SW3150906_HISTORICAL FILE_20151028

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
FIHISTORICAL FILE
El COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

July 30, 2015
Sheetz, Inc.
3472 Grandview Crossing Lane
Greensboro, North Carolina 27040
Attention: Mr. Samuel A. Smith, RLA ASLA
Reference: Seasonal High Water Table Evaluation
Proposed Sheetz Store — 1520 Salisbury Highway
Statesville, North Carolina
S&ME Project No. 1358-15-052
Dear Mr. Smith:
S&ME, Inc. (S&ME) has conducted Stormwater Best Management Practices (BMP) Soil Testing in
accordance with S&ME Proposal No. 13-1500376 dated July 14, 2015. The Stormwater BMP Soil Testing
was performed to provide information for a Stormwater Management Permit Application to the North
Carolina Department of Environment and Natural Resources (NCDENR) — Division of Energy, Mineral and
Land Resources (DEMLR), Stormwater Permitting Program and/or local regulatory agency. A soil scientist
investigation was conducted to evaluate the seasonal high water table (SHWT) elevation within an area
that has been identified for a proposed Stormwater BMP. A Preliminary Layout Plan was provided to
S&ME by LE&D Professionals, P.C. that indicated the area of the proposed Stormwater BMP.
❖ DISCUSSION
The use of Stormwater BMPs is subject to the suitability of site soils and regulatory approval. Regulatory
guidance for the permitting of stormwater BMP's is provided in the North Carolina Division of Water
Resources — Stormwater Best Management Practices Manual (NCDENR-SW-BMP), dated July 2007
(Revised, 2009). The NCDENR-SW-BMP requires that the SHWT must be taken into consideration for the
design of most Stormwater BMP's.
PROJECT BACKGROUND
The subject site is located southeast of the intersection of Interstate 77 and United States Highway 70
(Salisbury Highway) at 1520 Salisbury Highway in Statesville, North Carolina (Figure 1). The proposed
Sheetz store location is being considered for site improvements. The soil scientist evaluation was
performed within two areas designated as a potential area for a proposed Stormwater BMP. Both
locations evaluated were in a flat grassed area.
S&ME, Inc. 18646 W Market St, Ste 105 1 Greensboro, NC 27409 1 p 336.288.7180 1 f 336.288.8980 1 wwwsmeinccom

Seasonal High Water Table Evaluation
•
FINDINGS
Proposed Sheetz Store — IS20 Salisbury Highway
Statesville, North Carolina
S&ME Project No. 1358-15-052
The SHWT evaluation was performed by evaluating the soil material excavated from two hand auger
borings (HAB) approximately 6 to 8 feet below the existing ground surface (bgs) (Figure 2). The soils were
evaluated by a Licensed Soil Scientist for evidence of SHWT influence. This evaluation involved observing
the actual moisture content in the soil and observing the matrix and mottle colors. Depending on the soil
texture, the soil color will indicate processes that are driven by seasonally high water table fluctuations,
such as iron reduction and oxidation and organic matter staining.
HAB-1 consisted of an area with approximately 36 inches of fill material that was red to reddish brown
and consisted predominantly of clay loam textures. HAB-1 transitioned into soil at approximately 36
inches bgs that consisted of clay loam to clay textures to 100 inches bgs where the boring was
terminated. At approximately 94 inches bgs evidence of a SHWT was observed. HAB-2 consisted of an
area with approximately 34 inches of fill material that was red to reddish brown and consisted
predominantly of clay loam textures. HAB-2 transitioned into soil at approximately 34 inches bgs that
consisted of clay loam textures to 70 inches bgs where the boring was terminated. At approximately 62
inches bgs evidence of a SHWT was observed. Reference attached Figure 2 for the approximate SHWT
test locations and Table 1 for the approximated SHWT depths.
Please note that SHWT evaluations are based on secondary evidence and not on direct groundwater level
measurements. Groundwater levels fluctuate for numerous reasons and these findings do not indicate
that groundwater levels have not or will not rise above the noted depths.
Table 1 - Approximated SHWT Depths
Test location
SHWT Depth (inches bgs)
°e° CONCLUSIONS
Based upon the information obtained from the 2 hand auger borings conducted, a SHWT was identified at
approximately 94 inches bgs at test location 1 and 62 inches bgs at test location 2. The SHWT depths
should be considered when designing an appropriate Stormwater BMP for the site.
July 30, 2015

Seasonal High Water Table Evaluation
Proposed Sheetz Store — 1S20 Salisbury Highway
Statesville, North Carolina
S&ME Project No. 1358-15-052
°e° CLOSING
S&ME appreciates the opportunity to provide these services to you. If you have any questions, please
contact us.
Sincerely,
S&'jMMEE,'I-nnc.`
Martin Mabe
Agronomist
Rob Willcox, L.S.S.
Senior Project Manager
Tables: Table 1: Approximated Seasonal High Water Table Depths
Figures: Figure 1 — Vicinity Map
Figure 2 — Hand Auger Boring Location Map
Attachments: Hand Auger Boring Profile Descriptions
T:\Projects\2015\GEO\1358-15-052 Sheetz Statesville\Phase 01 - SHWT Evaluation\Deliverables\1358-15-052 Sheetz Statesville
SHVVT Evaluation Report.docx
July 30, 2015 3

STORM WATER QUALITY REPORT FOR:
SHEETZ, INC.
STATESVILLE, NORTH CAROLINA
1520 SALISBURY HIGHWAY a
STATESVILLE, NORTH CAROLII � ,,
N p2
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.'nkl-wif(p .
SEPTEMBER 18, 2015
LE&D PROFESSIONALS, PC
River Run Executive Offices
Suite B
110 Exchange Street
Danville, VA 24541
Office: [phone]
Fax: [phone]
LE&D Project No. SZ S7'VNC14

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QUAD MAP '/// iLJ ��� `�i'\O oI`1` J�,
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STATESVILLE EAST &SHEPHERDS

Table of Contents
Quad Map
Discussion............................................................................................................ I
Calculations:
Pre- & Post Hydrology.....................................................................................2
Water Quality BMP Sand Filter.........................................................................3
SandFilter Details.................................................................................................4-7
Appendix
Drainage Area Maps A
Rainfall Data B
Hydrograph Printouts C
Soil Map D

SHEETZ, INC., STATESVILLE, NORTH CAROLINA
1520 SALISBURY HIGHWAY
STORM WATER QUALITY REPORT
9-18-2015
PURPOSE: The purpose of this project is the development of a Sheetz convenience/gas store.
The project construction will include: (1) Land clearing, (2) Demolition of existing
structures, paving, utilities, cte., (3) Grading, utility installation, building
construction, paving and (4) Re -stabilization of all disturbed areas.
SITE DATA: The 4.36 acre site is located at the southeast comer of Salisbury Highway and N.
Barkley Road, approximately''/a mile east of Interstate Hwy. 77. The pre -developed
site contains an existing industrial building, paved parking areas and some gassed areas.
The site has flat to moderate slopes. The site is divided by a ridge in the center and
drains to the east and west. The entire site drains to Third Creek. Properties adjacent to
the site to the north, east, south and west are developed industrial and commercial.
PROCEDURE: The western portion of the site (Basin "A") drains to an existing storm drain system.
Stormwater detention will be provided for the increase in runoff due to additional
area and impervious surface. Stormwater quality treatment will be provided for the
increase in impervious surface or Built Upon Area (BUA.) The eastern portion of
ion the site (Basin "B") drains to an existing storm drain system and will be
developed with a reduction in drainage area and BUA.
Stormwater runoff will be determined for pre- and post -development conditions for
the site by the Curve Number Method (TR-55.)
Runoff reduction to pre -developed rates in Basin "A" will be determined by
reservoir routing. Stonmwater detention will be provided in underground storage
pipes.
An open sand filter will be provided in Basin "A" for storm water quality treatment
for the proposed increase in BUA.
The storm pipe system will be designed using the rational method to determine
runoff and inlet/outlet control hydraulics.

