SW7100609_CURRENT PERMIT_20210712

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPE
CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE)
YYYYM M D D

iVaAo
ROY COOPER
Governor
ELIZABETH S. BISER
Secrerary
BRIAN WRENN
Director
Without Limits Christian Center, Inc.
Attention: Pastor James McIver
P.O. Box 15094
New Bern, NC 28560
NORTH CAROLINA
Environmental Quality
July 12, 2021
Subject: Stormwater Permit No. SW7100609 Renewal
Without Limits Christian Center
High Density Project
Craven County
Dear Pastor McIver:
The Washington Regional Office received a Stormwater Management Permit
Application for renewal of the subject permit on June 11, 2021. Staff review of the
application has determined that the permit can be reissued. We are forwarding Permit
No. SV 7100609 dated July 12, 2021, for the continued operation of the wet detention
pond stormwater system.
This permit, upon its effective date, will replace all previous State Stormwater permits for
this project. This permit shall be effective from January 1, 2022, until December 31, 2029,
and shall be subject to the conditions and limitations as specified therein and does not
supercede any other agency permit that may be required. Please pay special attention to
the Operation and Maintenance requirements in this permit. Failure to establish an
adequate system for operation and maintenance of the stormwater management system
will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you
have the right to request an adjudicatory hearing upon written request within thirty (30)
days following receipt of this permit. This request must be in the form of a written petition,
conforming to Chapter 150B of the North Carolina General Statutes, and filed with the
Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714.
Unless such demands are made this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please
contact me at [phone].
Sincerely,
017- ,
Roger K.,Thorpe
Environmental Engineer
North Carolina Department of Environmental Quality ! Division of Energy. Mineral and Land Resources
Washington Regional Office ; 943 Washington Squarr Mall 1 Washington, North Carolina 27889
2.5294b.6481

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North
Carolina as amended, and other applicable Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
Without Limits Christian Center, Inc.
Without Limits Christian Center
Located at 102 Washington Post Road, New Bern, NC
Craven County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with the
provisions of 15A NCAC 2H .1000 (hereafter referred to as the "stormwater rules') and
the approved stormwater management plans and specifications and other supporting
data as attached and on file with and approved by the Division of Energy, Mineral, and
Land Resources (Division) and considered a part of this permit.
This permit shall be effective from January 1, 2022, until December 31, 2029, and
shall be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.7 of this permit. The stormwater control has been
designed to handle the runoff from 76,666 square feet of impervious area.
The tract will be limited to the amount of built -upon area indicated in Section I. of
this permit, and per approved plans.
r —
North Carolina Department of Environmental Qualitv Division of Energy. Mineral and land Resources
EQ Washington Regional Office 1 033 Washington Square %fall I Washington, North Carolina 2788a
*���^w p^^� 252.4t6.8481

4. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The built -upon areas associated with this project shall be located at least 50 feet
landward of all perennial and intermittent surface waters.
7. The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a.
Drainage Area, ft2:
126,378
b.
Total Impervious Surfaces, ft2:
76,666
C.
Design Storm, inches:
1.5
d.
Pond Depth - average, feet:
4.5
e.
TSS removal efficiency:
90%
f.
Permanent Pool Elevation, FMSL:
25.00
g.
Permanent Pool Surface Area required, ft2:
6,066
h.
Permanent Pool Surface Area, ft2:
6,706
i.
Min. Volume required, ft3:
9,474
j.
Permitted Storage Volume, ft3:
15,999 at temp. pool el.
k.
Temporary Storage Elevation, FMSL:
26.75
I.
Controlling Orifice:
1.5" fd pipe
M.
Permitted Forebay Volume, ft3:
4,214
n.
Receiving Stream/River Basin:
Neuse River
o.
Stream Index Number:
27-(96)
P.
Classification of Water Body:
"SC;Sw;NSW"
Il. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater system functions at 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 vegetated filter strip.
d. Immediate repair of eroded areas.
North Carolina Department of Environmental Quality 1 Division of Energy. hline:al and Land Resources
Washington Regional Office 14-13 Washington Square Mall 'i Washington, ?forth Carolina 27889
W1� , 000 252446.61181

