(S County of Iry , \`, 11 a Notary Public for the State of. do hereby certify that 1 � personally appeared before me this the '7 day of (1 Cam-, 20_Lf�, and acknowledge the due execution of the forgoing instrument. Witness my hand and official seal, } My commission,expires a' l a o t 1 Notary Signature - MELISSA RICHARDSON Notary Public, North Carolina Wilkes County . My Commission Expires February 20, 2017 : -State of North Carolina Department of Environment, Healthy and Natural Resources Wilmington Regional Office Division of Water Quality James B. Hunt, Jr., Governor Wayne McDevitt, Secretary A. Preston Howard, Jr., P.E., Director September 3, 1997 Mr. T. Cameron Finley, Member/Manager Crisman Corporation PO Box 843 Wilkesboro, NC 28697 Subject: Permit No. SW8 970415 Lowe's Home Center Jacksonville High Density Commercial Stormwater Project Onslow County Dear Mr. Finley: The Wilmington Regional Office received the Stormwater Management Permit Application for Lowe's Home Center Jacksonville on April 16, 1997, with final 'information on August.7, 1997. Staff review of the plans and specifications has determined that the project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A NCAC 2H.1000. We are forwarding Permit No. SW8 970415 dated September 3, 1997, for the construction of "we's Home Center Jacksonville. This permit shall be effective from the date of issuance until September 3, 2007, 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. Failure to establish an adequate system for operation and maintenance of the stormwater management system will result in future compliance problems. If any parts, requirerrtents, 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. If. you have any questions, or need additional information concerning this matter, please contact Linda Lewis, or me at (910) 395-3900. Sincerely, Rick Shiver, P.G. Acting Regional Water Quality Supervisor RSSlarl: S:IWQSISTORMWATIPERMIT1970415.SEP cc: Dale Isom, P.E. Sharon Smith Jennings, Onslow County Inspections Linda Lewis Wiliriingtoi Regional Office Central Files P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone 919-733-5063 FAX 919-733-9919 An Equal Opportunity Affirmative Action Employer State Stormwater Management Systems Permit No. SW8 970415 STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT, HEALTH AND NATURAL RESOURCES DMSION OF WATER QUALITY STATE ST0RM[WA1ER!! NA - EMENT 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 Crisman Corporation Lowe's Home Center Jacksonville Onslow County FOR THE construction, operation and maintenance of two (2) detention ponds 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. This permit shall be effective from the date of issuance until September 3, 2007 and shall be subject to the following specified conditions and limitations: I. DESIGN STANDARDS 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 on page 3 of this permit, the Project Data Sheet. Pond 1 of the stormwater control has been designed to handle the runoff from 486,165 ft2; and Pond 2 has been designed for the runoff from 97,000 square feet of impervious area. 3. Approved plans and specifications for this project are incorporated by reference and are enforceable parts of the permit. 4. The tract will be limited to the amount of built -upon area indicated on page 3 of this permit, and per approved plans. 5. The portion of the paved area noted in red on Sheet C-2 of the DWQ approved plans shall not be constructed until a modification to the permit for Circuit City (No. SW8 941107) is submitted and approved. 2 State Stormwater Management Systems Permit No. SW8 970415 Project Name: Permit Number: Location: Applicant: Mailing Address: DIVISION OF WATER QUALITY PROJECT DATA SHEET Lowe's Home Center Jacksonville Application Date: Water Body Receiving Stormwater Runoff Classification of Water Body: 970415 Onslow County Mr. T. Cameron Finley, Member/Manager Crisman Corporation PO Box 843 Wilkesboro, NC 28697 April 16, 1997 Mill Creek "SC" POND I POND 2 Pond Depth: 7' 3.5' Permanent Pool Elevation: 43 FMSL 45 FMSL Total Impervious Surfaces Allowed: 486,165 ft2 97,000 square feet All Future development shown on plans must either design and submit for approval it's own pond or submit for a modification to enlarge this pond. Offsite Area entering Pond: none per Engineer Required Surface Area: 20,806 ft2 9,700 ft2 Provided Surface Area: 28,324 ft2 10,539 ft2 Required Storage Volume: 38,894 ft3 7,856 ft3 Provided Storage Volume: 43,928 ft3 13,648 ft3 Temporary Storage Elevation: 44.4 FMSL 45 FMSL Controlling Orifice: 2.5" 1.5" pipe 3 State Stormwater Management Svstems Permit No. SW8 970415 6. The permittee is responsible for verifying that the proposed built -upon area does not exceed the allowable built - upon area. 7. The following items will require a modification to the permit: a. Any revision to the approved plans, regardless of size. b. Project name change. C. Transfer of ownership. d. Redesign or addition to the approved amount of built -upon area. e. Further subdivision of the project area. f. Filling in, altering, or piping of any vegetative conveyance shown on the approved plan. In addition, the Director may determine that other revisions to the project should require a modification to the permit. 8. 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. ]f. SCHEDULE OF COMPLIANCE The permittee will comply with the following schedule for construction and maintenance of the stormwater management system: a. The stormwater management system shall be constructed in it's entirety, vegetated and operational for it's intended use prior to the construction of any built -upon surface except roads. b. During construction, erosion shall be kept to a minimum and any eroded areas of the system will be repaired immediately. 2. The permittee shall at ail times provide the operation and maintenance necessary to assure the permitted stormwater system functions at optimum.efficiency. 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 side slopes. d. Immediate xepair of eroded areas. e. Maintenance of side slopes in accordance with approved plans and specifications. f. Debris removal and unclogging of outlet structure, orifice device and catch basins and piping. g. Access to the outlet structure must be available at all times. 3. Records of maintenance activities must be kept and madc 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. 4. 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. S. 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. 2 State Storrnwater Management Systems Permit No, SW8 970415 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. Prior to the sale of any portion of the property, an' access/maintenance easement to the stormwater facilities shall be granted in favor of the permittee if access to the stormwater facilities will be restricted by the sale of any portion of the property. 8. The weir in the forebay for Pond 1 where the pipe from CI-15 enters must be located and constructed per the DWQ approved plans such that the runoff does not short-circuit the system.. 