LE&D Professionals, PC
CALCULATION SHEET
De ignff & 6 - Date q-/?-/.5- Check, Date —Project N.Si - SVAIQ �
Tiflc3/ 2L- S'4G154611XY &W' S.bi.1 Y Sheet No.—Of—
L7�
... . ... ....
4> 515-t-Dr. CA/I:E1.6
0
ov,

Sand Filter Design SHEETZ STATES VILLE, NC, SALISBURY HWY.
Water Quality Volume (WQV) =
R, (unitless) x
1
An(acres)
1
x
43560n3 x inchR x ft
1 Acre 1 12 in
WQV =
2601 ft3
WQVADJ: Volume above Sand filter=
(0.75)WQV
WQVAoJ=
1951 ft,
Volumetric runoff coefficient (Rv) =
0.05+0.009(%Imp)
Rv =
0.7025
% Impervious(percent impervious from total drainage
area to sand filter
72.5
Drainage Area to Sand Filter (AD) =
1.02 acres
Ro inch Rain(first 1" of rain) =
1 in
Average head on the sand filter (hA)=
hMaxFlnar(ft)
2
hMaxFilter(ft)
WQVAoj
(h3)
As+Af
(az)
2
1951
975
hA=
1 ft
3
1951
650
Maximum head on Sand filter (hMaxFilter )=
WQVAdi(ft3)
As(ft2)+ AAft2)
4
1951
488
5
1951
390
hMaxFilter _
2 ft
6
1951 1
325
Minimum surface area of the sediment basin(As)=
[240' Rv(unitless)' Ao(acres)]' RD(ft)
As=
171.972 ft2
Provided surface area for sediment basin=
272 ft2
Settling velocity of Particles
(20 microns assumed) (w) =
0.0004 ft/sec
Minimum surface area of the sand filter(AF)=
(WQV)(dF)
(k)(t)(hA + cIF)
depth of sand filter bed
(minimum 1.5') (dF)=
1.5 ft
Coefficient of permeability (k) =
3.5 ft/day
AF=
269 ft2
time required to drain WQV (t) =
1.66 days
Provided surface area for sand filter=l 330 ft2 1 _
Trap Efficiency (E) = 0.9 Volume required above sand filter= 602 ft
Volume provided above sand filter=1 2903
Underdrain Sizing D=16(Q'n/SA0.5)A3/8 S=.005 n=0.011 D=16(0.405-.011/.005A0.5)A.375= 5.67"
Q=10-(.75-WQV 11.66 Days) / 86400 = (cfs)
Q= 0.405 CFS w
Number of underdrain pipes required per Table 5-1 2 @ 6" 2 Provided

MH-16
NCDOT STD. 840.52 SDMH
CB-14 R/M,,7OP ELEV. 896.50
(2)C.O.S. ST--5 (MH-15) INV. IN 891.00 oTo
CONC. CATCH BASIN (6� 1NV. IN 890.16
TOP ELEV. 897.76 /NV. OUT 890.06
INLET ELEV.. 897.26 1
INV. OUT 894.26 EXCAVATION LIMIT_s ,' 1 �/� •O
TANK,
1
�° p� 1 • (21) NEW 24" INV. IN 886.42
'1 O O• Y, . '. 1 • TOP CB = 893.14
. p U :. • 1 ° INV. IN(NE) = 886.29
43'-15" RCP 1 O • INV. IN(S) = 888.97
CL 111 0 1.88%��` 1 :..: .. '::0. ;;, INV. OUT = 886.32
` 1 2.00% _ 20\-244 RCP
• 1 6 _15, R= C-111� , ' CL Ill 0 1.00% \
� saw� IM
T N_'' C
MH-15 -18
NCDOT STD. 840.52 SDMH INV. 893.20 0
SPUTTER SEE DETAIL THIS SHEET f i MH-22
5' -15" RCP NCDOT STD. 840.52 SDMH
RIM/TOP ELEV. 898.00 CL Ill 0 1.00% R1M/7OP ELEV.. 896.50
(CB-14) INV. IN 893.45 15 -15' RCP (OCS-9-6 PVC) INV. IN 886.72
(MH-16) INV. OUT 895.00 CL N 0 1.00% / INK. OUT 886.62
(EW-17)INV. OUT 893.35
d OCS-9
FOREBAY OUTLET CONTROL STRUCTURE
SAND STORM STRUCTURE 72" DIA.
FILTER PRECAST MANHOLE
TOP ELEVA77ON 898.00
6" PVC SDR 35 PERFORATED SEE DETAIL THIS SHEET
UNDER DRAIN W/ J" PERFORATIONS (CB- RT 1N 88
0 0.50� (MH-16)I6)INVERT IN 889.9.91
(2 REO.'D W/ CLEANOUTS) EQUALLY INVERT OUT (6' 42 BCCMP) 891.00
SPACED INVERT OUT (6'-15 RCP) 886.00
INVERT OUT (6'-6 PVC W/ 310RIRCE) 886.75 '
STORM DETENTION / SAND FILTER PLAN
NO SCALE

E
MOM
NOW
A
WEIR 895.0
EMBANKMEN
RIP
RAP
TOP 896.0
TO
BERM
- - _ -
AP
ON
96.0
0
15`0
15'"0
m
----
RCP
RCP
c
'>
OREBAY
893.0
15
o
SAND FILTER
Z5"0
R
P-
TOP 893.0
BOT 891.5
PVC
PERF
RATED
24"0
EX 30"0
RCP
RCP
STORM DETENTION / SAND FILTER PROFILE
SCALE: I" = 30' H / 5' V
•//
:•I
m

A
VEGETATED SIDE
SLOPES TYPICAL
SEDIMENT FOREBAY
3: 1
mg
15"RCP
BOTTOM
FOREBAY /
=893.0
BERM WITH 10' WIDE
RIP -RAP WEIR AT 895.0
SHWT> 2' BELOW
SAND FILTER
TOP OF BERM
FOR FOREBAY
=896.0
SAND FILTER
CLEANOUT
TOP OF SAND
FILTER =893.0
11 i s
BOTTOM OF SAND
FILTER =891.5
TOP EMBANK.
i = 896.0
15RCP
48" PRECAST MANHOLE
TOP = 896.50
6" PVC INV. IN = 890.16
15" RCP INV. OUT = 890.06
6"0 SDR 35 PVC PERFORATED UNDERDRAINS
SLOPE @ 0.50% TO OUTLET STRUCTURE
2 EACH REQ.'D EQUALLY SPACED
WITH CLEANOUTS (SEE DETAIL)
SAND FILTER TO BE 22' WIDE x 15' LONG x 18" DEEP
SAND FILTER DETAIL
NTS
FILTER
FABRIC
3" 3'
MIN. MIN.
3"
MIN.
WRAP UNDERDRAINS W/
#57 WASHED STONE
AND FILTER FABRIC
DRILL 4 EACH 3/8"0 PERFORATIONS
AROUND PERIMETER OF PIPE EQUALLY
SPACED. PLACE PERFORATIONS AT 6"
INTERVALS ALONG LENGTH OF PIPE
6" PVC UNDER DRAIN DETAIL
N TS

15" 0 RCP
STEPS @ 12"
Q
48"o °
PRECAST BASE
1 5"nr
TO
DE
15"0 RCP
TO FOREBAY &
SAND FILTER
P LAN
MANHOLE
ACCESS TOP ELEV.
898.00
15" 0 RCP
TO STORM
DETENTION
1=//895.0
15"0 RCP;
i 893.45
SPUTTER
893.351 li
ri
15" 0 RCP
TO FOREBAY &
SAND FILTER
6" MIN. COMPACTED
AGGREGATE BASE
BOX DETA�L
NO SCALE

Nv..
r 1 I
71-- W . 6NLM \
O P� \
Trrv°Pa ee�' s a. was ---- 0.15 AC _---- - .'.OUT an �
.Niv M moo, - 0.34 AC. IMPERV. - ---'� ` `,\\
. M.
Nv. N - UM1
_ M. aT - ex,a
1w " '" PRE -DEVELOPED
M..=.e,:'a6, , , ----•, _�-------------� ' - ' \\ 3 \ DR.4/NAGS MAP
M.
Nv. our ee,.,s , , , , \ �_--- ,
o' 30' 60' 90'
m
Y\`` �``� 3 \`
I
OFFSITE
BASIN B PRE—DEVEL.
0.68 AC. \ O 96 BASIN B \ ]I \ : M : eie 42 Q`
\ 1\� ' \Nv. our-eIS.M / O
AN t) 2. 16 AC. 1 1 ``
0.48 AC 0.12 AC
IMPERV. ( 1 WOODED--�----
0.31 AC
MT - MO
— [as] li' acv [as] 11 NV. Top"p ` 861ea �.'� v/ IMPERV. '- J `'
\ ( r On 1
\ Q
EXISTING IMPERVIOUS
' -\
!1 78 SCSEF. A------� _\ PRE -BEVEL. I \ \ \
eAs/M A I
2.20'AC.
�-'_-------�_ _s r' V. `� \ �l
B99 _ �'IMPER
'\ I \, 15\ a -.PO
--- -- -----�rrv. our - a
896 IN\
TOP a - wa.la
\ ` ` NV. N�' - 666.2V
Nv. N(s) - e 97
666.M
M-mw as
OFFSITE
TOTAL OFFSITE p 2/ q \` _ _ \
ae 1/ , ` I o
BASIN B / -�• J,
1.64 AC. O. •� \ I \`I
0.58 AC
IMPER
1.21 AC V.
.� • p \ _ \
IMPERV.
--- * - +
Id
IN
W
S �E! M F a �.+ / 12 M 1, }
S S S S �s _ `s ss —is \\II s JYt�` s— ''/,\—� — s `s �T s
sm.111/ J� �.1 .FYI
NV. OIfT . pp6,2 904 / / — /' —. / MF . "Y. j� M -j'As
16'70P NP
\as�
I / M. NCO:66n / TOPN 6.6"
M. N .61YL NV. N . 692N1

