SW8070323_Current Permit_20170123

Energy, Mineral &
Land Resources
ENVIRONMENTAL QUALITY
January 23, 2016
Jack Askew, General Manager
Carteret County ABC Board
410 Live Oak St.
Beaufort, NC 28516
Subject: Permit Renewal / Permit Extension
State Stormwater Management Permit No. SW8 070323
ABC Store — Town of Beaufort
Carteret County
Dear Mr. Askew:
ROY COOPER
Governor
MICHAEL S. REGAN
ser;reforr
TRACY DAVIS
Director
Effective August 1, 2013 the State Stormwater program has been transferred from the Division of Water
Quality (DWQ) to the Division of Energy, Mineral and Land Resources (DEMLR). All previous references to
DWQ will remain in older stormwater permits issued prior to August 1, 2013 until they are modified. Please
note that this permit will now reference DEMLR as the Division responsible for issuance of the permit.
On August 5, 2009, the Governor signed Session Law 2009-406. This law impacted any development approval
issued by the former Division of Water Quality under Article 21 of Chapter 143 of the General Statutes, which
was current and valid at any point between January 1, 2008, and December 31, 2010. The law extended the
effective period of any stormwater permit that was set to expire during this time frame to three (3) years from
its current expiration date. On August 2, 2010, the Governor signed Session Law 7010-177 which granted an
extra year for a total of up to four (4) years extension.
The Wilmington Regional Office received a complete 8 year Stormwater Management Permit Renewal
Application for the ABC Store in the Town of Beaufort on December 5, 2016. The Division is hereby
notifying you thatpermit SW8 070323 has been renewed on January 23, 2017, and shall be effective until
March 28, 2029, which includes all available extensions. For your records, please find enclosed a renewed,
updated, and re -issued permit and a copy of the renewal application. Please keep this permit on file at all
times. Please note that the renewed, updated, and re -issued permit does not impose new or different terms; it
merely restates some of the previous terms to provide you with a better understanding of your obligations
under the permit.
The renewal and reissuance of this stormwater pe&it does not imply that the site is currently in compliance.
with the terms and conditions of this state stormwater permit. The plans originally approved on March 28,
2007, will remain in full force and effect in accordance with the regulations set forth in Title 15A NCAC
2H.1000 effective September 1, 1995.
This permit is subject to the conditions and limitations as specified therein. Please pay special attention to the
conditions listed in this permit regarding the Operation and Maintenance of the BMP(s), recordation of deed
restrictions, procedures for changes of ownership, transferring the permit, and renewing the permit. Failure to
establish an adequate system for operation and maintenance of the stormwater management system, to record
deed restrictions, to transfer the permit, or to renew the permit, 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 by filing a written petition with the Office of Administrative Hearings (OAH).
The written petition must conform to Chapter 150B of the North Carolina General Statutes, and must be filed
with the OAH within thirty (30) days of receipt of this permit. You should contact the OAH with all questions
regarding the filing fee (if a filing fee is required) arid/or the details of the filing process at 6714 Mail Service
Center, Raleigh, NC 27699-6714, or via telephone at 919-431-3000, or visit their website at
www.NCOAH.com. Unless such demands are made this permit shall be final and binding.
State of hlorth Carolina I Environmental Quality I Energy. Nrmeral and Land Resources
Wilmington Regional office 1 127 CardinalDrive Extension I Wilmington, NC 28405
910 796 77-15

JCQLG SLOtiriwe.LCY Pcrmitivo. SW8 070323
Page 2 of 2
If you have any questions, need additional copies of the permit or approved plans, please contact Christine Hall
at [phone].
n
Sincerely,
"I Q0t;1I
3 Tracy Davis P.E., Director
Division of Energy, Mineral and Land Resources
GDS/cash: \\\Stormwater\Permits & Projects\2007\070323 HD\2017 01 permit 070323
cc: Wilmington Regional Office
State of North Carolina I Environmental Quality I Energy. Miner -di and Land Resources
Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington, NC 28405
910 796 7215

