SW6110802_CURRENT PERMIT_20110819

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW 111MQ
DOC TYPE
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE6,r,
YYYYMMDD

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North Carolina
Beverly Eaves Perdue
Governor
or
NC®ENR
Department of Environment and
Division of Water Quality
Nazareth Missionary Baptist Church
Attn: Pastor Darrel Gibson, Jr.
25020 Nazareth Church Street
Wagram, NC 28396
Coleen H. Sullins
Director
August 19, 2011
Subject: Stormwater Management Permit SW6110802
Nazareth Missionary Baptist Church
High Density Project
Scotland County
Dear Pastor Gibson:
Natural Resources
Dee Freeman
Secretary
The Fayetteville Regional Office of the Division of Water Quality received a complete Stormwater Management
Permit Application for the Nazareth Missionary Baptist Church project on August 11, 2011. Staff review of the
plans and specifications has determined that the project, as proposed, will comply with the Stormwater
Regulations set forth in Title 15A NCAC 2H .1000. Therefore, we are forwarding herewith Stormwater
Management Permit SW6110802 dated August 19, 2011 for the construction, operation and maintenance of the
subject project.
This permit shall be effective from the date of issuance until August 19, 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.
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) calendar 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, P.O. Drawer 27447, Raleigh, NC 27611-7447.
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 Mike Lawyer at
[phone] or by e-mail at mike, [e-mail].
Sincerely, '6�..4r• f�
Belinda S. Henson
Regional Supervisor
Surface Water Protection Section
BSH: ML/ml
cc: Wesley Anderson -Anderson Engineering & Associates, PA (via e-mail)
Sam Powers, PE -Anderson Engineering & Associates, PA (via e-mail)
LFRQSurface Water Protection_Stormwater Files
Location: 225 Green Street, Suite 714, Fayetteville, North Carolina 28301
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: http://pooal.ncdenr.org/weblwq
An Equat Opportunity 1 Affirmative Action Employer
NorthCarolina
Natumllry

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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
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
Nazareth Missionary Baptist Church
Nazareth Missionary Baptist Church
Scotland County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with the provisions of
15A NCAC 214 .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 Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until August 19, 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 1.6 of this permit. The stormwater control has been designed to handle the
runoff from a total of 83,200 square feet of built -upon area.
3. The tract will be limited to the amount of built -upon area as indicated in Section 1.6 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.
The following design criteria have been provided in the wet detention pond and must be
maintained at design condition:
a. Drainage Area, acres: 5.6
Onsite, ft2: 243,936
Offsite, ft2: 0
b. Total Impervious Surfaces, ft2: 83,200

C. Design Storm, inches:
d. Pond Depth, feet:
e. TSS removal efficiency:
f. Permanent Pool Elevation, FMSL:
g. Permanent Pool Surface Area 1ftZ:
h. Permitted Storage Volume, ft:
i. Temporary Storage Elevation, FMSL:
j. Controlling Orifice:
k. Permitted Forebay Volume, ft3:
I. Receiving Stream/River Basin:
in. Stream Index Number:
n. Classification of Water Body:
IL SCHEDULE OF COMPLIANCE
1
3.5
90%
228.50
14,478
23,426
230.00
2" O pipe
8,478
Lumber River / Lumber
14-(3)
"WS-IV,B;Sw,HQW"
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.
During construction, erosion shall be kept to a minimum and any eroded areas of the system will
be repaired immediately.
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 revegetation of slopes and the vegetated filter.
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, flow spreader, catch
basins and piping.
g. Access to the outlet structure must be available at all times.
4. Records of maintenance activities must be kept and made available upon request to authorized
personnel of D WQ. The records will indicate the date, activity, name of person performing the
work and what actions were taken.
5. Decorative spray fountains will be allowed in the stormwater treatment system, subject to the
following criteria:
a. The fountain must draw its water from less than 2' below the permanent pool surface.
b. Separated units, where the nozzle, pump and intake are connected by tubing, may be used
only if they draw water from the surface in the deepest part of the pond.
C. The falling water from the fountain must be centered in the pond, away from the
shoreline.
d. The maximum horsepower for a fountain in this pond is 1 /6th horsepower.
6. The facilities shall be constructed as shown on the approved plans. This permit shall become
voidable unless the facilities are constructed in accordance with the conditions of this permit, the
approved plans and specifications, and other supporting data.
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.

