SW1190801_Signed Paperwork_10/17/2019

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Project Name.
Project Location:
Leicester Volunteer Fire Department
1563 Alexander Road, Leicester NC
Caye"r Aa ;
Maintenance records shall be kept on the following BMP(s). This maintenance record shall be kept in a log in a known set location.
Any deficient BMP elements noted in the inspection will be corrected, repaired, or replaced Immediately. These deficiencies can
affect the integrity of structures, safety of the public, and the pollutant removal efficiency of the BMP(s).
The BMP(s) on this project Include (check all that apply & cc
Bioretention Cell
Quantity:
Dry Detention Basin
Quantity:
Grassed Swale
Quantity:
Green Roof
Quantity:
Infiltration Basin
Quantity:
Infiltration Trench
Quantity;
Level SpreaderNPS
Quantity:
Permeable Pavement
Quantity:
Proprietary System
Quantity:
Rainwater Harvesting
Quantity:
Sand Filter
Quantity:
Stormwater Wetland
Quantity:
Wet Detention Basin
Quantity:
Disconnected Impervious Area
Present:
User Defined BMP
Present:
ng O&M tab as will
Location(s);
Location(s):
Locat(on(s):
Locatlon(s):
Location(s):
Location(s);
Looation(s):
Location(s):
Location(s):
Location(s);
Location(s):
Location(s):
Location(s);
Location(s):
Location(s):
De aaaea
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed
for each BMP above, and attached O&M tables, I agree to notify NCDBNR of any problems with the system or prior to any
changes to the system or responsible party.
* Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Bmail:
rttaL
Signature: z, Date: b i u l�
I, ,yam, , �T?)h p7�,,., Pr�'6t-,r ds Notary Public for the State of ►'1L7�1`i Ir1 t 3.�[jLr'r�
County of YZ �G�Ljt_�� !.l C do hearby certify that T"fn4o,- d.1,)r-c- T. 60 cL Le Sle:Si J e-
personally appeared before me this day of Or" L31r�v�,--f_} 1 and
acknowledge the due execution of the Operations and Maintenance Agreement.
Witness my hand and official seal,
KAREN J NNSON PERIAR0
Notary Pu Ilc w North Carollne
Mc dwell County
My Commiss an Expires Apr 4, 2022
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STORMAEZ
Version 1.4
KAREN JOHNSON PERIARD
Notary Public - Nod Carolina
Mc DowtA County
My Commission Expfros Apr 4, 2022
O&M Manual
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. , >'� B'rr.orbtentlnn M�iritenarice: R,a u9�einents...;`
Important operation and maintenance procedures:
Immediately after the bloretentlon cell is established, the plants will be watered twice weekly if needed until the plants
become established (commonly six weeks).
Snow, mulch or any other material will NEVER be piled on the surface of the bloretention cell.
- Wheeled or tracked equipment will NEVER be driven overthe bloretention planting surface.
Special care will be taken to prevent sediment from entering the bloretention cell.
If standing water Is present 2 days after rainfall, conduct an infiltration test of the soil media,
After the bloretention cell Is established, inspect it quarterly. Inspection activities shall be performed as follows and maintenance
activites shall commence immediately to remediate any problems observed per the table below.
BMP element;
Potential problem:
How to remediate the problem;
The entire BMP
Trash/debris is present.
Remove the trashldebrls.
The perimeter of the BMP
Areas of bare soil and/or
Regrade the soil to remove the gully, and plant a ground cover and
erosive gullies have formed.
water until it is established. Provide lime and a one-time fertilizer
application.
Vegetation is too short or too
Maintain vegetation at a height of approximately six Inches.
long.
The Inlet device
The pipe Is clogged.
Unclog the pipe. Dispose of the sediment off -site.
The pipe is cracked or
Replace the pipe,
otherwise damaged.
Erosion is occurring in the
Regrade the Swale to smooth it over and provide erosion control
Swale.
devices such as reinforced turf matting or riprap to avoid future
problems.