o p \ \
w a
Q a a
w \ \ a=ILI
a
to
1
1
1
I
8 �
8=
n

mv. u l- ea*.ui / 1 A 1 I-\\\\y
IN - 878.45
'. OUT - 878.19
AC
3 IMP STORM PIPE
74 DRAINAGE AREAS
0' 30' 60' 90'
�NV,. NN- 876.482
t — J 0. MP , 10 A
CB-2
00. .1r 13 ABC \
��A P
.� 0.1 P
/ C-19 \ C=.87 /
TOP\DI — 896.57
INV. QUT - 893.64 \� / TO MH 4 _ \ \ ♦ \
EX. \\ "
j DI-18 \ 699 CB S
� 0.32AC � #01 7 1
' ) i 0-5 IMP 0.05AC _ _ / 0.11 C
C=. �4 O MH 5 � I 1 6 1 0.11 # C=.951 / 1
INV IN
EX. DI INV. OUT
CONVERT .31 AC
�"----- CB-1 I*4w T 22IMP
-----s� / / r 80
TOP
---- -- 0.26A �� jNV.
I
t
•
` EX IN �
d �, 5 •, \ \� �� \ rr +'. CSJ CB12 4�\\\ iN
TOP MN - 899.90 0.8 \ _ @�— — — ,r+
INV. CL - 882.71 f X / Q�'
�4 P > \
MH-
Y ypl \
• PP \ \ \ I T \
.�o • MH-15'
S „r�-� y ,z DIP

NOAA Atlas 14, Volume 2, Version 3
Location name: Statesville, North Carolina, us- \\\
Latitude: 35.7675°, Longitude:-80.8522° 1
Elevation: 893 ft' s p
source: Google Maps
POINT PRECIPITATION FREQUENCY ESTIMATES
G.M. Bonnie, 0. Marta. B. Lin, T. Pamybok, M.Yekta, and D. Riley
NDAA, National Weather Service, Silver Sprang, Maryland
PF tabular I PF oraohical I Malts 8 aerials
PF tabular
PDS-based point precipitation frequency estimates with 90% confidence intervals (in inches)"
Average recurrence interval ears
Duration
1
2
5
10
25
s
F o 5
100
200
500
1000
0.376
0.445
0.521
0.577
0.642
0.687
0.730
0.768
0.813
0.846
5-min
(0.347-0408)
(0411-0484)
(0.480-0568)
(0.530-0627
(0.585-0697)
0,623-0748)
(0656-0.796)
(0.685-0841)
0.715-0.896)
(0.735-0.936
0.600
0.711
0.835
0.923
1.02
1.09
1.16
1.22
1.29
1.33
10-min
(0,554-0.651)
(0.657-0774)
(0,769-0909)
(0847-1.()0)
(0.933-1.11)
(0992-1.19)
(104-126)
(109-1.33)
(1.13-1.42 )
( 1.16-148 )
15-min
(IDS9270814
0826-0973
0.973-6.15
1.07-1.27
1.1831041
1,26-11..51
1.3241.60
1.37--r�1.68
1.426L78)
14561.85
30-min
(0.949-3.12)
1 (1,1421.35)
1 (1.38510.63)
1 (1.55611..84)
1 (1.759209)
1. 902.27
(2. 2-2.45)
2.1332.62
(2,27-2.84)
1 (2.3573.00)
1.28
1.55
1.92
2.20
2.56
2.83
3.09
3.36
3.70
3.95
60-min
(1.18-1.39)
(1.43-1.69)
1 (1.77-2.10)
1 (2.02-2.39)
(2.33-2.78)
(2.56-3.08)
(2,78-3.37)
(2.99-3.67)
1 (3,25-4.07)
(3.43-4.38)
1.49
7.81
2.26
2.60
3.06
3.41
3.77
4.12
4.60
4.96
2-hr
(1.37-7.62)
(1.9-1.97)
(2.07-2.66)
(2.38-2.83)
(2.78-3.33)
13.08-3.72)
(3.37-4.12)
(3.65-4.52)
(4.07-5.08)
(4.28-5.51)
3-hr
(1.47610.74
1.7892.11
2. 3-2.65
2,57-3,06
3: 23363
337'408
3,71'4.54
4.04-502
(44 85.70
4.81-6.24
1.96
2.36
2.96
3.44
4.08
4.59
5.11
5.65
6.39
6.97
6-hr
(181-2,13)
1 (2.19-2.58)
1 (2.73-3.23)
3.16-3.73
(372-4.42)
1 (4.15-498)
1 (458-556)
L500-616)
5.56-6.99)
(5.98-7.66
235
2.84
3.57
7 4.15
4.94
5.57
6.22
6.90
7.84
8.58
12-In
(2.18-2.56)
1 (2.63-3.10)
1 (330-3.88)
1 (3.81-450)
11 (450-5.35)
1 (5,04-602)
1 (558-673)
1 (6.11-746)
(6.83-849)
(7.36-9.32)
282
3.42
4.33
5.03
6.01
6.79
7.58
8.41
9.54
10.4
24-hr
(2.62-3.05)
(3.17-3.70)
(400-4.68J
(4.64-544)
(553-650)
(6,22-734)
(693-821)
(7.65-9.11)
(864-104)
(940-11.3)
3.32
4.01
5.02
5.81
6.87
7.72
8.57
9.45
10.6
11.6
2-day
(308-359)
1(3.72-434
466-5.43
537-628
634-7.43
7.09-8.34
7.86-9.27
8.63-10.2
967-11.5
10.5-12.6
3.53
4.25
5.29
720
8.07
8.95
9.85
11.1
12.0
3-day
(3.29-380)
396-459
( 4.92-5.77 )
(566'F
(6.65-7.77) 11
(7,44-871)
(6.23-9.67) 11
(9.03-10.7)
(10.1-12.0)
(10.9-13.1)
3.74
4.49
5.57
6.40
7.53
8.43
9.33
10.3
11.5
12.5
4-day
(349-402)
(420-484)
(519-600)
(5.95-690)
(697-812)
(7.79-9.08)
( 8.60-10.1)
( 9.43-11.1)
(105-12.5)
(114-135 )
4.J1
5.15
6.28
7.14
8.31
9.22
t0.1
11.1
12.3
13.3
7-day
(4.05-4.62)
(4.84-552)
(5.88-672)
(669-7.65)
(7.75-889)
(B.59-9.87)
(9.41-10.9)
(102-11.9 1
( TA-13.2)
(12.2-143 )
10-day
4,67-5.26
5.558627
6.6707.53
7.519850
8.61'9.77
9 (5-10.8
103-11.8
11.11-12.0
123314.7
13.1415.1
6.63
7.84
9.26
10.4
71.8
t2.9
14.1
15.2
16.7
17.9
20-day
(629-6.99)
7.44-826
(8.77-975)
( 980-109
( 11.2-12.5) 11
(122-137)
1 (13.2-14.9) 1
(16.6-190)
8.21
966
11.1
12.3
13.7
14.8
15.8
16.8
18.2
19.22
30-day
(7.85-861)
1 (923-101) 11
(107-11.7)
1 (11.7-128)
1 (130-14.4) 11
(14.0-155)
1 (15.0-16.6) 11
(160-17.7)
1 (172-19.1)
1 (18.1-202)
10.4
12.1
13.7
14.9
76.5
17.6
18.7
19.7
21.1
22.1
45-day
(992-108)
1 (11.6-12.7) 11
(13.1-14.3)
1 (143-156)
1 (157-17.2) 11
(168-184)
1 (178-19.6) 11
(18.8-20.7)
1 (200-22.1)
1 (21.0-232)
12.3
14.4
16.1
17.5
t9.2
20.4
2t.6
22.8
24.3
25.4
60-day
(118-12.8)
(138-150)
L-J(155-168)
(16.8-182)
(18.4-20.0)
(1B 6-213)
1 (20.7-22.6)
(21.8-23.8)
(231-25.4)
(26.1-266)
t Precipitation frequency (PF) estimates in this table are based on frequency analysis of partial duration series (PDS).
Numbers in parenthesis are PF estimates at lower and upper bounds of the 90 %confidence interval. The probability that precipitation frequency estimates (fare
given duration and average recurrence interval) will be greater than the upper bound (or less than the tower bound) is 5%. Estimates at upper bounds are not
ecked against probable maximum precipitation (PMP) estimates and may be higher than currently valid PMP values.
Please refer to NOAA Atlas 14 document for more information.
Back to Too
PF graphical