e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device, level
spreader, filter strip, catch basins and piping.
q. Access to the outlet structure must be available at all times.
Records of maintenance activities must be kept for each permitted SCM. The
records will indicate the date, activity, name of person performing the work and
what actions were taken.
5. The permittee shall submit to the Division an annual summary report of the
maintenance inspection records for each SCM. The report shall summarize the
inspection dates, results of the inspections, and the maintenance work performed
at each inspection.
6. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
7. The facilities shall be constructed as shown on the approved plans. This permit
shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other
supporting data.
8. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A
modification may be required for those deviations.
9. 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.
10. 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 approval or a CAMA
Major permit was sought.
DEQ� North Carolina Department of Environmental Quality
�� Dieision of Energy. b7ina:al and land Resources
Washington Regional Office 140 Washington Square Mall' Washington. North Carolina 31-889
y.�a.u. 252.94b.h4d1

f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made.
12. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
13. A copy of the approved plans and specifications shall be maintained on file by
the Permittee at all times.
Ill. GENERAL CONDITIONS
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, to the Division, signed by
both parties, and accompanied by supporting documentation as listed on page 2
of the form. The project must be in good standing with the Division. The approval
of this request will be considered on its merits and may or may not be approved.
The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request.
Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division, 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 DEQ 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.
I ®� �Aft North Carolina Department of Emironmental Quality I Division of Energy. Kline. al and sand Resources
G� Washington Regional Office 1 0 2 Washington Square %loll I Washington. ?forth Carolina P38o
252.9.16.6.18I

3. 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.
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 Title 15A NCAC
2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division of any name, ownership or mailing address
changes at least 30 days prior to making such changes.
12. This permit shall be effective from January 1, 2022, until December 31, 2029.
Application for permit renewal shall be submitted 180 days prior to the expiration
date of this permit and must be accompanied by the processing fee.
Permit issued this the 12 th day of July 2021.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
or
Brian Wrenn, Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW7100609
North Carolina Department of Environmental Quality', Division of Energy.,Mineral and Land Resources
W'ashinguon Regional Office 1 9.13 Washington Sguare Stall i Washinaton, North Carolina 27989

- - 1)t Ml_K 11SE ONLY
Date Received
Fee Paid
Permit Number
2I
s�s�o
io0
a
NC DEQ Division of Energy, Mineral and Land Resources
STATE STORMWATER:
PERMIT RENEWAL APPLICATION FORM
In accordance with 15A NCAC 2H.1045(3), the current permit holder shall renew their high density permit 180 days
prior to its expiration. Renewed permits are valid for a period of 8 years per Session Law 2011-398 (SB 781)
Section 60. (c). This application form is for permit renewals only.
A. PROJECT INFORMATION
1. State Stormwater
2. Project name:
3. Project str et add
City:
4. What, if any, char
If the project has changed from the original approved plans, please complete SWU-101 fora Major
Modification or Minor Modification Application form available at: https://deg.nc.gov/about/divisions/energy-
mineral-land-resources/energy-mineral-land-rules/stormwater-program/post-construction.
B. PERMITTEE INFORMATION
If changes to the permittee or project name have been made, please complete either the Permit Update form
or the Permit Transfer form available at: https://deg.nc.gov/about/divisions/energy-mineral-land-
resources/energy-mineral-land-rules/stormwater-program/post-construction. State Stormwater Permits do not
automatically transfer with the sale of the property.
1. Current Permit Holder's Company Nam
2. Signing Official's Name:
3. Signing Official's Title:
4. Mailing Address:
City:
5. Street Add
City:
6. Phone:Email:
CeAt
ZIP :
ZIP
I.J
Stormwater Permit Renewal Form Page 1 of 3 May 11, 2018