Stone verge is clogged or
Remove sediment and replace with clean stone.
covered In sediment (if
applicable),
The pretreatment area
Flow is bypassing
Regrade If necessary to route all flow to the pretreatment area.
pretreatment area and/or
Restabilize the area after grading,
gullies have formed.
Sediment has accumulated to
Search for the source of the sediment and remedy the problem if
a depth greater than three
possible. Remove the sediment and restabilize the pretreatment area.
inches.
Erosion has occurred.
Provide additional erosion protection such as reinforced turf matting or
riprap if needed to prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by hand.
The bloretention cell:
Best professional practices
Prune according to best professional practices.
vegetation
show that pruning is needed
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the problem: soils, hydrology, disease, etc.
dying.
Remedy the problem and replace plants. Provide a one-time fertilizer
application to establish the ground cover if a soil test indicates it is
necessary.
Tree stakes/wires are present
Remove tree stake/wires (which can kill the tree if not removed).
six months after planting.
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131retort ott Maintenance Fie: 'sire exits:. cgnttnued
BMP element:
Potential problem:
Mow to remediate the problem:
The bioretention cell:
Mulch is breaking down or
Spot mulch if there are only random void areas. Replace whole mulch
soils and mulch
has floated away.
layer if necessary. Remove the remaining much and replace with
triple shredded hard wood mulch at a maximum depth of three inches.
Soils endlor mulch are
Determine the extent of the clogging - remove and replace slther just
clogged with sediment.
the top layers or the entire media as needed. Dispose of the spoil in
an appropriate off -site location. Use triple shredded hard wood mulch
at a maximum depth of three inches. Search for the source of the
sediment and remedy the problem if possible.
An annual soil test shows that
Dolomitic lime shall be applied as recommended per the soil test and
pH has dropped or heavy
toxic soils shall be removed, disposed of properly and replaced with
metals have accumulated in
new planting media.
the soil media.
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
(if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop Inlet. Dispose of the sediment off -site.
The drop inlet is damaged
repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the local NC Department of Environment and Natural
damage have occurred at the
Resources Regional Office.
outlet.
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t�P,Ivii.lt TjSF ONLY
Date Received
Fee Paid
Permit Number
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all tkat apply) ❑ Nora -Coastal SW- HQW/ORW Waters ❑ Universal Storinwater Management Plan
❑ Other WQ VI nit Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form majif be photocopied fir- Ilse as ara original
L GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment nine - should be consistent With project mine oil plans,
specifications, letters, operation and maintenance agreements, etc.):
Leicester Volunteer Tire Denartment
2. Location of Project (street address):
1563 Alexander Road
City:Leicester County:13u ncombe Zip:37660
3. Directions to project (front nearest major intersection):
Patton Ave. to New Leicester Highway, Riglit on Alexander I2d.
4. Latitude:35* 39' 29,6" N Longitude;82° 41' 35.9" W of the 11-tain entrance to the project.
if. PERMIT INFORMATION:
I. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
tRenmals witli modifications also requires 5iAU-102 - Reneu;al Applicatiou Fonn
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its Issue date (if known) and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's crn-tif cation
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 stoxmwater management permit application, list the stormwater project number,
If assigned, _ and the previous name of the project, if different than currently
proposed,
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: 4,68 ac of 0isturbed Area
❑NPDES Industrial Storinwaier ❑404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Penilit Number,
issue date and the type of each permit:
Is the project located within 5 nlites of a public airport? XNo ❑yes
If yes, see S.L. 2012-200, Part VI.• http://12ortal.ncdeiir.orgtweb/Ir/rules-and-regttlations
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III. CONTACT INFORMATION
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/ Or ganiz a tin:
Signing; Official & Title:
b. Contact information for person listed in item 1a above:
Street Address:2852 New Leicester Highway_
City: Leicester State: NC Zip:28748
Mailing Address (if applicable)TO BOX'100
City: Leicester
Phone: (828 ) 683-3433 Ext•.17
Fax: ( _ )
Entail: tgodleski©leicesterfire.coin
State: MC Zip:28748
Phone: [phone]
c. Please check the appropriate box. The applicant listed above W
®The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease ag;reentent and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a Logy of die pending sales agreement and complete Contact Information, itern 2a and
2b below)
❑ Developer* (Complete Contact Inforniadon, item 2a and 2b below.)
