SW3170701 - SMG Leasing LLC

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ect all that apply) ❑ Non -Coastal SW- HQW/ORW Waters
❑ Other WQ Mgmt Plan:
- 2008 Ph H - Post Construction
❑ Universal Stormwater Management Plan
State of North Carolina
Department of Environment and Natural Resources RECEIVED
Division of Energy, Mineral and Land Resources JUL 112017
STORMWATER MANAGEMENT PERMIT APPLICATION 170MR-LAND QUALITY
This form may be photocopied for use as an original STORMWATER PERMITTING
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.):
A Proposed Facility for SMG Leasing, LLC
2. Location of Project (street address):
City:Statesville County:Iredell Zip:28625
3. Directions to project (from nearest major intersection):
North on Old Mocksville Rd from intersection of I-40 & Old Mocksville Road. Take first right onto Sherlock
Drive. New construction is adjacent to (the east of) the existing dermatology office.
4. Latitude:35° 49' 1.49" N Longitude:800 49'38.69" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
tRenewals with modifications also requires SWM -102 - Renewal Application Form
b. If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numbern/a , its issue date (if known) , and the status of
construction: ❑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
DEMLR requesting a state stormwater management permit application, list the stormwater project number,
if assigned, n/a and the previous name of the project, if different than currently
proposed, n/a
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):
❑CAMA Major
❑Sedimentation/Erosion Control:
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
ac of Disturbed Area
b. If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:Erosion control issued by Iredell County Development Services,
nroiect IREDE-2017-078 dated Mav 2.2017
5. Is the project located within 5 miles of a public airport? ®No ❑Yes
If yes, see S L. 2012-200, Part VP htW:Hl2ortal.ncdenr.org/web/lr/rules-and-regulations
Form SWU-101 Version Oct. 31, 2013 Page 1 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: SMG Leasing, LLC
Signing Official & Title:Lorraine Lambert, Office Manager
b. Contact information for person listed in item 1a above:
Street Address:129 Sherlock Dr
City:Statesville State:NC Zi -D:28625
Mailing Address (if
City:
Phone: ( 1
State: Zip:
Fax: ( 1
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 & Title:
b. Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if applicable):
City:_
Phone:
Email:
State:
State:
Fax: ( 1
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:Mark Tart, PE, G.L. Wilson Building Co. Inc
Signing Official & Title:Mark Tart. PE
b. Contact information for person listed in item 3a above:
Mailing Address:190 Wilson Park Rd
City:Statesville State:NC Zip:28625
Phone: [phone] Fax: .(704 ) 872-8281
Email:[e-mail]
4. Local jurisdiction for building permits: Iredell County
Point of Contact:Lynn Niblock Phone #: (704 ) 878-3124
Form SWU-101 Version Oct. 31, 2013 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Stormwater runoff from all new impervious areas will be conveyed through new dro inlets and new storm
water piping to the proposed underground detention/infiltration system.
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:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b. If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW —1995 ❑ Ph II — Post Construction
3. Stormwater runoff from this project drains to the Yadkin River basin.
4. Total Property Area: 5.3 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': 5.3 acres
+ Total project area 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 = 18.75 %
9. How many drainage areas does the project have?1 (For high density, count I for each proposed engineered
stormwater BMP. For low density and other projects, use I 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
UT to Beaver Ck
Stream Class *
C
Stream Index Number *
12-108-13-1
Total Drainage Area (sf)
79026
On-site Drainage Area (sf)
79026
Off-site Drainage Area (sf)
0
d Imervious Area** (sf)
EIm
43286
rvious Area** (total)
18.75
Impervious" Surface Area
Drainage Area 1 Drainage Area _ Drainage Area _ Drainage Area
On-site Buildings/Lots (sf)
0
On-site Streets (sf)
0
On-site Parking (so
0
On-site Sidewalks (so
0
Other on-site (sf)
0
Future (sf)
0
Off-site (sf)
0
Existing BUA*** (sf)
0
Total (sf):
* Stream Class and Index Number can be determined at: http://portal.ncdenr.org/web/wq/ps/csu/classifitcations
** Im ervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidpewalks, gravel areas, etc.
Form SWU-101 Version Oct. 31, 2013 Page 3 of 6