8. 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.
9. Access to the stormwater facilities shall be maintained via appropriate easements at all times.
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.
C. 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 permittee shall submit final site layout and grading plans for any permitted future areas
shown on the approved plans, prior to construction.
12. A copy of the approved plans and specifications shall be maintained on file by the Permittee for
a minimum of ten years from the date of the completion of construction.
13. 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.
II1. 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 formal permit transfer
request to the Division of Water Quality, accompanied by a completed name/ownership change
form, documentation from the parties involved, and other supporting materials as may be
appropriate. 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.
2. Failure to abide by the conditions and limitations contained in this permit may subject the
Permittee to enforcement action by the Division of Water Quality, to accordance with North
Carolina General Statute 143-215.6A to 143-215.6C.
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.
4. 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.
5. The permittee grants DENR Staff permission to enter the property during normal business hours
for the purpose of inspecting all components of the permitted stormwater management facility.

6. The permit may be modified, revoked and reissued or terminated for cause. The filing of a
request for a permit modification, revocation and reissuance or termination does not stay any
permit condition.
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.
Approved plans and specifications for this project are incorporated by reference and are
enforceable parts of the permit.
9. The permittee shall notify the Division any name, ownership or mailing address changes within
30 calendar days.
Permit issued this the nineteenth day of August 2011.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
or Coleen ?Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Stormwater Management Permit SW6110802

Nazareth Missionary Baptist Church Pagel of 2
Stormwater Management Permit SW6110802
Scotland County
Designer's Certification
1, , as a duly registered in the State of North
Carolina, having been authorized to observe (periodically/ weekly/ full time) the construction of the
project,
(Project Name)
for (Project Owner) hereby state that, to the best of my
abilities, due care and diligence was used in the observation of the project construction such that the
construction was observed to be built within substantial compliance and intent of the approved plans and
specifications. ,
The checklist of items on page 2 of this form is a part of this Certification.
Noted deviations from approved plans and specification:
SEAL
Signature
Registration Number
Date

Certification Requirements: Page 2 of 2
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.
All the built -upon area associated with the project is graded such that the runoff drains to
the system.
All roof drains are located such that the runoff is directed into the system.
5. The outleUbypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
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. with vegetated shelf at 10:1.
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.
Please submit this Designer's Certification to: D WQ Fayetteville Regional Office
Surface Water Protection Section
225 Green Street, Suite 714
Fayetteville, NC 28301-5043

Anderson E
P.O. Box 1736
305 North Chippewa
Lumberton, N C. 28359
Licensure No.: C-0793
February 14, 2013
NCDENR - Division of Water Quality
Attention: Mike Lawyer
225 Green Street — Suite 714
Fayetteville, NC 28301
Ref: Nazareth Missionary( Baptist�G!
Stormwater Certifiao
Mr. Lawyer,
Please find encloset�v
tormwater D
your file. 1
Should you have a'riyquestion or coma
Sincerely,
J. Powers[ P
SJPijib
Enclosures
cc: United Builders
File
W eering & Assoc., P.A.
A .
for
Larry Anderson, P.E.
President
®ENR-FRO
FEB 15 2013
DWQ
project for
National Society of
Professional Engineers®
AWPELAmensedhAwnber
Phone: [phone] Fax: [phone] Email: aridersonengineeringpa [e-mail]

Nazareth Missionary Baptist Church Page 1 of2
Stormwater Management Permit SW6110802
Scotland County
Designer's Certification
I, SAMuE b I PowERS as a duly registered ?tzofrs4iwAt, 1;g6wre%L in the State of North
Carolina, having been authorized to observe eriodi y weekly/ hill time) the construction of the
project,
}1A2aR-Er1A IAlSSS,(C A4" 5APr IsT CtjufLr 14
(Project Name)
for MA?AuTVA M1tSIOAA2y jjVVST "011 (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 a part of this Certification.
Noted deviations from approved plans and specification; N006
��\\M III///, .
`\\o��N�ss�Op2 `z
2, �F
a SEAL
36199 =
��s,9 INE��' SEAT,
Signature zzz�UFC
Registration er p3(ul9`► �z�itllillPt����`
Date _ 02, A Z- &o 13

