SW3140601_CURRENT PERMIT_20140703

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW/`f��Ol
DOC TYPE
PERMITrURRENT
PPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

� gmty-A
NC®ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
July 3, 2014
Mr. Rich Heareth
Epcon Marvin LLC
8600 Sam Farr road Suite 180
Huntersville, North Carolina 28078
Subject: Stormwater Permit No. SW3140601
Courtyards at Marvin, Union County
Dear Mr. Heareth:
John E. Skvarla, III
DIPIS/ pN Secretary
�A*y OF
C�� ✓(�� C N CFS
h/
` c �
The Division of Energy, Mineral, and Land Resources (DELMR), received a complete Stormwater
Management Permit Application for the subject project on July 1, 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 21-1.1000 and Session Law 2006-246. We are forwarding Permit No. SW3140601,
dated July 3, 2014, for the construction, operation and maintenance of the subject project and the stormwater
system. This permit shall be effective from the date of issuance until July 2, 2022 and shall be subject to the
conditions and limitations as specified therein, and does not supersede any other agency permit that may be
required.
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 150E 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.
This project will be kept on file at the Mooresville Regional Office. If you have any questions, or need
additional information concerning this matter, please contact Mike Randall at [phone]; or
[e-mail].
Sincerely,
/
for Tracy E. Davis, PE, CPM, Director
cc: SW3130702 File, Mooresville Regional Office
cc: Wesley A. Smith, EMH&T
Andrew McDonald, EMH&T
Division of Energy, Mineral, and Land Resources
Energy Section • Geological Survey Section • Land Quality Section
1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707.92001 FAX: [phone]
512 North Salisbury Street, Raleigh, North Carolina 27604 • Internet: http://portal.ncdenr,org/web/Ir/
An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper

State Stormwater Permit
Permit No. SW3140601
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General atutes of
North Carolina as amended, and other applicable Laws, Rules, and Re i�NO �s
PERMISSION IS HEREBY GRANTED TO �/A�Oq
✓ `1SFOnO gOFS
Epcon Marvin LLC Ot�^ (/� N
Courtyards at Marvin �q•�������4
2012 Providence Road South, Marvin North Carolina in Union Co ktw; M
FOR THE ALaT
construction, operation and maintenance of one Wet Detention Basin in compliance..
with the provisions of Session Law 2006-246 and 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 State and considered a part of this permit.
This permit shall be effective from the date of issuance until July 2, 2022, and shall be
subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. The Wet Detention Basin is approved for the management of stormwater runoff
as.described in the application documents and as shown on the approved plans.
3. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
4. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
5. The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
Page 1 of 4

State Stormwater Permit
Permit No. SW3140601
II. SCHEDULE OF COMPLIANCE
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 all time provide the operation and maintenance necessary
to assure the permitted Wet Detention Basin 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 re -vegetation of slopes and the filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans.
f. Debris removal and unclogging of all drainage structures, level spreader,
filter media, planting media, underdrains, catch basins and piping.
g. Access to the cell and outlet structure must be available at all times.
Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and
what actions were taken.
4. The permittee shall submit an annual summary report of the maintenance and
inspection records for the Wet Detention Basin. The report shall summarize the
inspection dates, results of the inspections, and the maintenance work
performed at each inspection.
5. The Wet Detention Basin shall be constructed in accordance with the approved
plans and specifications, the conditions of this permit, and with other supporting
data.
6. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the Wet Detention Basin certifying that the
permitted facility has been installed in accordance with this permit, the approved
plans and specifications, and other supporting documentation. Any deviations
from the approved plans and specifications must be noted on the Certification. A
modification may be required for those deviations.
7. If the stormwater system was used as an Erosion Control device, it must'be
restored to design condition prior to operation as a stormwater treatment device,
and prior to occupancy of the facility.
8. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project
area. The project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan was sought.
Page 2 of 4

State Stormwater Permit
Permit No. SW3140601
Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
9. A copy of the approved plans and specifications shall be maintained on file by
the Permittee for a minimum of eight years from the date of the completion of
construction.
10. 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
Directorfor modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made.
III. GENERAL CONDITIONS
1. This permit is not transferable except after notice to and approval by the Director.
In the event of a change of ownership, or a name change, the permittee must
submit a completed Name/Ownership Change form signed by both parties, to the
State, accompanied by the supporting documentation. The approval of this
request will be considered on its merits and may or may not be approved.
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves a request to transfer the permit.
3. Failure to abide by the conditions and limitations. contained in this permit may
subject the Permittee to enforcement action by the State, in accordance with
North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
Page 3 of 4

State Stormwater Permit
Permit No. SW3140601
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 21-1.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
12. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 3'd day of July, 2014.
or racy E. Davis, ., CPM
Director Division of Energy, Mineral, and Land Resources
Page 4 of 4

State Stormwater Permit
Permit No. SW3140601
project name
county County
Designer's Certification
I, , as a duly registered in the
State of North Carolina, having been authorized to observe (periodically/ weekly/
full time) the construction of the project,
(Project Name)
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
cc: NCDENR-DEMLR Regional Office
Page 1 of 1

,6.
Permit Number:
(to be Provided by DWQ)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection ill be
corrected, repaired or replaced immediately. These deficiencies can affect the int�pty
of structures, safety of the public, and the removal efficiency of the BIB$'. y�y
0
The wet detention basin system is defined as the wet detentionw, G �g
pretreatment including forebays and the vegetated filter if one is vi.
� ' tP M
This system (check one): `\ci
`� 1��N��9�
❑ does ® does not incorporate a vegetated filter at the outl FN
This system (check one): 1'
❑ does ® does not incorporate pretreatment other than a forebay.
Important maintenance procedures:
— Immediately after the wet detention basin is established, the plants on the
vegetated shelf and perimeter of the basin should be watered twice weekly if
needed, until the plants become established (commonly six weeks).
— No portion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
— Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— If the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
— Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected once a month and
within 24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a
Coastal County). Records of operation and maintenance should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element.
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash debris.
The perimeter of the wet
Areas of bare soil and/or
Regrade the soil if necessary to
detention basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide time and a
one-time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of
long.
I approximately six inches.
Form SW401-Wet Detention Basin O&M-Rev.4
Page 1 of 4

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
The pipe is clogged.
Unclog the pipe. Dispose of the
Swale
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the Swale if necessary to
Swale.
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible. Remove the sediment and
sediment storage.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional
show that pruning is needed
practices
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design sediment
possible. Remove the sediment and
storage depth.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over
Consult a professional to remove
50% of the area.
and control the algal growth.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray).
the basin surface.
Form SW401-Wet Detention Basin O&M-Rev.4
Page 2 of 4

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair. if applicable)
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Division of
damage have occurred at the
Water Quality Regional Office, or
outlet.
the 401 Oversight Unit at 919-733-
1786.
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads
sediment shall be removed.
When the permanent pool depth reads
shall be removed.
Sediment Removal
Bottom
feet in the main pond, the
feet in the forebay, the sediment
BASIN DIAGRAM
(fill in the blankv)
Permanent Pool Elevation 589.50
I Pe manen Pool
---------- i-- Volume Sediment Removal Elevation _ Volume
581 ft Min. ------
Sediment Bottom Elevation 581 2 1-ft n
Storage Sedimer
Storage
FOREBAY MAIN POND
Form SW401-Wet Detention Basin O&M-Rev.4
Page 3 of 4