9. Any future development must either design, submit and have approved a new pond, or submit a modification to the permit issued for this pond, No. SW8 970415. III. GENERAL CONDITIONS This permit is not transferable. In -the event there is a desire for the facilities to change ownership, or there is a name change of the Permittee, a formal permit request must be submitted to the Division of Water Quality accompanied by an application fee, 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. 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) which have 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. S. The permittee grants DEHNR Staff permission to enter the property for the purpose of inspecting all components of the permitted stormwater management facility. 6. The permit may be modified, revolted 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. Permit issued this the 3rd day of September, 1997, NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION t =0 f-2,—A. Preston Howard, Jr., P.E., Director Division of Water Quality By Authority of the Environmental Management Commission Permit Number SWS 970415 61 State Stormwater Management Systems Permit No. SW8 970415 Lowe's Home Center Jacksonville Stormwater Permit No. SW8 970415 Onslow County Engineer's Certification 1, , as a duly registered Professional Engineer 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. Noted deviations from approved plans and specification: Signature Registration Number Date SEAL 0 )iDMS)ION OF WATER QUALITY NORTH CA11d01i.,]INA, STORMWWATER MANAGEMENT P11?RM)<T,APPLI<CA.TION.__......-.._. —— ,—a 1. GENE, RAL INFORMATION (Please print clearly or type) 1. Project Name Lowes Home Center 2. Location, directions to project (include County, Address, State Road) Attach map _.. ,...-- -.—_-..._-_... Onslow County,Western Blvd., Jacksonvi.11e, NC 3. Owner's Name Crisman Corporation Phone (910) 667-8000 4. Owner's Mailing Address PO Box 843 City Wilkesboro State NC Zip' 28697 5. Nearest Receiving Stream Mill Creek 6. Projectdescription Lowes Home Center Warehouse —.---.--- ---200,-000 square feet; faith parking if. PERMIT INFORMATION 1.PernlitNo.(d'nhejilledLthyplVQJ SW8970415 Class SC 2. A ppl ication Date May 4, 1997, fo ��-7U-.-!, -:-� Fee enclosed $ previously sent, ��. � , 3.Permit Type: X New Renewal Modification (existing Permit No.) 4. Project Type: Low Density X Detention Infiltration Redevelop —General —Alter' Offsite 5. Other State/Federal Permits/Approvals Required (Check apprnprinte blanks) CAMA Major Sedimentation/Erosion Control X 404 Permit 111. BUILT UPON AREA (Please see NC,1 C 2H.1005 that .1007 for applicable density lintits) Drainage Drainaze Breakdown of Impervious Area Basin Basin (Please indicate below the design impervious area) Classification D-CiL 5 ;,Z Buildings 179,165 (pond 01) Existing Bililt-upon Area -0- -0- Streets -0- 97,000 sq. ft. Pond #2 Proposed Built -upon Area 11.2 2.2 Parking/SW307,000 sq. ft.__Pond #1 Total Project Area 13.4 3.2 % Built -upon Area 83% 70% IV. STORMWATER `I'REATATENT pescrihe how the ninof s4411 he treated) Wet Detention Ponds Other -0- 486,000,sq. ft. Pond #1 Totals 97, 000 sa. ft. Pond #2 M V1 VH. cc DEED RESTRICTIONS AND PROTECTIVE COVENANTS Deed restrictions and protective covenants are required to be recorded for all low density projects and all subdivisions prior to the sale of any lot. Please see Attachment A for the specific items that must be recorded for the type of project applied for. By your signature below, you certify that the recorded deed restrictions and protective covenants for this project shall include all the items required by the permit, that the covenants will be binding on all parties and persons claiming under them, that they will run with the land, that the covenant cannot be changed or deleted without concurrence from the State, and that they will be recorded prior to the sale of any lot_ OWNER'S CERTIFICATION 1, ]f 91271r) trl �� , certify that the information included or. this permit (Please print clearly or type) j application form is correct, that the project will be constructed in conformance with the approved plans, that the deed restrictions will be recorded with all required permit conditions, and that to the best of my knowledge, the proposed project complies with the requirements of 15A NCAC 2H.1000. I authorize the below named person or firm -to submit stormwater plans on my behalf. _ and Title Date Authorized Agent AGENT AUTHORIZATION (Please fill in the name of the engineer/surveyor authorized to submit plans on the owner's behalf.) Person or firm name f2h (& L • 1�7 Mailing Address 13 KAI City b 1 f`7G12� State Zip9_7 Phonel 10 443'4�a�� Please submit application, fee, plans and calculations to the appropriate Regional Office. Applicant/WiRO//Central Piles SUSltli): 0253136 Date Filed: 8/11/2015 12:29.00 PM Elaine F. Marshall l Y9 (42) North Carolina Secretary of State G Business CorporaVon Annual Re 10z213 CA2015 111 02522 Name of Business Corporation: CRI SMAN CORP. Secretary of State ID: 0233921 State of Formation: NC fiscal Year Ending: 12 31 14 LI hereby canny that an annual repork comptcted in its entirety has been submitted and the inlormadon requested below (required by NCGS 55-1622) has not changad and is Iher,ef" complete. Section A: Re�tstered Aaenfs Information 1. Name of Registered Agent DANIEL A BARRERO 2. Signature of the Now Registered Agent 15ipnawta ConsWN mnaenl to lhv Sppon%?Wt) 3. Registered Office Street Address & County 4. Registered Office Mailing Address 924 MAIN STREET, SUITE 300 PO BOX 843 WILKES NORTH WI NC 28659 WILKESBORO NC 28697 Section B: Principal Nce Information 1. Description of Mature of Business: REAL, ESTATE 2. Principal Office Phone Number. 3 3 6— 6 67 —8 0 D O 3. Principal Office Email: D . BARREROM DEVELO PM 4. Principal Office Street Address & County 5, Principal Office Mailing Address 924 MAIN STREET PO BOX 843 WILKES NORTH WI NC 28659 WILKESBORO NC 28697 Section C: man: (Enter additional Officers in Section E.) Name: DANIEL A BARRERO Name: Name: Fig$_ PRESIDENT Title: Title: Address: 4967 BRUSHY MOU Address: Address: MORAVIAN FALLS NC 28654 Secti3ftnuonual ort cb n D must be completed in its entirety and signed by a person listeda p ning ranCity listed under Seclon C. rp (F m yen ofter of axporatonl Data DANIEL, A BARRERO PRESIDENT Plea or Tips Nana of oTpty Tllb CA201508904190 SOSTD: 1217466 Date Piled: 3/30/2015 4:44:00 PM Elaine F. Marshall LIMITED LIAB0LiTY COMPANY ANNUAL REPORT North Carolina Secretary of State CA2015 0a9 04190 NAME OF LIMITED LIABILITY COMPANY: VP Blair LLC Fidbous Name, If any, used in North Carolina: Filing Of a Use only SECRETARY OF STATE ID NUMBER: 1217466 STATE OF FORMATION: NC REPORT FOR THE YEAR: 2015 Changes SECTION A:REGISTERED AGENT'S INFORMATION 1. NAME OF REGISTERED AGENT: Martin D Koon • f 2. SIGNATURE OF THE NEW REGISTERED AGENT: SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 3. REGISTERED OFFICE STREET ADDRESS A COUNTY 4. REGISTERED OFFICE MAILING ADDRESS 126 Executive Drive, Suite 200 PO Box 843 Wilkesboro NC 28697 Wilkes Wilkesboro NC 28697 SECTION B: PRINCIPAL OFFICE INFORMATION 1, DESCRIPTION OF NATURE OF BUSINESS: Real. estate I 2. PRINCIPAL OFFICE PHONE