State Stormwater Management Systems
Permit No. SW8 070323
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North
Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Carteret County ABC Board
ABC Store — Town of Beaufort
1791 Live Oak Street, Beaufort, Carteret County
FOR THE
construction, operation and maintenance of one (1) infiltration basin discharging to Class SA
waters in compliance with the provisions of 15A NCAC 2H .1000 (hereafter referred to as the
"stormwater rules') and the approved stormwater management plans and specifications and
other supporting data as attached and on file with and approved by the Division of Fnergy,
Mineral and Land Resources (hereafter referred to as the Division or DEMLR) and
considered a part of this permit.
This permit shall be effective from the date of issuance until March 28, 2029, 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 on page 3 of this permit. The stormwater control has been
designed to handle the runoff from 88,863 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated on page 3 of this
permit, and per approved plans. The built -upon area for the future development is
limited to 57,935 square feet.
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.
Page 1 of 6

State Stormwater Management Systems
Permit No. SW8 070323
6. The following design criteria have been provided in the infiltration basin and must be
maintained at design condition:
a.
Drainage Area, acres:
3.71
Onsite, ft2:
161,608
Offsite, ft2:
None
b.
Total Impervious Surfaces, ft2:
88,863
C.
Design Storm, inches:
1.5
d.
Basin Depth, feet:
1
e.
Bottom Elevation, FMSL:
10.1
f.
Bottom Surface Area, ft2:
11,375
g.
Bypass Weir Elevation, FMSL:
*`
h.
Permitted Storage Volume, ft3:
11,375
i.
Type of Soil:
Sandy Loam
j.
Expected Infiltration Rate, in/hr:
0.62
k.
Seasonal High Water Table, FMSL:
8.1
I.
Time to Draw Down, hours:
7.2
M.
Receiving Stream/River Basin:
UT to Turner Creek / White Oak
n.
Stream Index Number:
21-35-1-11-1
o.
Classification of Water Body:
IISA; HQW"
** Stormwater runoff is collected in two detention basins then pumped to the
infiltration basin. Each detention basin has a spillway properly designed to
overflow after collecting the required 1.5" storm event.
II. SCHEDULE OF COMPLIANCE
No person or entity, including the permittee, shall alter any component of the approved
stormwater system shown on the approved plans unless and until the Division has
approved of the revised plan..
2. 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.
3. During construction, erosion shall be kept to a minimum and any eroded areas of the
system will be repaired immediately.
4. The permittee shall at all times provide the operation and maintenance necessary to
assure that all components of the permitted stormwater system function at design
condition. The approved Operation and Maintenance Agreement is incorporated by
reference into this permit and must be followed in its entirety and maintenance must
occur at the scheduled intervals.
5. Records of maintenance activities must be kept and made available upon request to
authorized personnel of the Division. The records will indicate the date, activity, name
of person performing the work and what actions were taken.
6. The facilities shall be constructed in accordance with the conditions of this permit, the
approved plans and specifications, and other supporting data.
7. 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.
Page 2 of 6

State Stormwater Management Systems
Permit No. SW8 070323
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. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
C. Further development, subdivision, acquisition, lease or sale of any, 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.
d. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
e. The construction of any future BUA listed on the application.
11. 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.
12. Prior to transfer of the permit, the stormwater facilities will be inspected by Division
personnel. The project and the stormwater facility must be in substantial compliance
with all permit conditions. Any items not in substantial compliance must be repaired,
replaced or restored to design condition prior to the transfer. Records of maintenance
activities performed to date will be required.
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.
III. GENERAL CONDITIONS
1. Any individual or entity found to be in noncompliance with the provisions of a
stormwater management permit or the stormwater rules, is subject to enforcement
action as set forth in NCGS 143, Article 21.
2. 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.
3. The permittee is responsible for compliance with all permit conditions until such time
as the Division approves the transfer request. Neither the sale of the project, in whole
or in part, nor the conveyance of common area to a third party constitutes an approved
transfer of the stormwater permit.
4. The permittee grants Division Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
Page 3 of 6