G) NOAA Atlas 14, Volume 2, Version 3
Location name: Statesville, North Carolina, US'
Latitude: 35.7675°, Longitude:-80.8522° ;
Elevation: 893 W p
' source: Google Maps
POINT PRECIPITATION FREQUENCY ESTIMATES
G.M. Bonin, D. Martin, 8. Lin, T Pamybok, M Vekta, and D. Riley
NOAA, National Weather Service, Silver Spring, Maryland
PF tabular I PF araohical I Maps 8 aerials
PF tabular
PDS-based point precipitation frequency estimates with 90% confidence intervals (in inches/hour)'
Average recurrence interval ears)
Duration
000
10
25
52
100
200
500
1000
5.34
625
6.92
7.-8
8.24
8.76
9.-1
9.-1
10.2
5-min
6-4
(d.16-4.90)
(4.93-5.81)
(5.76-682)
(636-7.52)
(702-836)
(748-8.98)
(787-9.55)
(8.22-10.1)
(858-108)
1 (8.82-11.2)
3.60
4.27
5.01
5.54
6.14
6.56
6.96
7.31
7.72
7.99
10-min
F�
(332-391)
1 (3.94-464) 11
(4.61-545)
1 (5.08-6.02)
1 (5.60-667)
1 (5.95-7.15)
(626-758) 11
(6.51-8.00)
1 (6.79-8.50)
(6.94-8.85)
15-min
277-326
3.305389
3, 9-4.60
4,29-5.07
4,3-5.63
5. 2-603
5,27-639
5: 8-672
5. 9�13
5,81-77,40
2.06
2.47
3.00
3.38
3.84
4.17
4.49
4.78
5.15
5.42
30-min
(1.90-2.23)
(2.28-269)
(2.76-327)
(3.11-3.68)
(3.50-4.17)
(3.78-4.54)
(4.04-4.89) 11
(426-5.23)
1 (453-5.67)
(4.70-6.00)
1.28
1.55
1.92
2.20
2.56
2.83
3.09
3.36
3.70
3.95
60-min
(1.18-1.39)
(1.43-1.69)
(1.77-2.10)
(202-2.39)
(2.33-2.78)
(2.56-35)
(2.78-337)
1 (2.99-3.67)
1 (3.25-4.07)
1 (343-438)
0.744
0.902
1.13
1.30
1.53
1.71 IFT88
2.06
2.30
2.48
2-hr
(0.686-0.809)
(0.830-0.984
1 (1.04-1.23)
1 (1.19-1.42)
1 (139-1.66)
1 (1.54-186)
1 (169-206) 11
(1.83-2.26)
(2.01-254)
(2.14-2.75)
3-hr
0.491-0,580
0.593 0703
0.743-0882
0.856--1.02
101,1,21
1.122436
1.24318.51
1.3551 67
1: 97L90
1.6082.08
0.327
0.395
0.495
0.574
0.681
0.766
F
F0.943
1.07
1.16
6-hr
(0.302-0356)1(0.365-0.430)1(0.457-0.539)
0.527-0623
(0,621-0739)1(0.694-0832)
(0.765-0.928
(0836-103)
0929-IA7)
0999-128)
0.195
0.236
0.296
0.344
0.410
0.462
0.576
0.573
0.650
0.712
12-hr
(0.181-0212)
(0218-0.257)
(0274-0.322)
(0.316-0374
(0.374-0444)
(0.418-0.500)
(0.463-0.558
(0.507-0.619)
0.566-0705)
(0.611-0.773)
0.117
0.142
0.180
0.210
0.250
0.283
0.316
0.350
0.397
0.435
24-hr
(0.109-0.127)
(0.132-0154
(0.167-0.195)
(0.194-0.227
(0.230-0.271)
0.259-0.306)
(0.289-0.342
(0.319-0.380)
0.360-0431)
(0.392-0.472
FO 2
7
2•day
70.90
Q
0.064 0 075
0.07
0097' 05113
0.1102'
131
0.132 03155
0.148-0'174
0.164' 09193
0.180' 0 213
0.20b0 240
0.2108-0262
F 0.085
0.100
0.112
0.124
0.137
0.154
1 0.167
3•day
(0.046 0.053)
1(0.055-0.064
(0.068-0079)
0.079-0091
0.092-0.108
0, 103-0.121
(0.114-0134)11(0.125-0148)
0,140-0167)
0.152-0181
0.039
F 0.047
F 0.058
70067
0.078
0.088
0.097
0.107
0.120
0.130
4 d7y4-day
(0.036-0.042)1(0.044-0.050
(0.054-052)
(0062-0072
(0073-0085)
(0.081-0.095)
(0.090-0105)
(0.098-0.115)
0.110-0130)
(0.119-0141)
0.026
O.OJ1
0.037
0.043
0.049
0.055
0.060
0.066
0.073
0.079
7-day
(0.024-0.027)
(0.029-0.033
(0,035-0040)
(0.040-004fi
(0.046-0053)
0.051-0059)
(0056-055
(0.06 0071)
0.068-0079)
(0.073-0085
025
029
10-day
00o9 Q022
002 -0026
0028-0037
0031-0035
0.036-0.041
0.039-0.045
0.04 -0.049
0.046-0053
0.05100059
0. 55-0.063
20-day
(000 -0015)
10.0115 0017
(0.0108-0020)
(0020 0023
(0.02 3-0026
(0.025-0028)1(0.028
0031
0.030-0033)
0.032-0037)
0.035-0.040)
0.011
0.013
0.015
0.017
0.019
0.020
0.022
0.023
0.025
0.027
30-day
(0.011-0012)
(0013-0.014)
(0015-0016)
(0016-0018
(0018-0020)
(0.019-0.021)
(0021-0.023)
(0.022-0025)
0.024-0027)
(0025-0.028)
0.010
0.011
0.01J
0.014
0.015
0.016
0.017
0.018
0.020
0.020
45-da y
(0,D09-0,010 )
(0.011-0.012 )
(0012-0.013)
(0.0130.014
(0.015-0.016)
(0.016-0.017)
(0.016-0.018)
(0.017-0.019)
0.019-0.021)
(0.019-0.022)
60•day
0.009
(0,008-0.009)
0.010
(0.010-0010)
0.017
(0.017-0.012)
0.012
(0.012-0.013
0.013
(0.013-0014)
0.014
K0.014-0015)
0.075
(0.014-0.016
0.076
(0.015-0.017)
0.017
0.016-0018)
0.018
(0.017-0.018
r Precipitation frequency (PF) estimates in this table are based on frequency analysis of partial duration series (PDS).
Numbers in parenthesis are PF estimates at lower and upper bounds of the 90%confidence interval. The probability that precipitation frequency estimates (for a
given duration and average recurrence interval) will be greater than the upper bound (or less than the lower bound) is 5%. Estimates at upper bounds are not
ecked against probable maximum precipitation (PMP) estimates and may be higher than currently valid Pill values.
Please refer to NOAA Atlas 14 document for more information.
Back to Top
PF graphical

SZ-STVNC14-POST
Prepared by (enter your company name here) Page 1
HydroCADO 8.00 s/n 004988 © 2006 HydroCAD Software Solutions LLC 9/17/2014
Area Listing (selected nodes)
Area (acres) CN Description (subcats)
0.250 61 GRASS (4S)
0.770 98 IMPERVIOUS (4S)
1.020

SZ-STVNC14-POST
Prepared by {enter your company name
Type 11 24-hr 1 YR Rainfall=2.82"
Page 2
Subcatchment 4S: PRE-DEVEL SAND FILTER
Runoff = 3.21 cfs @ 11.96 hrs, Volume= 0.145 af, Depth> 1.71"
Runoff by SCS TR-20 method, UH=SCS, Time Span= 1.00-23.00 hrs, dt= 0.02 hrs
Type II 24-hr 1 YR Rainfall=2.82"
Area (ac) CN Description
0.250
61 GRASS
0.770
98 IMPERVIOUS
1.020
89 Weighted Average
0.250
Pervious Area
0.770
Impervious Area
Tc Length Slope Velocity Capacity Description
(min) (feet) (fUft) (fUsec) (cfs)
1.9 235 0.0310 2.01 Sheet Flow,
Smooth surfaces n= 0.011 P2= 3.42"
1.9 235 Total, Increased to minimum Tc = 5.0 min
w
U
3
0
LL
Subcatchment 4S: PRE-DEVEL SAND FILTER
Hydrograph
3,21 cfs
3 Type II, 24-hr 1 YR
Rainfall=2.82"
Runoff Area=1.020 ac
2 _ . _ . _ _ . _ . .... Runoff Volume=0:;145_af_
Runoff Depth>1:71"
Flow Length=235'
i
1 Slope=0.0310 '/'
Tc=5.0 min
C N=89
0
1 2 3 4 5 6 7 8 9 1011121314151617181920212223
Time (hours)
— Runoff