NUMBER: 336-667-8000 3. PRINCIPAL O Privacy Redactiotr 4. PRINCIPAL OFFICE STREET ADDRESS & COUNTY 126 Executive Drive, Suite2_00 Wilkesboro NC 28697 Wilkes S. PRINCIPAL OFFICE MAILING ADDRESS PO Box 843 Wilkesboro NC 28697 SECTION C: COMPANY OFFICIALSIORGANIT..ERS(Enter additional Company OfficialslOrgenizers in Section E.) NAME: martin D Koon NAME: 4 Our Kids, LLC NAME: Thomas C Finley TITLE: Manager TITLE: Member ADDR.: 128 South Oakwoods Trae ADDR.: PO Box 843 Wilkesboro Mtn 9ece7 TITLE: Member ADDR.: 1142 Ancient Oak Drive Wilkesboro Wilkesboro —^ HDLn7 —T 70en7 i SECTION D: CERTIFICATION OF ANNUAL REPORTSertion D must be completed in its entirety by a personlbusiness entity. SIGNATURE DATE Form must be signed by a Company Offlclalfftanlzer 11sted under Section C of this form. Martin D Koon, for 4 Our Kida, LLC Manager. Print or Type Name of Company Official/Organizer TITLE =0 SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF $200 MAIL TO: Secretary of State, Corporations Division, Post Office Box 2025, Raleigh, NC 27626-0525 a' LiWTED LIABILITY COMPANY ANNUAL REPORT NAME OF LIMITED LIABILITY COMPANY: Lowe's Home Centers, LLC SECRETARY OF STATE ID NUMBER: 0087619 STATE OF FORMATION: NC REPORT FOR THE YEAR: 2016 SECTION A: REQISTERED AQENT'S INFORMATIQN 1. NAME OF REGISTERED AGENT: Corporation Service Company 2. SIGNATURE OF THE NEW REGISTERED AGENT: 3. REGISTERED OFFICE STREET ADDRESS & COUNTY 327 Hillsborough Street Raleigh, NC 27603-1725 Wake Countv SECTION B: PRINCIPAL ©FFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: Retail Sales Flimp Office Use Only E-Filed Annual Report fl087S19 CA201809504378 4012016 04:29 FIChanges SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 4. REGISTERED OFFICE MAILING ADDRESS 327 Hillsborough Street Raleigh. NC 27603-1725 2. PRINCIPAL OFFICE PHONE NUMBER: (704) 758-2520 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction 4. PRINCIPAL OFFICE STREET ADDRESS &: COUNTY 5. PRINCIPAL OFFICE MAILING ADDRESS 1605 Curtis Bridge Rd ^_ 1000 Lowes Blvd N134TA Wilkesboro, NC 28697-2231 Mooresville, NC 28117-8520 SECTION C: -C-QERANY QFFIC9&L-$ (Enter additional Company Officials in Section E.) NAME: Ricky D. Dalnron TITLE: Manager ADDRESS: 1000 Lovve's Blvd Mooresville, NC 28117 NAME: David R Green TITLE: Vice President ADDRESS: 1000 Lowe's Blvd Mooresville, NC 28117 NAME: Robert F. Hull, Jr. TITLE: Manager ADDRESS: 1000 Lowe's Blvd. Mooresville, NC 28117 SECTION D: CERTIFICATION QF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity. David R Green SIGNATURE Form must be signed by a Company OfScial listed under Section C of this form. David R Green Print or Type Name of Company Official 4/4/2016 DATE Vice President Print or Type The Tide of the Company Officiai MAIL TO: Secretary of State, Corporations Division, Post Office Box 29525, Raleigh, NC 27626-0525 SECTION E: ADDITIONAL COMPANY OFFICIALS NAME: Ross W McCaniess NAME: Robert A Niblock NAME: TITLE: Manager TITLE: Manager TITLE: ADDRESS: ADDRESS: ADDRESS: 1000. Lowe's Blvd 1 OOO Lowe's Blvd Mooresville, EEC 28117-8520 NAME: TITLE: ADDRESS: h NAME: TITLE: ADDRESS: Mooresville, NC 28117 NAME: NAME: TITLE: TITLE: ADDRESS: ADDRESS: NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: Name. TITLE: ADDRESS: NAME: TITLE: ADDRESS: S ue Or North earollera Department of the Secmkry or -Rafe AR11CLES OF OIdQ;&H[LkTION FNCL9JDENG AR79CLU OF CORVEnION SosiD,; o087619 12ate Filed: 10/30/2013 3.47.00 PM Effective: 11/1/2013 Elaine F. Marshall Nortb Carohna Secretary of State C2013 303 00267 Pursuaht to §§ 57C_2-21, M-9A-01 and 57C-9A-03 ofthe'General Statutes of North Carolina, the unders100 cnnyertina business -entity does hereby submit these Artioles 6f G3cWiza iori Including Articics.of Conversion for the purpose offbrming a limited liability company. The name of the limited liability company is: LovWs Home Ce mvs. LLc 'The limited -liability company is:being formed pursuant to a conversion of another business entity.. 2. The narbc ofthe converting business entity is r ovae's kvr�m C.et9ters, r►�. and the organization and internal affairs ofthe converting busines catity arc:gbverrred by the laws of the state or country of North cawir plan of conversion has been approved by the convMing business onfity as MgUirm by 181W. 3. The converting business entity is a (check one): Q domestic corporation, Ofmciign corporation; ❑ foreign limited liability company; ❑ domestic lirnited:partneasship; 'Foreign limited partnership; O domestic registered -limited liability -partnership; foreign limited iiability partnership: or O other partnership as defined in-G.S- 59-36A whether or not formed undertht rows of North C>$rolina. 4. if the litnited liability company is to dissolve by a specific date, the latcst:datc On Which the limited liability company is to dissolve: (If no ciace far d4solution is specffied, there Aall:be no limit on the durarion r)f the ?haired liability compan)� )__ 6. 7. g. The name and address of'each person cy ecuting these articles of organiz9flon is as follows: (State whether each person is exec wing these articles of organization in the capacity of a member, organizer or bath). Gfterra. xesra. jr.. Organizer 1000 I_owe's Bivd. Wort§Yl�l T'he street address and county of the initial registered office of"the limiW liability company is: Number and Street 327 Hillsborough Street City, State, Lip Code Raleigh, IBC, 27603 County The ratail ing address, if diffaculfr m lite street aaaldras, of the initial mgiistcr0d office is: The Brame of the initial registered agent is: Corporation Service Company CO18 RATIONS DIVISION P.O. BOX 29622 RALEIGH,WC 276264622 (Revised denuary 2002) (Form L-01A) 9. Trincipal oflice_inforination: (Seicc either a or h) a. 0 The IiinitW IiabiIity company has a principal affice. o The street address and county of the principal office of the limited liability eGntpany is: Number and Street 1605 Curtis Bridge Road City, State, ;Lip CodeWllkesburo, NO 28597 Courtly v/niae6 A The mailing address, ifdiffereatframthes7reeifiddFaw,.ofthe principal office of the. limited inability 'Company iS: A000 Lowe's Blvd. Mooresville. NC 26117 b. ❑ The limited babiliiy company dacs not have a principal office. 10. Check one of the follo~ving: ❑ (i) Member-mi7naRed LLB': all members by virtue of'their status as members shall be managers of Ns limited liability company. (ii) Meanager-rriaaoragee1 L,i C: except as pi-ovided by 1N.C.C.S. Sec4i6.st:57C-3-20(s), the members of this limited liability company. shall not be managers by virtue of their status as members. 11. Anyother provisions which the limited liability company Meets to inplude are attched. I2.. These,articles wit be effective upon filing, unless a date andlor time is specified: November 1, 2013 l"his is the day of ( . 