Certification Requirements: Page 2 of 2
S-JQ 1. The drainage area to the system contains approximately the permitted acreage.
53Q 2. The drainage area to the system contains no more than the permitted amount of built -
upon area.
SJ 3. All the built -upon area associated with the project is graded such that the runoff drains to
the system.
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.
53P 6. The outlet structure is located per the approved plans.
SSP 7. . Trash rack is provided on the outlet/bypass structure.
SY? 8. All slopes are grassed with permanent vegetation.
51? 9. Vegetated slopes are no steeper than 3:1 with vegetated shelf at 10:1.
S l�j 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.
&T? 12. Required drawdown devices are correctly sized per the approved plans.
SJ P 13. All required design depths are provided.
SJP 14. All required parts of the system are provided, such as a vegetated shelf, and a forebay.
STP 15. The required system dimensions are provided per the approved plans.
Please submit this Designer's Certification to: DWQ Fayetteville Regional Office
Surface Water Protection Section
225 Green Street, Suite 714
Fayetteville, NC 28301-5043

, � 4
�. , r
NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
May 9, 2011
CERTIFIED MAIL: 7009 0820 0000 2473 8077
RETURN RECEIPT REQUESTED
Nazareth Missionary Baptist Church
Attn: Darrel Gibson, Jr., Pastor
PO Box 481
Wagram, NC 28639
SUBJECT: Post -Construction Stormwater Permit Notification (HQWIORW)
Nazareth Missionary Baptist Church
Scotland County
Dear Pastor Gibson:
Dee Freeman
Secretary
Our office has received a copy of the Financial Responsibility/Ownership Form (FR/O) from the Division of Land
Resources, Land Quality Section for the Nazareth Missionary Baptist Church project to be located in Scotland
County. Based on project location information provided on the FR/O, we have determined that the project is
subject to a State Stormwater Management Permit for development activities within one mile of and draining to
High Quality Waters (HQW).
Please be advised that construction of any built -upon areas prior to issuance of a State Stormwater
Management Permit will be considered a violation of the NC Administrative Codes and could result in the
assessment of civil penalties of up to $25,000 per day, per violation. The State Stormwater Management
Permit is in addition to the NPDES Stormwater General Permit (NCG010000) received for construction activities.
For more information and to obtain the application and applicable supplement forms, please visit:
http://portal.ncdenr.org/web/wq/ws/su/statesw.
If you have any questions concerning this matter, please contact me at [phone].
Sincer ly,
e�
Michael Lawyer, CPSWQ
Environmental Specialist
cc: Scotland County Planning Department, 507 West Covington Street, Laurinburg, NC 28352
FRO -Surface Water Protection
FRO -Land Quality
Location: 225 Green Street, Suite 714, Fayetteville, North Carolina 28301
Phone: [phone] FAX: 91OA86-07071 Customer Service: 1-877-623-6748
Internet: htm/lirortal,ncdenr.orglwec1wq
North Carolina
Naturally
An Equal Opportunity 1 Affirmative Action Employer

'm
OFFICIAL USE 11
t` postage $
S
N
Certllletl Fee
pReturn Receipt Fee P H reed
r3 (Endomerrent Required)
,:=etl Delivery Fee
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(EMorsement Required)
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� Total Postage & Fees $ J • J /
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Street Api No:i-.....---. _- ..
0 or PO Box No. 0.ohl.A)
t` Ciry Slate. Z/Pa...............................................
■ Complete items 1, 2, and 3. Also complete
item 4, if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece
or on the front if space permits.
1. Article Addressed to:>
A. Signature
X ❑ Agent
O Addressee '
r87. Received by (Printed Nam C. Date of Delivery
D. Is delivery address different from Item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
NA7_ARETH MISSIONARY BAPTIST HURCH
AT"IN: PASTOR DARREL GIBSON,
PO BOX 481
WAGRAM-, NC 28639 3. Service Type
❑ Certified Mall ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise .
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2' 700910820 ODOOi 24R3�'80717 1;1
�
PS Form 3811, February 20D4 Domestic Return Retoilipi' - - tozsgsoz+.t-teye
1

