SW3140304_CURRENT PERMIT_20140512

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO. SW :3eMK
DOC TYPE CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATEXA) &,effp"A�
YYYYMMDD

Pat McCrory
Governor
A p
NCDENR
North Carolina Department of Environment and Natural Resources
May 12, 2014
The Honorable Edgar 0. Murphrey, Jr., Mayor
City of King's Mountain
101 W. Gold Street
King's Mountain, North Carolina 28086
Subject: Stormwater Permit No. SW3140304
T.J. Ellison Water Treatment Plant Upgrade
Low Density Stormwater Project
King's Mountain, Cleveland County
The Honorable Edgar 0. Murphrey, Jr, Mayor:
John E. Skvarla, III
�Q Secretary
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The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for
the subject project on March 11, 2014. 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 and Session Law 2006-246. We are forwarding Permit No. SW3140304, dated May 12, 2014,
for the construction, operation and maintenance of the subject project.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
conditions and limitations as specified therein, and does not supersede any other agency permit that
may be required. Please pay special attention to the conditions listed in this permit regarding the
Operation and Maintenance of the BMP(s), recordation of deed restrictions, procedures for changes of
ownership, transferring the permit, and renewing the permit. Failure to establish an adequate system
for operation and maintenance of the stormwater management system, to record deed restrictions, to
follow the procedures for transfer of the permit, or to renew the permit, will result in future
compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right
to request an adjudicatory hearing by filing a written petition with the Office of Administrative
Hearings (OAH). The written petition must conform to Chapter 150B of the North Carolina General
Statutes. Per NCGS 143-215(e) the petition must be filed with the OAH within thirty (30) days of
receipt of this permit. You should contact the OAH with all questions regarding the filing fee (if a filing
fee is required) and/or the details of the filing process at 6714 Mail Service Center, Raleigh, NC 27699-
6714, or via telephone at 919-431-3000, or visit their website at www.NCOAH.com. Unless such
demands are made, this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please contact Bill
Diuguid at [phone], or [e-mail].
Sincerely,
Original Signed by William H. Diuguid
William H. Diuguid, AICP, Plans Reviewer
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
1612 Mail Service Center, Raleigh, North Carolina 27699-1612
Phone: [phone] \ Internet: www.ncdenr.gov
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
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Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This fora nay be photocopied for use as an original o
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I. GENERAL INFORMATION N �
1. Project Name (subdivision, facility, or establishment name - should be consistent with
specifications, letters, operation and maintenance agreements, etc.):
2. Location of Project (street address):
1432 Oak Grove Road
City:Kings Mountain County:Cleveland Zip:28086
3. Directions to project (from nearest major intersection):
t plans, e
From the intersection of I-IWY 74 and HWY 7413, take FIWY 7413/Stony Point Rd north until it intersects with
Oak Grove Road (approximately 2 2 miles). Turn Left onto Oak Grove Road and after approximately 1.7
miles the WTP will be on your right at 1432 Oak Grove Road.
4. Latitude:35° 16' 27.88" N Longitude:81° 2709.98" W of the main entrance to the project.
If. PERMIT INFORMATION:
a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
tRenemnls With modifications also requires SINU-102 - Renewal Application Fonn
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) , and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
®Low Density ❑High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stornnvater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state pennits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑LAMA Major
❑NPDES Industrial Stormwater
®Sedimentation/Eros ion Control: 3.05 ac of Disturbed Area
0404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? ANo UYes
If yes, see S.L..2012-200, Part VI: httl2://portal.iicdeiir.org/web/wq/ws/su/statesw/­rules laws
FormSWU-101 Version06Aug2012 Page I of

III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicatit/ Organization:City of Kings Mountain
Signing Official & Title:Edgar O. Murphrey, Jr., Mayor
b.Contact information for person listed in item la above:
Street Address:101 W. Gold Street
City:Kings Mountain State:NC Zip:28086
Mailing Address (if applicable):PO Box 429
City:Kings Mountain State:NC Zip:28086
Phone: (704 ) 734-4525
Email:marilyns©cityofkm.com
Fax: (704 ) 730-2152
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official &'Title:
b.Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if
City:_
Zip:
State: Zip:
Phone: ( _ )_ Fax:
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:Marziano & McGougan P.A.
Signing Official & Title:(oseph W. McGougan P.E.
b.Contact information for person listed in item 3a above:
Mailing Address:1300 Second Ave Ste. 211
City:Conway State:SC Zip:29526
Phone: (843 ) 488-0124
Email:jmcgougan oOmarziano-mcgougan.com
Fax: (843 ) 488-0129
4. Local jurisdiction for building permits: Cleveland County
Point of ContactPaul Ezell Phone #: (704 ) 4844997
Form SWU-101 Version 06Aug2012 Page 2 of