SZ-STVNC14-POST Type 1124-hr WQ Rainfall=1.00"
Prepared by {enter your company name here} Page 3
HydroCAD® 8.00 s/n 004988 © 2006 HydroCAD Software Solutions LLC 9/17/2015
Subcatchment 4S: PRE-DEVEL SAND FILTER
Runoff = 0.53 cfs @ 11.97 hrs, Volume= 0.024 af, Depth> 0.28"
Runoff by SCS TR-20 method, UH=SCS, Time Span= 1.00-23.00 hrs, dt= 0.02 hrs
Type II 24-hr WQ Rainfall=1.00"
Area (ac) CN Description
0.250
61 GRASS
0.770
98 IMPERVIOUS
1.020
89 Weighted Average
0.250
Pervious Area
0.770
Impervious Area
Tc Length Slope
On) (feet) (ft/ft)
1.9 235 0.0310
1.9
0.1 E
0.1
Velocity Capacity Description
2.01 Sheet
235 Total, Increased to minimum Tc = 5.0 min
Subcatchment 4S: PRE-DEVEL SAND FILTER
Hydrograph
0.53 cfs
--- - -- --- --,
Type II 24-hr WQ
Rainfall=1:00"
Runoff Area=1.020 ac-
Runoff Volume=0.024 of
Runoff Depth>0:28"
Flow Length=235'
Slope=0.0310 '/'
Tc=5.0 min
am
1 2 3 4 5 6 7 8 9 1011121314151617181920212223
Time (hours)
— Runoff

SZ-STVNC14-POST
Prepared by {enter your company name here} Page 1
Area Listing (selected nodes)
Area (acres) CN Description (subcats)
0.280 61 GRASS (3S)
0.740 98 IMPERVIOUS (3S)
1.020

SZ-STVNC14-POST Type 11 24-hr 1 YR Rainfall=2.82"
Prepared by {enter your company name here} Page 2
HydroCAD® 8.00 s/n 004988 @ 2006 HydroCAD Software Solutions LLC 9/17/2015
Subcatchment 3S: SAND FILTER
Runoff = 3.08 cfs @ 11.96 hrs, Volume= 0.138 af, Depth> 1.63"
Runoff by SCS TR-20 method, UH=SCS, Time Span= 1.00-23.00 hrs, dt= 0.02 hrs
Type II 24-hr 1 YR Rainfall=2.82"
Area (ac) CN Description
0.280
61 GRASS
0.740
98 IMPERVIOUS
1.020
88 Weighted Average
0.280
Pervious Area
0.740
Impervious Area
Tc Length Slope Velocity Capacity Description
(min) (feet) (fUft) (ft/sec) (cfs)
1.9 235 0.0310 2.01 Sheet Flow,
Smooth surfaces n= 0.011 P2= 3.42"
1.9 235 Total, Increased to minimum Tc = 5.0 min
w
U
3
0
LL
Subcatchment 3S: SAND FILTER
Hydrograph
3.08 cfs
Type II 24-h'r 1 YR
Rainfall=2:82"
Runoff Area=1.020 ac
Runoff Volume=0138 of
Runoff Depth>1.63"
Flow Length=235'
Slope=0.0310 7'
Tc=5.0 min
CN=88
1 2 3 4 5 6 7 8 9 1011 12131415 161718 1920212223
Time (hours)
— Runoff

SZ-STVNC14-POST
Prepared by {enter your company name
Type II 24-hr WQ Rainfall=1.00"
Page 3
Subcatchment 3S: SAND FILTER
Runoff = 0.46 cfs @ 11.97 hrs, Volume= 0.021 af, Depth> 0.25"
Runoff by SCS TR-20 method, UH=SCS, Time Span= 1.00-23.00 hrs, dt= 0.02 hrs
Type II 24-hr WQ Rainfall=1.00"
Area (ac) CN Description
0.280
61 GRASS
0.740
98 IMPERVIOUS
1.020
88 Weighted Average
0.280
Pervious Area
0.740
Impervious Area
Tc Length Slope Velocity Capacity Description
(min) (feet) (ft/ft) (fUsec) (cfs)
1.9 235 0.0310 2.01 Sheet Flow,
Smooth surfaces n= 0.011 P2= 3.42"
1.9 235 Total, Increased to minimum Tc = 5.0 min
Subcatchment 3S: SAND FILTER
Hydrograph
0.5 0.46 cfs
0.45 Type II 24-hr WQ
0.4 Rainfall=1:00"
0.35= - Runoff -Area-1.020 ac-
0.3 Runoff Volume=0.021 of
3 0.25- Runoff Depth>0:25"
LL 0 2= Flow Length=235'
0.15 - Slope=0.0310
Tc=5.0 min
. 0.1
C N=88
0.05
p
1 2 3 4 5 6 7 8 9 1011121314151617181920212223
Time (hours)
— Runoff

M51 IT
35O a'N
3 Soil Map-4redell County, North Carolina s
k
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513050 513D30 513110 513M 5131M 5132W
3
Map Sole: I:IAW if prlroed on A portrait (8.5" x 11-) sttxt.
N Meters
0 20 40 eo 120
red
0 50 10D 200 300
Map proption: Web MaoNr Cm coordrabe;: NCS94 Edge tics: UfM Zane 17N WCS84
USDA Natural Resources Web Soil Survey
Conservation Service National Cooperative Soil Survey
a �ITN
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513230 513260
3
1/27/2015
Page 1 of 3

®III
® It Professionals; PC
F0 TRANSMITTAL
River Run Executive Offices, Suite B
110 Exchange Street Phone:
o
�j FGF
[phone]
Danville, VA 24541 Fax: [phone]
�Y d�yO�y d
�s�PO'Q
?ors o
TO: NC DENR
• P .9-19-15
Division of Water Quality
Proje o.: SZ-STVNC15
1617 Mail Service Center
Project: heetz Store
Raleigh, NC 27699-1617
Reference: Salisbury Hwy
Attention: Mr. Bill Diugiud
Carbon Copy:
We Transmit:
As per requested
Under separate cover
By mail
By messenger
By pickup
By overnight carrier
the following:
❑
Prints
❑
Specifications
❑
❑
Change Order
❑
❑
Shop Drawings
❑
❑
Reproducibles
❑
®
Other
El
Coples Date Number Description
for:
Your approval
❑
Your review/comment
El
Your file/use
❑
Revision and submission
❑
Distribution
❑
2
9-19-15
Site Construction Drawings folded
1
9-16-15
1
Review Fee Check #13371 Amount $505.00
1
Storm Water Management Permit Application Original and one copy incl required attachments
1
Business Corporation Annual Report for Secretary of State
1
10-01-14
Agreement for Sale
L
Comments: DENRd ANn Fit W .. ,
K WATER PERMITTING
Please call if questions Thanks G Mark Johnson
Please notify us at once If enclosures are not as noted.
Signed

DWQ USG ONLY
Date Received
Fee Paid
Permit Number
[Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
ct 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 APPLICSTWN ARM
This form may be photocopied for use as no original ^� N7o p� 2
I. GENERAL INFORMATION � PP`I''��(r`� '�'f
1. Project Name (subdivision, facility, or establishmentname - should be consistent NN .0 't name on plans,
specifications, letters, operation and maintenance agreements, etc.): N�
Q_
2. Location of Project (street address):
Ci ty:Statesvi I le Cou nty:Iredell 7 ip:28677
3. Directions to project (from nearest major intersection):
Approximately 0 5 miles cast of file intersection of Interstate Hwy 77 and Salisbury Hwy. U.S. 70
4. Latitude:35° 46' 07" N Longitude:80* 51' 16" W of the main entrance to the project.
it. PERMIT INFORMATION:
].a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
t Renewals with modifications also requires SWU-102 - Renewal Application Forin
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 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: 3.74 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
b.lf 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? JNNo LJYes
If yes, see S.L. 2012-200, Part VI: http'//portal ncdenr org/web/wq/ws/su/statesw/rules laws
Form SWU-101 Version 06Aug2012 Page I of