Permit
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to.the system or responsible party.
Project name:Courtvards at Marvin
BMP drainage area number:31.98 Acres
Print name:Rich Heareth
Title:Carolinas VP Operations
Address:8600 Sam Furr Road Suite 180
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I, " l r� , a Notary Public for the State of
. (1aR91, b4Lp n a County of LI A % do hereby certify that
—R!; c,l-- -,50— personally appeared before me this 4-
day of 0t,nv_ I &D)4, and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,
U �9%
NOTARY c
PUBLIC
U�
Z'�4�NCOUt\�0��`•
SEAL
My commission expires My Commission Expires 07/2712015
Form SW401-Wet Detention Basin O&M-Rev.4
Page 4 of 4

O
Hioh Density Residential Subdivisions ,
Deed Restrictions & Protective Covenances
In accordance with Title 15 NCAC 2H.1000 and S.L. 2006-246, the Stormwater Managemenf
deed restrictions and protective covenants are required for High Density Residential Subdiv
lots will be subdivided and sold and runoff will be treated in an engineered stormwater control fa
restrictions and protective covenants are necessary to ensure that the development maintains a
area consistent with the design criteria used to size the stormwator control facility.
�G? \9% (P9F
�gL)
aulaigIns, J'
I, Rich Heareth , acknowledge, affirm and agree by my signature below, that
I wi cause the following dee restrictions and,covenants to be recorded prior to the sale of any lot:
1. The following covenants are intended to ensure ongoing compliance with State Stormwater
Management Permit Number , as issued by the Division of Water Quality under the
Stormwater Management Repu ation
2. The State of North Carolina is made a beneficiary of these covenants to the extent necessary to
maintain compliance with the Stormwater management permit.
3. These covenants are to run with the land and be binding on all persons and parties claiming under
them.
4. The covenants pertaining to stormwater may not be altered or rescinded without the express written
consent of the State of North Carolina, Division of Water Quality,
5. Alteration of the drainage as shown on the approved plan may not take place without the concurrence
of the Division of Water Quality.
6. The maximum allowable built -upon area per lot is square feet. This allotted amount
includes any built -upon area constructed within the lot property boundaries, and that portion of the
right-of-way between the front lot line and the edge of the pavement. Built upon area includes, but is not
limited to, structures, asphalt, concrete, gravel, brick, stone, slate, coquina and parking areas, but does
not include raised, open wood decking, or the water surface of swimming pools.
OR, If the proposed built -upon areas per lot will vary, please REPLACE #6 above with the following:
6. The maximum built -upon area per lot, In square feet, is as listed below:
This allotted amount Includes any built -upon area constructed within the lot property boundaries, and
that portion of the right-of-way between the front lot line and the edge of the pavement. Built upon area
Includes, but Is not 11mited to, structures, asphalt, concrete, gravel, brick, stone, slate, coquina and
parking areas, but does not include raised, open wood decking, or the water surface of swimming
pools.
7. Each lot will maintain a 30'" toot wide vegetated buffer between all Impervious areas and surface
waters,
""50 foot for projects located to the 20 coastal counties.
8. All runoff from the built -upon areas on the lot must drain into the permitted system, This may be
accomplished through a variety of means including roof drain gutters which drain to the street, grading
the lot to drain toward the street, or grading perimeter swales to collect the lot runoff and directing them
Into a component of the stormwater collection system. Lots that will naturally drain into the system are
not required to provide these additional measures.
Form DRPC-3 Rev.2 05Nov2009 Page I of 2

yr; •i
High Density Residential Subdivisions
Deed Restrictions & Protective Covenances
a Notary Public in the
State of -4)oP-A-t-.C-A2oltra County of Uv.tia.-
do hereby certify that —R; c= O'L r 1'2 personally appeared
before me this the LA day of 3u.,,e. 20 4 , and acknowledge
the due execution of the foregoing instrument. Witness my hand and official seal,
Signattfre
W Commisslon Eypires 07/27/2015
My Commission expires
U
NOTARY
PUBLIC
Form DRPC-3 Rev.2 05Nov2009 Page 2 of 2

Cc�vt��Grc+S (� rAcF )\n
NC DEQ Division of Energy, Mineral and Land Resources
STATE STORMWATER FAST TRACK PROCESS:
FINAL PERMIT SUBMITTAL CHECKLIST
The As -Built Package Submittal, including a permit application fee of $505.00, must be
submitted by the permittee of the current ATC within 45 days of completion of the project and
must include the following per 15A NCAC 02H.1044(3).
21.
Completed Application Form SWU 101" w/ appropriate signatures that include the following
information:
a. Current and Previous Project Names
b. Physical Location of Project
c. ATC# and any other permit #'s associated with project (CAMA, NPDES, SECP, 401)
d. Density of entire project and each drainage(s) area
e. Written description of project and SCM(s) used on site.
f. Applicant and owner name and contact information. Please ensure to grovide
documentation to demonstrate they are an authorized representative p4 V6A NCAC
rn
02H.1040(1). _po rn
—/
LN 2.
The appropriate supplement(s) g rn
a. Low Density Supplement NfA 3
C
b. Supplement EZ ✓ d o
rn
//
13/3.
Operation and Maintenance (O&M) agreement(s) " (See also recorded documegts below)
M 4.
Signed, Sealed and Dated As -Built Calculations
❑ 5.
Signed, Sealed and Dated Soil Report for SCM(s) that require SHWT evaluation or soil infiltration
N/q
rate (see 1044(3)(c) for specific soil report requirements).
❑ 6. Site plans signed, sealed, and dated that are a minimum size of 22" x 34" and shall include:
N/A, a. A location map w/street names and State Route #s to nearest intersection; legend and
north arrow.
b. Project name, designer, and dates.
c. Dimensioned project or project phase boundary with bearings and distances.
d. Boundaries of all surface waters, wetlands, regulatory flood zones, protected vegetated
setbacks and/or riparian buffersORnote on plans stating none exist.
e. Site Layout that includes all items outlined in 1044(3)(e)(iv).
Z7. SCM and Planting As -Built Plans
a. SCM plans signed, sealed, and dated in both plan view and cross-section at scale of 1"
equal to 30ft or larger (see iii below for exceptions to this scale. Other scales may be
accepted IF legible when copied). The plans shall include:
i. dimensions, side slopes & elevations w/benchmark for clean -out if appropriate
ii. all conveyance system device and spec sheet/construction information on plans as
outlined in 1044(3)(f)(ii) & (iii).
b. SCM Planting plans signed, sealed, and dated for wetland and bio-retention cell (or
N)A, typical) scale shall be 1" equals 20ft or larger. The planting plan shall include plant:
i. Layout, total # and size of all plant species.
ii. Species names & location
iii. For wetlands, a delineation of planting zones
c. Wet ponds shall include a planting plan that demonstrates the SCM meets the
requirements of 15A NCAC 02H.1053(6) and (11).
Fast Track Final Permit Submittal Checklist NC DEQ Feb 13, 2018

