SW3200302_Application_20200323

DEMLR USE ONLY
Date Received Fee Paid Permit Number
o 'ti — roitl I Q15 1 5W 320 0 302
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph 11- Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WO MQmt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT APPLICATION FO -�
This form may be photocopied for use as an original 3 020
1. GENERAL INFORMATION D r? LAND 00IJA IV
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
2. Location of Project (street address):
4401 Helms Road
City: Waxhaw County: Union Zip:28173
3. Directions to project (from nearest major intersection):
Traveling south west on Helms Road from the intersection of Helms Road and Waxhaw Marvin Road
the project is driectly on the left and a project entrance is the first left turn
4. Latitude:340 55' 30" N Longitude:80° 45' 40" 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 SWU-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 number , 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):
El 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, 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: 22.62 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
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:
5.
is the project located within 5 miles of a public airport? ®No ❑Yes
If yes, see S.L. 2012-200, Part W. bit-R:Ll2ortal.ncdenr.org/web/`lrlrules-and-regulations
Form SAU-101 Version Oct. 31, 2013 Pagel of6

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/ Organization: Broadstreet Homes
Signing Official & Title:Brian Iaenemma, manager
b. Contact information for person listed in item 1a above:
Street Address:1312 Came Creek Road
City:Lancaster State:SC Zip:29720
Mailing Address (if applicable):
City: State: Zip:
Phone: (704 ) 776-1079 Fax: ( )
Email:[e-mail]
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: Paula Buie Hamilton
Signing Official & Title:Paula Buie Hamilton property owner
b- Contact information for person listed in item 2a above:
Street Address:601 Evans Manor Dr
City:Matthews State:NC Zip:28104
Mailing Address (if applicable):
City: State:
Phone: (704 ) 321-2920 Fax:
Email:[e-mail]
Zip:
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:
Signing Official &
b. Contact information for person listed in item 3a above:
Mailing Add
City:
Phone: (
Email:
State:
Fax:
4. Local jurisdiction for building permits: Town of Waxhaw
Point of Contact:Dan Pruss Phone #: (704 ) 843.2195 ext. 255
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.
Most of the runoff from the site is directed to two splitter boxes In the water duality event
these splitter boxes direct flow to the proposed sand filters (SCM A and SCM B). The splitter
boxes direct any runoff exceeding the water quality volume to the enhanced pond for detention
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 Catawba River basin.
4. Total Property Area: 30 acres 5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: 1.58 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area+:28.42 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 Hi h Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or= 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 = 35
9. How many drainage areas does the project have?2 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 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
Draina e Area A
Drains e Area B
Drainage Area
Drainage Area
Receiving Stream Name
Rone Branch
Rone Branch
_
Stream Class *
C
C
Stream Index Number *
11-138-4
11-138-4
Total Drainage Area (so
509468
359354
On -site Drainage Area (sf)
459507
359354
Off -site Drainage Area (so
49961
0
Proposed Impervious Area**
s
223102
208145
Im ervious Area** total
44 %
58%
Impervious" Surface Area
Drainage Area A
Drainage Area B
Drainage Area
Drainage Area
On -site Buildings/Lots (so
_
On -site Streets (sf)
On -site Parking (sf)
On -site Sidewalks (so
Other on -site (so
203217
208145
Future (so
Off -site (so
19885
0
Existing BUA*** (sf)
Total (sf):
223102
208145
YTIM111 Ulass and index Number can ve determined at. littp://portal.ncdenr.org/web/wq/ps/csu/classi cations
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SUU-101 Version Oct. 31, 2013 Page 3 of

'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 B UA.
11. How was the off -site impervious area listed above determined? Provide documentation. Off -site impervious
area was measured from available survey and GIS information
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 htW://portal.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
http://portalmcdenr org web/ww /ws su statesw/forms does. 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 htt.p://12ortal.ncdenr.org/wehZ.w-q/­­"ws/­­"su/­­­`malLs.)
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.ncdenrorg/web/wq/ws/su/statesw/"forms does.
1. Original and one copy of the Stormwater Management Permit Application Form. Initials
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
httv://www.envhelp.org/12ages/onestopexpress.hhrd 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/management for
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 1/2 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.
Form SWU-101 Version Oct. 31, 2013 Page 4 of 6