'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 15A 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://12ortal.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
htW://12ortal.ncdenr.org/web/­wq/ws/su/statesw/for-rns 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 hW2://12ortal.ncdenr.org/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 htW://portal.ncdenr.org/web/wq/ws/su/statesw/forms docs.
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
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http://www.envhelp.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/managementfor
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 1/z mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
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.
1. 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.
Form SWU-101 Version Oct. 31, 2013 Page 4 of 6

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).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
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"x11" 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 for DEMLR to verify the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 2158 Page No: 1131
11. 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 1a, 2a, and/or 3a per 15A 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.
htW://www.secretaiy.state.nc.us/CoLporations/CSearch.aspx
VII. 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://portal.ncdenr.org/web/lr/state-stormwater-
forms docs. 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 DEMLR, 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:Mark Tart. PE
Consulting Firm: G.L. Wilson Building Co. Inc
Mailing Address:190 Wilson Park Rd
City:Statesville
Phone: (704 ) 872-2441
Email:[e-mail]
State:NC Zip:28625
Fax: (704 ) 872-8281
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 1a) 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 Oct. 31, 2013 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 DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR 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.
Signature: Date:
I, , 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 expires
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 1a) ,COrrg,ne%
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 stowater rules under 15A NAC 2H.1000 and any other applicable state stormwater requirements.
0 f
Signa
Date: —7--1-17
/I a Notary Public for the State of /16 .z +d In t , County of
- T .�e�/ do hereby certify that Zaz-re, ne ,�o, k,,Z- personally appeared
before me this ,%tel day of 2o17 , and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires D �/y —/7
Form SWU-101 Version Oct. 31, 2013 Page 6 of 6

f f FIV
/� Mark Tart Statesville
NG L Willson Bu ding Co RECEIVE®
'I. JUL 112017
112017
SMG Properties
a DENR-LAND QUALITY Statesville, NC IREDELL Coun ORMW DENR-LAND QUALITY All�ja
ATER PERMITTING NC®EMR
-i
STORMWATER PERMITTING Mark Tart, P.E. , G.L. Wilson Building Co.
Application J
Type of application: New Permit
Only complete application packages will be accepted and reviewed. A complete package includes all of the items in the checklist
below. Add any comments, and indicate the page or plan sheet number where the following information can be found. Please
indicate that you have provided the following required information by initialing in the space provided next to each item.
Item
Part I: Submittal Checklist I
Notes / Comments Initials
1 Original and one copy of this application form (all worksheets) and the permit
attached
PSB
application fee For applications submitted to the DEMLR regular permitting
program, the fee is $505 payable to NCDENR For Express Review, click on the
link below for information and fee schedule Contact the appropriate regional
office Express Review Coordinator to schedule the required pre -application
meeting
Click here for Express Permitting info
2 A USGS map identifying the site location If the receiving stream is reported as
attached, Exhibit A
PSB
class SA or the receiving stream drains to and is within 1/2 mile of SA waters,
then include the 1/2 mile radius on the map.
3 A copy of the most current property deed
attached
PSB
4 Two copies of additional calculations (as needed) Sealed, signed and dated
attached
PSB
5 Two sets of sealed, signed, & dated full-sized plans of the entire site at a
PSB
readable scale, including
a Project name, engineer and firm, revision number and dates
sheet CO 1
PSB
b Location map with street names and SR numbers, legend, north arrow,
sheet CO 1
PSB
scale
c Dimensioned property/project boundary with bearings & distances
sheet CO 2
PSB
d The boundaries of all surface waters, regulatory flood zones, and protected
n/a
PSB
riparian buffers or a note on the plans that none exist
e. The boundaries of all vegetated or protected riparian buffers
n/a
PSB
f Site layout showing all built -upon areas, drainage features, stormwater
sheet C1 0 & C1 1
PSB
collection systems (inlets, outlets, swales, pipe elevations, slopes and
diameters), and SCMs at ultimate build -out
g Existing contours, proposed contours, spot elevations, and finished floor
sheet C2 0 & C2 1
PSB
elevations
h Existing drainage (including off-site), drainage easements, pipe sizes,
sheet C2 0 & C2 2
PSB
runoff calculations
i Drainage area boundaries (included in the main set of plans, not as a
SHEET ex -1 & ex -2
PSB
separate document)
/ Existing and proposed maintenance access routes, utility easements,
N/A
PSB
drainage easements, public rights-of-way etc
k A construction sequence that shows how the SCMs will be protected from
sheet c3 0
PSB
sediment until the entire drainage area is stabilized
6 Two sets of sealed, signed, & dated full-sized plan details of each SCM (or
sheet C2 0, C4 1, C4 2
PSB
typical if appropriate) in both plan view and cross-section at a scale of 1" = 30' or
larger, including
a Dimensions, side slopes, length to width ratios and elevations with a
n/a
PSB
benchmark for clean-out if appropriate
b All applicable conveyance devices, including bypass structure,
sheet C2 0, C4 1, C4 2
PSB
pretreatment area, flow distribution device, underdrains, outlet device, outlet
dissipater and level spreader
c A table of elevations, incremental volumes and accumulated volumes (if
page 17, calcs
PSB
applicable)
d Specifications for applicable materials, such as planting media, aggregate,
n/a
PSB
sod, underdrams, outlet devices, etc
STORM -EZ 7/7/2017
Version 14 Application Page 1 of 16

