SW7130809_CURRENT PERMIT_20131018

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
Sw_m3e
_tq
DOC TYPE
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

w
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral, and Land Resources
Land Quality Section
Tracy E. Davis, PE, CPM Pat McCrory, Governor
Director John E. Skvada, III, Secretary
October 18, 2013
First Citizens Bank
Attn.: Mr. Paul Rizzardi, Senior Vice President
100 East Tryon Road
Raleigh, NC 27603
Subject: Stormwater Permit No. SW7130809
First Citizens Bank — Elizabeth City
High Density Commercial Wet Pond Project
Pasquotank County
Dear Mr. Rizzardi:
The Washington Regional Office received a complete Stormwater Management Permit
Application for the First Citizens Bank — Elizabeth City project on August 23, 2013 and
additional information on October 14, 2013. Staff review of the plans and specifications
has determined that the project, as proposed, will comply with the Stormwater
Regulations set forth in Session Law 2008-211 and Title 15A NCAC 2H.1000. We are
forwarding Permit No. SW7130809 dated October 18, 2013, for the construction of the
subject project.
This permit shall be effective from the date of issuance until October 18, 2021, and shall
be subject to the conditions and limitations as specified therein. Please pay special
attention to the Operation and Maintenance requirements in this permit. Failure to
establish an adequate system for operation and maintenance of the stormwater
management system will result in future compliance problems.
This project is located within 5 miles from the Elizabeth City Regional Airport. The
Permitee was advised of Session Law 2012-200, Part VI.
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].
Washington Regional Office
943 Washington Square Mall, Washington, North Carolina 27889 • Phone: [phone] FAX: [phone]
Internet: http:/Iwww.portal.ncdenr.org/web/Ir/land-quality
An Equal Opportunity / Affirmative Action Employer - 50%Recycled110% Post Consumer Paper

Sincerely,
Samir Dumpor, PE
Environmental Engineer
SD: G:\LR\SWP\SD\SW7130809
cc: `Peter Bishop, PE, Kimley-Horn and Associates, Inc. (333 Fayetteville
Street, Suite 600, Raleigh, NC 27601)
fPasquotank County Building Inspections
Scott Hinton, Airport Manager, Elizabeth City Regional Airport, (1028
✓Colsolidated Road, Elizabeth City, NC 27909)
✓Washington Regional Office

'r
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
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
First Citizens Bank
First Citizens Bank — Elizabeth City
Pasquotank County
FOR THE
construction, operation and maintenance of one wet detention pond in compliance with
the provisions of Session Law 2008-211 and 15A NCAC 2H .1000 (hereafter referred to
as the "stormwater rules') and the approved stormwater management plans and
specifications and other supporting data as attached and on file with and approved by
the Division of Energy, Mineral, and Land Resources and considered a part of this
permit.
This permit shall be effective from the date of issuance until October 18, 2021, and
shall be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. 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 34,848 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated in Section I. of
this permit, and per approved plans.
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.
Page 2 of 7

7. The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a.
Drainage Area, ft2:
53,143
b.
Total Impervious Surfaces, ft2:
34,848
C.
Design Storm, inches:
1.5
d.
Pond Depth - average, feet:
3.0
e.
TSS removal efficiency:
90%
f.
Permanent Pool Elevation, FMSL:
8.00
g.
Permanent Pool Surface Area required, ft2:
4,044
h.
Permanent Pool Surface�Area , ft :
5,535
i.
Min. Volume required, ft :
4,253
j.
Permitted Storage Volume, ft3:
4,253
k.
Temporary Storage Elevation, FMSL:
8.65
I.
Controlling Orifice:
1.00"0 pipe
M.
Permitted Forebay Volume, ft3:
2,010
n.
Receiving Stream/River Basin: UT to Knobbs Creek/Pasquotank Basin
o.
Stream Index Number:
30-3-8
p.
Classification of Water Body:
"C; Sw"
II. 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 time 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.
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.
g. Access to the outlet structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. 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 of Energy, Mineral, and Land
Resources an annual summary report of the maintenance inspection records for
each BMP. 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
Page 3 of 7

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.
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.
III. 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 of Energy,
Mineral, and Land Resources, 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.
Page 4 of 7