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 Ownei
Sighing Official
b. Contact information for person listed in item 2a above:
Street Address: f' `
city: Le �c-e a-4/- State: I!) c e- Zip:_ 8 2 +
Mailing Address (if applicable):_ .0 /, 100
_
City, _L e= i !L State: M e Cr Zip: b-
Phone: (� �.t) -?i�-3 Fax: ( 6 2-8 53 18 7 -7s
F �
3. a. (Optional) Print the name and title of another contact such as the projeces construction supervisor or other
person who can answer questionsabout the project:
Other Contact Person/O.rgartizatioti: 'ciiael Dposit'o. ADW Architects
Signing Official &
b. Contact information for person listed in item 3a above:
Mailing Address:2815 Coliseum Centre: Drive
City:Charlotte State:NC 4:28217
Phone: (704 ) 379-1919 Fax: { )
Email:ntesposito(MADWArchitects.cont _
4. Local jurisdiction for building permits: Buncombe County
Point of Contact:Lodtua Freeman Phone #: [phone]
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IV. PROJECT INFORMAXION
1. In the space provided bolow, h9gGy summarize how the storinwater runoff will be treated.
5tormwater runoff will be treated by a two separate bioretention basins.
2. a. If claiming vested tights, identify the supporting documents provided and the date they wore 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. Storinwa ter runoff from this project drains to the
4. Total Property Area:10.68 acres
River basin.
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*: '10.68 acres
+ Total project area sliall be calculated to exelude the folloroin t the rr0rrrral 001 of irrr ounded sh•uctrtres, the area
beiaveen the banks of streaurs and rivers, the area beloro the LI-Inal Hi h lImil rr (NM lure or Menu High Water
(11�iI�1>) Jirae, arrci coastal wetlarrris laudrvm d (ionl the NHGV (or MHV�j tills, T1re resttltaut project Wren is used to
calcr1late over rill per cent built ttporr ar ea (BZIA), Non -coastal wetlands landward of the NEW (or 1bI IM lime may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 14.68
9. How many drainage areas does the project have76 (Far high densih) , count 1 for each proposed engineered
storruronter BNIP. For loco density and other projects, Ilse 1 for- tilt, w7lole 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 146rniation
Drainage Area
1A
Drainage Area
1B
Drainage Area
2A :
Drainage Area .
213
Receiving Streaut Name
Sluder Branch
Sluder Branch
Newfound
Creels
Newfound
Creek
Stream Class *
C
C
C
C
Stream Index Number *
6-84-5
6-84-5
6-84
6-84
Total Drainage Area (sf)
194277,E
61149.5
110740.8
15681.6
Ott -site Drainage Area (st)
149432.3
61149.5
71988.9
15681.6
Off -site Drainage Area (sf)
44845.3
00
44741.9
_ 0
Proposed Impervious Area" (so
0
42253.2
47044.8
0
Impervious Area"*' (total)
0
__.-_._ 69
40
0
Itn ervious"w Surface Area . .
Drama e Area .;
Draina e Area .
Drainage Area _
Drainage Area
On -site Buildings/Lots (sf)
0
21183.5
3455.5
0
On -site Streets (sf)
0
8031.7
16586.3
0
Oil -site Parkin r (so
0
6156
10240
0
Chi -site Sidewalks (st)
0
0
1663
0
Other on -site (sf)
0
6882
0
0
Future (st)
0
0
0
0
Off -site (st)
0
0
15100.3
0
Existin BUA-* (A
0
0
0
0
Total (so:
0
47044.8
47044.8
0
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Basin h formatiok
Drainage Area :
3.
Dr4inage Area
4
Dra'inage Avea _
.Drainage Area.