Statesville, NC IREDELL County
Mark Tart, P E , G L Wilson Budding Co
7 Two sealed, signed, & dated planting plans for each SCM (or typical) at a scale
n/a
PSB
of 1" = 20' or larger, as applicable, including:
a The locations of each species and a planting detail
n/a -
PSB
b A table summarizing the size, spacing and total quantity of each plant
n/a
PSB
species that should be used
c The source nursery for the plants
n/a
PSB
d A one-time fertilizer specification to establish plants if necessary
n/a
PSB
8 A sods report based on field evaluation indicating the SHWT elevations within
attached, Catawba Valley
PSB
the footprints of the proposed SCM(s). Provide a map of the boring locations
Engineering & Testing
with the existing elevations and boring logs For infiltration SCMs, the report
shall include the soil type, infiltration rate and method for determining the
infiltration rate Sods information shall be signed and sealed by a licensed soil
scientist
9 A copy of the signed and notarized operation and maintenance (O & M)
attached
PSB
agreement
10 A copy of the proposed deed restrictions protecting the SCMs and limiting the
n/a - future development not
PSB
built -upon area so that it does not exceed the capacity of the SCM(s) or the high
possible
density threshold (as applicable)
NCDENR Deed Restriction Forms
11 For corporations and limited liability corporations (LLC) Documentation from the
attached
PSB
NC Secretary of State or other official documentation, which supports the titles
-
and positions held by the persons listed in the Contact Information section 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
NC Dept of the Secretary of State
12 A copy of the lease agreement or pending sales agreement if applicable
n/a
PSB
STORM -EZ 7/7/2017
Version 14 Application Page 2 of 16

