SW8990940_HISTORICAL FILE_20090724

STORMWATER DIVISION CODING SHEET
POST-CONSTRUCTION PERMITS
PERMIT NO. SW8 ` g'0cfK0
DOC TYPE ❑ CURRENT PERMIT
❑l APPROVED PLANS
ka HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE Rlt
YYYYMMDD

A�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
July 24, 2009
Mr. Chris Burke
Ross-Civello Development, Inc.
3220 Spring Forest Road
Raleigh, NC 27616
Subject: State Stormwater Management Permit No. SW8 990940 Renewal
Kerr Drug - Southport
High Density Commercial Sand filter Project
Brunswick County
Dear Mr. Burke:
The Wilmington Regional Office received a complete Stormwater Management Permit Renewal
Application for Kerr Drug - Southport on June 15, 2009. Therefore permit SW8 990940 has
been renewed on July 24, 2009, and shall be effective until December 16, 2019.
The re-issuance of this stormwater permit does not imply that the site is currently in compliance
with the terms and conditions of this state stormwater permit. A plan of action to correct the
deficiencies noted in the April 8, 2009 Notice of Inspection must be submitted to the Division of
Water Quality by August 25, 2009. Failure to provide the requested plan of action may initiate
enforcement action. The plans previously approved on December 16, 1999 in accordance with
the regulations set forth in Title 15A NCAC 2H.1000 effective September 1, 1995 remain in full
force and effect.
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) days following
receipt of this permit. This request must be in the form of a written petition, conforming to
Chapter 1506 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
Angela Hammers, or me at [phone].
Sinc rely,
Georgette Scott
Stormwater Supervisor
Division of Water Quality
GDS/akh: S:\WQS\STORMWATER\PERMIT\990940ren.ju109
cc: Brian Soltz, PE, (John R. McAdams Company)
Jeff Phillips, Brunswick County Engineering
Angela Hammers; WiRO: Central Files
Wilmington Regional Office
127 Cardinal Drive Extension,Wilmington,North Carolina 28405 One
Phone:[phone] FAX:[phone] Customer Service:1 V7-623-3748 North Carolina
Internet:www.ncwaterquality.org (��/-J��ryK` {na ly
An Equal Opportunity l Affirmative Action Employer !1"

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY COMMERCIAL 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
Chris Burke & Ross-Civello Development, Inc.
Kerr Drugs - Southport
1531 North Howe Street, Southport, Brunswick County
FOR THE
operation and maintenance of 7 sand filters in compliance with the provisions of 15A
NCAC 2H .1000 effective September 1, 1995 (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 December 16, 2019, 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. A series of seven (7) sand filters has been approved for the management of
stormwater runoff as described in Section 1.6 on page 3 of this permit. Each sand
filter has been designed to handle the runoff from a maximum amount of built-
upon area as follows: #1 @ 12,200 square feet; #2 @ 2,614 square feet; #3 @
10,020 square feet; #4 @ 1,742 square feet; #5 @ 10,890 square feet; #6 @
1,742 square feet; #7 @ 871 square feet.
2

3. The stormwater control has been designed to handle the runoff from 38,821
square feet of impervious area.
4. 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 0 square feet.
5. 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.
6. The runoff from all built-upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
7. The following design criteria have been permitted for the sand filter and must be
provided and maintained at design condition:
Drainage Area, acres: 1.11
Onsite, ftZ: 48,351
Offsite, ftZ: 0
Total Impervious Surfaces, ftZ: 38,821
Design Storm, inches: 1
Sand Filter#: 1 2 3 4 5 6 7
Sand Depth, inches: 18" 18" 18" 18" 18" 18" 18"
Invert Elevation, FMSL: 19.5 19.95 21.25 19.75 19.5 20.25 21
Drainage Area, ftZ: 12,200 2,614 10,020 1,742 10,890 1,742 871
Total Impervious Surfaces, ftZ: 12,200 2,614 10,020 1,742 10,890 1,742 871
Offsite Area entering Filter, ftZ: None, per Engineer
Required Surface Area, ftZ: 202 43 166 29 180 29 14
Provided Surface Area, ftZ: 224 64 192 32 192 32 32
Required Storage Volume, ft': 302 65 248 43 270 43 22
Provided Storage Volume, ft': 336 96 288 48 288 48 48
Top of Weir Elevation, FMSL: 21 21.45 22.75 21.25 21 21.75 22.5
Controlling Orifice, pipe: 61,cp 61,cp 61,cp 61,(p 6"9 61,cp 61,cp
Receiving Stream/River Basin: Price Creek/ Cape Fear River
Stream Index Number: 18-88-3
Classification of Water Body: "SC SW"
3

II. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety,
operational for its intended use prior to the construction of any built-upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all 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. Debris removal and unclogging of the filter media, orifice devices, catch
basins, and piping.
d. Access to the sediment chamber and sand filter must be available at all
times.
4. Records of maintenance activities must be kept and made available upon
request to authorized personnel of DWQ. The records will indicate the date,
activity, name of person performing the work and what actions were taken.
5. 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.
6. 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.
7. Access to the stormwater facilities shall be maintained via appropriate recorded
easements at all times.
8. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built-upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built upon area or to the
drainage area.
e. Further 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.
4

f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
9. Prior to the construction of any permitted future areas shown on the approved
plans, the permittee shall submit final site layout and grading plans to the
Division for approval.
10. A copy of the approved plans and specifications shall be maintained on file by
the Permittee at all times. At the time the permit is transferred to a new owner,
the permittee shall forward the approved plans to the new owner.
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. No person or other legal entity shall alter the approved stormwater management
system, of fill in, alter, or pipe any drainage feature, including swales, shown on
the approved plans as part of the stormwater management system, unless and
until the permittee submits a modification to the permit and receives approval
from the Division.
13. The permittee is responsible for verifying that the proposed built-upon area for
the entire project does not exceed the allowable built-upon area.
14. The Division may determine that other revisions to the project should require a
modification to the permit.
15. Built upon area includes, but is not limited to, structures, asphalt, concrete,
gravel, brick, stone, slate, coquina and parking areas, but does not include
raised, open wood decking or the water surface of swimming pools.
16. 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. This permit is not transferable to any person or entity except after notice to and
approval by the Director. In the event of a change of ownership, or a name
change, the permittee must submit a completed Name/Ownership Change form
to the Division of Water Quality, signed by both parties, and accompanied by the
supporting documentation as listed on page 2 of the form. The approval of this
request will be considered on its merits and may or may not be approved.
2. 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
nor the transfer of common area to a third party constitutes an approved transfer
of the stormwater permit.
3. 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, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
5

4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit remains in force and effect until modified, revoked, terminated, or
renewed. The permit may be modified, revoked and reissued or terminated for
cause. The filing of a request for a permit modification, revocation and
reissuance, renewal 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 permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
11. The permittee shall submit a permit renewal application at least 180 days prior to
the expiration date of this permit. The renewal request must include the
appropriate documentation and the processing fee.
Permit issued this the 24th day of July 2009.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
C c�V
for ColeerYH. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
6

Kerr Drug - Southport
Stormwater Permit No. SW8 990940
Brunswick County
Designer's Certification
I, as a duly registered in the
State of North Carolina, having been authorized to observe (periodically/ weekly/ full
time) the construction of the project,
(Project)
for (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
SEAL
Signature
Registration Number
Date
7

Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built-upon area.
3. All the built-upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The sand filter elevations are per the approved plan.
6. The sand filter is located per the approved plans.
7. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
8. The permitted amounts of surface area and/or volume have been
provided.
9. Required drawdown devices are correctly sized and located per the
approved plans.
10. All permitted design depths are provided.
11. All required parts of the system are provided such as the sedimentation
chamber and the sand filter chamber.
12. The permitted dimensions of the system are provided, per the approved
plan.
cc: NCDENR-DWQ Regional Office
Inspector, Brunswick County Building Inspections
8