FINANCIAL RESPONSIBILITY/OWNERSHIP FORM o ^ )'
j" SEDIMENTATION POLLUTION CONTROL ACT /tFGt Z 0
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: Nazareth Missionary Baptist Church
®ENR-FRC
2. Location of land -disturbing activity: County: Scottland City or Township: WagraNAY Q y 2u
Highway/Street: US 401/Raeford Road Latitude+ 34.8964 N Longitude-79.3588 V/(,
3. Approximate date land -disturbing activity will commence: April 2011
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Institutional/Church
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 5.0 AC
6. Amount of fee enclosed: 325.00 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:
Name Darrel Gibson Jr. _
E-mail Address
pastorgibson(a),yahoo.com
Telephone [phone]
Cell # 910.318.1534
Fax #
910-369.2216
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Nazareth Missionary Baptist Church [phone] 910.369.2216
Name Telephone Fax Number
PO Box 481 25020 Nazareth Church St.
Current Mailing Address Current Street Address
Wagram NC 28369 Wagram NC 28369
City State Zip City State Zip
10. Deed Book No. 1229 Page No. 208-209 Provide a copy of the most current deed.
Part B.
Person(s) - or firm(s) who are financially responsible for the land -disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet):
Nazareth Missionary Baptist Church pastorgibson(g)yahoo.com
Name E-mail Address
PO Box 481 25020 Nazareth Church St.
Current Mailing Address Current Street Address
Wagram NC 28369 Wagram NC 28369
City State Zip-,-- City- - State Zip
Telephone [phone] Fax Number 910.369-2216

2. (a) If the FinanciallyResponsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name
Current Mailing Address
City
Zip
E-mail Address
Street Address
City State Zip
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:
of Registered Agent
E-mail Address
Current Mailing Address Current Street Address
City
Telephone
State Zip
Fax Number
State Zip
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 in the information provided herein.
Type or print name
sQri - D Lsz.o;S
Title or
Oa?-O ?-//
Date
a Notary Public of the County of IzkADZ3"
State of North Carolina, hereby certify that Vi0..rrt-1 CTl%s pr-) f appeared
personally before me this day and being duly sworn acknowledged that the above form was
executed by him.
Witness my hand and notarial seal, this _day of K bhf0.►'lt 20_LL_
/�"A44 © "
Notary
Seal ,S I a S I r3
My commission expires

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Copyright (C) 1998, Maptech, Inc.

North Carolina Areas Subject to Phase II Post -Construction & Other Stormwater Program... Page 1 of I
i b
N. -C Division,o Water uQahi stout he division contact tlw sections gloss*,
Q y Ig Ig n.
andenea..ArtNea h`r. .v t,._ �` a,,,,, •s- r e ',-
r✓'�y�+{��]}and enhance ME 107,
- a
Address
Lat/Long Results
Permitting :
Multiple
HQW/ORW Area AND
Type:
Water Supply
HOW and WS-IV
Basis:
Watershed
see
Notes:
Aorta I. ncden r.org/web,
DAD Regional Office
Contact:
and local WSPrpgram
County:
SCOTLAND
DENR
Region:
Fayetteville
Phase 11:
Not a Phase 11 area
Jurisdiction:
SCOTLAND CO
9®I
http://] 49.168.87.13/stormwater/
5/9/2011