Statesville, NC IREDELL County
Mark Tart, P E , G L. Wilson Budding Co
Part II: General Project and Applicant Information
Project Name: SMG Properties Date: 9 -Feb -17
Project Street Address 208 Old Mocksville Road Lat 35*49'2" N
City. Statesville Zip 28625 Long- 80*49'39" W
Directions to Project 1-40 to Old Mocksvdle Rd (SR2206) North on SR2206 0 15 Mile, Right on County IREDELL
(from nearest intersection) Sherlock Drive NON -COASTAL
Project Applicant: JSMG Properties, LLC
(Identify the corporation, organization, property owner, designated
government official, etc. which owns the nrolect.)
Owner / Signing Offical's Name:
Title:
Address.
City
State
Zip
Phone
Fax
Email
Lorraine Lambert
Office Manager
142 Sherlock Drive
Statesville
NC
28625
704-924-4283
Lorraine Lambertiedmonthealthcare com
Status of applicant: Owner
River Basin Yadkin
Receiving Stream(s) UT to Beaver Creek
Stream Class(es) C
Surface Water Area (ac) 0 Coastal wetland area (ac) 0
Total property area (ac) 26 Total project area (ac)" 26
Goals/characteristics YES
Volume Matching (LID)
NO
Drains to an offsite stormwater system
NO
Low Density
NO
Within 575' of Saltwater ORW
YES
High Density
NO
Within 5 miles of a public airport
Briefly summarize how the
stormwater runoff will be treated
Part III: Permit Information
Status of construction I Partially Com feted
Other permits needed YES Sedimentation & erosion control NO 404 Permit/ 401 Certification
NO CAMA Major Permit NO Isolated Wetlands Permit
NO Threatened & Endangered Species NO NPDES Industrial Stormwater Permit
If an application for this project has been previously returned, provide the original project number and previous name of the project*
n/a
Provide the permit type, number and issue date for any permits that have already been obtained for this project
Erosion control approved through Iredell County, permit # IREDE-2017--078
If claiming vested rights, then identify (and attach) the supporting documents and approval dates:
aNO
]Other
Approval of a site-specific development plan or PUD Approval date
Valid building permit Issue date
Date
Not Started
Point of Contact Phone number
STORM -EZ 7/7/2017
Version 14 Application Page 3 of 16

Statesville, NC IREDELL County
Mark Tart, P E , G L Wilson Budding Co
I Part IV: Additional Contact Information !
(Optional) Additional Contact
Person / Orgmization
Signing Official & Title
Street address
City, State, Zip
Phone number(s)
Email
Mark Tart, PE/GL Wilson Budding Co, Inc
Mark Tart, PE / Engineering Director
190 Wilson Park Rd
Statesville, NC 28625
704-872-2411
MtartO)glwilson com
(Note: Person/Organization noted above may be contacted for additional project information if applicant
cannot be reached.)
I Part V: Consultant Information
Complete this section if you wish to designate authority to another individual or firm so that they may provide information on your
behalf for this project (such as addressing requests for additional information).
Consultant.
Firm
Street address.
City, State, Zip.
Phone number(s)-
Email.
Mark Tart, P E
G L Wilson Budding Co
190 Wilson Park Rd
Statesville, NC 28625
704-872-2411
mtart(&glwdson com
I, (the Owner & Applicant listed above),
Part VI: Property Owner / Applicant Certification 1
, certify that the information included
on this permit applicant 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 restnctusion and protective covenants will be recorded, and that the proposed project complies with the
requirements of the applicable state stormwater rules and requirements
Signatur Date. - -� - k -7
I, /^/�i!"l�i /�i fi �'i�SD/7 a Notary Public for the State of AI -A 64y 1'-6'1R
County of �zT=e -1-!/ do hearby certify that
personally appeared before me this of � -1
and acknowledge the due execution of t e a plication for a s,torm ter permit
Witness my hand and official seal,-� ...�
My commission expires 0 9-1d -/::z
Seal
STORM -EZ 7/7/2017
Version 14 Application Page 4 of 16