2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Energy, Mineral,
and Land Resources, in accordance with North Carolina General Statute 143-
215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staffpermission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2008-
211, 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 the date of issuance until October 18, 2021.
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 18th day of October, 2013.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for
Division of Energy, Mineral, and Land Resources
By Authority of the Environmental Management Commission
Stormwater Permit No. SW7130809
Page 5 of 7

r;
First Citizens bank — Elizabeth City
Stormwater Permit No. SW7130809
Pasquotank County
Designer's Certification
I, , as a duly registered in the
State of North Carolina, having been authorized to observe (periodically/ weekly/ full
time) the construction of the project,
(Project)
for (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 6 of 7

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
5. The outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Trash rack is provided on the outlet/bypass structure.
8. All slopes are grassed with permanent vegetation.
9. 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
provided.
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,
and a forebay.
15. The required system dimensions are provided per the approved plans
cc: NCDENR-DEMLR Washington Regional Office
Pasquotank County Building Inspections
Page 7 of 7

KimlepMorn
May 19, 2015
RECEIVED/NCDENR/DWR
MAY 21 2015
Water Quality Regional
Qporadona sewon
Washington Roglonal Qdloe
Mr. Samir Dumpor
North Carolina Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
943 Washington Square Mall
Washington, NC 27889
RE: First Citizens Bank -Elizabeth City -SW Permit No. SW7130809
Dear Mr. Dumpor:
Please find attached the Designer's Certification for this project. Please note, the proposed
Stormwater Wet Pond was constructed within substantial compliance and intent of the approved
plans.
Please contact me at [phone] or [e-mail] should you have any
questions or comments.
Sincerely,
John D. Kuzenski, P.E.
Enclosures: Designer's Certification and Checklist
CC. Rob Tessar, FCB
File

First Citizens bank — Elizabeth City
Stormwater Permit No. SW7130809
Pasouotank County
Designer's Certification
1, John D. Kuzenski , as a duly registered Professional Engineer in the
State of North Carolina, having been authorized to observe eno ica weekly/ full
time) the construction of the project,
First Citizens Bank, Elizabeth City
(Project)
for First Citizens Bank (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
SEAL
Signature
Registration Number 033891 �` °eo •�
-4 SEAL
Date 9 15 = 033841
KU
V
Page 6 of 7

Certification Requirements:
X
1.
The drainage area to the system contains approximately the permitted
acreage.
x
2.
The drainage area to the system contains no more than the permitted
amount of built -upon area.
X
3.
All the built -upon area associated with the project is graded such that the
runoff drains to the system.
x
4.
All roof drains are located such that the runoff is directed into the system.
X
5.
The outlet/bypass structure elevations are per the approved plan.
x
6.
The outlet structure is located per the approved plans.
x
7.
Trash rack is provided on the outlet/bypass structure.
X
S.
All slopes are grassed with permanent vegetation.
X
9.
Vegetated slopes are no steeper than 3:1.
x
10.
The inlets are located per the approved plans and do not cause short-
circuiting of the system.
X
11.
The permitted amounts of surface area and/or volume have been
provided.
X
12.
Required drawdown devices are correctly sized per the approved plans.
x
13.
All required design depths are provided.
x
14.
All required parts of the system are provided, such as a vegetated shelf,
and a forebay. Constructed vegetative shelf varies between 5:1
X
15.
and 10:1
The required system dimensions are provided per the approved plans.
cc:
NCDENR-DEMLR Washington Regional Office
Pasquotank County Building Inspections
Page 7 of 7

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
$-9-3—
50 5
1 S
Applicable Rules:
(select all that apply)
❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph 11 - Post Construction
❑ Non -Coastal SW- HQW /ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M gmt Plan: dui' C 8 3
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality 11..,Z' y
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original AUG 2 3 2013
L GENERAL INFORMATION GQ
cfbva2. nn1trp�
1. Project Name (subdivision, facility, or establishment name - should be consistent with ,� Ri 1isr-� i
specifications, letters, operation and maintenance agreements, etc.): y Y
First Citizens Bank - Elizabeth City '�/
2. Location of Project (street address):
City:Elizabeth City County:Pasquotank Zip:27909
3. Directions to project (from nearest major intersection):
Northwest of the intersection of Halstead Blvd and Walker Ave on the east side of Halstead Blvd.
4. Latitude:36' 17' 19" N Longitude:76° 14' 33" W of the main entrance to the project.
it. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modification'
'RenelValS With modifications also requires S W U-702 - Reneeoal Application Pone
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: 2.32 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:
5. Is the project located within 5 miles of a public airport? ❑No ®Yes
tf yes, see S.L. 2012-200, Part Vl: littl2://pot-tal.iicdenr.org/web/wq/ws/su/statesw/rules laws
Form SWU-101 Version 06Aug2012 Page I of 6