1 ; DWQ I�SE ON1.1'
Dale Kvmiced Per t'aid I'rrmit\unilalr
-/S'O9 oS, oo xe 3d39i2 d
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT RENEWAL APPLICATION FORM
Fhic furor rndu br p6o6n 011h"I for ucr ds do nriplial
1. GENERAL INFORMATION
1. Stornncater Management Permit Number: SW lY99U990
2. Permit Holder's name (specify the name of the corporation, individual, etc.):
doss -GiV6/lo /�o'Y6/o�M�✓T �'vrc
3. Print Owner/Signing Official's name and title (person legally responsible for permit):
e/3 RuelCE' D//2EL%o2 o{ i/i%tc� /�fANN/��G !�i eons% me ftOtOAY
4. Mailing Address for person listed in item 2 above:
37-2o 6&-S-j- A20Ab
CitY: eA/c/v14 State: iIOCL Zip: 2-7(41 /ro
Phone: ( 9 tq ) S44-- 3 3 9/y Fay: ( 9/<j ) S.4-.¢- 971'7
Email: Cbu ride (9 kerlbQru y. com
S. Project Name: Kc'Ye �2U6-
6. Location of Project (street address):
153 / A&P-774 lyoxJ6 % [ //wy z 11)
City: SCUTMOOR-% County: Beu,Usw(C- Zip: 2134b/
7. Directions to project (from nearest major intersection):
--54jr cr /S QAJ 7h,5-e?lCalT 16- 7i?�av _/ .✓G Sou77, C" AzW z(/
Jr(sT 0id]G) i4LOV S-7 X,J i---YSEG71ro.J
H. PERMIT INFORMATION: JUN 1 5 2009
BY:
I. Specify the l%pe of stormcvater treatment ❑Constructed Wetland ❑Biore[cntion ❑6Vet Detention Basin
❑Drc Detention Basin ❑Infiltration Basin ❑Infiltration Trench ®Sand Filler ❑Other
2. List any changes from project that was originally approved (attach additional pages if needed):
Fornt SV111-102 (Renewal For in) Version 02.10.09 Pace I ot3

t 3. Dn coo hace d eopc of the original Operation and Mointenance Agreement' wheck one)
®Yes (If yes, submit the attached (page 3) Operations and Maintenance verification sheet.)
❑No (If no, then submit a new Operations and Maintenance Agreement that can be located on the
Division of Water Quality Home Page under the BMP Manual link:
http://h2o.enr.state.nc.us/su/bmp_form s.htm)
Ill. SUBMITTAL REQUIREMENTS
Onh'complete application packages will be accepted and reviewed by the Division of Water Quality (DW'Q).
A complete package includes all of the items listed below. The complete application package should be
submitted to the appropriate DW'Q Office. (Appropriate office mac be found br locating project on the
ioteractiX e online map at httn:':h_o.cnr+gate nc us',u nl,i )
I. Please indicate that 'Nou have provided the following required information bN' initialing in the space provided
nest to each item.
Initials
• Original& I copy l of the Shonnw'ater Management Permit Renewal Application Form GB
• Application fee of$500.00 (made)unable to .NCDENR) Gg
• Operation g Maintenance Verification or a new O&NI Agreement e3
• SWU-101 Application Form (if requesting a rnodificotion to the permit)
• Transfer of Ownership/Name Change Form (if requesting transfer of ownership) G+3
VI. APPLICANT'S CERTIFICATION
1, (print or tape name of person listed in General Information, item 3) ellefs aaf?y6
certify' that the information included on this permit renewal application is, to the best of my knowledge, correct
and complete. //__ � /�
Signature: zt r� 704/�/11 / Date: 40
Fonn Sl1'1i-102 (Renewal Form) Version 02.1 o.00 Paee 2 of I

Operations and Maintenance Verification
I acknowledgc and a,ree be m\- signature belo\\ that I am responsible for the performance of the
maintenance procedures listed in the original Operations and Maintenance Agreement. I agree to notify
D\VQ of any problems with/the system or prior to am' changes to the s\stem or responsible part.
Print name: Germs jyt y—t5
Title: DIacc(—of2 R.4A ,d& s LOY/Yi,—eLCG/[OAI
Address: 3Z20 Sr�,rJG �'o/L6S/ 12OAA 1241e rff, AlG 7-7&t (o
Phone: 9/9- S-¢9- --3 9 17t,
Signature: Liz/ P
Date: S�1°/09
Note: The legally responsible parry should not be a homeomiers association unless more than 50",,,of the lots have been sold
and a resident of the subdivision has been named the president. "
1, DiAAAF 8Al I Cl A.QT.V /L tlr a Notary Public for the State of loEtTH CAAUI/dA.
County of WAh(& do hereby certify that ddR/S 234t& 't
personally appeared before me this day of /Y/AY , 200 , and acknowledge the due
execution of the forgoing stonnwater BMP maintenance requirements. Witness my liand and official
seal,
Notary Signature: L{//�e /�cLctm9itth�
�rIIB IUMGg9
(SE
0TA.,�+L'BUc
CO....._
My commission expires: 1.)—//3 /0 9
Fonn SV1-U-102 (Renewal Form) Aversion 02.16.09 Page 3 of