State Stormwater Management Systems
Permit No. SW8 070323
5. This permit is not transferable to any person or entity except after notice to and
approval by the Director. The permittee shall submit a completed and signed
Name/Ownership Change Form, accompanied by the supporting documentation as
listed on the form, to the Division of Energy, Mineral and Land Resources at least 60
days prior to any one or more of the following events:
a. An ownership change including the sale or conveyance of the project area in
whole or in part, except in the case of an individual lot sale that is made subject
to the recorded deed restrictions-
b. The sale or conveyance of the common areas to a Homeowner's or Property
Owner's Association, subject to the requirements of Session Law 2011-256;
C. Bankruptcy;
d. Foreclosure, subject to the requirements of Session Law 2013-121;
e. Dissolution of the partnership or corporate entity, subject to NCGS 57D-2-01(e)
and NCGS 57D-6-07;
f. A name change of the current permittee;
g. A name change of the project;
h. A mailing address change of the permittee;
6. 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. Additional or replacement stormwater
management systems shall receive a permit from the Division prior to construction.
7. 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.
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 submit a permit renewal application request at least 180 days prior
to the expiration date of this permit. The renewal request must include the appropriate
application, documentation and the processing fee.
Permit renewed, updated, and re -issued this the 23rd day of January 2017.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
i racy uavi r.t., uirector -
Division of En rgy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW8 070323
Page 4 of 6

State Stormwater Management Systems
Permit No. SW8 070323
ABC Store — Town of Beaufort
Stormwater Permit No. SW8 070323
Carteret Countv
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 5 of 6

State Stormwater Management Systems
Permit No. SW8 070323
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 bypass structure weir elevation is per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the 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 pc, miffed amounts of surface area and/or volume have been provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved plans.
cc: NCDEQ-DEMLR Regional Office
Carteret County Building Inspections
Page 6 of 6

Permit No. SV,'j O 7 D-6 a 3
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWO Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : Town of Beaufort ABC Store
Contact Person: Peter W. Sokalski, PE
This worksheet applies to: Basin No.
(as identified on plans)
Phone Number: ( 252 ) 972-7703
in Drainage Area 1
(from Form SWU-101)
H. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type Sandy Loam
Infiltration Rate 0.62
SHWT Elevation 8.10
Basin Design Parameters
Design Storm 1.5
Design Volume 3840
Drawdown Time 0.3
Basin Dimensions
Basin Size 65
Basin Volume Provided 11,375
in/hr or cf/hr/sf (circle appropriate units)
fmsl (Seasonal High Water Table elevation)
inch (1.5 inch event for SA waters, 1 inch event for others)
c.f.
days
ft. x 175
c.f.
Basin Elevations
Bottom Elevation 10.10 fmsl
Storage Elevation 11.10 fmsl
Top Elevation 11.10 fmsl
Form SWU-103 Rev 3.99 Page 1 of 3
ft. = 11,375 sq. ft. (bottom dimensions)

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
PWs a.
System is located 50 feet from class SA waters and 30 feet from other surface waters.
PWs b.
System is located at least 100 feet from water supply wells.
PWs c.
Bottom of system is at least 2 feet above the seasonal high water table.
PWs d.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
PWs e.
System is not sited on or in fill material or DWQ approval has been obtained.
see attached f.
System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
PWs g.
Drainage area for the device is less than 5 acres.
PWs h.
Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
PWs i.
System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
PWs j.
System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
PWs k.
All side slopes stabilized with vegetated cover are no steeper than 3:1 (H: V).
PWs 1.
A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
PWs in.
Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
Pws n.
Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
PWs o.
Flow distribution mechanism within the basin is provided.
see attached p.
A benchmark is provided to determine the sediment accumulation in the pretreatment device.
PWs q.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
PWs r.
System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
PWs s.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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.
Print Name and Title: Robert D. Shipp, Jr., Supervisor/General Manager
Address: 410 Live Oak Street, Beaufort, NC 28516
[phone]
Date: 3 - '23 - 2.00 11
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.
VAo.A10 . a Notary Public for the State of �O@rK C WWPJO , County of
CA4.'ML: T , do hereby certify that & erk D . SN.o p , Tr• personally appeared before me this 13
day of Marc,4% AQ07 , and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL
My commission expires 3-3- ao08
Form SWU-103 Rev 3.99 Page 3 of 3