C. SUBMITTAL REQUIREMENTS
Submit the application package to the appropriate DEMLR Regional Office (Coastal, SA Waters) or DEMLR
Central Office (Urbanizing Areas Ph 2, USMP, Non -Coastal HQW/ORW). Only applications packages that
include all required items listed below will be accepted and reviewed.
1 ' ial each item below to indicate that the required information is provided in the application package:
1. A permit application processing fee of $505.00 payable to NCDEQ.
2. One original signed hard copy and one electronic copy of this completed form. The signing official
named on this application to represent the current permittee must meet one of the following:
a. Corporation — a principle executive officer of at least the level of vice-president;
A
b. Limited Liability Company (LLC) — a manager or company official as those terms are defined
in G.S. 57D "North Carolina Limited Liability Company Act;"
c. Public Entity — a principal executive officer, ranking official, or other duly authorized employee;
d. Partnership or limited partnership — the general partner;
e. Sole proprietor, or
f. Letter of authorization signed by one of the signatories noted in a — e above authorizing the
signature of another entity.
3. One hard copy and one electronic copy of recorded documents required by the original permit that
have not yet been received by DEMLR, including: deed restrictions, protective covenants,
condominium/planned community declaration and easements. If the project has been built, include
documentation that the maximum BUA per lot or maximum total BUA has not been exceeded. If
the project has not been built, include a signed agreement that the final recorded deed restrictions
and protective covenants will be submitted at a later date.
4. O&M Agreements, Please select one:
I have a copy of the current recorded O&M Agreement for all SCMs, and I will continue to
keep this on file with the permit; or
❑ I do not have a copy of the current recorded O&M Agreement for all SCMs and am
requesting a copy be sent to me. I agree to keep this on file with the permit.
5. igner Certifications, Please select one:
A! A copy of the certification(s) confirming that the project was built in accordance with the
approved plans have been previously provided to the Division; or
❑ A copy of the certification(s) confirming that the project was built in accordance with the
approved plans are enclosed; or
❑ The project has not yet been built.
6. [IF APPLICABLE] If the project has been built, one original hard copy and one electronic copy of a
I`(p signed, sealed, and dated letter from a licensed professional stating that the SCMs have been
inspected, and that they have been built and maintained in accordance with the permit.
[IF APPLICABLE] When the permittee is a corporation or a limited liability corporation (LLC):
Provide one hard copy and one electronic copy of documentation from the NC Secretary of State,
or other official documentation, which supports the titles and positions held by the persons listed in
Section C.2 per 15A NCAC 2H. 1043(3)(b).
https://www.sosnc.gov/online services/search/by title/ Business Registration
Stormwater Permit Renewal Application Form Page 2 of 3 May 11, 2018

D. PERMITTEE'S CERTIFICATION
I, Za 6LO S t ,t� CTV-ev- �� , the person legally responsible for the permit, certify that I have
a copy of the Permit and O&M Agreement on site (or I will obtain a copy and it will be kept on site), that I am
responsible for the performance of the maintenance procedures, and the site has been and will be maintained
according to the O&M Agreement and approved plans. I agree to notify DEMLR of any problems with the SCMs
or built -upon area and to submit the proper forms to modify or transfer the permit prior to any changes to the
project, SCMs, or ownership. All information provided on this permit renewal application is, to the best of my
knowledge orrect nd complete.
Signature: , � Date:
6-
NOTARIZATION:
1, u (�wr� C. BNB, a Notary Public for the State of
County of Crajz&d , do hereby certify
that
this the l/ day of Je4wp ,
execution of the forgoing instrument. Witness my hand and official seal,
(Notary Seal)
Notary Signature.
C• o
My commission expires 10 �Ze7z5
NOTARY
PUBLIC
personally appeared before me
20 Z/ , and acknowledge the due
Stormwater Permit Renewal Application Form Page 3 of 3 May 11, 2018

THOMAS ENGINEERING, PA
CIVIL ENGINEERING•LAND DEVELOPMENT•PROJECT MANAGEMENT
US Mail
To: Surface Water Protection Section
DWQ-NCDENR
943 Washington Square Mall
Washington, NC 27889
Attn: Roger Thorpe
Environmental Engineer
Re: Without Limits Christian Center, Inc.
State Stormwater Permit SW7100609
Craven County, NC
2010-012
Dear Roger;
October 9, 2013
OCT 18 2013
Please find attached the "Designer's Certification" for the referenced facility.
If you have y questions or comments, please do not hesitate to call. I hope you are
doing we
�ohn�. Thomas, PE
Presi ent
Encls
Cc w/encls: Pastor James McIver (Without Limits Christian Center, Inc.)
401 Howell Road.P.0. Box 1309.New Bern, NC 28563
Phone: [phone].Fa : [phone].Website: ThomasEngineeringPkcom

f

State Stormwater Management Systems
Permit No. SW7100609
Without Limits Christian Center
Stormwater Permit No. SW7100609
Craven County
Designer's Certification
�7. as a duly registered ro esstol.,a 61/tice'`In the
State of North Carolina, having been authorized to observe no is eekly/ full
time) the construction of the project,
for roject Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Page 6 of 7