,1
8312CreedmoorRoad Raleigh,NC27613
COMMERCIAL 919.848.6121 Phone [phone] Fax
SITE DESIGN www . csitedesign . coIn
TRANSMITTAL COVER SHEET
c:
Angela Hammers
NCDENR (Wilmington Office)
127 Cardinal Drive Ext.
Wilmington,NC 28405
910-796-7215
SENDER: PROJECT NAME:
Brian Soltz Kerr Drug—Southport,NC
SW8-990940
DATE: PROJECT NUMBER:
08/24/09 KICR-0706
OOVERNIGHT ❑REGULAR MAIL ❑HAND DELIVER ❑HOLD FOR PICK-UP
COPIES DATE DESCRIPTION
1 Engincer's Certification
NOTES/COMMENTS:
Angela,
Please email (soltz as csitedesign.com) me confirming that this is all you need for this project. Call me
if you have any questions.
'Chanks,
Brian
AUG 2 5 2009
BY:

Internal Review Tracking Sheet-Renewal
Keep on File Until After Reviewed By Supervisor
Team Leader Review: Johnson
Permit Reviewer: Hammers
Date: 24 July 2009
Permit: SW8 990940
Permit Name: Kerr Drugs, Southport
X Issue
Please see recommendations below
1. Initial questions:
a. Location: Southport
b. Rule Subject: 1995
c. Density: High
d. Development Type: Commercial
e. Types of BMP(s): 7 sand filters
f. SA or ORW issues? No
g. Notes:
I.) I think that the way you handled the sand filter design data(by using the infiltration shell) is the
best way to do it since there isn't a 1995 shell for a sand filter. I tried to go back and find all of
the data that is in the 2008 sand filter shell, but the data is not available in this file. (The entire
design process for sand filters changed in 2007, FYI, so I don't think that they were recording as
much info back then.)
2.) I went through the 2008 sand filter shell line by line and compared it to this one. I added some
requirements in track changes.
3.) I changed the engineer's certification to be more in line with sand filters rather than infiltration
basins
4.) I also tried to change the technical data to Arial, like the rest of the text. You must have left if
Times because it really messed up the formatting! 1 left it,too!

Hammers, Angela
From: Hammers, Angela
Sent: Wednesday, July 08, 2009 4:14 PM
To: '[e-mail]' _ - q� g -Syy-3.f'96x /g9L-
Subject: Kerr Drug - Southport
Hi Chris,
I hope this finds you well. I did receive the renewal and transfer of ownership packet for the stormwater permit,SW8
990940, 3 weeks ago. It looks fine, but I have one question for you. I know you had been working on getting the PE for
the stormwater system also. What is the status of that process? I remember you have been working on this, 1 just need
to update my database with a new due date (the old one was May8th).
I should be available most of tomorrow if you have any questions.
Sincerely,
Angel Hammers (Please note my new email address is [e-mail])
Environmental Specialist
NC Department of Environment and Natural Resources
Wilmington Regional Office
127 Cardinal Drive Ext.
Wilmington, NC 28405
Office: 910.796.7215
Fax: [phone]
E-mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
t