SMG Properties ����
Statesville, NC IREDELL County i
Yadkin River Basin NC®ENR
RAINFALL & CALCULATION DATA I
Project CountyIREDELL
Project City Statesville
Rainfall Source Hickory
Loaded Rainfall: Hickory
Design Storm: P90
Calculation Method Discrete SCS Method,
Pre - Post
(Minimum Design Storm = P90 for non -SA, 1 -yr, 24 -hr for SA)
Storm Event
Depth
(inches)
First Flush / WQV
1 00
P95
1 33
1 91
1 -yr, 24 -hr
2 98
2 -yr, 24 -hr
362
10 -yr, 24 -hr
535
25 -yr, 24 -hr
640
50 -yr, 24 -hr
723
100 -yr, 24 -hr
809
NOTE Please use the Storm -EZ calculation sheets to document the stormwater design
and create the O&M Agreement Highlighted Storm is Design Storm
i PROJECT INFORMATION
Total Property Area 530 acres
Total Coastal Wetlands Area 000 acres
Total Surface Water Area 000 acres
Complete the breakdown of impervious area for the project
Basin Information
Entire Site
Receiving Stream name
UT to Beaver Cr
Stream Class
C
Stream Index Number
12-108-13-1
Total Drainage Area
79,026
On -Site Drainage Area (so
79,026
Offsite Drainage Areas
0
Proposed Impervious Areas
43,286
% Impervious Area total
55%
Impervious Surface Area
Entire Site
On -Site Buildings/Lots (so
6,070
On -Site Streets (so
0
On -Site Parking (so
35,665
On -Site Sidewalks (so
1,551
Other On -Site s
0
Future (so
0
Off-site s
0
Existing BUA s
0
Total
43,286
Total Impervious Area q99 I acres
Project % impervious area 55%
ALL AREAS ARE IN SQUARE FEET
Use Worksheet Data? I No
STORM -EZ 7/7/2017
Version 1 4 Project Data Page 5 of 16

SMG Properties
a Statesville, NC IREDELL County ®P.'
Yadkin River Basin �/
Drainage Area # E:T:l of �1� NCDENR
PRE -DEVELOPMENT LAND USE CALCULATIONS
Pre -Development Land U,
Note Enter BUA Draining to
Permeable Pavement Below
User Defined Drainage
Existing Permeable Pavement (Infiltration):
SCM # Description
100
HSG
Soil Gravel Total Orifice Orifice
Pavement Area Additional BUA Infiltratio Gravel
n Rate Void Space Depth Dia Height
BUA %
Has Synthetic
Liner?
D S
BMP
(so (so (in/hr)
273
acres
Permeable Pavement + Additional BUA
0
000
acres
Green Roofs
0
000
Existing Green Roofs:
DSD PAW Dg,Area
DS SCM # Notes
SCM # Description (in) (%) (in) (sf) (acres)
1501 1 133 1 0 1 000
Pre -Development SCMs:
Land Use Summa .,
Area sf
Drainage Area
From Land Use Tables
118,919
273
acres
Permeable Pavement + Additional BUA
0
000
acres
Green Roofs
0
000
acres
Preserved Surface Waters & Non -Coastal Wetlands
0
000
acres
Preserved Coastal Wetlands
0
000
acres
Total Site Area,
118,919
273
acres
Green Roof ET =
000 acre -inches =
0
SCM #
20C
Design Storm Runoff Fate Summary.,
WQ Volume
Provided
Drainage Area
Rainfall Volume=
Im Oen
s s
Downstream
SCM Type
HSG
0 118919
SCM
•' No BMP '•
0
B
Disconnected Impervious Surfaces =
000 acne -inches =
Design Storm Runoff Fate Summary.,
Rainfall Volume=
363 acre -inches =
13,180
cf
Runoff Reduction Components:
Natural Infiltration & ET =
-363 acre -inches =
-13,190
cf
Disconnected Impervious Surfaces =
000 acne -inches =
0
cf
SCM Infiltration =
000 acre -inches =
o
cf
Permeable Pavement Infiltration =
000 acre -inches =
0
cf
Green Roof ET =
000 acre -inches =
0
cf
Post Filtration Discharge =
000 acre -inches =
0
cf
Total Runoff Reduction =
.363 acre -inches =
-13,180
cf
SCM Treatment.,
Treated SCM Outflow =
000 acre -inches =
0
cf
Untreated Surface Runoff=
0.00 acre -inches =
0
cf
The Pre -Development project area contains 0 sf of built upon area, resulting in an overall density of 0%.
STORM -EZ 7f1/2017
Version 14 Pre -Development Page 6 of 16