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State Stormwater Management Systems
Permit No. SW7100609
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
✓ 2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
✓ 3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
✓ 4. All roof drains are located such that the runoff is directed into the system.
✓. 55 The outlet bypass structure elevations are per the approved plan.
t/ 6. The outlet structure is located per the approved plans.
NIZZL7. Trash rack is provided on the outlet/bypass structure.
✓ 8. All slopes are grassed with permanent vegetation.
r/ 99 Vegetated slopes are no steeper than 3:1.
✓ 10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
`! 11. The permitted amounts of surface area and/or volume have been
rovided
P
12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
✓ 14. All required parts of the system are provided, such as a vegetated shelf,
�nd a forebay.
15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Washington Regional Office
Craven County Building Inspections
Page 7 of 7

_ DWQ USE ONLY
Date Received
Fee Paid
Permit Number
_-sw
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 Mgmt Plan: S1A, cy,(o o
State of North Carolinas 171
Department of Environment and Natural Resources
Division of Water Quality JUN 18 2010
STORMWATER MANAGEMENT PERMIT APPLICATION FORK ))Wr)
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Without Limits Christian Center
2. Location of Project (street address):
No street address yet provided
City:New Bern County:Craven Zip:28562
3. Directions to project (from nearest major intersection):
From the intersection/split of NC 55 and NC 43 North of New Bern, NC, go approximately 500 LF south on
NC 43. Turn left onto Honeycutt Court. Project is located on the right.
4. Latitude:35° 08' 31" N Longitude:77* 06' 11" W of the main entrance to the project.
II. PERMIT INFORMATION
1. a. Specify whether project is (check one): ®New ❑Modification
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):
❑CAMA Major ®Sedimentation/Erosion Control: 3 ac of Disturbed Area
❑NPDES Industrial Stormwater 0404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:N/a
Form SWU-101 Version 14May2010
Paget of 6

III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:Without Limits Christian Center, Inc.
Signing Official & Title:Pastor Tames McIver - Head Pastor
b. Contact information for person listed in item la above:
Street Address:2111-E Neuse Boulevard
City:New Bern State:NC Zip:28562
Mailing Address (if applicable):PO Box 15094
City:New Bern State:NC Zip:28561
Phone: (252 ) 635.6673
Email pastor®wlcconline.com
Fax: (252 ) 876,5256
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official & Title:
b. Contact information for person listed in item 2a above:
Street Address:
City: State: Zip:
Mailing Address (if applicable):
City: State: Zip:
Phone: ( ) Fax: ( )
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:Thomas Engineering, PA
Signing Official & Title:Bobby Billingsley, PE - Project Engineer
b. Contact information for person listed in item 3a above:
Mailing Address:PO Box 1309
City:New Bern State:NC Zip:28563
Phone: (252 ) 637.2727 Fax: (252 ) 636.2448
Email:[e-mail]
4. Local jurisdiction for building permits: New Bern
Point of Contact1ohnny Clark Phone #: (252 ) 639.7581
Form SWU-101 Version 14May2010 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Paved parking to catch basins/area drains. Piped to pond forebay. Outlet structure w/trash rack. 90% table
90% table used to size permanent pool.
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.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 Neuse River basin.
4. Total Property Area: 2.90 acres
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area':2.90 acres
Total project area shall be calculated to exclude the following the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NM line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (B UA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 60.7 %
9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area,
provided in the same format as below.
Basin Information
Drainage Area 1
Drainage Area _
Drainage Area _
Drainage Area _
Receiving Stream Name
Neuse River
Stream Class *
SC;Sw;NSW
Stream Index Number *
27-(96)
Total Drainage Area (so
126,378
On -site Drainage Area (so
126,378
Off -site Drainage Area (sf)
1 0
Proposed Impervious Area** (so
76,666
Impervious Area** total
60.7 t/
Impervious' Surface Area
Drainage Area 1
Draina e Area
Draina e Area
Draina e Area
On -site Buildings/Lots (sf)
15,836
On -site Streets (so
Included below
On -site Parking (so
60,830
On -site Sidewalks (so
Included above
Other on -site (so
0
Future (sf)
0
Off -site (sf)
0
Existing BUA*** (so
0
Total (so:
76,666 V/
* Stream Class and Index Number can be determined at: Irttn://oortaLncdenr.org/webAvq&s/csu/classificatio)ts
** Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 14May2010 Page 3 of 6

'Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new B UA.
11. How was the off -site impervious area listed above determined? Provide documentation.
Protects in Union County: Contact DWQ Central Office staff to check ifthe project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from htto://t)ortal.ncdenr.ore/web/wa/ws/su/bmD-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from://Portal.ncdenr.OT9/web/wg/ws/su/statesw/forms does. Thecomplete
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.ncdenr.org/web/wq/ws/su/mats.)
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 hqp://portal.ncdenr.org/web/wq/ws/su/statesw/forms does.
1. Original and one copy of the Stormwater Management Permit Application Form. I�1tia
2. Orginal and one copy of the signed and notarized Deed Restrictions & Protective Covenants �4eC'4
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
hU://www.envhelp.org/12ages/onestopexpress.htm for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management
6. A USGS map identifying the site 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.
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.
in. 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).
4l
for �
Form SWU-101 Version 14May2010 Page 4 of 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"xll" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHWT prior
to submittal, [phone].) f
ZL'4
A4-�
A copy of the most current property deed. Deed book: 2895 Page No: 70
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 NCAC 21-1.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http:/ /www.secretaLy.state.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
htto://yortal.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.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer:lohn G. Thomas, PE
Consulting Firm: Thomas Engineering, PA
Mailing
City:New Bern
Phone: (252 ) 637.2727
Email:[e-mail]
State:NC Zip:28563
Fax: (252 ) 636.2448
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (printer hjpe name of person listed in Contact Information, item 2a) certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item la) with (print or type name of organization listed in
Contact Information, item 1a) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 14May2010 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 DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Date:
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
I, (print or type name of person listed in Contact Information, item la) Pastor ]antes McIver
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable s ter rules under 15 NCAC 21-1.1000, SL 2006-246 (Ph. II - Post Construction) or SLL 2005-211.
Signature: Date: 6 — 1 ` — ( O
I, Fr Ci 1\ V— S , a Notary Public for the State of ' V o! i { 1 GY0 I i✓•G, County of
_Cmyl h —doherebycertify that �QYYNl5 � c Zvc,r personally appeared
�� before me this day of �J U rl 2 2010 anrowledge the due xecutio� of the ap lication for
a stormwater permit. Witness my hand and official-seaF
\OT
sEAg'v
UBUG
COUN,i`Oe Q
My commission expires i
Form SWU-101 Version 14May2010 Page 6 of

a
Permit No.
fro be povided by DWQ)
SEP 9 2010
pF WATF'q
TA
NCDENR o
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information.
I. PROJECT INFORMATION
Project name Without Limits Christian Center
Contact person Bobby Billingsley
Phone number 252.637,2727
Date 6f712010
Drainage area number 1
II: DESIGN INFORMATION
She Characteristics
Drainage area
126,378 fe
Impervious area, post -development
76,666 fe
%impervious
60.66 %
Design rainfall depth
1.5 in
Storage Volume: Non -SA Waters
Minimum volume required
9,474 ft3 31 OK
Volume provided
15,999 ft3
-OK, volume provided is equal to or in excess of volume required.
Storage Volume: SA Waters
1.5' runoff volume
ft3
Pre -development 1-yr, 24-hr runoff
ft3
Post -development 1-yc 24-hr runoff
ft3
Minimum volume required
0 It,
Volume provided
It,
Peak Flow Calculations
Is the pre/post control of the 1yr 24hr storm peak flow required?
N (Y or N)
1-yr, 24-hr rainfall depth
3.7 in
Rational C, pre -development
0.20 (unitless)
Rational C, post -development
0.60 limitless)
Rainfall intensity: 1-yr, 24-hr storm
6.00 inlhr OK
Pre -development 1-yr, 24-hr peak flow
1.06 ft3)sec
Post -development 1-yr, 24-hr peak flow
3.58 ft3lsec
PfelPost 1-yr, 24-hr peak flow control
2�.52 ft3lse`c�
Elevations
Temporary pool elevation
Permanent pool elevation
25.00 fmsl
SHWT elevation (approx. at the pen. pool elevation)
24.00 fmsl
Tap of 10ft vegetated shelf elevation
25.50 fmsl
Bottom of 1 Oft vegetated shelf elevation
24.50 fmsl
Sediment cleanout, top elevation (bottom of pond)
18.50 fmsl
Sediment cleanout, bottom elevation
17.50 fmsi
Sediment storage provided
1.00 ft
Is there additional volume stored above the state -required temp. pool?
n (Y or N)
Elevation of the top of the additional volume
fmsl
Form SW401-Wet Detenuon Basin-Rev.6.7J20109 Pans I. & 11. Design Summary, Page 1 of 2