1
1 Q�'LJ
NCDENR
North Carolina Department of Environment and Natural Resources
Divisiun of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
STATE STOWNIWATER PERMIT
NAVE/OWNERSHIP CHANGE FOR11
1. CURRENT PERMIT INFORMATION;
I. Slnmrwater Management Permit Numbcr: We FIjD�j40
2. Permit Holder's name: /2055 -C,.re(IO Y- -V ,urx I Irte -
3. Signing official's name: ewos E-IaAe= Title: T
(pan,m legally reeponnible I'm pem,il)
Mailing address: 3zzo _S%I la wR. %jc A_�City:. A--We--f(xra
State: AJC ZipCode: 7-1 Phone: 91 q 544-38% Fax: 9Yrlj•S44-g7¢oj
(Ataa Code mid Numbet) IAtca GuL•amt Number)
If. NEW ONN'NER y PROJECT / ADDRESS INFORMATION
1. This request is for (please check all that apply)
Q a. Change in ownership of the property/company(Please complete Items #2, #3, and
#4 below).
Ea b. Name change of pmiect (Please complete helm #5 bclnw)
9 c. Mailing address change. (Please complete Item #4 below)
❑ d. Other(please explain):
2. New owner's name to be put on permit: 50, TH✓o2T I, y LLC
3. New Signing of name: 2Qdk Cf�Zkc—, Title:
Ipam,n Icgall)re<punuhlc f..pem,w
4. New \1ailingaJdrcss: Ztl C f,JS Mum2 Zt%k? City: ST-.-t/E,t/SVWE
Slatc: Md •• 7_ipC'odc: 21(Pbb Phone: Fax:
1.%wi 1 5hlc a,,d Number i (Arc Cad,an,l\m...tv,
5. New Project Narne to he placed on pcmtil:
Flemington Rea,onal duce
I22 Ca goal Drive E Ienwnn kt,Imngton.Nanh Calalfne 25100
One
in:e- cAAwn•n,15quah: ?;fb3502C1)a Cuscmerc_ervae t•c:ic2]•E748 j\t(1YII7Cilf011l7il
Inte•ne; wewnona:emual,ycrg �hittirra��j
I'aga l ot'1 .

PERMIT NAME/O%N'NERSHIP CHANGE FORM
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED Bl' THE DIVISION OF
WATER QUALITY UNLESS ALL OF THE APPLICABLE ITEMS LISTED BELOW
ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed form.
2. Legal documentation of the transfer of ownership.
3. A copy of the recorded deed restrictions, if required by the permit.
4. The designer's certification, if required by the pennit.
5. An Operation and Maintenance plan, signed by the new applicant, if a system that requires
maintenance will change ownership.
6. Maintenance records.
CERTIFICATION MUST BE COMPLETED AND SIGNED BY BOTH THE CURRENT
PERMIT HOLDER AND THE NEW APPLICANT IN THE CASE OF A CHANGE OF
OWNERSHIP.
FOR NAME CHANGES, COMPLETE AND SIGN ONLY THE CURRENT
PERMITTEE'S CERTIFICATION.
Current Permittee's Certification:
1, z:*e14 3m a [o— attest that this application for a name/ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this application are not completed and that if all required
supporting information and attachments are not included, this application package will be
retumed as incomplete.
/
Signature: Date: 7/ '/a
Nett' AppIican I's Ccrttfication: OUW be compleled for all transfers of ownership)
—� 1, _%.f ek G t,� , attest that this application for a name/ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this application are not completed and that if all required
supporting information and attachnmcras arc not included. this application package will be
returned as incomplete. T�
Signature Date:: -
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS, SHOULD BE SENT TO THE FOLLOWING
ADDRESS:
NCDENR Division of Water Quality
Surface Water Protection Section —Stormwater
127 Cardinal Drive Extension
Wilmington. NC 28405
Name Ovenership Change Form-0212n9
Pace 2 of 2

SAND FILTERS OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the system
for trash accumulation and general condition.
2. At least once a year each filter must be inspected after a rainfall event to determine if
the filter bed is passing the runoff within 24 hours.
3. The following maintenance operations must be performed when storms of
approximately one inch are not passing through the filter withing 24 hours.
a. The first two or three inches of discolored sand must be removed from the sand
filter and replaced with new sand. Note that the removal sand shall be dewatered,
if necessary, and the land filled.
b. The sediment chamber shall be pumped and cleaned. It is also likely that the
sediment removed will need to be dewatered prior to landfill disposed.
I acknowledge and agree by my signature below that I am responsible for the
performance of the above maintenance procedures. I agree to notify DWQ of any
problems with the system or changes in the name of the project, responsible party, or
address.
Print name: Rocs-Civello Dev lopment Inc TP*Tv Root
Address: 2522 S. Tri-Center Blvd. Durham NC 27713
Phone: [phone]
Title: Dire o of Planning on traction
Signature:
Date: If LIU
I, t r1M)1W i>7 f 9oe a Notary Public for the State of /X"Ic7 s' G4/rcGin A,
County of Lr� 9/r —, do hereby certify that JZ,?A y pJ. f'noT
�D
personally appeared before me on this Z day of •S� /.3e�� 19
and acknowledge the due execution of the forgoing infiltration system maintenance
requirements. Witness my hand and official seal, GPRRO(� '''•,,
y �
Z
Ivry commission expires //— /�/-Z liOZ ~a �cJ