SMG Properties kA
a Statesville, NC IREDELL County �a+�;�
Yadkin River Basin NC®ENR
Drainage Area # 1 of 1
POST -DEVELOPMENT LAND USE CALCULATIONS
oarr„eat,i> aa�or.,onr•
SCM #
500
Area Retrofit? Downstream Comments
r__1 SCM #
Residential Lot CN Calculator Excluding R/W and dedicated o ens aces
Lot Area # of Lots Max Imp I Lot %Imp Woods I Lot Open Space I Lot Avg Lot Size
Land Excluded or Partially Excluded from Volume Calculations' sf ac
Surface Waters & Non -Coastal Wetlands 0 000
Coastal Wetlands 0 000
Total Site Area 118,919 273
V� Rainfall Volume=
363 acre -inches =
Total
Infiltration
Has Orifice Orifice
Down -
HSG
Pvmt Type
Pavement Area Additional BUA Rate Void Space Gravel
Depth
Synthetic Dia Height
Liner?
stream
Infiltration
Check
Detention
Check
0
cf
SCM
-117 acre -inches =
-4,257
(sf) (acres) (sf)
(acres) (in/hr) (%) (n)
(1n) (1, n)
0
cf
000
0 00
NO
cf
Post Filtration Discharge =
0 00 acre -inches =
Area Retrofit? Downstream Comments
r__1 SCM #
Residential Lot CN Calculator Excluding R/W and dedicated o ens aces
Lot Area # of Lots Max Imp I Lot %Imp Woods I Lot Open Space I Lot Avg Lot Size
Land Excluded or Partially Excluded from Volume Calculations' sf ac
Surface Waters & Non -Coastal Wetlands 0 000
Coastal Wetlands 0 000
Total Site Area 118,919 273
V� Rainfall Volume=
363 acre -inches =
13,180
cf
Runoff Reduction Components,
Natural Infiltration & ET =
-246 acre -inches =
-6,923
cf
Disconnected Impervious Surfaces =
000 acre -inches =
0
cf
SCM infiltration=
-117 acre -inches =
-4,257
cf
Permeable Pavement Infiltration =
000 acre -inches =
0
cf
Green Roof ET=
0 00 acre -inches =
0
cf
Post Filtration Discharge =
0 00 acre -inches =
0
cf
Total Runoff Reduction =
.363 acre -inches =
-13,180
cf
STORM -P2 717/2017
Version 1 4 Post Development Page 7 of 16

SMG Properties
• Statesville, NC IREDELL County MI -IMA
Yadkin River Basin NC®ENR
Drainage Area # 1 of 1
POST -DEVELOPMENT LAND USE CALCULATIONS
SCM Treatment.
Treated SCM Outflow= 000 acre -inches =
Untreated Surface Runoff=
o00 acre -inches =
0
cf
Pre-Develo ment Runoff =
0 00 acre -inches =
0
cf
Difference=
000 acre -inches =
0
cf
The Post -Development project area contains
45896 sf of built upon area, resulting
in an overall density
of 36 59%
STORM -F2 7/72017
Version 14 Post Development Page 8 of 16