i
Pennit No.
(to be provIded by DWO)
IIS' DESIGNI IN FORMATION
Surface Areas
Area, temporary pool
10,566 fit'
Area REQUIRED, permanent pool
6,066 fit'
SA/DA ratio
4.80 (unitless)
Area PROVIDED, permanent pool, A..
6,706 ft`
OK
Area, bottom of 1 Oft vegetated shelf, Am�m,
4,835 fit'
Area, sediment cleanout, top elevation (bottom of pond), A,.
1,618 fit'
Volumes
Volume, temporary pool
15,999 ft'
OK
Volume, permanent pool, Voe,, _pw
22,244 ft'
Volume, forebay (sum of forebays if more than one forebay)
4,214 ft9
Forebay %of permanent pool volume
18.9% %
OK
SAIDA Table Data
Design TSS removal
90 %
Coastal SAIDA Table Used?
Y (Y or N)
Mountain/Piedmont SAIDA Table Used?
N (Y or N)
SA/DA ratio
4.80 limitless)
Average depth (used in SA/DA table):
Calculation option 1 used? (See Figure 10-21b)
N (Y or N)
Volume, permanent pool, Vpe,,-y
ft°
Area provided, permanent pool, A._,,
ft
Average depth calculated
It
Average depth used in SA/DA, dm., (Round to nearest 0.5ft)
it
Calculation option 2 used? (See Figure 10-21b)
Y (Y or N)
Area provided, permanent pool, A,,,.,
6,706 it
OK
Area, bottom of 10ft vegetated shelf, Awn, y
4,835 fit'
OK
Area, sediment cleanout, top elevation (bottom of pond), A Lpa
1,618 e
OK
"Depth" (distance b/w bottom of 10ft shelf and tap of sediment)
6.00 It
OK
Average depth calculated
4.43 It
OK
Average depth used in SA/DA, dw, (Round to nearest 0.5ft)
4.5 It
OK
Drawdown Calculations
Drawdown through office?
Y (Y or N)
Diameter of orifice (if circular)
1.50 in
Area of orifice (if -non -circular)
in'
Coefficient of discharge (CD)
0.60 limitless)
Driving head (Ho)
1.50 it
Drawdown through weir?
N (Y or N)
Weir type
(unitless)
Coefficient of discharge (C„)
limitless)
Length of weir (L)
it
Driving head (H)
It
Pre-0evelopment l-yr, 24-hr peak flow
1.06 13/sec
Insufficient pre -development peak flow.
Post -development l-yr, 24-hr peak flow
3.58 ft'/sec
OK
Storage volume discharge rate (through discharge office or weir)
0.04 1'/sec
Storage volume drawdown time
2.00 days
OK, draws down in 2-5 days.
OK, drawdown time is correct.
Additional Information
Vegetated side slopes
3 :1
OK
Vegetated shelf slope
10 :1
OK
Vegetated shelf width
10.0 it
OK
Length of flowpalh to width mtio
4 :1
OK
Length to width ratio
4.3 :1
OK
Trash rack for overflow& orifice?
N (Y or N)
Trash rack or similar device recommended.
Freeboard provided
1.0 It
OK
Vegetated filter provided?
N (Y or N)
OK
Recorded drainage easement provided?
Y (Y or N)
OK
Capures all runoff at ultimate build -out?
Y (Y or N)
OK
Drain mechanism for maintenance or emergencies
Mechanical Pumps
Form SW401-Wet Detention Basin-Rev.6-2/20/09 Parts I. all. Design Summary, Page 2 of 2