Receiving Stream Name
Newfound
Creek
Newfound
Creek
Stream Class *
C
C
Stream Index Number *
6-84
6-84
Tohl Drainage Area (st)
27878.4
'117176.4
Oil -site Drainage Area (sf)
27878.4
114639.8
Off -site Drainage Area (sf)
0
2536.E
Proposed Impervious Area** (sf)
0
0
% Impervious Area" (total)
0
0
Inl erviou?* Surface Area
Drainage Area `
Drainage. Area
Drainage rea L
Drainage Area
On -site Bulldiilgs/Lots (sf)
0
0
Oil -site Streets (sf)
0
0
On -site .Parking (sf)
0
0
On -site Sidewalks (sf)
_
0
0
Other on -site (sf)
0
0
Future (sf)
0
0
Off -site (so
0
0
Existing BUA*** (sf)
0
0
"Total (so:
0
0
* Stream Class antf Irides Naniber cant be detenriirted a. httl�,(or tal.ruderrr.or reb/iv�s/csarlclassifrcations
hu]pervious areal is d( filled as the brulf upon ar'cn including, but rwt tiinited to, buildings, roads, parking area,
sidewalks, gr'arrel a1'L'([9, CtC.
*** Report only that armour of existing BUA that will reinain after development. Do riot report any cresting BUA that
is to be removed and which ruin be r6W)rrred by naw BUA. •
11. How was the off -site impervious area listed above determined? Provide documentation. isle off -site
htlpervious area was determined by iookings at arial photouaphy calculating the area of imperivous
surfaces. See attached storm water report for details.
PrDieCtS in Untolt Conn : Contact DENIER Cenlr'al Office stgff to check if the project is located within a Threatened &
Endangered Species watershed that nray be subject to utor a slrirrgerrt storurrr'atnr r'equfr eurerrts asper 15A NCAC 07B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state storniwater management permit supplement and operation and maintenance (O&M) forms
must be subrrtitted for each BMP specified for this project, The latest versions of the forms can be downloaded
from http.//port,it.acdenr.org/web/m cg/ws/su/bpilLniaiival.
VI. SUBMI` -fAL 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 SMP checklists are available from
http://i)ortal.ncdenr.org/web/wa/ws/su/statesw/forms_docs. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online n7ap atl-tt!p://portalncdenr.org/web/wq/ws/su/snaps.)
Please indicate that the followitig required information have been provided by initialing ill 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 fronthttp:/_docs.
Initials
1. Original read one ropy of the St'oriuwater Managemetit Permit Application Form.
2. Original and one copy of the sighed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VII below)
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3. Origitxil of (lie applicable Supplement Form(s) (sealed, sighed and dated) and O&M —
agmement(e) ,for each IMP.
4. Permit application processing fee of $505 payable to NCDENR (For an Express review, refer to _
ht('R:J Jwww,emvhelp.ordpageslonesLopGx x, p_ess l3tnil 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 mneeting.)
5. A detailed narrative (one to two pages) describing the storinwater treatment/nnanagement for
b. A USCS Wrap identifying the site location. If the receiving stream is reported as class SA or the
receiving strcain drains to class SA waters within 1/2 mule of the site boundary, include the tih
mile radius oun the Wrap.
7, Sealed, signed and dated calculations (one copy). --
& Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Developnment/Project naIim
b. Engineer and firim
c. Location snap 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 mid 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, iIUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished .floor elevations.
1. Details of roads, drainage features, collection systems, and stormnwater control measures.
in, 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.
ni. Existing drainage (including oft -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate doctuuent).
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 niap 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: Scltadtde a site uisif. for DEMLR to verifij the SHWT prior
to sttbitiittrti [phone].)
10. A copy of the most current property deed. Deed book: 4848 Page No.1277
11. For corporations and limited liability corporations (LLC): Provide docuunentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contactltiformation, item la, 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.
hUp: f /www.secretaiy.stale.tic.ns/CorporationsIQSearch.aspx,
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Vil. DEED RESTRICTIONS AND PROTUMVE COVENANT'S
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 corn leted and unot ized deed restriction foxinn. The appropriate deed
restrictions andprotective covenantsforms can be downloaded from htW:/h)ortal.ncdenr.or _webllr state-
storaiwater-forms_docs. Download the latest versions for each stubmittai.