Crr 8. Recorded Documents — The following documents must have been recorded with the appropriate
county or local government office before submittal to DEQ for the final SW permit:
a. The signed and notarized Operation and Maintenance Agreement(s). The O & M(s) must
include the project name and any permit numbers associated with the project on the
agreement(s).
b. Deed Restrictions/ Protective Covenants and any amendments for the project which
include any associated permit numbers and limit BUA per the permit requirements.
c. Drainage Easements
0'9. As -Built Designer "General MDC" Certification" and all applicable SCM-specific As -Built
Certifications" signed and sealed by the licensed professional of record. This includes the
SCMS, conveyance system, and drainage areas. Indicate which of the following certifications
have been provided:
Quantity
Locations
[�
General MDC
❑
Low Density
❑
Infiltration System
❑
Bioretention Cell
p�
❑
Wet Pond
Stormwater Wetland
/
❑
Permeable Pavement
❑
Sand Filter
❑
Rainwater Harvesting
❑
Green Roof
❑
Level Spreader — Filter Strip
❑
Disconnected Impervious
Surface
❑
Treatment Swale
❑
Dry Pond
❑
StormFilter
❑
SilvaCell
E5 10. As -Built "Permittee Certification"" signed by the permittee certifying that the permittee has
met their permitting requirements. This includes recording the necessary documents and
certifying the built -upon area has not been exceeded.
" SW application materials and templates are available at:
Application Form SWU-101 and Low Density Supplement Form:
https://deg. nc.gov/abouUdivisions/energy-mineral-land-resources/energy-mineral-land-rules/stormwater-
program/post-construction
Supplement EZ and O&M Forms: https:Hdeg.nc.gov/sw-bmp-manual
As -Built Certification Forms: https://deg.nc.gov/about/divisions/energy-mineral-land-resources/energy-
m inera I -la nd-ru les/stormwate r-p rog ra m/post-co nstruction/fast-track
Fast Track Final Permit Submittal Checklist NC DEQ Feb 13, 2018

Project Name C(3QrVyrrcls CO- N-'r%)Nn Permit #SW8 SW3S'1b60\
AS -BUILT PERMITTEE CERTIFICATION
I hereby state that I am the current permittee for the project named above, and I certify by my signature below,
that the project meets the below listed Final Submittal Requirements found in 15a NCAC 02H.1042(4) and the
terms, conditions and provisions listed in the permit documents, plans and specifications on file with or provided
to the Division.
❑ Check here if this is a partial certification. Section/phase/SCM #1
® Check here if this is part of a Fast -Track As -Built Package Submittal per 5A NCAC^`02H 044(3).
Printed Na'meBobb Kardos Signature
I, �A A4t10. r1J �)iAfLICtX) a Notary Public in theQte[iNiha. f Ue"ViA.
County of I I (Al, lou do hereby certify that !job f Ku m
personally appeared before me this � day of /�fAQASi— 20�3_ Iq
and acknowledge the due execution of this as -built certification. (;Eaj1C�Vt`
rn
Witness my hand and official seal Q� c
Ala . 4 i h I Ltd = li
n NOTARY Macn v
My commission expires /1
nnn
Permittee's Certification 15A NCAC 02H .1042(4)
DEED RESTRICTIONS / BUA RECORDS
Completed /
Provided
N/A
1. The deed restrictions and protective covenants have been recorded and
(Dr N
contain the necessary language to ensure that the project is maintained
consistent with the stormwater regulations and with the permit conditions.
2. A copy of the recorded deed restrictions and protective covenants has been
Y or N
provided to the Division.
YorN
3. Records which track the BUA on each lot are being kept. (See Note 1)
MAINTENANCE ACCESS
Completed /
Provided
N/A
Or N
1. The SCMs are accessible for inspection, maintenance and repair.
YorN
2. The access is a minimum of 10-feet wide.
Y r N
3. The access extends to the nearest public right-of-way.
NCDEQ 2/9/2018

`�u4 bt1F3f1C �; �F':

Project Name C.prA, a� Muru:, % Permit # SW8 C1Q 'S`L`1I 06 h\
EASEMENTS
Completed /
Provided
1. The SCMs and the components of the runoff collection / conveyance system
are located in recorded drainage easements.
or N
2. A copy of the recorded plat(s) is provided.
(2 or N
SINGLE-FAMILY RESIDENTIAL LOTS
Completed /
Plats for residential lots that have an SCM include the following:
Provided
1. The specific location of the SCM on the lot.
Poor N
2. A typical detail for the SCM.
Y ors
3. A note that the SCM is required to meet stormwater regulations and that the
lot owner is subject to enforcement action as set forth in NCGS 143 Article
Y or N
21 if the SCM is removed relocated or altered without prior approval.
OPERATION AND MAINTENANCE AGREEMENT
Completed /
Provided
1. The O&M Agreement is referenced on the final recorded plat.
Y or(@
2. The O&M Agreement is recorded with the Register of Deeds and appears in
the chain of title.
Oor N
OPERATION AND MAINTENANCE PLAN
Completed /
Provided
1. Maintenance records are being kept in a known, set location for each SCM
and are available for review.
oor N
DESIGNER'S CERTIFICATION FORM
Completed /
Provided
1. A completed designer's certification form has been provided to the
Division.
oy or N
Provide an explanation below for every requirement that was not met, and for every Item marked "N/A."
Attach additional pages as needed.
Single Family Residential Lot (#2) - A typical section of the SCM is provided on the asbuiltdrawings and
Operation and Mainettance Agreement (#t) - The Operation and Maintenance Agreement was recorded
before the final plat.
NCDEQ 2/9/2018

DEMLR USE ONLY
Date Received
Fee Paid
Permit Number
Applicable Rules: ❑Coastal SW -1995 ❑Coastal SW - 2008 ❑ Ph II -Post ConSS¢¢urrction
(select all that apply) ❑Nom-Coastal SW- HQW/ORW Waters [I Universal Stormwater MaiDgFnent
Pla
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Courtyards at Marvin
2. Location of Project (street address):
2012 Providence Road South
City:Marvin County:Union Zip:28173
3. Directions to project (from nearest major intersection):
North 0 25 miles of Providence Road South and Bonds Grove Church Road
4. Latitude:34° 58' 43" N Longitude:80` 46' 23" W of the main entrance to the project.
11. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ❑New ®Modification ❑ Renewal w/ Modificationt
tRmetuals with modifications also requires SWU-102 - Renenval Application Form
b.If this application is beingg submitted as the resultof a modification to an existing permit, list the existing
permit numberSSW3740607 its issue date (if known)july 3. 2014 and the status of
construction: [I 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
DEMLR requesting a state Stormwater management permit application, list the Stormwater project number;
if assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623.6748):
❑LAMA Major ®Sedimentation/Erosion Control: 18.96 ac of Disturbed Area
❑NPDES Industrial Stormwater ED404/401 Permit: Proposed Impacts Excavatiomand fill placement and
installation of culvert
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:Courtyards at Marvin. 404Permit, SAW-2014-01155
Courtyards at Marvin. Sedmintation and Erosio Control,NCG010000
5. Is the project located within 5 miles of a public airport? ®No ❑Yes
If yes, see S.L. 2012-200, Part VI: http://portai:ncdencore/web/Ir/rules-and-regulations
Form SWU-101 Version Oct. 31, 2013 Pagel of 6