Ill. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:Sheetz, Inc.
Signing Official & Title:Steven P. Augustine, Asst. VP/Assistant
Secretary
b.Contact information for person listed in item I above:
Street Address:5700 Sixth Ave.
City:Altoona
State:PA Zip:16602
Mailing Address (if applicable):Sanne
City:
State: Zip:
Phone: (336 ) 978-1028
Fax: ( 1
Email:
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:Billy R. Moose
Signing Official & Title:Billy R. Moose, Owner
b. Contact information for person listed in item 2a above:
Street Address:224 E. Lackey Farm Rd.
City:Stony Point State:NC Zip:28678
Mailing Address (if applicable):Same
Phone:
Em
Fax:
Zip:
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:Sam Smith - Sheetz, Inc.
Signing Official & Title:Sam Smith
b.Contact information for person listed in item 3,1 above:
Mailing Address:3472 Grandview Crossing Lane
City:Pfafftown State:NC Zip:27040
Phone: (336 ) 978-5354 Fax:
E m a il: sa s m i th©sh eetz. corn
4. Local jurisdiction for building permits:
Point of Con tact: Brendon Pritchard Phone #: (704 ) 878-3552
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.
The stormwater runoff will be conveyed through a storm pipe system to a sediment forebay, an open sand
filter and a normally dry detention basin and discharge to an existing storm pipe system.
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 11 - Post Construction
3. Stonnwater runoff from this project drains to the Yadkin Pee -Dee River basin.
4. Total Property Area: 4.36 acres
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area4:4.36 acres
Total project area shall be calculated to exclude the followingg the normal pool of impounded structures, the area
between the banks of strearrrs and rivers, the area below the Nornml High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands Iandzaard from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal zwetlands landzward of the NHW (or MHW) line nrny
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 =
9. How many drainage areas does the project have? 1 (For high density, count 1 for each proposed engineered
stornawater BMP. For lozw 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 A
Drainage Area
Drainage Area
Drainage Area
Receiving Stream Name
Third Creek
WS-37
Stream Class *
C
Stream Index Number *
12-108-204
Total Drainage Area (sf)
37462
On -site Drainage Area (so
37462
Off -site Drainage Area (so
0
Proposed Impervious Area** (so
32234
Impervious Area** total
86
Impervious** Surface Area
Drainage Area A
Drainage Area
Drainage Area
Drainage Area _
On -site Buildings/Lots (so
5316
On -site Streets (so
On -site Parking (sf)
23807
On -site Sidewalks (so
1500
Other on -site (so
1611
Future (so
Off -site (sf)
Existing BUA*** (so
Total (so:
32234
Stream Class and Index Number can be determined at http://portal.ncdenr.or oeb/zwq[ps/esu/classifications
Form SWU-101 Version 06Aug2012 Page 3 of 6

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 muount of existing BUA that Will remain after development. Do not report any existing BUA that
is to be removed and Which ¢pill be replaced by new BUA.
1"I. 1-low was the off -site impervious area listed above determined? Provide documentation.
Projects in Union County: Contact DII'Q Central OJJice staff10 check if the project is located within « Threatened &
Endangered Species watershed that nrcry be subject to more stringent stormwater requirements as per 15A NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stornnvater 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 littl2://portal.ncdeiir.org/web/­wqZwsZsu/­bmp-nianuat.
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 littp://portal.iicdetir.org/N%,eb/wqZws/su/statesw/forms does. 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 iicdeiir.org/webZwq/ws/su/mli2s.)
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 ncdenr org/web/wq/ws/su/statesw/forms does.
1. Original and one copy of the StornlNvater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part Vll 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
http7//www envlie]p orV/Vages/onestopexpress.htnil 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 h,eatmcnt/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.
7. Sealed, signed and dated calculations (one copy).
8: "rwo 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.
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 tine 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 hearings & 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.
FormSWU-101 Version06Aug2012 Page 4of6

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).
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"x11" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DINQ to verifij the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 1028 Page No: 873
11. Por 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 mist be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http //wrew secretary,state.ncus/Corporations/CSearch.aspx
VI1. DEED RESTRICnONSAND PROTECTIVECOVENANTS
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 lohsizes vary significantly or the proposed
13UA allocations vary, a table listing each lot number, lotsize, 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/wg/ws/su/statesw/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 DWQ and that they will be recorded prior to the sale of any lot.
V III. 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:Michael A. Ellis
Consulting Firm: LE & D Professionals PC
Mailing Address:l"10Exchange St.
City:Danville State:Va. Zip:24541
Phone: [phone] Pax: ( )
Email:mellisOO landengcorn
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, itea 2 has been fulled out, complete this
section)
1, (print or type naune of person listed in Contact Information, item 2a) Billy R. Moose Owner certify that I
own the property identified in this permit application, and thus give permission to (print or type nmue of person
listed in Contact lnfor nation, item la) Steven P. Augustine with (print or type naune of organization listed in
Contact Information, items la) Sheetz, Inc. to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the storrawater 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 Nan1c/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.
Date: `-16 ^ 70 / S--
a Notary Public for the State of a-i2t6 Qwa G)MCounty of
do hereby certify that U i o aS 2 personally appeared
before me thisAttkday of 0101 �, and acknowle gc the d execution of the application for
a stormwater permit. Witness my hand and official seal,
OFF11I1'A L-AL
NornC0�7ra•AlY,t,o�69yfl�
X. APPLICANT'S CERTIFICATION
SEAL
My commission expires
1, (print or type name of person listed in Contact Information, item 1n)
certify that the _infor[nation 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, aid that tlt roposed project complies with the requirements of the
applicable stornrwater�jrinder 15A�1��+C 2Hand any other applicable state stormwater requirements.
Date: 9 - 10 - Yj
I, J` f c
�i1Y11 ter-� J a Notary Public /for the State of-12r1P15�� vt__ 0"n i e_ti_, County of
L\ ai ' do hereby certify that ��eJe Y��i ii} nE personally appeared
before me this L6 day of _ �en6e r aot , and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, 4y
COMMONWEALTH OF PENNSYLVANIA
SEAL NOTARIAL SEAL
JeD. SChramke, Notary Public
of Altoona, Blair County
Flyyimission Expires April 7, 2019
MEMBER, FENNSYLVANIA ASSOCIATION OF NOTARIES
My commission expires
Form SWU-101 Version 06Aug2012 Page 6 of

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CCR ,'C'1'!il[F"f _.H 06 �Fi'.:1'Lf"ii'y Ni
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\"

pEPRIM
BUSINESS CORPORATION
ANNUAL REPORT
NAME OF BUSINESS CORPORATION: Sheet_ Inc.
FISCAL YEAR ENDING: 913012014
SECRETARY OF S'I'A"TE CORPORA'TS IDNUMBER: 0597312
NATURE OF BUSINESS: Recoil Convenience.Stme
REGISTIERED AGENT: CT Corporation System
REGIS'I'ERL'D OFFICE MAILING ADDRESS: 1501 areaeville St., Bov 1011
Raleigh. NC 27601-2957
1 Filet, Annual Report
5345086
Do not data enter manually.
STATE OF INCORPORATION: PA
REGISTERED OFFICE, STREET ADDRESS: 150 Fovetteville Sl., Box 1011
Raleigh, NC 2 7601-295 7 ]fake Coun(v
11RINC IPAL OFFICE TELEPFIONENUM BER: [phone]
PRINCIPAL OFFICE MAILING ADDRESS: .5700 Sixth Avennue
Altoono, R/I 16602-1111
PRINCIPAL OFFICE S"IREET ADDRESS:
PRINCIPAL OFFICERS:
Name: Slcphcn G Sheet -
Title: Chairman
Andress:
5700 Sixth Ave
Altoona, P4 16602
Nome: Stephanie Doliveirei
Tide: Nee President
Address:
5700 Sixth Ave
Ahoona, R4 16602
5700 Sixth Avennue
Altoono, PA 16602-1111
Name: Stanton R Sheets
7}71e: Chc h coon Of The Bocird
Address:
5700 Sixth Ave
Altoona, PA 16602
Name: Joseph S Sheetz
Title: President
Address:
5700 Sixth Avc
Altoona. PA 16602
Name: Randall A Sheer
Title: I ice President
Address:
5700 Sixth Ave
Ahoona, P4 16602
Name: Steven PAugustine
Title: Assistant Secretary
Address:
5700 Sixth Ave
Altoona, PA 16602
CER"TIFICATION OF ANNUAL REPORT MUST BE COMPLETED I3Y ALL BUSINESS CORPORATIONS
Thomas P Luciano
FORM MUST 13E SIGNED BY AN OFFICER OF THE CORPORATION
Thomas P Luciano
2/27/2015
DATE
Vice President
TYPE: OR PRINT NAME TYPE OR PRINT TITLE
ANNUAL REPORT FEE: E-Paid MAIL TO: Secretory of State • CoMorations Division • Post Office Box 29523 • Raleigh, NC 27626-0525

•PRINCIPAL OFFICERS: (COlttimted)
Name: Gary Zimmennan
Title: Assistant Vice President
Address:
5700 Sixth Ave
Altoona, PA 16602
Name: Travis T Shear
Title: Vice President
Address:
5700 Sixth Ave
Altoona, PA 1 6602
Name: David P Hazelet
Title: Assistant Secretary
Address:
5700 Sixth Ave
Altoona, PA 16602
Nano: Thomas P Luciano
Title: Vice President
Address:
5700 Sixth Ave
Altoona, PA 16602
Name: Michael A Laccsa
Title: Assistant Secretary
Address:
5700 Sixth Ave
Altoona, PA 16602

