SW6211205_Application Form_20230201 (2)

Basin Information
Draina e Area 1
Draina e Area
Draina e Area
DrainageArea—
Receiving Stream Name
Black Branch
Stream Class *
C
Stream Index Number*
18-31-19-5-1
Total Drainage Area (sf)
2,565,939
On -site Drainage Area (sf)
2,557,625
Off -site Drainage Area (sf)
8,314
Proposed Impervious Area** (sf)
1,380,437
% Impervious Area** (total)
54.0
Impervious— Surface Area
Drainage Area 1
Drainage Area
Drainage Area
Drainage Area
On -site Buildings/Lots (sf)
903,580
On -site Streets (sf)
287,439
On -site Parkin (sf)
On -site Sidewalks (sf)
83,979
Other on -site (sf)
97,125
Future (sf)
Off -site (sf)
8,314
Existing BUA*** (sf)
Total (sf):
1,380,437
* Stream Class and Index Number can be determined at.-
http.//portal. ncdenr. ora/web/wgZps/csu/classifications
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. NCDOT
Improvements in Public R/W
Proiects in Union County: Contact DEMLR Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 1 SA 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 Energy, Mineral and Land
Resources (DEMLR). A complete package includes all of the items listed below. A detailed application instruction
sheet and BMP checklists are available from http://portal.ncdenr.org/web/wq/ws/su/statesw/forms docs. The
complete application package should be submitted to the appropriate DEMLR Office. (The appropriate office may
be found by locating project on the interactive online map at http://portal.ncdenr.orci/web/wq/ws/su/maps.)
Please indicate that the following required information have been provided by initialing in the space provided for
each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions for each
submitted application package from http://portal.ncdenr.org/web/wq/ws/su/statesw/forms docs.
Initials
1. Original and one copyof the Stormwater Management Permit Application Form.
2. Original and one copyof the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part l/II below)
3. Onginalof 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 NCOENR. (For an Express review, refer to
http://www.envhelp.org[pages/onestopexpress.html for information on the Express program
Form SWU-101 Version Oct. 31, 2013 Page 4 of 7