DWQ USE ONLY
Date Received
Pee Paid
Permit Number
or- l/- /I
I 5't✓&//6eo2
Applicable Rules: ❑ Coastal SW —1995 ❑ Coastal SW
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters
❑ Other WQ M mt Plan:
— 2008 ❑ Ph II - Post Construction
❑ Universal Stormwater Management Plan
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
DENR-FRO
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
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.):
Nazareth Missionary Baptist Church
2. Location of Project (street address):
City:Wagram County:Scotland Zig.7.8369 2839(p
3. Directions to project (from nearest major intersection):
Heading East on US 401 out of Wagram, toward Raeford, the site is on the left side of the road approximately
300 feet E of the intersection of Howard St. and US 401.
4. Latitude: 34 ° 53' 47.039" N Longitude:79° 21' 31.68" 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
constnuction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
[]LAMA Major ®Sedimentation/Erosion Control: 5.0 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑404/401 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 tvoe of each Dermit:Proiect Name: Nazareth Missionary Baptist Chruch: ID SCOTL-2011-
Form S W U-101 Version 07July2009 Page I 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:Nazareth Missionary Baptist Church
Signing Official & Title: Pastor Darrel Gibson Jr.
b.Contact information for person listed in item la above:
Street Address: 25020 Nazareth Church St
City: Wagram State:NC Zip:2836T 28376,
Mailing Address (ifapplicable):PO Box 481
City:Wagram State:NC zip
.283f9 Z%396
Phone: (910 ) 369.2790
Email: pastorgibsonft ahoo.com
Fax: ( 910 ) 369.2216
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:
Mailing Address (if
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:United Builders of Lumberton
Signing Official & Title: Jimmy Tim Lewis, Owner
b.Contact information for person listed in item 3a above:
Mailing Address: 615 East 5" Street
City: Lumberton State:NC Zip:28358
Phone: (910 ) 738-6243 Fax: (910 ) 738-5327
4. Local jurisdiction for building permits: Scotland County
Point of Contact:Eamest Stephens Phone #: (910 ) 277-2420
Form SWU-101 Version 07July2009 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
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:
El Valid Building Permit Issued Date:
F1 Other: Date:
b.Identify the regulation(s) thepproject has been designed in accordance with:
❑ Coastal SW —1995 LJ Ph II — Post Construction
3. Stormwater runoff from this project drains to the Lumber River basin.
4. Total Property Area: 5.6 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':
Total project wren 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 (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). 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 = 34.11 %
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
Lumber River
Stream Class
WS-IV,B;
Sw,H W
Stream Index Number *
14-(3)
Total Drainage Area (sf)
243,936
On -site Drainage Area (sf)
243,936
Off -site Drainage Area (sf)
0
Proposed Impervious Area** (so
83,199.6
%Impervious Area** (total)
34.11
Impervious" Surface Area
Drainage Area 1
Drainage Area _
Drainage Area
Drainage Area
On -site Buildings/Lots (so
20,037.6
On -site Streets (sf)
0
On -site Parking (sf)
58,370.4
On -site Sidewalks (sf)
4,791.6
Other on -site (so
0
Future (sf)
0
Off -site (sf)
0
Existing BUA*** (sf)
0
Total (sf):
83,199.6
* Stream Class and Index Number can be determined at: http://h2o.enr.state.nc.us/biros/reportslreportsWB html
** Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
*** Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that is
to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation.
Form SWU-101 Version 07July2009 Page 3 of 6

Projects in Union County: Contact DWQ Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that maybe 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
fromhtto://h2o.enr.state.nc.us/su/bmo forms.htm.
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://h2o.enr.state.nc.(ts/su/bmp forms.htm. The complete application package
should be submitted to the appropriate DWQ Office. (The appropriate office may be found by locating project
on the interactive online map at http://h2o.enr.state.nc.us/su/msi maps.htm.)
Please indicate that the following required information have been provided by initialing in the space provided for
each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions for
each submitted application package from http://h2o.enr.state.nc.us/su/bmp forms.htm.
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
htto://www.envhelenvhelp.org/pages/onestopexpress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management for
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within Vi mile of the site boundary, include the Y2
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.
I. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
A
rg:
u�
Form SWU-101 Version 07July2009 Page 4 of 6

9. Copy of any applicable soils report with the associated SHWT elevations (Please identify 14
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 far DWQ to verify the SHWT prior
to submittal, [phone]J
Me
A copy of the most current property deed. Deed book: 1229 Page No: 208-209
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 2H.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http://www.secretary.state.nc.us/Corporations/CSearch aspx
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
http://h2o.enr.state.nc.us/su/bmp forms.htm#deed restrictions. 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:Samuel 1. Powers, PE
Consulting Firm: Anderson Engineering and Associates. PA
Mailing Address:305 North Chippewa Street
City:Lumberton State:NC Zip:28358
Phone: (910 ) 671.9530
Email:samit)[e-mail]
Fax: (910 ) 618.0838
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 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 1a) with (print or type name of organization listed in
Contact Information, item I b) 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 07July2009 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.
a Notary Public for the State of
County of
do hereby certify that personally appeared
before me this _ day of and acknowledge the due execution of the application for a
stormwater permit. Witness my hand and official seal,
SEAL
My commission expi
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 2) Pastor Darrel Gibson Jr.
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 storms ater rules undq 15A NCAC 2H .1000, �L 2006-246 (Ph. II — Post Construction) or SL 2008-211.
Date:_ 0-Is —//
I, �en IPublic for the State of N C County of
Rc)b 5.•-\ do hereby certify that V)< rr i\ D• G b S D . Sr • personally appeared
before me this _5_ day of A . 10 11 . and acknowledge the dAe execution of the application for a
stormwater permit. Witness my hand and official seal,
a
SEAL
My commission expires C ( kk rJ
Form SWU-101 Version 07July2009 Page 6 of 6