AGREEMENT OF SALE
THIS AGREEMENT OF SALE (this "Agreement") is hereby entered into this
day of U C� L , 2014, (the 'Effective Date", which is the date this Agreement is
signed by the last of the parties hereto) by and between:
BILLY R. MOOSE, with an address of 224 E. Lackey Farm Road, Stony Point, NC
28678 (the "Seller")
and
PTM, L.P., a Delaware limited partnership, or its assigns, having a place of business at
5700 Sixth Avenue, Altoona, Pennsylvania 16602 (the "Buyer").
RECITALS
A. Seller is the fee owner of a 4.56f acre parcel of land located at the southeast
corner of Salisbury Highway and North Barkley Road; City of Statesville, Ircdell County, North
Carolina, being Iredell County parcel number 4743998676.000. Seller having acquired title
thereto by virtue of Deed recorded with the Iredell County Register of Deeds Office at Deed
Book 1028, Page 873, and shown on the Preliminary Site Plan attached hereto as Exhibit "A"
(hereinafter referred to as the "Property").
B. Buyer intends to develop the Property ("Buyer's Project") for a Sheetz
Convenience Store open 24 hours per day, seven days a week with the retail sale of gasoline/auto
diesel, diesel islands, limited indoor and outdoor seating, red back lit canopies, a car wash, and
drive thru ("Buyer's Intended Uses").
C. Seller desires to sell the Property, together with all improvements and fixtures
thereon and all rights, including all mineral, oil, gas rights, privileges, easements, benefits and
agreements appurtenant thereto and Buyer desires to purchase the Property in accordance with
and subject to the terms and conditions hereinafter set forth.
NOW, THEREFORE, in consideration of the mutual promises herein contained, and for
other good .and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, Buyer agrees to buy and Seller agrees to sell the Property upon the following
terms and conditions:
1.0 Incorporation. The above recitals are hereby incorporated herein by reference as
if more fully set forth herein.

15.6 Other Documents. Buyer and Seller each agree to execute and deliver to
the other party such additional documents as may be reasonably required or necessary for the
consummation of the transaction contemplated by this Agreement.
15.7 Waiver. Failure by Buyer or Seller to insist upon or enforce any of its
rights hereto shall not constitute a waiver thereof.
15.8 Confidentiality. The terms hereof shall be kept confidential by the parties,
except as may be required for the performance of Buyer's due diligence or the filing of any plans
for purpose of development approvals. Either party shall not record this Agreement.
15.9 Headings. The headings of the various paragraphs in this Agreement have
been inserted only for the purpose of convenience and shall not be deemed in any manner to
modify, explain, qualify or restrict any of the provisions of this Agreement.
15.10 Counterparts. This Agreement of Sale may be executed by the parties in
any number of identical counterparts, all of which shall constitute one agreement.
IN WITNESS WIMREOF, intending to be legally bound hereby, the parties hereto
have set their hands and seals to this Agreement of Sale day and year first above written.
Witness/Attest: SELLER:
Witness/Attest:
By: jel"a te 146z---U�
Billy . Moose
BUYER:
PTM, L.P., a Delaware limited partnership, by and
through PlE, LLC Delaware limited liability
company, its gcncr cr
By. 141
Joseph S,'Sheetz
Vice President
11

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aTpTP6y111..n" SITM 1^PLAN
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and P.C.

I UDELL COUIRr IC 06/12/97
$1631.00
Pon 1 Rytl
C, NA Rawl Estate
ExNsa Tex
Exefae laz 1'(031• 10
Tax Lot No.
Verified by
b
BK 1028pGO813
J
FILED
IREDFLL COUNTY NC
06/12/97 10:36 AM
BRENDA D. BELL
Register Of Deeds
According Time. Book and Page
............. I ...... .., Parcel Identifier No.
....... County on the .............. day of
y.._........ ... ........... ............._. ....,............ ........... .....,.............
NO TITLE OPINION RENDERED BY DEED PREPARER
19............
Mailafter recording to ........... ............. _. _...... ,.......... _... ..._........... .......... ......... ........_......... ............................. _ _....... _.. _..
This instrument was prepared b Jphn, McLain„Massey,, Attorney, at_ Law, P 0... 89x 1. 22,, Statesville,_,BC
Brief description for the Index 28687-0122
NORTH CAROLINA NON -WARRANTY DEED
THIS DEED made this day of ............. .Lune
GRANTOR
IREDELL FIBER, INC., a North Carolina
corporation
.......... _. ..., 19._97...., by and between
GRANTEE
BILLY R. MOOSE
Mailing address:
224 E. Lackey Farm Rd,
Stony Point, NC 28678
Enter in appropriate black for each early: nacre, address, and, if avwopri.te, ch.r.ater of erauty, s.4 terporafioa or oartaenhb.
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and
shall include singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby
acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that
certain lot or parcel of land situated in the City of...Statesville_.... .._................. Statesville... Inside „ Township,
,_... .... Iredell _...._I.,.... I . County, North Carolina and more particularly described as follows:
TRACT 1: BEGINNING at a railroad spike in the western margin of the right-of-way of Barkley Road (S.R. 2352), a comer
of Irodell Mini Storage and Rental Uniform, and running thence along and with the line of Rental Uniform, South 130 51 min.
06 sec. West 168.12 fed to a railroad spike located within the right-of-way of Barkley Road; thence along and with the right-
of-way of Barkley Road South 310 32 min. 09 sec. West 391.07 feet to a railroad spike on the east side of Barkley Road;
thence South240 00 min. 16 sec. East 17.60 feet to a railroad spike; thence crossing Barkley Road through a railroad spike
located on Barkley Road North 80' 21 min. 03 sec, West 887.80 feet to a concrete monument, comer of Hugh L. Moose and
North State Propertes; thence along acid with the line of North State Properties, North 020 22 min. 16 sec. East 401.58 feet to
an existing iron, comer of IrrdeO Mind Storage; thence along and with the line of Irede6 Mini Storage, South 88a 02 min. 42
am East 1096.89 fed to a railroad spike located in the western margin of Barkley Road, the point and place of BEGINNING,
and being the property shorn on a Grading & Erosion Control Plan for Billy Moose prepared by Gerald V. Grant, dated 5
April 1988.
There is excepted from the above that property described in Deed Book 994, page 69, and that property described in Deed
Book 883, page 328, and re -recorded in Book 886, page 918, Ircddl County Registry.
TRACT 2: BEGINNING at an iron rod located in the southern margin of U. S. Highway 70, the common comer of Theorists
S. Roseaherg and the Marguerite B. Taylor property described in Deed Book 804, page 250, Iredell County Registry; thence
with the line of Taylor, South 070 19' 18" West 153.88 feet to an iron; thence South 550 50'06" East 212.06 fed to an iron in
the line of Franco Distributors; thence with the line of Franco Distributors, South 340 58' 02" West 251.98 fed to an iron
N. C. an Aaoa. Farm No. t V 1977-r•..,..wn..,,. ♦ rn.,,x, m. vy rM�Nai., .. c. nose
rnn,cW4r,n•.ni-nn,u x,C ,o aa.c ,W,