20's Signature Gaither M. Keemr.Jr. Organizer NOTPS: I. truing iet 15 sin, 'rhh dacumertt must he filed with ific Scudary afGrsty. -CORPORATIONS DIVISION P.O. BOX 29622 (Rsvise4Janravy 2002) Type'or Prim Arame and Tftk RALEIGH, NC 27626.0622 (Form Ld11A) JW,8Moq[S i ENGINEERING & CONSTRUCTION 1605 Curtis Bridge Road, Wilkesboro, NC U.S.A 28697 October 19, 2015 Georgette D. Scott Stormwater Supervisor Division of Energy, Mineral, and Land Resources 127 Cardinal Drive Extension Wilmington, NC 28405 RE: Permit Information Update Forms Lowe's Home Centers, LLC Dear Ms. Scott: Enclosed you will find executed Permit Information Update Forms for the following Lowe's projects: • XLowe's of Cape Carteret, NC— D '/✓ �f -- • Lowe's of Morehead City, NC _. G;s % 26) zf� • /Lowe's of Shallotte, NC --- --5 G-,'Y q 9/ ,;? z1 6 • Lowe's of Jacksonville, NC (Yopp Road) _-. 5 g 0 7/ :R 6 7 • Aowe's of Southport, NC S u., 3 T fpzf-�? 4 • ALowe's of Wilmington, NC u 6% 06 -:�3 ;Z J • "Lowe's of Jacksonville, NC (Western Boulevard) --- SG�; YV ��l�✓/� If you have any questions, or need additional information concerning this matter, please contact me at 336-658-4347. Kindest Regards, M. Devin Staley, PE {� Lowe's Companies, Inc. R4z r-� 3 3 5 OCT 2 6 2015 BY:- STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENERGY, MINERAL AND LAND RESOURCES STORMWATER MANAGEMENT PERMIT INFORMATION UPDATE FORM This form is only to be used by the current permittee to: 1) change the Point of Contact (signing official) for the current permittee (LLC, Corporation, HOA or POA); 2) change the mailing address, phone number or email address of the current permittee; 3) change the name of the project; and 4) change the legal corporate name as documented by a Name Change filed with the NCSOS. For all transfers of the permit to a NEW OWNER (including dissolution of the current permittee corporation or LLC and the transfer of assets to a new corporation or LLC), please complete the "Permit Transfer Form". I. CURRENT PERMIT INFORMATION 1. Stormwater Management Permit Number: SW8 970415 2. Project Name: Lowe's of ,Jacksonville, NC (Western Boulevard) 3. Current I Previous Corporation Name: Lowe's Home Centers, Inc. _ 4. Current Permit Holder's Company Name/Organization: LOWe'S Home Centers, LLC_ 5. Signing Official's Name: Stewart Scott Title: VP - Engineering/Construction Phone: ( 336) 658-4000 Fax: ( ) II. NEW PERMIT INFORMATION Request the following information be updated: (Please check all that apply. If more than ni f�G� t�prr ' ing address is being changed, please attach a separate sheet.) EU!` ! ❑ Project Name — (Complete Item 1 below) n�+ ❑x Corporation Name — (Complete Item 2 below and provide the Name Change filed94, h t ITN • O )1915 ❑ Point of Contact (i.e., Signing Official, Property Owner, LLC Manager, HOAIPOAsident/manager) — (Complete Items 3 & 4 below and provide a copy of supporting documentation suS-NGS9S-filing ❑ Mailing Address 1 Phone Number/ Email Address — (Complete Item 5, 6, or 7 below, as applicable) 1. New Project Name: 2. New Corporation Name: Lowe's Home Centers, LLC 3. New Point of Contact Name: M. Devin Staley, PE 4. New Point of Contact Title: Manager - Civil Design 5. New Mailing Address: Apt.ISuite# City: State: zip: 6. New Phone: (�} New Fax: { ) 7. New Email Address: devin.d.staley(a-lowes.com III. CURRENT PERMITTEE'S CERTIFICATION I, Stewart Scott , the current permittee, hereby notify DEMLR that I am making the above noted changes as listed i ecti 11. 1 further attest that this application for an update to the permit information currently on file is accurate c lete to t best of my knowledge. Il Signature: Date: T 16- 7- ZD(.S I, —,a Notary Public for the State of /*kJ oe 6pk„ 1,'r•-._, County of do hereby certify that personally appeared before me this the i day of Q Ut3 6-t,— 20L, and acknowledge the due execution of the forgoing instrument. Witness my hand and official seal, //11I_�� _ _ My commission expires �� { a o t rl N -far�y Signature MELISSA RICHARDSON Notary Public, North Carolina Wilkes County My Commission Expires February 20, 2017 r W U 1, 2 1 L u Ext- I N 0 C:A201508904190 SOSID: 1217466 Date Filed: 3/30/2015 4.44:01) PM Blaine F. Marshall LIMITED LIABILITY COMPANY ANNUAL REPORT North Carolina Secretary of State CA2015 089 04190 NAME OF LIMITED LIABILITY COMPANY: VP Blair LLC ficlitious Name, If any, used in North Carolina: SECRETARY OF STATE ID NUMBER: 1217466 REPORT FOR THE YEAR: 2015 SECTION A: REGISTERED AGENT'S INFORMATION 1. NAME OF REGISTERED AGENT: Martin D Koon 2. SIGNATURE OF THE NEW REGISTERED AGENT: STATE OF FORMATION: NC Fning Otroe Use Only Changes SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 3. REGISTERED OFFICE STREET ADDRESS & COUNTY 4. REGISTERED OFFICE MAILING ADDRESS 126 Executive Drive, Suite 200 PO Box 843 Wilkesboro NC 28697 Wilkes Wilkesboro NC 28697 i SECTION B: PRtNCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: Real estate I - Privacy Redaction 2. PRINCIPAL OFFICE PHONE NUMBER: 336-667-8000 3. PRINCIPALO 4. PRINCIPAL OFFICE STREET ADDRESS & COUNTY 126 Executive Drive, Suite 200 Wilkesboro NC 28697 Wilkes 5. PRINCIPAL OFFICE MAILING ADDRESS PO Box 843 Wilkesboro NC 28697 SECTION C: COMPANY OFFICIALSIORGANIZERS(Enter additional Company Officials/Organizers in Section E.) NAME: Martin D Koon NAME: 4 Our Kids, LLC NAME: Thomas C Finley TITLE: Manager TITLE: Member TITLE: Member ADDR.: 128 South Oakwoods Trac ADDR.: PO Box 843 Wilkesboro NC 28697 ADDR.:1142 Ancient Oak Drive Wilkesboro Wilkesboro NC 28697 NC 28697 I SECTION D: CERTIFICATION OF ANNUAL REPORT.Section D must be completed in its entirety by a personlbusiness entity. 3-I3-2y�s SIGNATURE DATE Form must be signed by a Company Offlcial/Organlzer listed under Section C of this form. Martin D Koon, for 4 Our Kids, LLC Manager Print or Type Name of Company Officlal)C%anizer TITLE SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF $200 MAIi. TO: Secretary of State, Corporations Division, Post Office Box 29525, Raleigh, NC 27626-0525 SVv8 97m4zs—LowetHome Center Jacksonville (Western Blvd) IMGoogle Calendar - W. x "M GIS Home Page D Onslaw County, NC x �:Vlcwe home improy(Tix- 14 Data DRwnlgad 451143, xCn ,LTTD MYSICALap I PARIV PIN OWNERI PACE SAUEDAn f.ALEPRICF. tPA"YOCALCITY �w-6 a7cgAt5 �1 SOS 1 D: 0253136 Date Filed: 8/11/201512:29:00 PM Elaine F. Marshall North Carolina Seeretary of State CD-479 (42) Business Corporation Annual Re 14-22-13 CA2015 11.1 02522 Name of Business Corporation: C R I SMAN CORP. Secretary of State ID: 0233921 State of Formation: NC Fiscal Year Ending: 12 31 1.4 DL1 hereby ca ity that sn annual report =npleted in Its entirety has been submitted and Qm information requested below (requlred by NCGS 55-16-22) has not changed and is therefore complete. Section A: Registered Agent's Information 1. Name of Registered Agent DANIEL A BARRERO 2. Signature of the Now Registered Agent 15i9noVe rye eaaant to 1M aprx+lff*ml 3. Regislared Office Street Address S County 4. Registered Office Mailing Address 924 MAIN STREET, SUITE 300 PO BOX 843 WILKES NORTH WI NC 28659 WILKESBORO NC 28697 Section B: PdnCipal Qfflgg InfeM2g!fM t. Description of Nature of Business: REAL ESTATE 2. Principal Office Phone Number: 3 3 6- 6 67 - 8 0 0 0 3. Principal Office Email: D . BARRERO @ V P 1DEVELOPM 4. Principal Office Street Address & County 5. Principal Office Mailing Address 924 MAIN STREET PO BOX 843 WILKES NORTH WI NC 26659 WILKESBORO NC 28697 f Section C: 0" 2 (Enter additional Officers in Section E.) DANIEL A BARRERO Name: Name; Name: Title: PRESIDENT Title: Title: Address: 4967 BRUSHY MOU Address: Address: MORAVIAN FALLS NC 28654 section : cerfitio6o6ft of AnKual R ort ce n D must be completed in its entirety and signed by a person listed derS ti o a P ring ran tiiy listed under Section C. rr. (fi t sn offim or mrpwatbn) - Drte DANIEL A SARRERO PRESIDENT vrttt ar ryga wR+. ar otrr..r tree State of Narth Caroling Department of the Secretary of State ARTICLES OF ORGANIZATION INCLUDING ARTICLES OF CONVERSION SOSI:D: 0087619 Date Filed: 10/30/2013 3:47:00 PM Effective: 11/1/2013 Elaine F. Marshall North Carolina Secretary of State C2013 303 00267 Pursuant to §§ 57C-2-21, 57C-9A-01 and 57C-9A-03 of the Genera) Statutes of North Carolina, the undersigned converting business entity does hereby submit these Articles of Organization Including Articles.of Conversion for the purpose of Wining a limited liability company. The name of the limited liability company is: LowdsHomeca*n.U_C The limited liability company is:being formed pursuant to a conversion of another business entity. 