Permit No_ 14"7100(00C)
(10 be provided by D WO)
Illi"REQUIRED! ITEMS'CH ECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Page/ Plan
Initials Sheet No.
Ate 1. Plans It" - 50' or larger) of the entire site shoring:
Design at ultimate build -out,
Off -site drainage (it applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Basin dimensions,
Pretreatment system.
High flow bypass system,
- Maintenance access,
Proposed drainage easement and public right of way (ROW),
- Overflow device, and
Boundaries of drainage easement.
�!Q _6 0k (° 2. Partial plan (1" = 30' or larger) and details for the wet detention basin showing:
- Outlet structure with trash rack or similar,
Maintenance access,
Permanent pool dimensions.
- Forebay and main pond :with hardened emergency spillway,
&•
Ate ,e&Po,ef
ILCig- _
,C if, d
Basin cross-section,
Vegotation specification for planting shelf, and
Filter strip.
3. Section view of the wet detention basin (1' = 20' or larger) shoring:
- Side slopes, 3:1 or lower,
Pretreatment and treatment areas, and
Intel and outlet structures.
.1. If the basin is used for sediment and erosion control during construction, clean out of the basin is specified
on the plans prior to use as a wet detention basin.
5. A table of elevations, areas, incremental volumes 8 accumulated volumes for overall pond and for forebay.
to verify volume provided.
6. A construction sequence that shows how the viol detention basin will be protected from sediment until the
entire drainage area is stabilized.
i. The supporting calculations.
8. A copy of the signed and notarized operation and maintenance (08M) agreement.
9. A copy of the deed restrictions (it required).
le G9-W 10. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. County
soil maps are not an acceptable source of soils information.
Form SV1401 AVVel Dotantion Basin-Rov.6-2/20109 Part III. Required hems Checklist, Pape 1 or 1

Permit Number:
(to be prmdded br DIM)
Drainaee 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 will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
The wet detention basin system is defined as the wet detention basing
pretreatment including forebays and the vegetated filter if one is provided. JUN 18 2010
This system (check one):
❑ does ® does not incorporate a vegetated filter at the outlet. i. Ykii ''_aVVAR€
This system (check ate):
❑ 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 lime and a
one-time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of
I
long.
approximately six inches.
Form SW401-Wet Detention Basin O&M-Rev.4 Page I of 4

Pennit Number:
(to be provider/ by DI PO)
Dminaee Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
Swale
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
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 s ravin .
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
wW not cause impacts to streams or
the BNIP.
Algal growth covers over
Consult a professional to remove
50 n of the area.
and control the algal growth.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50 a of
with pesticide (do not spray).
the basin surface.
Form SW401-Wet Detention Basin O&M-Rev,4 Page 2 of 4

Permit Number:
(lo he provided by DI O)
Drainage Area Number:
BMP element:
Potential problem:
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 66:5 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 6__5 feet in the forebay, the sediment
shall be removed.
BASIN DIAGRAM
(fill in rite blankv)
Sediment Removal . 18.5 Pe anen�
----------------- volume
Bottom Elet itio 17.5 R Min.
Sediment
Storage
FOREBAY
Permanent Pool Elevation 25.0
Sediment Removal Elevation 18.5 Volum
-------_---- -----�-/
Bottom Elevation 17.5 I 1-ft Xv
MAIN POND
Storage
Fonn SW401-Wet Detention Basin O&NI-Rev.4
Page 3 of 4

Permit Number:
(to be provided by DIVO)
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:Without Limits Christian Center
B.,VP drainage area number:
Print name:Pastor James McIver
Title:Head Pastor
Address:PO Box 15094. New Bern. NC 29561
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, '12er. n e-k 3 • I r a n k-S a Notary Public for the State of
Nbr-t-k G ro(ivv 4 , County of C trGV-e n do hereby certify that
�t h
„) Ct,-tn�e S AA S\,z!' personally appeared before me this �
day of 2010. and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal, r6 • 'ZJA 'Z'�
SEAL
My commission expires 7 /:q02// `2--
Form S\V401-Wet Detention Basin O&M-Rev.d Page 4 of 4