SMG Properties
Statesville, NC IREDELL County �'t IA
Yadkin River Basin NCDENR
Drainage Area# 1 of 1
PROPOSED SIPS & STRUCTURAL RUNOFF VOLUME CONTROLS
Enter only runoff volume below that will be infiltrated or drawn down over 2 to 5 days. Additional volume provided In devices should not be entered in this worksheet.
Drawdown time requirement applies to all storm events
Ofte Impervious o sf
Area Treated
Storm Runoff Fate Summary
Rainfall Volume =
363 acre-ches =
Drainage
Total
Runoff Reduction Components
Post
Natural Infiltration & ET =
-246 acre -inches =
Impervlous Pervlous
%of Total
%of Total
Storage Down-
Arealnflow
Inflow
Infiltration &
Filtration
Treated
%of SCM
SCM
000 acre-mches =
s s
Impervlous
Perilous
Volume stream SCM
Volume
Volume
ET
Oumow
Outflow
Volume
0 Name I Location
TypeWDevice HSG
45,896 73,023
Area
Area
(e1) M
(c0
(pt)
(c0
(of)
(c0
Ufilhed
700 UG Chamber
Infirmton Oevxe B
45.89667,250
100_%
1 92%
3850
4257
4257
1 4257
0
0
79%
sfopen space entered
700%oftotal
92%offotal
000 a—ches =
0
Cf
45896 shmpemous area entered67250
compared to 73023 sf total
mil meus
pemous
wmpered to 45696 sftotaltmpeMous
open space
oma
area
Storm Runoff Fate Summary
Rainfall Volume =
363 acre-ches =
13,180
of
Runoff Reduction Components
Natural Infiltration & ET =
-246 acre -inches =
-8923
If
Disconnected Impervious Area =
000 acre-mches =
0
of
SCM Infiltration =
-1 17 acre -inches =
-4257
of
Permeable Pavement Infiltration =
000 acre-mches =
0
of
Green RoofET=
000 acre -inches =
0
of
Post Filtration Discharge =
000 acre+nches =
0
of
Total Runoff Reduction =
-363 acre4nches =
-13,180
of
SCM Treatment -
Treated SCM Outflow =
000 acre -inches =
0
of
Untreated Surface Runoff=
000 acre -Inches
0
of
Pre -Development Runoff=
000 acre -inches
0
of
Difference =
000 a—ches =
0
Cf
**VOLUME MATCHING ACHIEVED -
0 cf of runoff generated by pervious areas Net untreafed runoff = 0 of Net 100% of impervious area routed through SCMs
The Post -Development project area contains 45896 sf of built upon area, resulting in an overall density of 38 59%
Warnings
STORM -EZ 7172017
Version 1 4 Stormwater Controls Page 9 o116

STORM -EZ W72017
Verswn 14 Rainfall Fate Graph Page 10 of 16
SMG Properties
Statesville, NC IREDELL County
AFA
Yadkin River Basin
NCDENR
Drainage Area # 1 of t
�\
FATE OF RAINFALL
Select Storm.P90
BASIC TREATMENT SCALE
Compliance Storm = P90 Storm - Rainfall Death = 1 33 Inches
Basic Treatment Threshold
VOLUME MATCHING SCALE
P90 Storm - Rainfall Depth = 1 33 inches
1,
Volume Matching Threshold
FATE OF RAINFALL GRAPHS
Pre Development Fates
Post Development Fates
1I%1%
90%
l00% --
90%
80%
70%
_____
_____ _ ___
7016
E W%
r
° 40%
X
_
_ __ —_—__ __ _ _____
r
o
q0%
a
3096
—____
—_—_— — --
30% ---
20% _—
SO%_
infihration and BT-13180 If Treated O utOow from BMPs-0 If U ntreated Surface Ru noff-Od
Infiltration and Ef 13180d Treated—fl—from BMP,.Od Untreated Surface Runoff-0A
Post Nina— Outflow-0 If .Other
a Post Fdiratian Oudlaw-0 If aother
• Infiltratan by BMPs-Ocf •Permeable Pavement lnfiltratlon Oct
■ Infik.1knibyald -4157d • Permeable Pavement lnfikrauon -Od
•Diseom ted lniperv—Infiltration-0 If iGreen Roof Evapalranspbauon-0 If
.Dlseo—Id lm pervious Infiltration -Od ■ Green Roof Evapotran,pindlon-Od
•Infiltratwnand ET-13—d
•Infikration and IT N3 If
or RamfaR
charts display di, hydrologic processes to wh,ch remfali volumes are subjected based on i e ,mb,nab,m of land use sod type, end stormwater controls entered by the user The charts ere designed to display the
slormwater
jT1e`Fm1
plan
In a form which Illustrates changes to the hydrologic cycle which result from urbanlzabon and various stormwater management strategies
STORM -EZ W72017
Verswn 14 Rainfall Fate Graph Page 10 of 16