2. The name of the converting business entity is LawWS"omoC.entem Ne. and -the organization and internal affairs. of the converting business entity are.governed by the laws of the stale or country of Hone comfi is A plan _of conversion has been approved by the converting business entity as required by law. 3. The converting business entity is a (check one): 0 domestic corporation, ❑foreign corporation; ❑ foreign limited liability company; ❑ domestic limited:partnership; foreign limited partnership; ❑ domestic registered limited liability partnership; foreign limited liability partnership; or ❑ other partnership as deliined in G.S. 59-36, whether or not formed underthe laws of North Carolina. 4. if the limited liability company is to dissolve by,a specific date. the latest.daW on which the limited liability company is to dissolve: (If no Aare for dissolurion is specifsed, there Aalf be no limit on the duration of the lirniled liability company. )r The name and address of cacti person executing these articles of organization is as follows: (Stale whether each perso' n is executing these articles of organization in the capacity of a member, organizer or both). oalbwr M. Keener. Jr.. _ Organizer 1000 Lowe's Blvd, Mooresville, NC 28117 _ 6. The street address and county of the initial registered office of the limited liability, company is: Number and Street 327 Hillsborough Street City, State, Zip Code Raleigh, NC, 27603 County Wake 7. The trailing address, if differentfrom Ilse street address, of the initial registered office is: a. The name of the initial registered agent is: Co ration Service Com n CORPORATIONS DIVISION P.O. BOX 29622 IRALEIGH, NC 27626-0622 (Revised Janucuy 2002) (Form l: 01 A) 9. -Principal office information: (Sciect ehher a or bJ a. 2 The limited liability company has a principal office. e The street address and county of the principal office of the limited liability company is: Number and Sirect 1605 Curtis Bridge Road City. State, ;Lip Codewmceseora_NC 28697 County !nikes C The mailing address,.tfdi,Jferentfrom(tie street address, of the principal office of the, limited liability company is: 1000 L—e's Blvd. Mooresvllte, NC 28117 b, ❑ The limited liability company does not have a principal office. 10. Check one of the following: ❑ (i) Member -managed LLC: all members by virtue of their status as members shall be managers of this limited liability company. Q (i i) Manager -managed LLC: except as provided by N.C.G.S. Section 57C-3-20(a), the members of this limited liability company shall not be managers by virtue of their siatus as members. 11. Anv,other provisions which the limited liability company elects to include are attached. 12. These. articles will be effective upon filing, unless a date and/or time is specified: November 1, 2013 Tti'ts is the �q day o f _____L . 20 " Signature Gaift? M. Keener. Jr. Organizer Type 'or Print Name and Title NGTUS. t. Pllirryl fcc b Sl2.S. This docun"i must be rthA wM the 5"war7 of Flxtc, -CORPORATIONS DIVISION. P.U. BOX 29622 (Revised Janrtary 2002) RALEIGH, NC 27626-0622 (Form L-01A) t t 3 LIMITED LIABILITY COMPANY ANNUAL REPORT NAME OF LIMITED LIABILITY COMPANY: Lowe's Home Centers, LLC SECRETARY OF STATE ID NUMBER: 0087619 STATE OF FORMATION: NC REPORT FOR THE YEAR: 2016 SECTION A: REGISTERED AGENT'S INFORMATIQN 1. NAME OF REGISTERED AGENT: Corporation Service Company 2. SIGNATURE OF THE NEW REGISTERED AGENT: Fiing Office Use Only E-Filed Annual Report 0087619 CA201609504378 4/4/2011 04:29 Changes SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 3. REGISTERED OFFICE STREET ADDRESS & COUNTY 4. REGISTERED OFFICE MAILING ADDRESS 327 Hillsborough Street 327 Hillsborough Street Raleigh, NC 27603-1725 Wake County Raleigh, NC 27603-1725 SECTION B: PRINCIPAL QFFIQE INF RMATI N 1. DESCRIPTION OF NATURE OF BUSINESS: Retail Sales 2. PRINCIPAL OFFICE PHONE NUMBER: (704) 758-2520 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction 4. PRINCIPAL OFFICE STREET ADDRESS & COUNTY 1605 Curtis Bridge Rd Wilkesboro, NC 28697-2231 5. PRINCIPAL OFFICE MAILING ADDRESS 1000 Lowes Blvd NB4TA Mooresville, NC 28117-8520 SECTION C: COMPANY QFFIQIALS (Enter additional Company Officials in Section E.) NAME: Ricky D. Damron TITLE: Manager ADDRESS: NAME: David R Green TITLE: Vice Prpsirient ADDRESS: NAME: Rohprt F Htlll- Ar. TITLE: Manager ADDRESS: 1000 Lowe's Blvd 1000 Lowe's Blvd 1000 Lowe's Blvd. Mooresville, NC 28117 Mooresville, NC 28117 Mooresville, NC 28117 SECTION D: CERTIFIQATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity. David R Green SIGNATURE Form must be signed by a Company Official listed under Section C of this form. David R Green Print or Type Name of Company Official 4/4/2016 DATE Vice President Print or Type The Thle of the Company Official MAIL TO: Secretary of State, Corporations Division, Post Office Box 29525, Raleigh, NC 27626-0525 SECTION E:ADDITIONAL COMPANY OFFICIALS NAME: Ross W McCanless NAME: Robert A Niblock TITLE: Manager TITLE: Manager ADDRESS: ADDRESS: 1000 Lowe's Blvd 1000 Lowe's Blvd Mooresville, NC 28117-8520 Mooresville, NC 28117 NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: NAME: NAME: TITLE: TITLE: ADDRESS: ADDRESS: NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: NAME: NAME: NAME: TITLE: TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: NAME: TITLE: ADDRESS: Name: TITLE: ADDRESS: NAME: TITLE: ADDRESS: Srr''X g1v�ls --�liu�P-C �vtco CA201508904188 SOSID: 1217886 Date Filed: 3/30/2015 4:40:00 PA'I Elaine F. Marshall North Carolina Secretary of State LIMITED LIABILITY COMPANY ANNUAL R ' CA2015 089 04188 NAME OF LIMITED LIABILITY COMPANY: VP Jacksonville, LLC Fictitious Name, If any, used in North Carolina: SECRETARY OF STATE ID NUMBER: 1217886 STATE OF FORMATION: DE REPORT FOR THE YEAR: 2015 SECTION A: REGISTERED AGENTS INFORMATION 1. NAME OF REGISTERED AGENT: Martin D. Koon 2. SIGNATURE OF THE NEW REGISTERED AGENT: riling Office Use Only ® Changes SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 3. REGISTERED OFFICE STREET ADDRESS 8, COUNTY 4. REGISTERED OFFICE MAILING ADDRESS 126 Executive Drive, Suite 200 . PO Box 843 Wilkesboro, NC 28697 Wilkes SECTION'B: PRINCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: Real Estate 2. PRINCIPAL OFFICE PHONE NUMBER: (336) 667-8000 4. PRINCIPAL OFFICE STREET ADDRESS 8r COUNTY 126 Executive Drive, Suite 100 Wilkesboro, NC 28697 Wilkes Wilkesboro, NC 28697 3. PRINCIPAL OFFICE EMAIL: 5. PRINCIPAL OFFICE MAILING ADDRESS PO Box 843 Wilkesboro, NC 28697 SECTION C: COMPANY OFFICIALSIORGANIZERS (Enter additional Company Officials/Organizers in Section E.) NAME: VP Blair, LLC TITLE: Member ADDRESS: PO Box 843 Wilkesboro, NC 28697 NAME: Martin D. Koon TITLE: Manaf;er NAME: TITLE: ADDRESS: 128 Oakwoods Trace ADDRESS: Wilkesboro, NC 28697 SECTION D: CERTIFICATION OF ANNUAL -RE Section D must be completed in its entirety by a personibusiness entity. 