Permit Number: �udl�OSaZ
(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,
pretreatment including forebays and the vegetated filter if one is provided.
®E; 'Ne —�
This system (check one): a ; t 2�.�
El does ® does not incorporate a vegetated filter at the outlet. G ' '
This system (check one): ®WQ
❑ 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 porfion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
— Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— If the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
— Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected once a month and
within 24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a
Coastal County). Records of operation and maintenance should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element.
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the wet
Areas of bare soil and/or
Regrade the soil if necessary to
detention basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide time and a
one-time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of
lon' .
approximately six inches.
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Permit Number: 5 Hip G i 15 8'd Z.
(to be provided by DWQ)
Drainage Area Number: !
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
The pipe is clogged.
Unclog the pipe. Dispose of the
swale
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to
swale.
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible. Remove the sediment and
sediment storage.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional
show that pruning is needed
practices
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design sediment
possible. Remove the sediment and
storage depth.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over
Consult a professional to remove
50% of the area.
and control the algal growth.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray).
the basin surface.
n--- I -CA

Permit Number: 5e161i6 5-a Z
(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. Cif 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 3.0 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 3.00 feet in the forebay, the sediment
shall be removed.
Sediment Removal
Bottom
224.5
---------------
BASIN DIAGRAM
(fill in the blanks)
�ft Min.
Sediment
Storage
Permanent Pool Elevation 228.5
Sediment Removal Elevation 224.5 Volume
----------------------- ? ------
k Bottom Elevation 223.50 1 1-ft W
Storage
FOREBAY
MAIN POND
V--.-. cuinni w„« ,. ;_none o.... n o...... Z —rA

Permit Number: 5i l(. (10 8"6 2
(to be provided by DWQ)
1 acknowledge and agree by my signature below that 1 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:Nazareth Missionary Baptist Church
BMP drainage area number:I
Print name: Darrel Gibson Jr
Title:Pastor
Address:25020 Nazareth Church St
Signat
D. 6: /
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.
1, S¢a r\Z • &��_ vvNn vI% , a Notary Public for the State of
NC , County of t�ob e S nr , do hereby certify that
Z)ct. v r e G , b Sar\ --\ r personally appeared before me this 3
day of (�4ga S_1 a o l\ , and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,�4��
SEAL
My commission expires C)L— \A — 4�� \ J
1 1. n....._.:.._ .--:-nose n,... a .---A -CA

Permit No. S"Ilda-6 Z
(to be provided by DWQ)
III.'REQUIRED.ITEMSCHECKLIST, ,..,..;,
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.
JA ac M
A C 104-
w-4 Glo¢
II '' AAA
[A
Pf4,E 1
OF CALL5
GtQk
B PHGES
KAIL
N/A
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NI
Plans (1" - 50' or larger) of the entire site showing:
- Design at ultimate build -out,
- Off -site drainage (if 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.
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,
Basin cross-section,
Vegetation specification for planting shelf, and
Filter strip.
3. Section view of the wet detention basin (1" = 20' or larger) showing:
Side slopes, 3:1 or lower,
Pretreatment and treatment areas, and
Inlet and outlet structures.
D V «�
4. 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 & accumulated volumes for overall pond and for forebay,
to verify volume provided.
6. A construction sequence that shows how the wet detention basin will be protected from sediment until the
entire drainage area is stabilized.
7. The supporting calculations.
8. A copy of the signed and notarized operation and maintenance (08M) agreement.
9. A copy of the deed restrictions (if required).
V' _ 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 SW401-Wet Detention Basin-Rev.8-9/17/09 Part III. Required Items Checklist, Page 1 of 1