Hammers, Angela
From: Hammers, Angela
Sent: Monday, August 24, 2009 4:15 PM
To: 'Brian Soltz'
Cc: '[e-mail]'
Subject: RE: Kerr Drug -Southport, NC -SW8 990940 (Renewal) - Designer Certification
Attachments: image001 Jpg
Brian,
Thank you for supplying the certification for the stormwater system of the Kerr Drug in Southport. That meets the
requirements noted both during my inspection and the cover page of the recently renewed stormwater permit.
If you have contact with Mr. Chris Burke of Ross-Civello Development, Inc. please let him know that it should be noted
that the stormwater permit has not been transferred from Ross-Civello to Southport Property, LLC as previously
requested. The transfer was not accepted due to DWQ not receiving a signed operation and maintenance agreement by
the representative of Southport Property, LLC.Therefore,the responsibility of the operation and maintenance of this
stormwater permit(SW8 990940) remains with Ross-Civello Inc.
Thanks again for your efforts. I will look for the original certification in the mail.
Sincerely,
Angela Hammers
From: Brian Soltz [mailto:[e-mail]]
Sent: Friday, August 21, 2009 4:18 PM
To: Hammers, Angela
Cc: Chris Burke; Kathryn Carroll
Subject: Kerr Drug - Southport, NC - SW8 990940 (Renewal) - Designer Certification
Angela,
Per the permit approval letter dated July 24, 2009 and your inspection letter dated April 8, 2009 find attached designer's
certification for the above note site. The original of this document is in the mail to your attention. Please reply to this email
confirming receipt and that no further action is necessary.
Thanks,
e I f4o COMMERCIAL
SITE DESIGN
Brian T. Soltz
8312 Creedmoor Road
Raleigh, NC 27613
919-848-6121
919-848-3741 FAX
919-414-4054 CELL
soltz(a-csitedesi ng com
www.csitedesign.com
t

SOSJD: 0481903
Date Filed: 4/28/2011 9:08:00 AM
State of North Carolina Elaine F.Marshall
Department of the Secretary of State North Carolina Secretary of State
C201106800396
APPLICATION FOR CERTIFICATE OF WITHDRAWAL
Pursuant to§55-15-20 or§55A-15-20 of the General Statutes of North Carolina,the undersigned corporation hereby applies to the
Secretary of State for a Certificate of Withdrawal and for that purpose submits the following statement.
The name of the foreign corporation is: Ross-Civello Development,Inc.
I. The corporation is organized under the laws of. Delaware
2. The corporation is not transacting business or conducting affairs in the State of North Carolina and surrenders its authority to transact
business or.conduct affairs in this State.
3. The corporation revokes the authority of its registered agent to accept service of process and consents that service of process in any
action or proceeding based upon any cause of action arising in the State of North Carolina,or arising out of business transacted or
affairs conducted in North Carolina,during the time the corporation was authorized to transact business or conduct affairs in North
Carolina may hereafter be made on such corporation by service thereof on the Secretary of State.
4. The mailing address to which the Secretary of State may mail a copy of any process served on the Secretary of State pursuant to the
paragraph above is:
C/O G.Johnson Rice Jr. President
Address 3220 Spring Forest Road
City,State,Zip Code Raleigh.North Carolina 27616
5. The corporation hereby agrees to file a statement of any subsequent change in its mailing address with the Secretary of State.
6. This application will be effective upon filing,unless a date and/or time is specified: (upon filing)
This the 19th day of April,2011.
Ross- Develo m t Inc.
Corporal n
Signature
G.Johnson Rice Jr. President
Type or Print Name and Title
NOTES
1. Filing fee is$25. This application must be filed with the Secretary of State.
CORPORATIONS DIVISION P.O.BOX 29622 RALEIGH,NC 27626-0622
(Revised October,2002) (Form BE-08)