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 ownsthe proiect):
Signing Official & Title:
b.Contact information for person listecrgitein la above:
Street Address:100 East Tryon Road
City:Raleigh
State:NC Zip:27603
Mailing Address (if applicable):100 East Tryon Road
City:Raleigh State:NC Zip:27603
Phone: (919 ) 716-4114
Email:[e-mail]
Fax: (919 ) 716-8840
r
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 &
b.Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if applicable):
City:
Phone: ( )
State: Zip:
State: Zip:
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
Signing Official &
b.Contact information for person listed in item 3a above:
Mailing Address:
City:
Phone: ( )
Email:
State: Zip:
Fax: ( )
4. Local jurisdiction for building permits: City of Elizabeth City
Point of Contact:Stanley Ward Phone #: (252 ) 337-6868
Form SWO-101 Version 06Aug2012 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Stormwater runoff from the proposed development will be captured and conveyed using the proposed storm
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 PUDApproval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW — 1995 ❑ Ph 11 — Post Construction
3. Stormwater runoff from this project drains to the Pasquotank River basin.
4. Total Property Are-_,
a.90 1 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 t
Total project area shall be calculated to exclude the following: the normal loot of impounded structures, the area
betzoeen the banks of streams and rivers, the area below Nor
mal oral High Zter (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landumrd from the NHW (or MHO) tilt(.. The resuhant project area is used to �.
calculate overall percent built upon area (BLIA). 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 = 27.26 ✓ (/o
9. How many drainage areas does the project have?3 (For high density, count 1 far each proposed engineered
stonnevater BMP. For too, 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 2
Draina ,e Area 3
Drainage Area _
Receiving Stream Name
Unnamed
Tributary to
Knobbs /
Creek V
Unnamed
Tributary to
Knobbs
Creek
Unnamed
Tributary to
Knobbs
Creek ✓
Stream Class *
C,Sw ✓
C,Sw V
C,Sw ✓
Stream Index Number *
30-3-8
30-3-8 ✓
30-3-8 ✓
Total Drainage Area (sf)
53,143 ✓
14,375
58,806
t—
On-site Drainage Area (sf)
53,143
14,375
58,806
Off -site Drainage Area (sf)
0
0
0
Proposed Impervious Area** (sf)
34,349
100
0
% Impervious Area** (total)
64.6% .1
0.70%
0%
Impervious— Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area 3
Drainage Area _
On -site Buildings/Lots (sf)
4,040
0
0
On -site Streets (so
21,929
0
0
On -site Parking (sf)
6,498
0
0
On -site Sidewalks (sf)
1,882
0
0
Other on -site (sf)
0 4/y
100
0
Future (sf)
0
1 0
1 0
Off -site (sf)
0
1 0
0
Existing BUA*** (sf)
0 _-11I{
0
0
Total (sf):
447349-✓/
100
0
* Stream Class and Index Number can b2, d ern ined at: littp://portal.ncdenr.org tveb/evg/ys/esu/classifications
Form SW U-101 Version 06Aug2012 Paoe 3 of 6

Impervious area is defined as the built upon area including, but not linriled to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Report only that amount of existing BUA that mill remain after development. Do not report any existing BUA that is
to be removed and Which Will be replaced by nerd BUA.
11. How was the off -site impervious area listed above determined? Provide documentation.
Take offs were performed during stormwater routing calculations.
Projects in Union County: Contact DWQ Central Office staff to check if the project is located Within a Threatened
Endangered Species watershed that may be subject to tnore soingent .stornnrater requirements as per 15A NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http: / / portal.ncdenr.org / web / wq / ws / su /bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from http://12ortal.ncdenr.org/web/wq/ws/su/statesw/forms does. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office maybe
found by locating project on the interactive online map at htte:///portal.ncdenr.org/web/wq/ws/su/mals.)
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 ham://portal.ncdenr.org/web/wq/ws/so/statesw/forms dots.
1. Original and one copy of the Stormwater Management Permit Application Form.
�/ Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants w JA 2.
Form. (if required per part Vll below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
/ agreement(s) for each BMP.
n /l 4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
VVV httl2://www.ei)vhelp.org/12ages/onestopexi2ress.litnil 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.)
V 5 A detailed narrative (one to two pages) describing the stormwater treatment/management for
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within'/z mile of the site boundary, include the'k
mile radius on the map.
C% 7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
�
b. Engineer and firm.
,7Vc. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
/f g. Revision number and dates.
C/ 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 Tune 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.
I. Details of roads, drainage features, collection systems, and stormwater control measures.
� 1
C_.` l�
Fonn SWU-101 Version 06Aug2012 Page 4 of 6