3-/3-zoo SIGN RE DATE Pone must be signed by a Company Officfal/Organtzer listed under SecBon C of this form. Martin D Koon, for VP Blair, LLC Manager Print or Type Name of Company OfficlaVOrganizer SUBMITF MAIL TO: Secretary of State, Corporations Division, Post Office Box 29525, Raleigh, NC 27626-0525 TITLE 911YIYBIR�I�IIIV Georgette: Awhile back you gave me the attached asking me to update BIMS with the new corporation. name (Lowes Home Center, ll1C_to Lowe's Home Center LLC} and to send out the Permit Info Update Acknowledgement Form for each permit referenced. I have completed it on all of them EXCEPT three. The current owner names are completely different (not Lowe's in any form) and I think each needs to submit the Ownership Transfer form/supporting documentation. They are as attached: SW8 071207: Owner name is JESMITE DEVELOPMENT, LLC SW8 980429: Owner name is SOUTHSTAR HOLDINGS-MOREHEAD CITY, LLC Q Sw8 970415: Owner name is CRISMAN CORPORATION, AND THE PERMIT EXPIRED IN 2007AND HAS NOT BEEN RENEWED. I guess somebody needs to address all this with them? Jo, 1/6/2016 Xvjo- w:Tl...jG 1? 1 H -Ircl�Vill"�,2-!.N(--)!-",Lil-lEv,:) - rri- ?WY hisan, o"vs; 0 7;i,jj C to � L 1 . b 11 , IPSA x , le s"um, ut C, �. I I. W) 3 U lj,4 G rr." C F J G 6 0,17. f 0 1-M A t I - G. , ,- C:" shnq onj EPA QW1E JU ilby, Wcju tA.+p f.pC JC?. I . W in !•. 5w3a`70L_Als - I aq__7 CAR4 _. STAT CAROLINA �:IN N L R PORT LUDE10.00 FIL FEE A8lE 0 N.C. SECT I STATE. e f Sp1>F o� OFFICE USE ONLY AMOUNT FI L E ��- PROCESSED BY i REPORT DUE DATE- 09-29-1997 V CORP ID- 0 2 5 3 1 3 6 OCT 6 1197 d' FILING No- A 0 0 7 EFFECTIVE �Z1� Ok6� NOTICE DATE- 07-31-1997 STATE OF INC- NC ELAINE F, MA SH ��r'`�" DATE OF INC- 07-31-1989 SECRETARY OF'STATE 1. NAME OF CORPORATION, PRINCIPAL OFFICE ADDRES!iO RTH CARQtMR PR AL OFFICE ADDRESS CHANGE HERE - CRISMAN CORP. P 0 am 1730 BLOWIING ROCK NC 28605 2. REGISTERED AGENT ANO'MAILING ADDRESS CRISMAN S JONES P 0 BOX 1730 BLOWING ROCS( NC 28605 3. STREET ADDRESS OF REGISTERED OFFICE 369 MOCKINGBIRD LN BLOWING ROCK NC 26605 COUNTY - WATALGA 4. IF REGISTERED AGENT CHANGED, SIGNATURE OF NEW AGENT ENTER AGENT NAME AND MAILING ADDRESS CHANGE HERE - ENTER STREET ADDRESS CHANGE HERE - (SIGNATME CONSTITUTES CONSENT TO APPDINTff.117) S. FEDERAL EMPLOYER IO NUMBER ENTER FEDERAL ID NUMBER CHANGE HERE - 6. ENTER NAME, AMMMINESS ADDRESS OF PRINCIPAL OFFICERS HERE - NAME- G1L1sw+0k14 S. TrNES ,TO, ADDR- P. 0 • Moie 1-7-So TITLE- AREs �EwT CITY-mow1% Rates ST-N( ZIP- I$1e0S' NAME- Tq 4E-r T- J 4FS ADDR- P- o . OAO x N-i 3 0 TITLE- d5t-�L)2c � CITY-3LOW146 4C,44, ST- Nk_zip- 2$(eaS NAME- ADOR- TITLE- CITY- ST- ZIP- NAME- ADDR- TITLE- CITY- ST- ZIP- 7. ENTER NAME AND BUSINESS ADDRESS OF DIRECTORS HERE - ATTACH am PACE IF NECESSARY NAME- ADDR_ �� CITY- ST- ZIP- NAME- ADDR- CITY- ST- ZIP- NAME- ADDR- CITY- ST- ZIP- S. BRIEFLY DESCRIBE THE NATURE OF ITS BUSINESS OR ACTIVITIES - ��L EST-'°17r DATE- IFORN /I,NED BY ER OF CORPORATION) (� „p,E_G21'� 1AiV �- �� _Swim -TITLE - TYPE OR PRINT NAME AND TITLE This form should be returned by the DUE DATE shown above with a check for $10.00 to: SECRETARY OF.S.TATE, ANNUAL REPDRT SECTION, POST OFFICE 29525, RALEIGH NC 27626-0525. CAR4 State of North Carolina Department of Environment, Health, and Natural Resources Wilmington Regional Office James B. Hunt, Jr. Division of Water Quality Jonathan B. Howes Governor Water Quality Section Secretary June 13, 1997 Mr. Jim Emerson Isom Associates 1311 Collegiate Drive Wilkesboro, NC 28697 Subject: REQUEST FOR ADDITIONAL INFORMATION Stormwater Project No. SW8 970415 Lowe's Homecenter of Jacksonville Onslow County Dear Mr. Emerson: The Wilmington Regional Office received previously requested information for the Stormwater Management Permit Application for Lowe's of Jacksonville on May 22, 1997. A preliminary review of that information has determined that the application is not complete. The following information is needed to continue the Stormwater review: 1. Please report the surface area provided at the storage elevation for each pond, ie., @44.4 and @46. 2. The forebay design is not in compliance with the design standards of the State. Please see the enclosed detail, from the Best Management Practices Guidance document. 3. The orifice size is based on the volume actually provided in the pond. The revised calculations you submitted still use the 1" required volume. Please recalculate the orifice using the correct volume. The outlet structure detail may need to change as well due to the new orifice size. Please submit 2 copies of the revised plans, if necessary. 4. The placement of the vegetated shelf is unclear. The detail indicates that a 6:1 slope is needed for a width of 5% but the line drawn on the detail is flat. Please clearly indicate at what elevation the shelf begins and ends. Please indicate the shelf area in contour on the plans 5. Please clearly dimension the permanent pools of the ponds.I am unable to read some of the numbers due to the heavy lines used for the contours. 6. Where did you put the note concerning the delineation of the wetlands, or none existing? 7. Provide calculations indicating that the forebays can hold a volume equilavent to 20% of the first inch. 8. Please delineate and label the design pool contour. 127 Cardinal Drive Extension, Wilmington, N.C. 28405-3845 • Telephone 910-395-3900 • Fax 910-350.2004 An Equal Opportunity Affirmative Action Employer Mr. Emerson June 12, 1997 Stormwater Project No. SW8 970415 Please combine as many inlets into the pond as possible to form as few as possible, preferably only one. Long skinny Pond #2 does not meet the design requirements due to the fact that some of the inlets into the pond are located too close to the outlet, causing a short-circuiting situation, where runoff enters and leaves the pond without treatment. 10. That portion of Pond 2 not 3.5' deep cannot be counted toward the surface area requirement. Pond 1 should be 7' deep at the outlet structure. Water will become stagnant in the deeper middle portion of the pond. The ideal pond should graduaIIy deepen and widen toward the outlet. If not for the multiple inlets and incorrect grading at the outlet, Pond 1 would be ideal. 