BN 1028PGO814
us
located in the north margin of Penney Street; thence with the north margin of Penney Street, North 570 55' 54" West 530.90
feet to an iron located in Barkley Road; thence with Barkley Road, North 1 to 56' 08" Fast 425,00 feet to a P. K. nail set at the
point of intersection of Barkley Road and U. S. Highway 70; thence with U. S. Highway 70, South 570 57' 01" East 413.60
feet to the point and place of BEGINNING, containing 4.813 acres, more or less, all in accordance with a survey by Grier
Surveying Company dated August 17, 1995, a portion of which is attached to deed recorded Ln Deed - Buck 958,
page 22, Iredell Country Registry,
The property hereillahove described wait acquired by Grunter by instrument recorded in .. ._............... _... ... .._..
A map showing the above described property is recorded in flat Book ..................... pose ... ..... .._....... ..
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the
Grantee in fee simple.
The Granlor ..it,. no warranty, express nr implied, as to title to the properly hereinabove described.
IN WITNESS W9IEan'OF' Inc Grantor has nereumu ul oil nna ono aril, or If rereor•tq hn nuva Inia inmumenl to be littler to r
aEwenlelt1 •e a nr sea dull u attired officers and its sell m be hereunto Artisan by authority of sea Nuara of mrermra. me ear ... Teo....
...._IREDELL FIB ER,__ I NC. y .._._.___-__.-ASEACI
, i.A ,jotr Panle Name) ,_,
It
Ideal
..--___._____._._..._. _
(Coeporate bean
} NORTH CAROLINA, .. _County.
a
I. a Nalar)Public of the Count, and Seale aforeaeld, re D1, real ... .. _. _. .. .. ... .
tl
ell.on.111 11Peared before me this day and al.mrse lord Inc ..-idiot of tire luretolnr icilrumenL M'tlneta mY
hand and official name ar sea), this it., of .. .. U
r
N
MY tommiaaian e.,I ... __ _ __ ------------- _--- __------ __ __ _____NMarY Public
aRAi STAMP„ NORTH CAROLWA- _______IYBd2II ____ _ _________county.
T____ m. a .___ J'ald
1, a Notary Puplk. of the fonntY and %tare aftrenlq errtlfY hose M .__.__._ _/U,.__.
:.' ___
rem ,. ear and .rxnawlraa,a anal ___ ne is __ ._-re.—r-e-rr--r_ sen.mrr, of
v
'r, i.''. �.�• f__ ar to - a --
Personally rams hero e '
.!, '._ILede11E1heS...Znc._._ -------- a north Carolina corporation, and that by authority duty
Sierra ana as me err nl the rdrpnuuon, the imlldme inatrnmrnl ,. s silos m sea tome by
d Pe.alderaC .,Sled wtm RI Ireptmt, San and SMatEd by herself .0 .----------------.secrrmrr.
Tr^ ........
y l,. witness my bound and official stamp or seal thisear r V.•/^fC . .. u97..
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or John McLain Massey,.a_Np[ary_Public of_Iredell_Cyunty, ---------
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BRPNDA D. BELL armaTEn OF DEEDS FOR IREDELL cuuNrr
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THIS INSTRUMENT DRAWN BY Kr9stel BmuMll
001464' CHECKED BY Book gsH 472 0433
Age 2 PAGES)
Rerurn I. DIVISION RIGHT OF WAY AGENT
330 SOUTH LAFAYETTE STREETFILED
O5/1]/1999 FILED
SHELBY, NORTH CAROLINA PB1d ,vpCLL COUNTY NC IREDELL CW14(Y NC
$76.00 05/17r1999 6103 AM
COUNTYRTH OF
n<rtn STATE HIGHWAY PF�UD,8El=402
COUNTY OF Intl 4 tlgjSpjMA � � Real Estate F.A. PFA3 M.r STF98tift)
TAX MAP AND LOT 4743-99-8685 Excise Tax I.D. NUMBER U-2421
PARCEL NUMBER 009
THIS FEE SIMPLE DEED, made and entered into this the 5th day of April 19 99
by and between BILLY R. MOOSE f�
hereinaHer referred to as the GFANTORS, and the Deparlment oT Trensporlation, an agency of the State of North
Carolina, hereinamer refered to as the DEPARTMENT:
WITNESSETH
That the GRANTORS, for themselves, their heirs, successors, and assigns, for and in consideration of the
SUM of $ 38,000.00------ agreed to be paid by the DEPARTMENT to the GRANTORS, do hereby
give, gram and convey unto the DEPARTMENT, its successors and assigns, in FEE SIMPLE the right of way located
in Chambersbunp Township, lmdell County, North Carolina, which is particularly described
as follows:
Right of Way - BEGINNING at a point located 31.5 feet easterly of and normal to Survey Station 10+54, Survey Line Y-
2; running thence in a westerly direction in a straight line along and with the southern right Of way limits of Survey Line
Y-2 to a point located 15 feet easterly of and normal to Survey Station 10+53.936. Survey Line Y-2; running thence in a
westerly direction to the point of intersection with Survey Station 10+53.938, Survey Line Y-2; running thence in a
westerly direction, in a straight line to the point o1 intersection with Survey Line Y-2; running thence in a northerly
direction along and with Survey Line Y-2 to its point of intersection with Survey Line L; conning thence In an easterly
direction along and with Survey Line L to the point of intersection with the extended eastern property line of the
undersigned; running thence In a southerly direction along and with the extended eastern property line of the
undersigned and the eastern property line of the undersigned to the point of intersection with the southern right of way
limits of Survey Line L; said point of intersection being located 49.21 feet southerly of and normal to Survey Line L:
running thence in a westerly direction in a straight line along and with the southem right of way limits Of Survey Line L to
a poll t located 49.21 feet southerly of and normal to Survey Station 12+32.696, Survey Line L; running thence in a
straight line in a southwesterly direction along and with the eastern right of way limits of Survey Line Y-2 to a point
located 31.64 feet easterly of and normal to Survey Station 10+32.779, Survey Line Y-2; running thence in a southerly
direction in a straight line along and with the eastern right of way limits of Survey Line Y-2 to the point of BEGINNING.
The un erslpned ran orjfur�ie� conveys"Femrarient Easement areaTs)-toEe usedsolely for the wnstnrcllon and
perpetual maintenance of drainage installations described as follows:
Permanent Drainage Easement #1 - BEGINNING at a point located 49.21 feet southerly of and normal to Survey
Station 12+35, Survey Line L; running thence in a southwesterly direction in a straight line to a point located 31.53 feet
easterly of and normal to Survey Station 10+48.661, Survey Line Y-2; running thence in a northerly direction in a
straight line along and with the eastern right of way limits of Survey Line Y-2 to a point located 31.64 feet easterly of and
normal to Survey Station 10+32.779, Survey Line Y-2; running thence in a northeasterly direction In a straight line along
and with the gastern right of way limits of Survey Line Y-2 to a point located 49.21 feet southerly of and normal to Survey
Station 12+3i11l Survey Line L; running thence in an easterly direction in a straight line along and with the southern
fight of way limits of Survey Line L to the point of BEGINNING - ...... _ _.._... ..._ _._ _
TO -MEMO TO HOLD the aforesaid right of way and all privileges and appurtenances themunto belonging to
the DEPARTMENT in FEE SIMPLE.
The property hereinabove descrtbedwas acquired by the GRANTORS by instrument(s)
recorded in the
County Registry in DEED BOOK 1028 AT PAGE 873;OOK 889 AT PAGE 493 upI/9L,
The rival right of way plans showing the above described right of way are to be certified and recorded in the
Office of the Register of Deeds for said County pursuant to N.C.G.S. 136-19.4, reference to which plans is hereby made
for purposes of further description.
This deed is subject to the following provisions only:
It is understood and agreed that the Undersigned hereby grants the DEPARTMENT a Temporary Construction Easement
Area having a maximum width of 9.85 feet outside the right of way, as shown on the project plans, right of and between
Survey Station 12434.896 and Survey Station , Survey Line L.
It Is understood and agreed that the DEPARTMENT shall have the right to construct and maintain the cut andlor fill
slopes in the above -described Temporary Construction Area until such time that the property owners after the adjacent
lands in such a manner that the lateral support of the cut and/or rill slopes is no longer needed. Any additional
construction areas lying beyond the cut ancilor fill slopes and extending beyond the right of way limits will terminate upon
completion of the project.
R/W D-1
January 1995
(1)
1

i
Project 8.1822402 Parcel: 009
The undersigned owners further request that the Department of Transportation enter upon our lands outside of the right
Of way to the extent as is necessary to reconnect our driveway and we will have no further claim against the Department
as a result of the reconstruction of said driveway.
The GRANTORS by the execution of this instrument, acknowledge that the plans for the aforesaid project as
they affect their property have been fully explained to them or their authorized representative,
Arid the GRANTORS covenant with the DEPARTMENT, that the GRANTORS are seized of the premises in fee
simple, have the right to convey the same In fee simple, that the title thereto is marketable and free and clear of all
encumbrances, and that the GRANTORS will warrant and defend the title against the lawful ctaims of all persons
whomsoever except for the exceptions hereinafter stated. Title to the property hereinabove described is hereby con-
veyed subject to the following exceptions: None
IN WITNESS WHEREOF, the GRANTORS have hereunto set their hands and seals (or if corporate, has
caused this instrument to be signed in its corporate name by its duly authorized officers and its seal to be hereunto
affixed by authority of as Board of Directors) the day and year first above written.
/Y//
(Corporate Name) BILL R. MOOSE (SEAL)
BY: (SEAL)
(President) (SEAL)
ATTEST:
(Secretary) (SEAL)
ACCEPTED FO HE DEPARTME TP F TRANSP TATION
NORTH CAROLINA, ii IREDELL COUNTY
ONoiarftlic of the County and State aforesaid, certify that BILLY R. MOOSE
5+�741rptlR3persdna ared before me this day and acknowledged the execution of the foregoing instrument.
Wi16 s fhy°lu ft�art 0U clal.stamp or seal, this the 5 Lh day of April 19 99
My y+�,,mMaidne his: 10/25/2002
.\'�.. NotarVPublic
NUK IM OAROLINA, COUNTY
I, a Notary Public of the County and State aforesaid certify that
Personally came before me this day antl acknowledged that he is Secretary of
a North Carolina corporation, and that by authority duly given
and as the act of the corporation, the foregoing instrument was signed in its name by its President, sealed
with its corporate seal and attested by as its Secretary. Witness my
hard and official stamp, or seal, this the _tlay of 1 g
My Commission expires:
Notary Public
isiarg rgnlfied to be correct. This instrument a d this certificate are duly registered on the
19 94 , in Book 1-,L , Page d L at :03 O'clock Q M.
AREND D. B L REGISTER OF DEEDS FOR IREDELL COUNTY
BY. b DeputyLOeaisfant - Register of Deeds
R/9v D-1
January 1995
(2)