AT;ILA vevta
NCDENR V+ f
North Carolina Department of Environment and Natural Resources
Division of Land Resources
James D. Simons, PG, PE Land Quality Section
Director and State Geologist
June 9, 2011
LETTER OF APPROVAL WITH MODIFICATIONS
Nazareth Missionary Baptist Church
Attn: Darrel Gibson Jr., Pastor
P.O. Box 481
Wagram, NC 28369-
RE: Project Name: Nazareth Missionary Baptist Church
Project ID: SCOTL-2011-004
County: Scotland Wagram US 401 Raeford Road
River Basin: Lumber Stream Classification: HQW
Submitted By: Anderson Engineering & Assoc., P.A.
Date Received by LQS: 5/26/2011
Plan Type: Revised
Dear Nazareth Missionary Baptist Church:
Acres Approved: 5
Beverly Eaves Perdue, Governor
Dee Freeman, Secretary
This office has reviewed the subject erosion and sedimentation control plan. We find the plan to
be acceptable with modifications and hereby issue this letter of Approval With Modifications. The
Modifications Required for Approval are listed on the attached page. This plan approval shall expire three
(3) years following the date of approval, if no land -disturbing activity has been undertaken, as is required
by Title 15A NCAC 4B .0129.
Please be advised that Title 15A NCAC 4B .0118(a) requires that a copy of the approved erosion
control plan be on -file at the job site. Also, you should consider this letter to give the Notice required by
G.S. 113A-61.l(a) of our right of periodic inspection to insure compliance with the approved plan.
North Carolina's Sedimentation Pollution Control Program is performance -oriented, requiring
protection of existing natural resources and adjoining properties. rf, following the commencement of this
project, it is determined that the erosion and sedimentation control plan is inadequate to meet the
requirements of the Sedimentation Pollution Control Act of 1973 (North Carolina General Statute 113A-
51 through 66), this office may require revisions to the plan and implementation of the revisions to insure
compliance with the Act.
Fayetteville Regional Office 225 Green Street - Suite 714, Fayetteville, North Carolina 28301
Phone: [phone] / FAX: [phone]-Internet: http://www.dir.enr.state.nc.us/pages/landqualitysection.htmi
An Equal Opportunity / Affirmative Action Employer - 50% Recycled / 10% Post Consumer Paper

r— ^
Letter of Approval with Modifications
Nazareth Missionary Baptist Church
June 9, 2011
Page 2 of 3
The developer is responsible for obtaining any and all permits and approvals necessary for the
development of this project prior to the commencement of this land disturbing activity. This could include
agencies such as the Division of Water Quality's stormwater regulations, their enforcement requirements within
Section 401 of the Clean Water Act, the Environmental Protection Agency and/or the U.S. Army Corps of
Engineers' jurisdiction of Section 404 of the Clean Water Act, the Division of Solid Waste Management's landfill
regulations, local County or Municipalities' ordinances, or others that may be required. This approval cannot
supersede any other permit or approval; however, in the case of a Cease and Desist Order from the Corps of
Engineers, that Order would only apply to wetland areas. All upland areas would still have to be in compliance
with the N.C. Sedimentation Pollution Control Act.
If any area on site falls within the jurisdiction of Section 401 or 404 of the Clean Water Act, the
developer is responsible for compliance with the requirements of the Division of Water Quality, the Corps of
Engineers and the Environmental Protection Agency (EPA) respectively. Any erosion control measures that fall
_._____within jurisdictional .wetland -areas. must be.approved-by.the.aforementioned agencies-prior.to-installation.- The--
Land Quality Section must be notified of a relocation of the measures in question to the transition point between
the wetlands and the uplands to assure that the migration of sediment will not occur. If that relocation presents a
problem or contradicts any requirements of either DWQ, the Corps, or the EPA, it is the responsibility of the
developer to inform the Land Quality Section regional office so that an adequate contingency plan can be made to
assure sufficient erosion control remains on site. Failure to do so will be considered a violation of this approval.
Please be aware that your project will be covered by the enclosed NPDES General Stormwater
Permit NCGO1000 (Construction Activities). You should first become familiar with all of the
requirements for compliance with the enclosed general permit.
Please note that this approval is based in part on the accuracy of the information provided in the
Financial Responsibility Form, which you have provided. You are requested to file an amended form if
there is any change in the information included on the form. In addition, it would be helpful if you notify
this office of the proposed starting date for this project. Please notify us if you plan to have a
preconstruction conference.
Your cooperation is appreciated.
Sincerely,
Sally Castle, EI
Land Quality Section
Enclosures: Certificate of Approval
Modifications Required for Approval
NPDES Permit
Cc: An$eison-Engineering & Assoc ,P A'?"
Ernest Stephens, Building Inspector
Belinda Henson, Division of Water Quality
Land Quality Section - Fayetteville Regional Office File ..