11. Has the 2.2 acres of future development into Pond 1 been accounted for in the design calculations? Please delete the pipe stub into Pond 1 drainage system if not accounted for. 12. All new impervious area must be directed into the ponds. The entire access road to the neighboring property is collected and allowed to leave the site without treatment in either Pond 1 or 2. It appears that the runoff will be collected into an existing pond. Has this pond been permitted by the State? If so, runoff in excess of the previously permitted amount must be approved by the State. Please note that this request for additional information is in response to a preliminary review. The requested information should be received by this Office prior to July 12, 1997, or the application will be returned as incomplete. The return of a project will necessitate resubmittal of all required items, including the application fee. If you have any questions concerning this matter please feel free to call me at (910) 395-3900. Sincerely, 4-6k, A". Ms. Linda Lewis Environmental Engineer RSSlarl: S:1WQSISTQRMWATIADDINFQ1970415.JUN cc: Linda Lewis Central Files 2 State of North Carolina Department of Environment, Health, and Natural Resources ` — Wilmington Regional Office James B. Hunt, Jr. Division of Water Quality Jonathan B. Howes Governor Water Quality Section Secretary 'July 28, 1997 Mr. Jim Emerson Isom and Associates 1311 Collegiate Drive Wilkesboro, NC 28697 Subject: ACKNOWLEDGEMENT OF RECEIPT AND REQUEST FOR ADDITIONAL INFORMATION Stormwater Project No. SW8 970415 Lowe's Home Center Onslow County Dear Mr. Emerson: The. Wilmington Regional Office received previously requested information for the Stormwater Management Permit Application for Lowe's Home Center on July 11, 1997. A preliminary review of that information has determined that the application is not complete. The following information is needed to continue the stormwater review: 1. Please respond point by point in your letters to this Office. I remember discussing the addinfo letter of June 13, 1997 with you, but I must rely on you to put our discussion in writing when you respond to this Office. t/2. The required surface area for Pond 2 is 9,700 square feet, based on a 3.5' deep pond, with 97,000 square feet of impervious area, and using the 90% TSS chart, but you have only provided 8,502 square feet. Please enlarge Pond 2 to provide the minimum required surface area. /3. Please delineate/label the 44.4 contour in Pond 1. 4. Has the 2.2 acre future drainage been accounted for, or will the pond be expanded in the 4 future? 5. If 941107 will accept some drainage from this site, that permit must be modified. Please submit revised plans, permit application, $385.00 fee, and revised calculations indicating sufficient capacity in the pond. 127 Cardinal Drive Extension, Wilmington, H.C. 29QS-3845 0 telephone 910-395-3900 • Fax 910-350-2004 An Equal Opportunity Affirmative Action Employer k Mr. Emerson July 28, 1997 Stormwater Project No. SWS 970415 Please note that -this request for additional information is in response to a preliminary review. The requested information should be received by this Office prior to August 28, 1997, or the application will be returned as incomplete. The return of a project will necessitate resubmittal of all required items, including the application fee. If you have any questions concerning this matter please feel free to call me at (910) 395-3900. Sincerely, Ms. Linda Lewis Environmental Engineer RSS/arl: S:IWQSISTORMWATIADDINF01970415.JUL cc: Linda Lewis Central Files :y 127 Cardinal Drive Extension, Wilmington, N.C. 28405-3845 • Telephone 910-395-3900 • Fax 910-350-2004 An Equal Opportunity Affirmative Action Employer �IsO M r S�;S�O C'l�A- rs, r JUL July 10, 1997 ' 133Y. COLLEGIATE r DRIVE Ms. Linda Lewis WILKESBORO State of North Carolina Dept. of Environmental, Health, and Natural Resources NORTH Wilmington Regional Office',. Water Quality Section 127 Cardinal Drive Extension CAROLINA Wilmington, NC 28645-3845 28697 Re: Lowes of Jacksonville, NC — Project #9656 Slormwater Project No. SWS 970415 — Resubmittal #2 Dear Linda: PHONE Enclosed please find our revised plains complying with your letter dated June 13,- 910 1997, We have complied with all requirements with the exception of comment #12. pursued information about the Circuit City pond and found it was permitted by your 83$ office and the project number is SWS 941107. 4007 • 1 have re4trested information from the engineer related to any excess capacity in this pond; which would accommodate the addition. of .16 acres of paved surface. Please FAX note that the existing area draining from Circuit City is 155 acres so the addition is '910 approximately 4%. We urgently need to be permitted on this project and I will work hard to provide you' s3s information,.quickly. 4318 Sincerely, ISOM SSOCIATES, P.A. Dale L, Isom, P.E. President DLI/psh Enclosures ARCHITECTS ENGINEERS PLANNERS®, - _ _ P.A. i e \ PC �r 1311 .97 COLLEGIATE Wednesday, May 21, .1997 DRIVE ' Ms. Linda Lewis WILKESBORO State of North Carolina Department of Environment, Health NORTH and Natural Resources Wilmington Rerional Office CAROLINA 127 Cardinal Drive Extension Wilmington,, North Carolina - 28697 28405-3845 ° Re? Lowe's of Jacksonville, North Carolina Project #9656 - PHONE Revised Stormwater Management Permit Application 910 Dear Ms. Lewis, 838 Please find enclosed (3) copies of revised sheets C-2 and C-6, (1) copy of the. 4007 sealed stormwater"calculations, and (1) copy of the revised Stormwater Management Permit Application. These sheets reflect comments made in your FAX letter dated May 2, 1997. If you have any questions, .please call me at 838-4007, ext. 35. Thank you. ; 910 - 838 Sincerely, 4318 Jim Emerson Engineering Tech II I ARCHITECTS* ENGINEERS- PLANNERS LS A 4/ 4/�7 IcLA'- qo,70 5ed 0 d e � a r2p 2g�e4 s� p2ECEIVED MAY 2 2 1997 43- 36, Tr K 2 2,5 J 3 -- i.. Area -, �u raco�� �•-off _- , 244) ! 0 CJ� cal Arw= P 9 STATE oA, CP i - n State of North Carolina Department of Environment, Health, and Natural Resources Wilmington Regional Office James B. Hunt, Jr. Division of Water Quality Jonathan B. Howes Governor Water Quality Section Secretary May 2, 1997 Mr. Dale Isom, P.E. Isom Associates, P.A. 1311 Collegiate Drive Wilkesboro, NC 28697 Subject: ACKNOWLEDGEMENT OF RECEIPT AND REQUEST FOR ADDITIONAL INFORMATION Stormwater Project No. SW8 970415 Lowes Home Center Onslow County Dear Mr. Isom: The Wilmington Regional Office received a Stormwater Management Permit Application for Lowes Home Center on April 16, 1997. A preliminary review of that information has determined that the application is not complete. The following information is needed to continue the stormwater review: 1. Please provide the mailing address for Crisman Corporation. In care of addresses are not acceptable. ;/ 2. Please split up the breakdown of impervious area between the two ponds. 3. Please fill in the name of the receiving stream 4. The total built -upon area is greater than the sum of the project areas. The total proposed built - upon area listed for each pond in the columns is less than the total in the breakdown section. Please correct and revise the application. I am unable to verify pond design at this time. ✓ 5. Please seal the calculations. 