carn dJ a �- )v uo
�� 2��sW ^jlDOloO�4 E_ o' �'�'F- P
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
JUN2 2 2010
SEDIMENTATION POLLUTION CONTROL ACT 0WQ AR0
No person may initiate any land -disturbing activity on one or more acres as covered by the Act before this
form and an acceptable erosion and sedimentation control plan have been completed and approved by the
Land Quality Section, N.C. Department of Environment and Natural Resources. (Please type or print and, if
the question is not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.)
Part A.
1. Project Name W11'I{ou.{ "PKI S CHZI-FtAw CEar&2-
2. Location of land -disturbing activity: County C(?A 6d City or Township dgt..f BEz)
Highway/Street0r- A y2, Latitude3501b," Q Longitude 770G, r ItitW
3. Approximate date land -disturbing activity will commence: TULY 201 0
4. Purpose of development (residential commercia , 'ndustrial, institutional, etc.): "gO cJf MAGI Li t u(
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas):
•� j&5,
6. Amount of fee enclosed: S 195 . The application fee of SW.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $450).
7. Has an erosion and sediment control plan been filed? Yes No Enclosed k
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name Bogey 13,LLIab5uEY E-mail Address -ISo6i3Y$iL-ial;sLgY@ rloM4SF I^tEe90"'
Telephone ZS2 . 6 3 7,27Z-7 Cell # ZS2 • 671.21Fo 8 Fax # 2 SL. 636 -7-"A Pk. coM
9. Landowner(s) of Record (attach accompanied page to list additional owners):
W rTNewf L m rrJ Cale/1'1'e4-J t:E^I1X;e' 1.4 C. ZSL, &.7 -6673 Z T2 - 976 -SZ Sb
Name
Telephone Fax Number
Al Geri g V-
2/// - E ACE- re'rc eauv
Current Mailing Address
Current Street Address
&6ej aC_ zgsK /
N5w 4?ewd A)C- z s.! 6z
City State Zip
City State Zip
10. Deed Book No. 2 6 9 V__ Page No.
-70 Provide a y" e r geukln� d�
�
®®®� ��h
Part B.
JUN I A 2010
1. Person(s) or firm(s) who are financially
responsible for the land -disturbing activi�yr (P,tovi a
`•'i' f' , P(gvji
comprehensive list of all responsible parties on
an attached sheet): (_ .`iJ !
q " f•;i � Civ Rc"'OP:i.L OrF;i:
W rrNakr Lim.,r,: 6WWW_i.R.) CF.�rk, �.L P�)sre�Cu`wZ cco�`�.Jr. C0,0
Name
E-mail Address
/00 dox- i -o 9
2/// - E 1dgzr rE $cYo
Current Mailing Address
Current Street Address
1,4Ey afrz"y
lVet j .) C_ 2
City State Zip
City State Zip
Telephone 2 5_Z'63S-1456_73
Fax Number ZSZ^ 633 6859

2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name
E-mail Address
Current Mailing Address
Current Street Address
City State
Zip City State Zip
Telephone
Fax Number
(b) If the Financially Responsible Party
is a Partnership or other person engaging in business under an
assumed name, attach a copy of the
Certificate of Assumed Name. If the Financially Responsible
Party is a Corporation, give name and street address of the Registered Agent:
Name of Registered Agent
E-mail Address
Current Mailing Address
Current Street Address
City State
Zip City State Zip
Telephone
Fax Number
The above information is true and correct to the best of my knowledge and belief and was provided
by me under oath (This form must be signed by the Financially Responsible Person if an individual
or his attorney -in -fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Person). I agree to provide
corrected information should there by any change in the information provided herein.
Pwmle- J-.4,WO-S a ,c3'V6-r- W61a V,rtro,c.Wjtwa tr L«,rs 6%eAf-r,4,)cr—r�
Type or print name I Title or Authority
Date
a Notary Public of the County of Crt-y 2 n
State of North Carolina, hereby certify that—3CIM,05 AA �: Svc c- appeared
personally before me this day and being duly sworn acknowledged that the above form was
executed by him.
Witness;my;tiand arSd.'hotarial seal, this day of zyl e 20 t (7
Sear
G '=V`' No ry
F�" "� My commission expires a ld--