SW3210301_Application Form_20230406

Basin Information Drains e Area 1 Drainage Area 2 Drainage Area Drainage Area_
Receiving Stream Name East Fork East Fork
TweIvemile Twelvemile
Creek Creels
Stream Class C C
Stream Index Number* 11-138-2 11-138-2
Total Drainage Area(sf) 1,973,268 757,944
On-site Drainage Area(so 1,973,268 757,944
Off site Drainage Area(sf) 0
Proposed Impervious Area** s 1,228,238 617,167
% Impervious Area** total 62 81
Impervious'*Surface Area Drainage Area 1 Drainage Area 2 Drainage Area_ Drainage Area_
On-site Buildings/Lots(so 802,500 347,500
On-site Streets (so 183,857 96,614
On-site Parking (sf) 186,250 87,500
On-site Sidewalks (sf) 55,631 29,258
Other on-site (sf) 0 0
Future(sf) 0 56,295
Off-site (so 0 0
Existing BUA***(sf) 1 0 0
Total (sf): 1 1,228,238 1 617,167
* Stream Class and Index Number can be determined at. http,4 ortal.ncdenr.org/web/wq&s/csat/classifications
* Imppervious 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.N/A
Projects 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 15,4 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:Z/poTtal.ncdenr.org/web/wq/ws/su/hmp-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,org/weh wql cvs j 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/w2/ws/su/statesw/forin—s dots.
Initials
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 IYK
agreement(s)for each BMP.
Form SWU-101 Version Oct.31,2013 Page 4 of 7