J"
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"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.
(%QJ (Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 1127 Page No: 351
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item In, 2a, and/or 3a per 15A NCAC 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
httn: / /www.secretary.state.nc.us/Cori2orations/CSeircli.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://12ortal.ncdenr.org/web/wq/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.
VIIL 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: Peter Bishop, P.E.
Consulting Firm: Kimley-Horn and Associates, Inc.
Mailing Address:333 Fayetteville Street, Suite 600
Phone: (919- ) 677-2164
Email:[e-mail]
State:NC Zip:27601
Fax: (919 ) 653-5847
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contract Information, item 2a)At/l—�i21Q(?.1�) certify that I
own the property identified in this mit application, and thus give permission to (print or type name of person
listed in Contact Information, item la)- - Nwe with (print or type name of organization listed in
Contact Information, item 7a) to develop the project as currently proposed. A copy of
the lease agreement or pending p operty sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 06Aug2012 Page 5 of 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 viola ' NC , eral Statue 143-215.1 and may result in appropriate enforcement action including
the assessme of cid a res of up to $25,000 per day, rrsuant to NCGS 143-215.6.
Signature: �fDate::
I, Vli$� 43 —a Notary Public for the State of Oby't,' l YAK' a, County of
if\ do hereby certify that 1%-u ) 2' z Z a' A'- personally appeared
before me this 19 day of Ar ol v S'r , 2�, and acknowledge the due execution
of the application for a
stormwater permit. Witness my hand and official seal,
NOTARY
PUBLIC o
X. APPLICANT'S CERTIFICATION
WWW"
My commission expires (11" 8 1 2A I
I, (print or type name of person listed in Contact Information, item 1a)!!�� IAA AE?0\7E
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 stormwater rules under 15A NCAC 2H .1000 and any other applicable state stormwater requirements.
a Notary Public for the State of
do hereby certify that
before me this _ day of
stormwater permit. Witness my hand and official seal,
SEAL
Date:
County of
personally appeared
and acknowledge the due execution of the application for a
My commission
Form SWU-101 Version 06Aug2012 Page 6 ol'6

No, `isi3'�a
G
vAaroy
PPN�I
''f��Iba0l �ttt�jt

Permit
(b be provided by DWO)
ffi-
NCDENR
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 (Pad III) must be printed, filled out and submitted along with all of the required information.
of W A7'Fg9
1:3iP.RWECTdNFORMATION,,
Project name
Contact person
Phone number
Dale
Drainage area number
1-Drainage Area to Wet Detention Pond
IISDESIGN '.INFORMATION
Site Characteristics
Drainage area 53,143 fir
Impervious area, post -development 34.848 lfr
%Impervious 65.57 %
Design rainfall depth
Storage Volume: Non -SA Waters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5' runoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
1.5 in
n3
k3
4.253 It3
332 0
4,251fir
4,253 fir
4,253 03
Peak Flow Calculations
Is the pretpost control of fhe.lyr 24hr storm peak flow required?
N(Y or,N)
1-yr, 24-hr rainfall depth
3.1 in
Rational C, predevelopment
0.46 limitless)
Rational C. post -development
0.74 (0111 s)
Rainfall lnlensIty:1-yr, 24-hr storm
0.131Nhr OK
Pre -development 1-yr, 24-hr peak flow
3.10 fl'/sac
Post -development 1-yr, 24-hr peak flow
2.34 It'/sec
Pre/Post 1-yr, 24-hr peak flow control
-0.76 fi3lsec
Elevations
Temporary pool elevation
8.65 final
Permanent pool elevation
8.DD final
SHWT elevation (approx. at the perm. pool elevation)
TDO final
Top of 108 vegetated shelf elevation
8.50 final
Bottom of 10f1 vegetated shelf elevation
7.50 first
SedMeml deanout, top elevation (bottom of pond) -
3.00 first
Sediment deanoul, bottom elevation
2.00 first
Sediment storage provided
1.00 8
Is there additional volume stored above the slate -required temp. pool?
Y (Y or N)
Elevation of the top of the additional volume
8.7. Imsl OK
Farm SW401-Wet Detention Basin-Rov.9.418112 Paris 1. a IL Design Summary, Page 1 of 2