1/ 6. Please report in the calculations which TSS chart was used, 85 % o 90 %. 127 Cardinal Drive Extension, Wilmington, N.C. 28405-3845 • Telephone 910-395-3900 • Fax 910-350-2004 An Equal Opportunity Affirmative Action Employer Mr. Isom May 2, 1997 Stormwater Project No. SW8 970415 7. Please report the storage provided in the ponds, and the surface area at the design storage elevation. S. The orifice size is based on the volume provided in the pond, not the required volume. 9. Delineate all wetlands on site, or note on the plans that none exist. 10. A forebay must be designed at each inlet to the pond, or a single larger forebay may be used where each pipe will inlet into. The forebay is shallower than the main pond, and must hold at least 20 % of the first inch volume. For individual forebays, divide the 20 % between the number of pipe inlets. 11. Delineate the permanent pool and design pool contours. 12. Dimension the permanent pool contour. v-" 13. A 6:1 vegetated shelf must be located adjacent to the permanent pool, planted with appropriate wetland species. Please indicate the location and width of this shelf on the detail. Please note that this request for additional information is in response to a preliminary review. The requested information should be received by this Office prior to June 2, 1997, or the application will be returned as incomplete. The return of a project will necessitate resubmittal of all required items, including the application fee. If you have any questions concerning this matter please feel free to call me at (910) 395-3900. Sincerely, Ms. Linda Lewis Environmental Engineer RSS/arl: ' S:IWQSISTORMWATIADDINF01970415.MAY cc: Linda Lewis Central Files C�6,%t- L ..Esom 'A7—, ro IC U lel- ,, i r4 .7- , 051 — TrY 2 STORMWATER E C E I V E _Gf�E 2, APR 161997 PROJ # W o+(5 4L� L- 43 -�.. Arm rats 1 Pro Aro = I l cvoo s-- �o� �2A 4g-�' rs = 10 8 067 r= , o6z�7 �2_ I- I'S'ON[� S`S�OCJAT -s PA, o. 1311 - COLLEGIATE DRIVE WILKESBORO TO: Linda Lewis NORTH 1.27 Cardinal Drive Extention Wilmington. NC 28405-3845 CAROLINA 28697 C _IVE-i, Y APR 161997 BY: DATE: 4/15/97 JOB NO: CLIENT: SUBJECT- Lowe's Jacksonville, NC 0 We are sending you the following: PHONE Prints Specifications Shop Drawings Other 910 COPIES DRAWING NO., DATE DESCRIPTION 1 838 Two (2) set of Prints 4007 i ti FAX 910 These are transmitted: 838 Per Your Request For Your Use 4318 For Your information/Records Approved For Your Approval/Comments Please Return X For Your Review/Comments Returning to you Revise and Resubmit For Correction Approved as Noted Not Approved REMARKS: ' Received by: SIGNED:C> 4;,47 y�y -ARCHITECTS o ENGINEERS o PLANNERS LS d \ . r ,, ' ,. r } l f . L � � , ,. f ,. ,, . - �� - � � . .- , . ' � l � - \ � � 1 , 1 � i ' I � Y � ' � � � � ` I � 1 V,S0NVILZA, City of Jacksonville Caring Community 0 4 ::& -, 'I- 04 r� LETTER OF TRANSMITTAL Date : Atari l 23, 1997 TO: Division _Qd__Envi ronmental Management 127 r in 1 -Drive Extension Wilmin on N 2840 Phone # (910) 395-3900 Linda. WE ARE SENDING YOU XX PRINTS COPY OF LETTER DESCRIPTION: Attn:Ms. Linda Lewis Ref:Erosion Sedimentation Control Plans and Finacial Responsibility Statement -for Lowe_'sof_jacksQuill at 1255 Western Boulevard. _. XX ATTACHED ! UNDER SEPARATE COVER THESE ARE TRANSMITTED AS CHECKED BELOW: PLANS SPECIFICATIONS OTHER Financial Responsibility statement FOR APPROVAL _ AS REQUESTED XX FOR REVIEW AND COMMENT XX FOR YOUR USE FOR BIDS DUE — PRINTS RETURNED AFTER LOAN TO US OTHER REMARKS: 199 COPIES TO: File Bill Sheppard ErTli neeri ng Techm ci an Post O1Tcc Box 128 i Jacksonville, North Carolina 28541 t T'1'1)# (910) 455-8852 t Fax (910) 455-6761 x i'�- .. t; + -.. 1 •- j 3i _ - - .._ � - -. _ ..__- .. 'f -. �4•�1i•� ft o'FR-01-1997 15:37 150ri ;S50C[AFES, P.A. 910 839 4318 F.02 ?ZUNCIAL SUMM,SIBILM/ 0 INS"nP Imm 8� ►TIce P=UTICN c,'ca"OL ]1C'r No person by tAe Act befa have been comp Invirv=ettt, as not applicable, initiate a land-diaturbl" activity on one or more acres as covered his form and an acceptable erosion and sedimpata;ti,on central plan 3 sad epwored by tag Land Quality section, x,c. Department of , and Natural ftsouzeas. (Pleas* type on print and, if qum mion in ce li/A in the blaU) Part A. 1. project A Lowe's of Jacksonville, NC 2. Location Of d istttrbia me�eett city: County Onslow City or T hip J acksonVq and q war Strent es ern . Ext . 2. Approximate to land-distuxbi g activity Will be enmmenc-ed. 4 ` 15 - 9 7 4. Purpose of d velopmont (residential, cocmorcial, industrial, etc.):Commercial S. Total acre 8sturbed or uncovered (including off -sits narrow and wets arena): 6. amcsuat of to enclosed 5 185.00 7. Has an erosi and sedimentation control plan been filed? You No ?t,�� Enclosed x 8. Paxson to co tact should sediment control issues arise during land -disturbing activity. 910-667-8000 x4me art n D. Koon 9. .Landowner(s) of Record (gas blank page to list additional owzsers) Venture P operties I, LLC Mr. Martin D. Koon/Member same a� Post Offic Box 843 924 Main Street, Suite 300 Current "inn esa Current street dream Wilkesboro ETC 28697 North Wilkesboro, NC 28659 ty s ate zip city State ..p IO . Recorded to 0 wd Rook no. 1087 Page 5 0 2 - 5 41 lro . R8ereon(a) or irm(s) irho a" fJmaacially respa sable for this. Ian! -disturbing activity (Use a blank page to list additional persona or ti.xma): Venture Pro erties I, LLC Mr. Martin D. Koon/Member ame o ran s) or ?' �,r�s (s) .—...,—�•.,•�• .,•� Post Office Box 843 924 Main Street, Suite 300 Wilkesboro, l NC 28697 0--667-800 Neal-21-1996 14 : 53 VU;R North Wilkesboro, NC 28659 Cy tars L p P.02 m PPR-07-1997 15:38 ISON ASSOCIATES, P.A. 910 838 4318 P.03 1. (a) It the >rl*cially Responsible Party is sat a resident of Korth ca"ILua give name red Straft address of a North Carollna Ageat. N/A Name mall City — - s tr sss ate a p City state Irv— (b) If the Fin&ricially Rssponoible Perky is a Partnership or other person esugaginq LA business a assumed mates, attach a co" of'the cartif Lents of assumed arms. If the ally Responsible Party is a corporation give name and strew i�4tered adds*; oft Agent. N/A awes of Rog erect Rt Kai ng A41dres a, Itreet tee City. state Zip City stater sip 'relsplsone 7e ep are• The above Lato tion to true and correct to the best of my knowledge and boliaf and was prvvid by ms ummr oath. (This f0ft must Do ■ignsd by the 91 anti sally sespoasibla son if an individual or his attvrresy-in- fact or it not as individkai by PIT,` n officer, disector, partner, or regiatored agent with authcwlty to execute for the financially raspo*dible person) . I agree to provide car ed information should there be any .change ire the information provided "re . Martin D. Zoon Member or print i Title or Author ty Signature Date L April 7, 1997 f, Vicki L. Adams , a fttary public of thM Comity of Wilkes state of North robs&, Aersby certify that Martin D. Koon appeared par sly before so this day sad be u y warn aamov at e above form was executed by him. wLthesa hand and notarial a«a this 7t11 day f April , 1997 Se (I A Notary s Q V1 KIE L ADAMS N TARYPUBLIC WI COUNTYNC ission ires`T• u7- aa1M NOIt-21-1996 t a : $3 illy eoesx as Loss expires 9 -17 - 2 0 0 0 n 96% P.03 TOTAL F.03