III. CONTACT INFORMATION
I. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who ownsthc:oroject):
Applicant/Organization:Eocon Marvin LLC
Signing Official & Title:Iiob Kardos /Regional President. EPCON Carolinas
b.Contact information for person listed in item la above:
Street Address:11020 David_Tavlor Drive, Suite105
City:Charlottc State:NC Zip:28262
Mailing Address (if app1icab1e):11 2 avid Taylor Drive; SUitL 105
City:Charlotte State:NC Zip28262
Phone: [phone] Fax: [phone]
Einail:bkardosOepconcommunities
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑; Lessee* (Attach a,copy, Wthe lease agreement and'complete Contact Information, item 2a and 2b below)
❑.f urchascr' (Attach a copy of.the pendingsales 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 tiile 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:
Mailing Address (if
Phone:
State: Zi
State:
Fax: ( 1
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:Scott Twiddy/EPCON Communities
Signing Official & Title:Scott Twiddd Land Manager
b.Contact information for person listed in item 3a above:
Mailing Address:11020 David Taylor Dr, Suite 105
City:Charlotte State:NC Z.ip:28262
Phone: (803 ) 389_3387 Fax: O
Emailstwiddyagpconcommunities.com
4. Local jurisdiction for building permits: Village of Marvin
Point of Contact:Rohit Ammanamanchi Phone #: [phone] ext.104
Form SWU-101 Version Oct. 31, 2013 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briQfly summarize how the stormwater runoff will be treated.
Stormwater runoff will be treated in wetoond consisting of two basins connected by an equalizer pipe.
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: October 17, 2013
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.if claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW —1995 ® Ph II — Post Construction
3. Stormwater runoff from this project drains to the Catawba River basin.
4. Total Property Area: 20.05 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area:.1.03 acres
7. Total Property Area (4) — Total Coastal Wetlands Area (5) — Total Surface Water Area (6) = Total Project Area`:
19.02 acres
'Potafproject area shall be calculated to exclude Nm fallowingg: the normal ool of imppounded structures, the area
betueerr thi banks of streams and rivers, the area below the Normal High Water (NHW) Irate or Mean H igh.Water
(MHW) line, and coastal retlands lardiwrrd from the NHW (or MHO) line. The resultant project area,rs used to
calndale overall percent built upon area.(BUA). Note -coastal wetlands larrdtvard of the NHW (or MHW) lime nray be
inchrded in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 39.70 %
9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered
stormwater BMP. For loco 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
Drainage Area I
Drainage Area
Drainage Area
Drainage Area
Receiving Stream Name
Twelve Mile
Creek
Stream Class '
C
Stream Index Number*
11-138
Total Drainage Area (sf)
1,098,148
On -site Drainage Area (sf)
1, 1
Off -site Drainage Area (90
476,546
Proposed Impervious Area" (sf)
326,78U
% Impervious Area" (total)
29.94
Impervious" Surface Area
Drainage Area 1
Drainage Area _
Drainage Area _
Drainage Area
On -site Buildings/Lots s
241,417
On -site Streets (sf)
69,448
On -site Parking (sf)
900
On -site Sidewalks (sf)
17,015
Other on -site (so
-
Future (sf)
Off -site (sf)
-
Existing BUA*** (so
0
Total (at):
328,78
* Stream Class and Index Number can be determined at: hilll/yorlal.unirnr.or� ttib rn y. csu classi rrntions
** Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
*** Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that is
to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. N/A
Form SWU-101 Version Oct. 31, 2013 Page 3 of 6

Projects in Union County: Contact DEMLR Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that maybe subject to more stringent siormwater requirements as per 15A NCAC 02R .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) fortes
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http:/1Portal.ncdenr.org/web w /ws/su/bmp.-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resm;rces (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
ht,_/1tiortiI.ncdenr.org web w /ws/su/statesw/forms does. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map athit
—.p-LL portnl.ncdenr4)rg web w ws/su maps.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. AB original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http.I/R(trtal.ncd iev.org webLw—q(ws/su/statesw7forms does.
Initials
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
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 payable to NCDENR. (For an Express review, refer to
hittz://www.envhelp org[piges/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/management for
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 %mile of the site boundary, include the 16
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
Porn SWU-101 Version Oct. 31, 2013 Page 4 of

9. Copy of any applicable soils report with the associated SHWT 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"xlt"copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted.to WiRO: Schedule a site visit for DEMLR touerify the SHWTprior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 6178 Page No: 693 _
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 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http://www.secretary.st,ite.nc.us/Corporations/CSearch aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from littk)://portal ncdenr org)web/Ir/state-stoi•nnvater-
forms does. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMLR, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting EngineenBrian Rossi
Consulting Firm: EMH&T
Mailing Address:301 McCullough Drive$uite 109
City:Charlotte State:NC Zip:28262
Phone: [phone] Fax: (704 ) 548-0334
E m a i I: b ros s i Qc m h t. co m
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
1, (print or type name of person listed in Contact information, item 2a) certify that 1
own the propertyy identified in this permit application, and thus give permission to (print or type name. of person
listed in Contact (n imnation, item la) with (print or type name oforgmuzation listed in
Contact Informatian, item 1a) to develop the project ascurrent y 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 Oct. 31, 2013 Page 5 of 6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR immediately and
submit a completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater
treatment facility without a valid permit. I understand that the operation of a stormwater treatment facility
without a valid permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement
action including the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
I, , 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
X. APPLICANT'S CERTIFICATION
1, (print or type nine ofperson fisted in Content Information, item 1a) -,7 _ 5
certifv that the information included on this permit application form is, to the best of my knowledge, correct and
that (lie project will be constructed in confor ante with the approved plans, that the required deed restrictions
and protective cove ants will be recorde and that the proposed project complies with the requirements of the
applicable stormwWertr;lestundgr 1 A CAC 21-I .1000 and any other applicable state stormwater requirements.
Signature: Y^ Date: P h6h l
I, a Notary Public for the State of N o CA- Q"Oo � . County of
�1 er t 1e�cxsc do hereby certify that 1�ar&gs personally appeared
before me this day of (a uc_ tom_, c3pi cl . and acknowledge the due execution of the application for a
stormwater permit. Witness my hand and official seal,
= `= NOTARY
=3 PUBLIC 2_
SEAL
My commission
My Commission
Expires April 11, 2023
Form SWU-101 Version Oct. 31, 2013 Page 6 of

GX§mavb m1'55
wACuka2lo

SUPPLEMENT-EZ COVER PAGE
'-I FORMS LOADED
PROJECT INFORMATION
1
Project Name
Courtyards at Marvin
2
Project Area ac
20.05
3
Coastal Wetland Area (ac
0
4
Surface Water Area ac
1,03
5
Is this project Hi h or Low Density?
High
6
Does this project use an off -site SCM?
No
COMPLIANCE WITH 02H .1003(4)
7
lWidth of vegetated setbacks provided feet
8
Will the vegetated setback remain ve etated?
Yes
9
1 Is BUA other that as listed in .1003 4 c-tl out of the setback?
Yes
10
Is streambank stabilization proposed on this project?
No
NUMBER AND TYPE OF SCMS:
11
Infiltration System
0
12
Bioretention Cell
0
13
Wet Pond
1
14
Stormwater Welland
0
15
Permeable Pavement
0
16
Sand Filter
0
17
Rainwater Harvesting RWH
0
18
Green Roof
0
19
Level Spreader -Filter Strip LS-FS
0
20
Disconnected Impervious Surface DIS
0
21
Treatment Swale
0
22
Dry Pond
0
23
Storm Filter
0
24
Silva Cell
0
25
Bayfilter
0
26
Filterra
0
FORMS LOADED
DESIGNER CERTIFICATION
27
Name and Title:
Brian Rossi, PE
28
Organization:
EMH&T
29
Street address:
301 McCullough Dr
30
City, State, Zip:
Charlotte, NC 28262
31
Phone numbers):
704-548-0333
32
Email:
[e-mail]
certify, under penalty of law that this Supplement-EZ form and all supporting information were prepared under my direction or
upervision; that the information provided in the form is, to the best of my knowledge and belief, true, accurate, and complete; and
iat the engineering plans, specifications, operation and maintenance agreements and other supporting information are consistent
rilh the information provided here.
CA
SEAL
045526
Signature of Designer
eJ) z8l()9
Date