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Stormwater runoff should be minimal and will be further restrained by silt fencing.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.lf claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Broad River basin.
4. Total Property Area: 3.05 acres
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0.52 acres
7. Total Property Area (4) -Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area+:2.53 acres
Total project area shall be calculated to exclude the follozoingg the normal pool of impounded structures, the area
between the banks of stremus and rivers, the area below the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Nou-coastal7oetlmnds landzaard of tlue NHW (or MHW) liuue may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 33 °
9. How many drainage areas does the project have?7 (For high density, count 1 for each proposed engineered
stormwater BMP. For loon density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Draina ge Area 1
Draina e Area __
Draina e Area _
Drainage Area _
Receiving Stream Name
Buffalo Creek
Stream Class *
WS-III; CA
Stream Index Number *
9-53-(2.9)
Total Drainage Area (so
2.53
On -site Drainage Area (so
2.53
Off -site Drainage Area (so
0
Proposed Impervious Area*' (so
36155
% Impervious Area** total
33
Impervious— Surface Area
Drainage Area
Prainage Area _
Draina >e Area _
Draina e Area _
On -site Buildings/Lots (so
6355
lavpr
On -site Streets (so
On -site Parking (so
2000
On -site Sidewalks (so
2400
`
Other on -site (so
1000
Future (so
Off -site (so
Existing BUA*** (so
24400
Total (so:
36155
* Stream Class and Index Number can be determined at: litty://nortal.uucdettr.or /zo)eb/zoq/pslcsn/classifications
huh�ervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidezuniks, gravel areas, etc.
*** Report only that annount of existing BUA that will reunain after development. Do not report any existing BUA that
is to be removed and Which Will be replaced by ne7v BUA.
Form SWU-101 Version 06Aug2012 Page 3 of 6

11. How was the off -site impervious area listed above determined? Provide documentation.
Projects in Union County: Contact DIt'Q Central Office staff to check if the project is located within a Threatened R
Endangered Species watershed that may he suhject to more stringent stornnvater requirements as per 15A NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http://portal.ncdenr.org/web/wq/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from http://portal.ncdenr.org/web/­wq/­ws/su/statesw/fornis-docs. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at http://portal.ncdennorg/web/wg/ws/so/maps.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http://portal.ticdenr.org/web/wq/ws/su/statesw/forms
does.
Is
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
1.
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
�(
agreement(s) for each BMP.
4. Permit application processing fee of $505 pnynble to NCDENR. (For an Express review, refer to
http://www.enviielp.org/Liages/onestopexpress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the 1/2
mile radius on the map.
T Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NI-IW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MI-IW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all 13UA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
FormSWU-101 Version06Aug2012 Page4of6

9. Copy of any applicable soils report with the associated SH WT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x 11" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verifij the SHWI' prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 3 Page No:112
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 21-1.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http: / / www.secreta ry.sta te.nc.0 s / Corpora tions / CSearcli.aspx
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
http://portal.ncdenr.org/web/wq/ws/su/statesw/forms_docs. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ and that they will be recorded prior to the sale of any lot.
Vill. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineenjoseph W. McGougan, P.E.
Consulting Firm: Marziano & McGougan, P.A.
Mailing Address:1300 Second Ave Ste. 211
Phone: (843 ) 488-0124
Email:imcgougan @marziano-mcgougan.com
State:SC Zip:29526
Fax: (843 ) 488-0129
IX. PROPERTY OWNER AUTHORIZATION (if Con tact Information, item 2 has been filled ouI, complete this
section)
I, (print or type name of person listed in Contact Information, items 2a) , certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
lister! in Contact Information, item In) with (print or type none of organization listed in
Contact Information, item In) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 06Aug2012 Page 5 of

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
a Notary Public for the State of , County of
do hereby certify that
before me this _ day of
personally appeared
and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expi
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 1n) Edgar O. Murphrey, Jr., Mnilor
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stornnvat�es mJer,1-5A�-hiChAC 21-I .1000 and any other applicable state stormwater requirements.
Signa
Date: 3—
I, AA N Je SSo vvl , a Notary Public for the State of Nok'Kt C20-o Cqc ,County of
do hereby certify that tFd!240- (0' 6kutrepersonally appeared
before me thisiaek-day of , c�o 1 4 , and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, QV� ) Lei
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Notory public
Cleveloncl County
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Fonn SWU-101 Version 06Aug2012 Page 6 of