Permit
(tobepwWdedby DWQ)
IIMDESIGNINFORMATION2,..,,4, u.:':
Surface Areas
Area, temporary pool
7,321. fi
Area REQUIRED, permanent pool
4,044 It
SAIDA ratio
7.61. (unitless)
Area PROVIDED, permanent pool, A,,.,
5,535 it
OK
Area, bottom of IOfi vegetated shelf, A, a.r
4,011. fir
Area, sediment cleanout, lop elevation (bottom of pond), Ab d
- 5 fir
Volumes
Volume, temporary pool
4,253 fir
OK
Volume, permanent pool, V,,,,,_,,,,
9,510 fls
Volume, forebay (sum of forebays It more than one forabay)
2,010 h3
Forebay % of permanent pool volume
21.1 % %
OK
SAIDA Table Data
Design TSS removal
90 %
Coastal SAIDA Table Used?
Y (Y or N)
MountairvRedmont SAIDA Table Used?
N (Y or N)
SAIDA ratio
7.61 (unitless)
Average depth (used In SAIDA table): '
Calculation option 1 used? (See Flgure 10-2b)
N (Y or N)
Volume, permanent pool, V,,,,,y,,,
9,51011,
Area provided, permanent pool, A„.,,,
5,5351?
Average depth calculated
WA 1t
OK
Average depth used In SAIDA, d,,, (Round to nearest 0.5fl)
WA - -6
pVALUEI
Calculation option 2 used? (See Figure 10-2b)
Y (Y or N)
Area provided, permanent pool, A,,,,,, y
5,535 flr
Area, bottom of 1 Off vegetated shall, Aw, y
4,011 flr
Area, sediment deanout, lop elevation (bottom of pond), A,,q
5 fir
'Depth' (distance bAv bottom of 10fl shelf and top of sediment)
4.50 fl
Average depth calculated
3.18 fi
OK
Average depth used In SAIDA, dam,., (Round to down to nearest 0.511)
3.0 it
OK
Drawdown Calculations
Drowdown through orifice?
Diameter of orifice (lf circular)
Area of orifice (d-non-oirculer)
Coefficient of discharge CD)
_DrWg head (Hd.
Omwdown through weir?
Weir type
Coefficient of discharge (C.)
Length of weir (L)
Driving head (H)
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
Storage volume discharge rate (through discharge orifice or weir)
Storage volume drawdown time
Additional Information
Vegetated side slopes
Vegetated shelf slope
Vegetated shelf width
Length of flowpath to width ratio
Length to width ratio
Trash rack for overflow 8 od0oe?
Freeboard provkded
Vegetated fitter provided?
Recorded drainage easement provided?
Cultures all nmoff at ultimate build -out?
Drain mechanism for maintenance or emergencies Is:
Y (Y or N)
1.00 In
In,
0.60 (unWess)
or N)
WA (unitless)
WA it
WA it
3.1011s/sec
2.34 fl /sec
0.03 fl /sec
3.69 days
OK, draws doom in 2.5 days.
3:1
OK
10:1
OK
10.0 fl
OK
3 :1
OK
3.2:1
OK
N
(Y or N)
Trash rack or similar device recommended.
2.2 it
OK
N
(Y or N)
OK
N
(Y or N)
Insufficient. Recorded drainage easement required.
Y
(Y or N)
OK
Pump out
Farts SW401-Wet Detemlon Bash Rev.9-411e/12 Pane L a II. Design Summery, Page 2 of 2

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection 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 basin, _, n
pretreatment including forebays and the vegetated filter if one is provided y
This system (check one): AUG 2 3 2013
❑ does ❑ does not incorporate a vegetated filter at the outlet. LQ
This system (check one):
6Au )�
�y v �, Y V ��® A1 % �.++
❑ 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 vet 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
long.
approximately six inches.
Form SW401-Wet Detention Basin O&M-Rev.4 Page 1 of 4