SOSID: 0481903
Date Filed:6/8/2009 2:41:00 PM
CD-479 1) Business Corporation North Carolina Annual Elaine F.Marshall
10 2& North Carolina Secretary of State
This report may be filed online at the Secretary of State website: www. 2009 167 00472
Na Business Corporation: ROSS—CIVELLO DEVELOPMENT, INC.
Fiscal Year Ending: 12/31/08 State of Incorporation: DELAWARE
MonthlDayNear
Secretary of State ID Number: 481903
1 hereby certify that the information requested below (required by NCGS 55-I6-22)has not changed since the most recently filed annual
report and is therefore complete.
Nature of Business: REAL ESTATE LEASING
Registered Agent: G. JOHNSON RICE, JR.
Registered Office Mailing Address: 3220 SPRING FOREST ROAD
County: WAKE City: RALEIGH State: NC Zip Code: 27616
Registered Office Street Address: 3220 SPRING FOREST ROAD
County: WAKE City: RALEIGH State: NC Zip Code: 27616
Signature of New Registered Agent:
(Signature constitutes consent to the appointment)
Principal Office Telephone Number:
Principal Office Mailing Address: 3220 SPRING FOREST ROAD
City: RALEIGH State: NC Zip Code: 27616
Principal Office Street Address: 3220 SPRING FOREST ROAD
City: RALEIGH State: NC Zip Code: 27616
Name,Title, and Business Address of Principal Officers:
Name: G. JOHNSON RICE JR. Title: PRESIDENT
Address: 3220 SPRING FOREST ROAD
City: RALEIGH State: NC Zip: 27614
Name: ANTHONY N. CIVELLO Title: CHAIRMAN
Address: 3220 SPRING FOREST ROAD
City: RALEIGH State: NC Zip: 27616
Name: RALPH E. PETRI Title: SECRETARY
Address: 3220 SPRING FOREST ROAD
City: RALEIGH State: NC Zip: 27616
14
Certification ual report(Must mpleted by all Business Corporations).
�l)� l09
Signature(Form must be signed by an officer of corporation) Date
J NSON RICE, JR. 10
Type or Print Name Title
NCCZ0501L 1111910E

arreary�, E-Filed Annual Report
7885274
I , LIMITED LIABILITY COMPANY
€ +' Do not data enter manually.
ANNUAL REPORT
NAME OF LIMITED LIABILITY COMPANY: Southport Property,LLC
REPORT FOR THE YEAR:2014 STATE OF INCORPORATION: DE
SECRETARY OF STATE L.L.C.ID NUMBER: 0819638
NATURE OF BUSINESS: Rental Real Estate
REGIS'I ERED AGENT: National Registered Agents, Inc.
REGISTERED OFFICE MAILING ADDRESS: 211 Chews Manor Drive
Box 1011
Raleigh,NC 2 7602-1 011
REGISTERED OFFICE STREET ADDRESS: 211 Chews Manor Drive
Raleigh, NC 2 7602-1 011 Wake County
PRINCIPAL OFFICE TELEPHONE NUMBER: 410-643-1797
PRINCIPAL OFFICE MAILING ADDRESS: 211 Chews Manor Drive
Stevensville, AM 21666-3875
PRINCIPAL OFFICE STREET ADDRESS: 211 Chews Manor Drive
Stevensville, W 21666-3875
Company Officials:
Name. John F Clarke III
Title:Manager
Address:
211 Chews Manor Drive
Stevensville, AID 21666
CERTIFICATION OF ANNUAL,REPORT MUST BE COMPLETED BY ALL LIMITED LIABILITY COMPANIES
John F.Clarke III,by john f clarke iii-partner 3/8/2014
FORM MUST BE SIGNED BY A MANAGERA EMBER DATE
John F.Clarke 111,by john f clarke iii-partner Manager
TYPE OR PRINT NAME TYPE OR PRINT TITLE
ANNUAL REPORT FEE:E-Paid MAIL TO: Secretary of State•Corporations Division•Post Office Box 29525 •Raleigh,NC 27626-0525

�esanr�a E-Filed Annual Report-1-0-7885274
LIMITED LIABILITY COMPANY For year2008
Do not data enter• ' t '�� ANNUAL REPORTmanually.
NAME OF LIMITED LIABILITY COMPANY: Southport Property, LLC
STATE OF INCORPORATION: DE
SECRETARY OF STATE L.L.C.ID NUMBER: 0819638
NATURE OF BUSINESS: Rental Real Estate
REGISTERED AGENT: CT Corporation System
REGISTERED OFFICE MAILING ADDRESS: 225 Hillsborough Street
Raleigh,NC 27603
REGISTERED OFFICE STREET ADDRESS: 225 Hillsborough Street
Raleigh,NC 27603 Wake County
PRINCIPAL OFFICE TELEPHONE NUMBER: 410-643-1797
PRINCIPAL OFFICE MAILING ADDRESS: 211 Chews Manor Drive
Stevensville,MD 21666
PRINCIPAL OFFICE STREET ADDRESS: 211 Chews Manor Drive
Stevensville,MD 21666 -
MANAGERS/MEMBERS/ORGANIZERS:
Name:John F. Clarke III
Title:Manager
Address:
211 Chews Manor Drive
Stevensville,MD 21666
CERTIFICATION OF ANNUAL REPORT MUST BE COMPLETED BY ALL LIMITED LIABILITY COMPANIES
John F.Clarke III
Ol/21/2008
FORM MUST BE SIGNED BY A MANAGERIMEMBER DATE
John F. Clarke III Manager
TYPE OR PRINT NAME TYPE OR PRINT TITLE
ANNUAL REPORT FEE: $200 MAIL TO: Secretary of State•Corporations Division•Post Office Box 29525•Raleigh,NC 27626-0525