DRAINAGE AREAS
1
Is this a hi h densit project?
Yes
2
If so, number of drainage areas/SCMs
1
3
Is all/part of this project subject to previous rule
versions
No
FORMS LOADED
DRAINAGE AREAtNF.ORMATION
Entire Situ
4
Type of SCM
Wet Pond
5
Total BUA in project (sq ft
328780 Sf
6
New BUA on subdivided lots (subject to permitting)
(sq ft
328780 Sf
7
New BUA outside of subdivided lots (subject to
ennitting) (so
Sf
8
Offsite - total area (sq ft
Sf
9
Offsite BUA (sq ft
Sf
10
lBreakdown of new BUA outside subdivided lots:
- Parking (sq ft
900 Sf
- Sidewalks ft
17015 Sf
- Roof (sq ft
241417 Sf
- Roadway s ft
69448 Sf
- Future (sq ft
Sf
- Other, please specify in the comment box
below (sq ft
Sf
11
New infiltrating permeable pavement on
subdivided lots (sq ft
Sf
12
New infiltrating permeable pavement outside of
subdivided lots sq ft
Sf
13permitting)
Exisitng BUA that will remain (not subject to
s ft
Sf
14
Existing BUA that is already permitted (sq ft
Sf
15
Existing BUA that will be removed (sq ft
Sf
16
Percent BUA
0.3
17
Design storm inches
1 In
18
Design volume of SCM cu ft
61169 Cf
19
Calculation method for design volume
Rational
ADDITIONALANF,ORMATION`,
20
Please use this space to provide any additional information about the
drainage area(,):

WET POND
1 Drainage area number
2 Design volume of SCN
rsucon� n
3
Is the SCM sized to treat the SW from all surfaces at build -out?
4
Is the SCM located away from contaminated soils?
5
What are the side slopes of the SCM (H:V)?
6
Does the SCM have retaining walls. gabion walls or other engineered
side slopes?
7
Are the inlets, outlets, and receiving stream protected from erosion
(10-year storm)?
8
Is there an overflow or bypass for inflow volume in excess of the
design volume?
9
W hat is the method for dewatering the SCM for maintenance?
10
If applicable, will the SCM be cleaned out after construction?
11
Does the maintenance access comply with General MDC (8)?
12
Does the drainage easement comply with General MDC (9)?
13
If the SCM is on a single family lot, does (will?) the plat comply with
General MDC (10)?
14
Is there an O&M Agreement that complies with General MDC (11)?
15
Is there an O&M Plan that complies with General MDC (12)?
16
Does the SCM follow the device specific MDC?
17
Was the SCM designed by an NC licensed professional?
61169
Yes
No
201 removal) (fmsl) 1 582.00
21 Elevation of the main pool bottom -(top of sediment removal) (fmsl) 1 581.00
the
area of the main
291Average depth equation used I Equation 2 1
1 361Is the outlet an orifice or a weir? I Orifice 1
4 in
weir
401 Drawdown time for the temporary pool (days) 13
Are the inlets) and outlet located in a manner that avoids short.
41 circuiting? I Yes
entrance
48
Does the orifice drawdown from below the top surface of the
permanent pool?
Yes
49
Does the pond minimize impacts to the receiving channel from the 1-
yr, 24-hr storm?
Yes
50
Are fountains proposed? (If Y, please provide documentation that
MDC(9) is met.)
Yes
51
Is a trash rack or other device provided to protect the outlet system?
No
52
Are the dam and embankment planted in non -clumping turf grass?
Yes
53
Species of turf that will be used on the dam and embankment
54
Has a planting plan been provided for the vegetated shelf?
Yes
Please use this space
any
Wet Pond 3 4:19 PM 8/27/2019

Project Name: lCourtyards at Marvin
Project Location: 12012 Providence Rd South
maintenance records shall be Kept on the toliowmg CMF'(s). [his maintenance record shall be kept in a login a known set locatio
Any deficient BMP elements noted in the inspection will be corrected, repaired, or replaced immediately. These deficiencies can
affect the integrity of structures, safety of the public, and the pollutant removal efficiency of the BMP(s).
The BMP(s) on this project include (check all that apply &
Bioretenlion Cell Quanti
Dry Detention Basin
Grassed Swale
Green Roof
Infiltration Basin
Infiltration Trench
Level SpreaderNFS
Permeable Pavement
Proprietary System
Rainwater Harvesting
Sand Filter
Stormwater Wetland
Wet Detention Basin
Disconnected Impervious Area
User Defined BMP
Quantity:
Quantity:
Quantity:
Present:
Present:
O&M tables will
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
IRestoration Drive, behind lots 29-35 1
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed for
each BMP above, and attached O&M tables. I agree to notify NCDENR of any problems with the systettor prior to any cl to
the system or responsible party. o r m m n
Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Email:
County of
personally appeared before me this
Bob Kardos Zt m
Regional President/ EPCON Carolinas 9 z
11020 Taylor Dr Suite 105 n
Charlotte, NC 28262
704-997.8316 w
[e-mail]
r
-o
r-n
N
C)
�o
n
Date: rj
a Notary Public for the Statee �
of k_Ca it i\r.
do hearby certify that Ko-rADS
15 day of �uS+ and
acknowledge the due execution of the Operations and Maintenance Agreement.
Witness �tld fihtlyfficial seal,
=3 *or
ERp�ARP
eulC
Seal My commission expires
STORM-EZ
Version 1.4 0&M Manual
6/4/2019
Page 1 of 4

I Wet,Detention Pond. Maintenance; Requirements I
The wet detention basin system is defined as the wet detention basin, pretreatment Including forebays and the vegetated filter if
one is provided.
Important maintenance procedures:
Immediately after the wet detention basin is established, the plants on the vegetated shelf and perimeter of the
basin should be watered twice weekly if needed, until the plants become established (commonly six weeks).
No portion of the wet detention pond should be fertilized after the first initial fertilization that is required to
establish the plants on the vegetated shelf.
Stable groundcover should be maintained in the drainage area to reduce the sediment load to the wet detention
basin.
If the basin must be drained for an emergency or to perform maintenance, the flushing of sediment through the
emergency drain should be minimized to the maximum extent practical.
- Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected once a month and within 24 hours after every storm event
greater than 1.0 inches (or 1.5 inches if in a Coastal County). Records of operation and maintenance should be kept In a
known set location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired immediately.
BMP element:
Potential problem:
How I will remediate the problem:
The entire BMP
Trash/debris is present.
Remove the trash/debris. '
The perimeter of the BMP
Areas of bare soil and/or
Regrade the soil if necessary to remove the gully, and then plant a
erosive gullies have formed.
ground cover and water until It is established. Provide lime and a one-
time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of approximately six inches.
long.
The Inlet device
The pipe is clogged.
Unclog the pipe. Dispose of the sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to smooth it over and provide erosion
swale.
control devices such as reinforced turf matting or riprap to avoid future
problems with erosion.
Stone verge is clogged or
Remove sediment and replace with clean stone.
covered in sediment (if
applicable).
The forebay
Sediment has accumulated to
Search for the source of the sediment and remedy the problem if
a depth greater than the
possible. Remove the sediment and dispose of it in a location where it
original design depth for
will not cause impacts to streams or the BMP.
sediment storage.
Erosion has occurred.
Provide additional erosion protection such as reinforced turf matting or
riprap If needed to prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by hand. If pesticide is used, wipe it on
the plants rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional practices
show that pruning is needed
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the problem: soils, hydrology, disease, etc.
dying.
Remedy the problem and replace plants. Provide a one-time fertilizer
application to establish the ground cover if a soil test indicates it is
necessary.
Weeds are present.
Remove the weeds, preferably by hand. If pesticide is used, wipe it on
the plants rather than spraying.
STORM-F2 9/4/2019
Version 1.4 O&M Manual Page 2 of 4