DEMLR USE ONLY
Da Recebed
Fee PaidPermit
Number
` /2
/
State of North Carolina
Department of Environment and Natural Resources
Division of Energy Mineral and Land Resources
(NCDENR DEMLR)
STORMWATER MANAGEMENT PERMIT RENEWAL APPLICATION FORM
This form may be photocopied for use as an original
This form is to be completed by the current permit holder pursuant to Title 15A NCAC 2H.1003 lhl (2): This states
that stormwater management permits, issued for projects that require the construction of engineered stormwater
control measures (High Density Permits), shall be required to submit an application to renew the permit 180 days
prior to expiration of the permit. Renewed permits are valid for a period of 8 years per Session Law 2011-398 (SB
781) Section 60. (c).
I. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the North Carolina Department of
Environment and Natural Resources (NCDENR) Division of Energy Mineral and Land Resources (DEMLR). A
complete package includes all of the items listed below. The complete application package should be
submitted to the appropriate DEMLR Regional Office. (The appropriate office may be found by clicking on the
interactive online map at �i.it fort ��cd �_�:.��r l�--_e ! T�_���_;s_irTiop. ^I�k-,fficpti. Copies of the original permit can be
obtained from the Regional Office of the Division of Energy, Mineral and Land Resources.)
This Renewal is for STORMWATER PERMIT #: SW 8070323
Please check which of the following permit renewal scenarios apply. Initial in the spaces provided that you have
provided the required information.
® A. Renewal Only:
-$505 fee
-Renewal Form - Sign and complete all sections (send original & 1 copy)
-Recorded Documents Required By Permit: Deed restrictions, covenants, condominium/planned
community declaration & easements (if not already submitted to NCDENR DEMLR). Copies are
acceptable.
-Designer's Certification (if required by permit and not already received by NCDENR DEMLR) (See the
last page of your permit for a copy of the certification form.)
-1 Have a Copy of the Current Operation and Maintenance Agreement (O&M): Please Keep this on File
with your permit.
-I Do Not Have a Copy of the Current O&M: Initial This Line to Request a copy. (If NCDENR DEMLR
does not have a copy on file, then you will be notified to submit a new O & M form.)��
❑ B. Renewal and Modification:
-$505 Fee and Pages 1 & 2 of this Renewal Form
-SWU-101 Application Form(
-Recorded Documents Required By Permit: Deed restrictions, covenants, condominium/planned
community declaration & easements (if not already submitted to NCDENR DEMLR). Copies are
acceptable.
- Under #II. 1. on SWU-101 Application Form -- Check Box for Modification w/Renewal
-Designer's Certification (if required by permit and not already received b 1 (See the
Iast page of your permit for a copy of the certification form.) J'�
- O&M Agreement DECO
J LYli1.7�nn
Form SWU-102 (Renewal Form) Rev. Oct. 31, 2013 Page 1 of 1
BY:

❑ C. Renewal and Either: 1.) Permit Transfer to a New Permittee, or 2.) Project Name Change:
Please submit all items in I.A, and:
Request a NCDENR DEMLR site inspection if transferring permit to new property owner.
Submit One of the Two Following Forms below (forms available at i.�ttp <rrizl ►�cdenr fir;_ : to :;'�_'1 r'stt:_
docq).
1. HOA Name/Ownership Change Form: For planned communities (per Chapter 47C or
Chapter 47F of the General Statutes)
2. Name/Ownership Change Form: For all other transfers
Please make sure all required information is submitted with the Name/Ownership Change form (as
stated in each of the available forms) and that all required signatures and initials are filled in properly.
Otherwise the name change or transfer can not be processed and the original owner will remain as the
permit holder.
❑ D. Renewal, Modification, and Transfer (or Name Change): Please submit pages 1 and 2 of this
Renewal form along with all items listed in I. B. and C. above (check this box and initial items in B.
& C. that you are submitting to NCDENR DEMLR).
II. APPLICANT'S CERTIFICATION
Note: The legally responsible party is the current permittee and/or the legally responsible representative until such time that the permit is
officially transferred through a request to DEMLR by the permittee.
I, (print or type name of permittee or person legally responsible for the permit ) lack Askew
certify that I have a copy of the DEMLR Approved Permit and O&M Agreement on -site (OR I have obtained a copy
from DEMLR and it will be kept on site), that I am responsible for the performance of the maintenance procedures
and the site has been, and will be, maintained according to the O & M Agreement. I agree to notify DEMLR of any
problems with the system and prior to any changes to the system or changes in ownership I will (or have through
this renewal application) notify NCDENR DEMLR and submit the proper forms to modify or transfer the permit.
All information provided on this permit renewal application is, to the best of my knowledge, correct and complete.
Permittee Title:General Manager
Address:410 Live Oak St., Beaufort, NC 28516
NOTARIZATION:
I, _ wM4 a Notary Public for the State of _41,Ikk C.3rul"Vs a
County of 12LtsneE do hereby certify that of ck-AS1[e0
personally appeared before me this day of 1 l /30 / (ei and acknowledge the due execution of the
forgoing stormwater BMP maintenance requirements. Witness my hand and official seal,
My commission expires: l (S
Notary Signature:
BY:
Form SWU-102 (Renewal Form) Rev. Oct. 31, 2013 Page 2 of 2

III. GENERAL INFORMATION
1. Stormwater Management Permit Number: SW8070323
2. Permit Holder's name (specify the name of the corporation, individual, etc.):
Carteret County ABC Board
3. Print Owner/Signing Official's name and title (person legally responsible for permit):
Tack Askew, Finance Officer
4. Mailing Address for person listed in item 2 above:
410 Live Oak St.
City:Beaufort State:NC Zip:28516
Phone: (252 ) 728-4269 Fax: (252 ) 728-4269
Email:[e-mail]
5. Project Name: ABC Store - Town of Beaufort
6. Location of Project (street address):
1791 Live Oak St.
City:Beaufort County:Carteret Zip:28516
7. Directions to project (from nearest major intersection):
Approximately 1 mile north along US Hwy. 70 from the intersection of NC 101 and US Hwy 70 (Live Oak Street
ECEIVE
DEC 0 5 2016
BY: 0
Form SWU-102 (Renewal Form) Rev. Oct. 31, 2013 Page 3 of 3

IV. ` PERMIT INFORMATION:
1. Specify the type of stormwater treatment: []Constructed Wetland ❑Bioretention ®Wet Detention Pond
❑Dry Detention Basin ❑Infiltration Basin ❑Infiltration Trench ❑Sand Filter Mother:
2. If any changes were made to the original DEMLR approved project list them in the space below (attach additional
pages if needed and provide "As -Built" drawings with this application). If major changes have been made to your
project please request a plan revision or modification of the permit and submit "As Built" drawings along with a
final or updated stormwater system engineer certification (if not already provided to NCDENR). DEMLR Engineer
and Designer Certification Forms are available from each NCDENR DEMLR Regional Office.
Form SWU-102 (Renewal Form) Rev. Oct. 31, 2013 Page 4 of 4
ECEIVEnk
DEC05201
RY:

State Stormwater Management Systems
Permit No. SW8 070323
ABC Store — Town of Beaufort
Stormwater Permit No. SW8 070323
Carteret Countv
Designer's Certification
elf as a duly registered L�
in the State of No h Carolina, aving been authorized to obs (periodically/ weekly/
full time) the construction of the project,
r-
(Project)
for �4&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
Registratic
Date 610? . --If- • 0 ¢—
SEAL
444.
CA ?
p@` oyEssr h•�Ei�.
•
aSEAL���
8421
Page 6 of 7

State Stormwater Management Systems
Permit No. SW8070323
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 bypass structure weir elevation is per the approved plan.
t/6.
The bypass structure is located per the approved plans.
XLZ,lf 7.
A Trash Rack is provided on the 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.
V 12. All required design depths are provided.
v'l 3. All required parts of the system are provided.
L-'�l 4. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Carteret County Building Inspections
Page 7 of 7