• I�DE�IR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H.Sullins Dee Freeman
Governor Director Secretary
March 9, 2009
Mr.Anthony Civello, Chairman and CEO
Ross-Civello Development, Inc. C j i t r k Z@ ke
2522 South Tri-Center Boulevard //n� J
Durham, NC 27713 1V1 l°I�S�{ LI
Subject Stornwater Permit No. SW8990940
Kerr Drugs-Southport
Brunswick County
Dear Mr.Civello:
The Division of Water Quality issued a Coastal Stormwater Management Permit, Number SW8990940 to Kerr Drugs-
Southport for a High Density project on December 16, 1999. This permit expires on December 16, 2009. Section .1003(h)
of 15 A NCAC 2H .1000(the stormweter rules)requires that applications for permit renewals shall be submitted 180 days
prior to the expiration of a permit and must be accompanied by a processing fee, which is currently set at$505.00. If this
is still an active project please complete and submit the enclosed renewal application in a timely manner. If this project
has not been constructed and a permit is no longer needed, please submit a request to have the permit rescinded. If you
have sold the project, or are no longer the pernittee, please provide the name, mailing address and phone number of the
person or entity that is now responsible for this permit. Enclosed is a form for change of ownership, which should be
completed and submitted if the property has changed hands.
Your permit requires that upon completion of construction and prior to operation of the permitted treatment units a
certification of completion be submitted to the Division from an appropriate designer for the system installed. This is to
certify that the permitted facility has been installed in accordance with the permit, the approved plans, specifications and
supporting documentation. Please include a copy of the certification with your permit renewal request and processing fee.
Enclosed is a copy of a sample certification. Also enclosed Is a new Operation and Maintenance agreement that should
he completed and submitted along with your renewal application.
You should be aware that failure to provide the Designer's Certification and the operation of a stornwater treatment
facility without a valid permit, are violations of NC General Statute 143-215.1 and may result in appropriate enforcement
action including the assessment of civil penalties of up to$10,000 per day.
If you have any questions, please feel free to contact David Cox at 910-796-7318.
S�jC'rn � U
Georgette Storntiirater Supervisor
Surface Water Protection Section
Wilmington Regional Office
Enclosures
cc: Wilmington Regional Office
127 Cardinal Drive Extension,Wlmirgton,NC 215405
PHONE:(910)796i72151EAK(M)35a2004 Ant �� n Equal Oppwtmiry t nfSm*A„cam'Employer - dV�[ Carolinatura!!

Kerr Drug Southport SW8 990940
Subject: Kerr Drug Southport SW8 990940
From: Angela Hammers <[e-mail]>
Date: Mon, 06 Apr 2009 11:14:12 -0400
To: [e-mail]
Hello Mr. Burke,
Thanks for your call this morning. Please find the links to the state stormwater
permit renewal application and transfer of ownership form below.
http://h2o.enr.state.nc.us/su/StateSWRenewalAP21icationSWU-102.Doc.Doc
http://h2o.enr.state.nc.us/su/documents/SWPermitownership-NameChange Form0808O8.pdf
The renewal package would include the application form, $505.00 renewal processing
fee, Sand Filters Operation & Maintenance Agreement signed/notarized by the Permittee
or verification that you have it from the original permit submittal, and a transfer
of ownership if the Permittee has changed from Mr. Anthony Civello or Ross-Civello
Development, Inc.
Please let me know if you have any questions.
Sincerely,
Angel Hammers
I of 1 4/6/2009 11:14 AM