I Wat Detention'Pond,Maintenance Reg iremente (Continued) I
The main treatment area
Sediment has accumulated to
Search for the source of the sediment and remedy the problem if
a depth greater than the
possible. Remove the sediment and dispose of it in a location where it
original design sediment
will not cause Impacts to streams or the BMP.
storage depth.
Algal growth covers over 50%
Consult a professional to remove and control the algal growth.
of the area.
Cattails, phragmites or other
Remove the plants by wiping them with pesticide (do not spray).
invasive plants cover 50% of
the basin surface.
The embankment
Shrubs have started to grow
Remove shrubs Immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and consult a professional to remove
beaver activity is present.
beavers.
A tree has started to grow on
Consult a dam safety specialist to remove the tree.
the embankment.
An annual Inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair. (if applicable)
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Department of Environment and Natural
damage have occurred at the
Resources Regional Office.
outlet.
The measuring device used to determine the sediment elevation shall be such that It will give an accurate depth reading and not
readily penetrate into accumulated sediments.
STORM-EZ 0/4/201 g
Version 1.4 O&M Manual Page 3 of 4

WET POND ID FOREBAY MAIN POND
0 Permanent Pool El. E,9.5
Permanent Pool El. E580
Temporary Pool EI: Temporary Pool EI:
Pretreatment other No Clean Out Depth: Clean Out Depth: than forebZI Sediment Removal El: Sediment Removal El: Has Vag. Fllter7 Yes Bottom Elevation: Bottom Elevation:
STORM-EZ 6/V2019
Version 1.4 O&M Manual Page 4 of 4

Project Name Permit # SW8 6 6b \
AS -BUILT DESIGNER'S CERTIFICATION FOR
WET DETENTION POND PROJECT
I hereby state that I am a licensed professional and I certify by my signature and seal below, that I have observed
the construction of the project named above to the best of my abilities with all due care and diligence, and that the
project meets all of the MDC found in 15A NCAC 02H.1053, in accordance with the permit documents, plans and
specifications on file with or provided to the Division, except as noted on the "AS -BUILT" drawings, such that the
intent of the stormwater rules and the general statutes has been preserved.
❑ Check here if this is a partial certification. Section/phase/SCM #1
® Check here if this is part of a Fast -Track As -Built Package Submittal per 15A NCAC 02H .1044(3).
❑ Check here if the Designer did not observe the construction but is certifying the project.
Check here if pictures of the SCM are provided. 1___?
Printed NameBrian Rossi Signature
NC Registration Number045526 Date
SEAL: auwmiin
SEAL
0 5526
08�26�I�j
,,, �qN R• R�c,\\�,•
"�inununuoo
Consultant's Mailing Address:
O
City:Charlotte State:NC Zip:2 862
Phone:[phone]
Consultant's Email address:
brossi aOemht.com
kAJ
D Circle N if the as -built value differs from the Plan/permit. If N is circled, provide an explanation on page 2.
O N/E = Not Evaluated (provide explanation on page 2). ON/A = Not Applicable to this project or SCM.
This Certification must be completed in conjunction with the General MDC certification under 15A NCAC 02H.1050.
Consultant's Certification (MDC 15A NCAC 02H .1053)
Forebay / Depths / FountainOAs-built
ON/E
OO N/A
1. The available Sediment storage is consistent with the approved
Oy or N
plan and is a minimum of 6 in.
2. Water flow over the forebay berm into the main pond occurs at a
/v
non -erosive velocity.
r N
3. The provided Forebay Volume is 15%-20% of the main pool
Y N
volume.
or
4. The Forebay entrance elevation is deeper than the exit elevation
(Y )or N
into the pond.
v
5. The Average Design Depth of the main pond below the
O or N
permanent pool elevation is consistent with the permitted value?
6. Fountain documentation is provided.
Y orU
NCDEQ 2/9/2018

Project Name CoaVaS C& M ry Permit#SW8 01 b\
Side slopes / Banks / Vegetated Shelf
OAs-built
ON/E
ON/A
1. The width of the Vegetated Shelf is consistent with the approved
plans and is a minimum of 6 feet.
�or N
2. The slope of the Vegetated Shelf is consistent with the approved
' N
plans and is no steeper than 6:1.
r
U
As -built Main Pool / Areas / Volumes / Elevations
OAs-built
OO N/E
ON/A
1. The permanent pool surface area provided is consistent with the
Oor N
permitted value.
2. The Temporary Pool Volume provided is consistent with the
Y N
permitted value.
or
3. The permanent pool elevation is consistent with the permitted
I �or N
value.
v
4. The temporary pool elevation is consistent with the permitted
N
value.
Y br
Inlets / Outlet / Drawdown
OAs-built
ON/E
ON/A
1. The design volume draws down in 2-5 days.
Oor N
2. The size of the Orifice is consistent with the permitted value.
Y or N
3. A trash rack is provided on the outlet structure.
o N
4. Hydrologic impacts to the receiving channel are minimized from
/Y
I for
the 1 yr 24-hr storm discharge?
N
0J
5. The inlets and the outlet location are situated per the approved
plan and avoid short-circuiting.
y\or N
Vegetation
OAs-built
ON/E
ON/A
1. The vegetated shelf has been planted with a minimum of 3
diverse species.
(Y�or N
�/
2. The vegetated shelf plant density is consistent with the
approved plans and is no less than 50 plants per 200 sf or no
/ vY�or N
less than 24 inches on center.
l)
Provide an explanation below for every MDC that was not met, and for every item marked "N/A" or "NIE."
Attach additional pages as needed.
NCDEQ 2/9/2018

sY
Y
r

Project Name rrV Mcr-u( Permit # SW8 51 J 31i h 6 b\
AS -BUILT DESIGNER'S CERTIFICATION FOR
GENERAL MDC
I hereby state that I am a licensed professional and I certify by my signature and seal below, that I have observed
the construction of the project named above to the best of my abilities with all due care and diligence, and that the
project meets all of the below listed General MDC found in 15A NCAC 02H.1050, in accordance with the permit
documents, plans and specifications on file with or provided to the Division, except as noted on the "AS -BUILT"
drawings, such that the intent of the stormwater rules and the general statutes has been preserved.
❑ Check here if this is a partial certification. Section/phase/SCM #1
® Check here if this is part of a Fast -Track As -Built Package Submittal per 15A NCAC 02H .1044(3).
❑ Check here if the Designer did not observe the construction but is certifying the project.
Check here if pictures of the SCMs are provided.
Printed NameBrian Rossi Signature
NC Registration Number045526 Date
Consultant's Mailing Address:
City:Charlotte State
Phone:[phone]
Consultant's Email address:
brossi(o)emht.com
D Circle N if the as -built value differs from the Plan/permit. If N is circled, provide an explanation on page 3.
O N/E = Not Evaluated (provide explanation on page 2). OO N/A = Not Applicable to this project or SCM.
Cn
Consultant's Certification 15A NCAC 02H .1003(3) & General MDC 15A NCAC 021-1 .1050
TREATMENT REQUIREMENTSOAs-built
ON/E
OO N/A
1. The SCM achieves runoff treatment.
Y or N
2. The SCM achieves runoff volume match.
Y or N
3. Runoff from offsite areas and/or existing BUA is bypassed.
Y or N
4. Runoff from offsite areas and/or existing BUA is directed into
Y or N
the permitted SCM and is accounted for at the full build -out
potential.
5. The project controls runoff through an offsite permitted SCM
Y or N
that meets the requirements of the MDC.
V
6. The net area of new BUA increase for an existing project has
Y or N
been accounted for at the appropriate design stonn level.
NCDEQ 2/9/2018
4061
5
rn
�

Project Name Coors y yN�j.S s,� Mary Permit # SW8 -3Q
7. The SCM(s) meets all the specific minimum design criteria.
(i)or N
VEGETATED SETBACKS /BUA
()As -built
OO N/E
ON/A
1. The width of the vegetated setback has been measured from
Y or N
the normal pool of impounded waters, the MHW line of tidal
waters or the top of bank of each side of rivers or streams.
2. The vegetated setback is maintained in grass or other
Y r N
vegetation.
3. BUA that meets the requirements of NCGS 143-214.7 (b2)(2)
Y or N
is located in the setback.
4. BUA that does not meet the requirements of NCGS 143-214.7
Y or N
(b2)(2) is located within the setback and is limited to:
• Publicly funded linear projects (road, greenway sidewalk)
• Water -dependent structures
• Minimal footprint uses (utility poles, signs, security
lighting and appurtenances)
5. Stormwater that is not treated in an SCM is released at the
Y or N
edge of the setback and allowed to flow through the setback as
dispersed flow.
STORMWATER OUTLETS
OAs-built
ON/E
ON/A
1. the outlet handles the peak flow from the 10-year storm with
no downslope erosion.
O or N
VARIATIONS
OAs-built
ON/E
ON/A
1. A variation (alternative) from the stormwater rule provisions
Y or N
has been implemented.
2. The variation provides equal or better stormwater control and
Y N
equal or better protection of surface waters.
or
COMPLIANCE WITH OTHER REGULATORY PROGRAMS
(DAs-built
ON/E
ON/A
1. The project is compliant with other applicable regulatory
YOor N
programs.
SIZING
OAs-built
ON/E
ON/A
1. The volume of the SCM takes the runoff from all surfaces into
account and is sufficient to handle the required storm depth.
I Y for N
�/
CONTAMINATED SOILS
OAs-built
ON/E
ON/A
1. Infiltrating SCM's are not located in or on areas with
contaminated soils.
�y or N
SIDE SLOPES
OAs-built
OO N/E
ON/A
1. Vegetated side slopes are no steeper than 3H:IV.
�rN
NCDEQ 2/9/2018

Project Name Co\�,r� a� Mary Permit # SW8 b o 1
2. Side slopes include retaining walls, gabion walls, or other
Y or N
surfaces that are steeper than 3H:1 V.
3. Vegetated side slopes are steeper than 3H:1 V (provide
Y or N
supporting documents for soils and vegetation).
EROSION PROTECTION
OAs-built
OO N/E
OO N/A
1. The inlets do not cause erosion in the SCM.
Y or N
2. The outlet does not cause erosion downslope of the discharge
Y or N
point during the peak flow from the 10-year storm.
EXCESS FLOWS
OAs-built
ON/E
ON/A
1. An overflow / bypass has been provided.
—or N
DEWATERING
OAs-built
ON/E
ON/A
1. A method to drawdown standing water has been provided to
facilitate maintenance and inspection.
Y or N
CLEANOUT AFTER CONSTRUCTION
OAs-built
OWE
ON/A
1. The SCM has been cleaned out and converted to its approved
design state.
I Y .br N
D��J
MAINTENANCE ACCESS
OAs-built
ON/E
ON/A
1. The SCM is accessible for maintenance and repair.
Y or N
2. The access does not include lateral or incline slopes >3:1.
Y or N
DESIGNER QUALIFICATIONS (FAST -TRACK PERMIT)
OAs-built
ON/E
ON/A
1. The designer is licensed under Chapters 89A, 89C, 89E, or
89F of the General Statutes.
y or N
Provide an explanation below for every MDC that was not met, and for every item marked "N/A" or "N/E."
Attach additional pages as needed.
NCDEQ 2/9/2018

DEMLR USE ONLY
Date Received
Pee Paid
Permit Number
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina 3 m
Department of Environment and Natural Resources o r-
cr
Division of Energy, Mineral and Land Resources a p o ti
STORMWATER MANAGEMENT PERMIT APPLICATION I &' m
This form "tag be pholocopied for use as an original ; S b
rn
I. GENERAL INFORMATION 0
n 1 "
1. Project Name (subdivision, facility, or establishment name -should be consistent with projo%%me on plans,
specifications, letters, operation and maintenance agreements, etc.):
ourlY---ands at Marvin
- -
2. Location of Project (street address):
2012 Providence Road South
City:Mat:v_in County:Union Lip28173
3. Directions to project (from nearest major intersection):
North f125 miles of Providence Road South and Bonds Grove Church Road,
4. Latitude:34' 58' 43" N Longitude:80'46' 23" W of the main entrance to the project.
it. PERMIT INFORMATION
1. a. Specify whether project is (check one): ❑New ®Modification ❑ Renewal w/ Modificationt
tReneu,als with modifications also requires SWU-102 - Renmal Application Fonn
b.If this application is beinbbI submittecl as the result of a modification to an existing permit, list the existing
permit number5W3_140 1 , its issue date (if known%d '1,2014 ,and the status of
construction: I]Nof Started ❑Partially Completed* ® Completed* *providea designer's certification
2. Specify the type of project (check one):
❑Low Density ®high Density ❑Drains loan Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from
DEMLR requesting a state stormwater management permit application, list the stormwater project number,
if assigned, and the previous name of the project, if different than currently
Proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major. ®Sedimentation/Erosion Control: 18.96 ac of Disturbed Area
❑NPDES industrial Stormwater E404/401 Permit: ['reposed Impacts Ex ac vaticm and fill placement and
installation of culvert
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 pennihCourtvards at Marvin.9 4 Permit, SAW-2014-01155
Courtyards at Marvin, Sedmintation and Erosio Control.NCG010000
5. Is the project located within 5 miles of a public airport? ®No QYes
If yes, see S.L. 2012-200, Part VI: h. lty_:L11s1t9al:ncdenr.or web/h'hulcs-anil-regulations
Form SWU-101 Version Oct. 31, 2013 Page I of