SMG Properties
Statesville, NC IREDELL County ��
Yadkin River Basin `'
Drainage Area # 1 of 1
NCDENR
ADDITIONAL CALCULATIONS
OF CONCENTRATION CALCULATIONS:
Pre -Development
Channel Flow
Channel Flow
Sheet Flow
Sheet Flow
Shallow Flow
Shallow Flow
Length (ft)
Slope (ft/ft)
Surtace Cover
Tt (hrs)
76'
005
Woods-
oods276
0 19
000
RVE NUMBER CALCULATIONS:
Dpment
Analysis Area = 2.73 Acres (0.004 sq. miles)
039
276
009-
Unpaved
0 02
P95
1 -Yr
I 2 -Yr
I 10 -Yr I
FlowArea
Length (ft) Slope (ft/ft) n -value (ftp) Wetted Perimeter (ft) T, (hrs)
293. 00.1 002 120 200 002
Pre -development T. = 13.11 min (Minimum 5minutes)
Post Development
Channel Flow
Channel Flow
Sheet Flow
Sheet Flow
Shallow Flow
Shallow Flow
Length (ft)
Slope (ft/ft)
Surface Cover
T, (hrs)
76
005
Woods
0 19
000
RVE NUMBER CALCULATIONS:
Dpment
Analysis Area = 2.73 Acres (0.004 sq. miles)
039
176
005769231
Paved
001
P95
1 -Yr
I 2 -Yr
I 10 -Yr I
ow rea
Length(ft) Slope (ft/ft) n -value (ftZ) Wetted Perimeter (ft) Tt (hrs)
393 001 002 120 200 002
Pre -Development
F.F.
Post -development Tc=
13.07
min
(Mmtmum 5 minutes)
Q* (m)
000
000
RVE NUMBER CALCULATIONS:
Dpment
Analysis Area = 2.73 Acres (0.004 sq. miles)
039
116
1 75
F.F.
P90
P95
1 -Yr
I 2 -Yr
I 10 -Yr I
25 -Yr I
50 -Yr I
100 -Yr
fall in =
1 00
133
191
298
1 362
1 535 1
640 1
723 1
809
=
000
000
001
019
039
116 1
175
227
285
idj
67
60
55
55
55
55
55
55
55
:)pment
386
458
qu (csm/hn)
26623
26623
26623
55311
55311
67465
67465
F.F.
P90
P95
1 -Yr
2 -Yr
10 -Yr
25 -Yr
50 -Yr
100 -Yr
fall m= 1
1 00
1 1 33 1
191 1
298
1 362
1 535 1
640 1
723 1
809
=
000
000 1
013 1
072
1 112
1 236 1
318 1
386 1
458
67
60 1
66 1
70
1 71
1 71 1
71 1
70 1
70
Pre -Development
F.F.
P90
Analysis Area = 2.73 Acres (0.004 sq. miles)
P95 1 -Yr 2 -Yr 10 -Yr 25 -Yr
50 -Yr
100 -Yr
Q* (m)
000
000
001
019
039
116
1 75
227
5
q„ (-m/In)
26596
26596
26596
26596
33688
55232
55232
55232
532
R
Q (cfs)
0.00
0.00
0.01 -
0.22
0.56
2.73
4.13
5.35
0
Post Development
Q" (in)
000
000
013
072
112
236
3.18
386
458
qu (csm/hn)
26623
26623
26623
55311
55311
67465
67465
67465
674 65
Q (cfs)
STORM -EZ 7/7/2017
Version 14 Peak Flow Calcs Page 11 of 16
0.00
0.00
0.15
1.69
2.65
6.79
9.15
11.10
13.17
N/A
N/A
1400.0%
6682%
1 376.1%
1484%
1215%
1 1073%
96.4%
STORM -EZ 7/7/2017
Version 14 Peak Flow Calcs Page 11 of 16

Note To decrease Post -development peak flows -increase storage volume being drawdown or infiltrated orlengthen post -
development time of concentration See LID HELP for more information
STORM -EZ 7/7/2017
Version 1 4 Peak Flow Calcs Page 12 of 16