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 theme, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMI.R, and that they will be recorded prior to the sale of any lot.
Vill. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firms (such as a
consulting engineer and/or firiu) so that they may provide information on your behalf for this project (Stich as
addressing requests for additional information),
Consulting Engineer:lacob Grieb, PE
Consulting Firm- Mattern & Craig
Mailing Address:403 E Market Street
City:lohnson City T State:TN Zip:37601
Plno;ie; (423 ) 979-2220 Fax: ( i
iaanail: jclgrielat�ntatteru7andcuaig.corn
IX. PROPERTY OWNER AUTI3ORIZATION (if'Contact Inforination, iterrr. 2 bas Ueen filledourt, rotnptete this
section)
1, (print or type dame of person listen in Contact Info"nation, itxni 20) certify that I
own the property identified in this pexinit application, anti thus give permission to (print or type dame of person
listen in Contact Infortnation, itc7n 1a) with (print ar type halm of augarcization lister! in
Contnet 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 stornnwater System,
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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 cornpliazice with. the DEVILR Storinwater permit reverts back
to ine, the property owner. As the property owner, it is my resportstbilityy to notify DhM1.lt iratuediately and
submit a completed Name/Ownership Change Form within 30 days; oflterwise I will be operating a storinwater
treatinent facility without a valid perinit. I understand that the operation of a storinwater treatment facility
without a valid perinit is a violation of NC General Statue 143-215.1 and inay result in appropriate enforcement
action including the assessment of civil peilakties of tip to $25,000 per day, pursuant to NCGS 143-215.6,
Date: i u l r~? ko J ft -
C� r�h r`rty O
a Notary Public for the State of n Coiuity of
YYtGDDL�aQ Cat- ,dohereby certify that T. 6-,QdLO" 'ersonallyappeared
before nze this day of _be-T-b and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official
KAREN JOHNSON PLtARD
Notary Public -- North Carolina
SEAL Me Dowell County
My Commission Expires Apr 4, 2D22
Ivly conunission expires /-4 4162,2' 4-
X. &PPI.ICr1,NT"'S CE..WfIFICATION
I, (print cr type naive of per —son lister! in Contact Inforrrrntiolr, itere In)
certify that the inforination included oil this peruitt application forin is, to the best of niy knowledge, correct and
that the project will be constructed in conformance With the approved plains, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicablestorinwater rules under 15A NCAC 2H .1000 and any other applicable state storinwater requirements.
Sigltahue:- - -� Dater ��% Z19Ll` ,
9LL � � h rti5t . d C.D county I, �CNotary Public for the State of rZDur-'��'l � C`cszutty of—
f do hereby certify that i h CO G'�Cr e a . 60 J LQ S i�I�e sonaliy appeared
before me this day of w D.CT7)) WW . 2�0A , and ackn wledge the mitre execution of the applicationfor
a storinwater pear t. Witness .my hand and official seal, ac� �.?^v ��i.[�r►
KAREN JOHN54N PERIARD
SEAL Me
Public- NDrih Carolina
Me Dowell County
My Commission Expires Apr 4, 2022
kly comnussion expires_ 4-14 l ZUL 2
Tonic SWU-101 Version Oct. 31, 2013 Page 7 of 7
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10-2-19
Michael A. Esposito, AIA
Principal
ADW Architects, p,a.
adwarchitects
environ€nentsforEife
architecture planning interiors
suite 500
281" Coliseum centre drive
charlotte, north carol€na zRz�7
t] 709.379•+939
Q 704379JIVO
www.a dwarch I t e cts.com
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dad.
LEICESTER VOLUNTEER FIRE DEPARTMENT, INC.
PU BOX 100
LEICESTER, NC 28748
//Cinrisloplier J Brown
Fire Chief
Leicester Volunteer lire Department
Leicester, NC 28748
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