Ill. CONTACTINFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated governmenfofficial, individual, etc. who owns the project):
Applicant/Organizafion:Epcon Marvin I.l.0
Signing Official &'I'ilacl3ub KardiisJRcgionat Prestdel-1 GPCON Carolinas _
b.Contact information for person listed in item 'la above:
Street Address:1020 Ujivid1•ay-Inr Drive, _Suite Ills
City:Charlotic Statc:NC Zip:2�
Mailing Address (ifapplicable):HOZO 12aKid l'�tlor Drivg,Suite 1115
Cilv':Charlolte
Phone: 704 ) 997-N116
Ertl aihbkarclos(E)CIX lncitmtininitics
State:NC 7_ip:2it262
Pax: (704 ) 919-5848
c. Please check the appropriate box. The applicant listen above is:
® The property owner (Ski4i to Contact Information, item 3a)
❑ Lessee' (Altach a copy o the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchascr' (Altach it copy of the pending sales agreement and complete Contact Information, item 2a and
2h below)
❑ Developer' (Complete Contact Information, item 2a and 2b below.)
2. a. Print Propperty Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person wlio owns the properly that the project is located on):
Property Owner/Organiza
Signing Officia I & Ti tic:_
b.Contact information for person listed in itern 2a above:
Street Address
City:__
Mailing Address (if
City:_
Phone: f 1
State: Zi
State:
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:Scott Twiddy/ ICON Communities
Signing Official &'1'illc:$cc�ll_fwid/Land Man�cgcr
b.Contact information for person listed in item 3a above.:
Mailing Addressa'1020 David Taylor Dr Suite 105
City:Charlotte State:NC Z.ip:28262 ,.
Phone: (803)_9t9--3387 Fax:
FinaiI:stwILId)'9epc:oncon munitic:s.c orn
4. Local jurisdiction for building permits: Village of Marvin
Point of Contact:Rohit Ammanammuhi Phone #: (704 ) 843-1680 ext.104
Form SWU-101 Version Oct. 31, 2013 Page 2 of6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the Stormwater runoff will be treated.
Stormwater runoff will be treated in a wetpond consisting of two basingconnected by an equalizer Ifipe,
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: _ tober 17 2013
❑ 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 Catawba River basin.
4. Total Property Area: 20,45 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 1.03 acres
7. Total Property Area (4) — Total Coastal Wetlands Area (5) —Total Surface Water Area (6) = Total Project Area':
19.02 acres
'total project area shall be cnlculrrtirl In ct'chuie thr firllotrirtt: the normal Fowl of intpMolded structures, the area
between the barks rf streams and rivers, the area below the Normal High Water ZW) line or Mean High Water
(MHW) line, and coastal wetlands lundt(Iarrltrout the NHW (or M710) line. The resultant project area is used to
calndnte nvernll perrenf built upon wren f1SUA). Nnn-constnl tcxtlands lundrunrd of fhe NHW (or• MHW) line rrray be
included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 39.70 _%
9. How many drainage areas does the project have?-1 (For high density, count 1 for each proposed engineered
stormwater BMP, for low density and other projects, use 1 far 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
rains a Area I
Drainage Area
Drainage Area
Drainage Area
Receiving Stream Name
Twelve Mile
Creek
Stream Class "
C
Cream Index Number *
11-138
Total Drainage Area (sf)
1,098,148
On -site Drainage Area (s)
6 1, 1
Off -site Drainage Area (s
476,546
Proposed Impervious Area"" (sf)
328,780
% Impervious Area" (total)
29.94
Impervious —Surface ArDrainage
Area I
Drainage Area _
Drainage Area _
Drainage Area _
On -site Buildings/Lots (Si
241,417
On -site Streets (sf)
69,448
On -site Parking (sf)
900
On -site Sidewalks (s
17,015
Other on -site (sf)
-
Future (sf)
-
Off -site (sf)
Existing BUA*** (sf)
0
Total (sf):
326,78
Stream Class and Index Number can be determined at: lit t p:(/hnrlr l.nnlenr,org/_reb rent/ps/csrt[cln sificnli)rn
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidetaniks, gravel areas, etc.
Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that is
to be removed and which will be replaced by net; BUA.
11. How was the off -site impervious area listed above determined? Provide documentation.
Form SWU-10I Version Oct. 31, 2013 Page 3 of 6

Projects in Union County: Contact DEMLR Central Ofrce staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15A NCAC 01B .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 Ix_tp://liort:il.nci(�n_r.rn /web/wil/ws/su/bmp_manua1.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resmirces (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
htl p;//Pumal,ncdcn/H�g/tiu/til_atesw mms udncv. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office maybe found by locating project on the
interactive online map at htl;1 ;J/piul;�IaiSdciiptwg/wet Lwq/ s(su/n,tp .)
Please indicate that (lie 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 Iulth://portal.nc�iralr,urg[tyCl,�/��gl/�y:j/emu/stale w./form~
does.
1. Original and one copy of the Sturmwater Management Permit Application Form.
Initials
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants.
u/4
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed. gnvA an t�tile A and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
htth:/1www.envhelp.org/ ages oncsto cxpff§ html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management for
NJ A,
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USCS map identifying the site location. If the receiving stream is reported as class SA or the
N/A
receiving stream drains to class SA waters within 1h mile of the site boundary, include the 1h
mile radius on the map.
7. Sealed, signed and dated calculations (one copy). �1
8. Two sets of plans fglded Ip 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.
I. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
Fonn SWU-101 Version Oct. 31, 2013 Page 4 o1'6

9. Copy of any applicable soils report with the associated SHWT 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"x1l"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 visitfor DEMI.R to verify Me SHW1,1001.
to subnriffal, [phone].)
10. A copy of the most current property deed. Deed book: 6178 Page No: 693 _
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 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
lit(p_//www�secr�fa�.gtatc,nc.us/. orporations/ ',car�taspr
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
Por 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 hit Aorta l.ncdenr org/web/I rlslate-smrnnvaler-
forms does. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the websitc, that the covenants will be binding on all parties and persons claiming
under them, that they will nun with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMLR, and that they will be recorded prior to the sale of any lot.
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 Engineer:Brian Rossi
Consulting Firm: EMI-1&T
Mailing Add ress:3t 1 McCullough DriveS vile 109
City:Cilatrlotte State:NC Z.ip2$262
Phone: 7( 04 ___L MU333 Fax: [phone]
Gmai I:bmss mocmhtcom
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or l i)pe name o/person listed in Contact lu/nrnuttion, item 2a) certify that
own the property identified in this permit application, and thus give Flennission to (print or f i/pe name r f person
listed to Conlact In(;)vrafion, item la) with (print or type name o or�auizalimr listed it)
Contact Ir yimnati(;u, item 'la) 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 Oct. 31, 2013 Page 5 of 6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR immediately and
submit a completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater
treatment facility without a valid permit. I understand that the operation of a stormwater treatment facility
without a valid permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement
action including the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Sigmature:_ Date:
a Notary Public for the State of County of
, do hereby certify that
before me this _ day of
stormwater permit. Witness my hand and official seal,
SEAL
personally appeared
and acknowledge the due execution of the application for a
My commission
X. APPLICANT'S CERTIFICATION
I, (print or type imme n(persun listed in Contact Iuftn•mnFion, item 1n) = u5
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 confor lance with the approved plans, that the required deed restrictions
and protective wve cants will be. recorder and that the proposed project complies with the requirements of the
applicable stormw.�I erlr1leslu1idy1- IPA P4CAC 2H .1000 and any other applicable state stormwater requirements.
Signature: -m —pinDale: &A-ilil_ _
I, ��' ux C..n . a Notary Public for the State of N Q z�� (`e.ro\ �_ , County of
ilerY\L k. G do hereby certifythat���CG� 1',CcrGiO personally appeared
before me this ti`1 day of laces i, (lcl .and ac nowledgc the due execution of the application for a
stormwater permit. Witness my hand and official seal,
B.
�-0
NOTARY
=3 PUBLIC z
SEAL
My commission
My Commission
Expires April 11, 2023
Form S WU-101 Version Oct. 31, 2013 Page 6 of 6