Permit Number:
(to he provided bY DWQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How 1 will remediate theproblem:
The inlet device: pipe or
The pipe is clogged.
Unclog the pipe. Dispose of the
swale
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to
swale.
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible. Remove the sediment and
sediment storage.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional
show that pruning is needed
practices
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design sediment
possible. Remove the sediment and
storage depth.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over
Consult a professional to remove
50% of the area.
and control the algal growth.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray).
the basin surface.
Form SW401-Wet Detention Basin O&M-Rev.4 Page 2 of 4

Permit
(to be provided by DWQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs re air. (if applicable)
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
I 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 1 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 1 feet in the forebay, the sediment shall
be removed.
Sediment Removal
Bottom
BASIN DIAGRAM
(fill in the blanks)
3 � Pe manen\
--------------- -- Volume
2 h Min.
Sediment
Storage
FOREBAY
Permanent Pool Elevation 8
Pool
Sediment Removal Elevation 3 Volur.
Bottom Elevation 2
MAIN POND
1-ft
Storage
Form SW401-Wet Detention Basin O&M-Rev.4 Page 3 of 4

Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:First Citizens Bank - Elizabeth City
BMP drainage area number: I - Drainai4c Area to Wet Pond
Note: The legally responsible party should not he it homeowners association unless more than 50%, of
the lots have been sold and it resident of the subdivision has been named the president.
1, 1LVt 15Z 4 O (JeS a Notary Public for the State of
(,O_ - w County of do hereby certify that
�aN tZ zzOrd- personally appeared before me this 19
day of 4-L,, f? 1.15 20 t� , and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal, _TD_ - �, �.e
NOTARY
PUBLIC
SEAL
My commission expires (Y u 9 ZD I
Form SW401-Wet Detention Basin O&M-Rev.4 Page 4 of 4

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
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 First Citizens Bank - Elizabeth
2. Location of land -disturbing activity: County Pasquotank City or Township Elizabeth City
Highway/Street 854 Halstead Blvd Latitude 36* 17' 19" N Longitude 76* 14' 33" W
3. Approximate date land -disturbing activity will
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Commercial
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 2.32 acres
6. Amount of fee enclosed: $ 195.00 The application fee of $65.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $585).
7. Has an erosion and sediment control plan been filed? Yes No Enclosed X
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
E-mail
Cell #
Fax #
9. Landowner(s) of Record (attach accompanied page to list additional owners):
First Citizens Bank - Paul Rizzardi
Name
100 East Tryon Road
Current Mailing Address
919-716-4114
Telephone
100 East Tryon Road
Current Street Address
919-716-8840
Fax Number
Raleigh NC 27603 Raleigh NC 27603
City State Zip City State Zip
10. Deed Book No. 1127 Page No. 351 Provide a copy of the most current deed.
Part B. 99{{��
1. .Person(s) or firm(s) who are financially responsible for the land -disc r ng aUpIvitty"(ANde
comprehensive list of all responsible parties on an attached sheet): LAND QUALITY SECTION
First Citizens Bank - Paul Rizzardi
_Name
100 East Tryon Road
Current Mailing Address
Raleigh NC 27603
City State Zip
919-716-4114
WASHINGTON REGIONAL OFFICE
[e-mail]
E-mail Address
100 East Tryon Road
Current Street Address
Raleigh NC 27603
City State Zip
Fax Number 919-716-8840

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:
E-mail Address
Mailing Address Current Street Address
State Zip
Fax Number
State Zip
(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
Current Mailing Address
E-mail Address
Current Street Address
State Zip City State Zip
Fax N
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 be any change intheinformation provided herein.
i!Aru fZ24MO I V4 3CStj)L7-)
��ebr orinWr ame Title or Authority
Date
------------------------------------------------------------------------------------------------------------------------------------
I, I 1Q l- t lSC, S a Notary Public of the County of �! e
State of North Carolina, hereby certify that -
personally before me this day and being
executed by him.
fZ ; 2--L . appeared
duly sworn acknowledged that the above form was
Witness my hand and notarial seal, this r1 day of /-"je� v s + 20 1 3
40
FsF�•`,' � Not
d+
NOTARY
PUBLIC _� My commission expires 1l 7-0 I
I� Avg