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.
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 SHVVT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 1263 Page No: 811 _
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 21-1.1003(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.
ht!p://www.secretary.state.nc.us/Corl2orations/CSearch.ast)x
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://l2ortal.ncdenr.org/web/Ir/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 p otective covenants foicm while the applicant is responsible for ensuring
that the deed restrictions are recorded. W .tV Pktzz i i � a fl
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 Engineeraon Aldridge, PE
Consulting Firm: McAdams
Mailing Address:3430 Toringdon Way, Suite 110
City:Charlotte
Phone: (704 ) 527.0800
Email:[e-mail]
State: NC Zip:28277
Fax: (919 ) 361.2269
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) Paula Buie Hamilton . 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) Brian Iagnemma wit} (prinior e name of organization listed in
Contact� Information, item 1a) Broadstreet Homes to �i p ffie currently proposed.
Form SWU-101 Version Oct. 31, 2013 Page 5 of 6

.7iI�T jt=�.=-'..:�' r'�wl .a.. - =_^ ee• :.:d-r...rr. -.-_.: iii M � _..,.. -R_.IM--- E.... -. ....
Si tore: {��«� ITd yy Dater
1, Q.0 1 Notary Public f r the State of� Q Y �tYl�ounty of
do hereby certify that 4A' I& t 0, t personally appeared
before me this day of _OA0. boa and acknowledge the due execution of the pli tion for
a stormwater permit. Witness my hand and official sea C%
SEAL
i
My commission expires
X. APPLICANT'S CERTIFICATION
1, (print or type name of person listed in Contact Information, item 1a) Brian Iagnemma
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 stormwater rules under 15A NCAC 2H .1000 and any other applicable state stormwater
requirements,_. ,
Signature: Q • Date: Z" 2O-^ 2 n
/ J.,�1, a otary Public for the State of 50L4 t rxl �� n bounty of
LLh1� do hereby ce y that >C !1 y� Q M personally appeared
before me thist day of d and acknowledge the due executio t e applicat of n for
a stormwater permit. Witness my han and official seal
SEAL
My commission expir
Form SAU-101 Version Oct. 31, 2013 Page 6 of

DEMLR USE ONLY
Date Received Fee Paid Permit Number
'Applicable Kules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ MQmt 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 may be photocopied for use as an original
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.):
Belshire
2. Location of Project (street address):
4401 Helms Road
City: Waxhaw County: Union Zip:28173
3. Directions to project (from nearest major intersection):
Traveling south west on Helms Road from the intersection of Helms Road and Waxhaw Marvin Road.
the 12roject is driectly on the Ieft and a nro- entrance is the first left turn
4. Latitude:340 55' 30" N Longitude:80* 45' 40" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New
[]Modification ❑Renewal w/ Modifications
tRenewals with modifications also requires SWU-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 number its issue date (if known) . and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Com leted*
certification p provide a designer's
2. Specify the type of project (check one):
[]Low Density ®High Density ❑Drains to an Offsite Stormwater System y ❑Other
3. If this application is being submitted as the result of a previously returned application or a Ietter from
DEMLR requesting a state stormwater 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: 22.62 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
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:
5. Is the project located within 5 miles of a public airport?
If yes, see S.L. 2012-200, Part W. httn•NnorW ncdWr org/wehn*�n®end rues
Form SWU-101 Version Oct. 31, 2013 Pagel of6

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 proJecd:
Applicant/Organization: Broadstreet Homes
Signing Official & Title:Brian Iagnemma, manager
b. Contact information for person listed in item la above:
Street Address:1312 Camp Creek Road
City:Lancaster State:SC Zip:29720
Mailing Address (if applicable):
City:
Phone: (704 ) 776-1079
Email: [e-mail]
State: Zip:
Fax: ( 1
c. Please check the appropriate box. The applicant listed above is:
❑ 'rhe 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: Paula Buie Hamilton
Signing Official & Title: Paula Buie Hamilton property owner
b. Contact information for person listed in item 2a above:
Street Address:601 Evans Manor Dr
City.Matthews State:NC Zip:28104
Mailing Address (if applicable):
City: State: Zip:
Phone: [phone] Fax: )
Email:paulabhanvltOn®aol com
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:
Signing Official & Title:
b. Contact information for person listed in item 3a above:
Mailing Address:
City:
Phone: ( )
Email:
State: Zip:
Fax: ( 1
4. Local jurisdiction for building permits: Town of Waxhaw
Point of Contact:Dan PruSS Phone #: (904 ) 843 2195 ext 255
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.
Most of the runoff from the site is directed to two snlitter boxes In the water quality event
these splitter boxes direct flow to the nrovosed sand filters (SCM A and SCM B)The splitter
boxes direct any runoff exceeding the water quality volume to the enhanced pond for detention
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 Catawba River basin.
4. Total Property Area: 30 acres 5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: 1.58 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area-,:28.42 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 Woro the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHI9 line. 71e 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 = 35 %
9. How many drainage areas does the project have?2 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 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
Receivin Stream Name
Drains Area A
Rone Branch
Drains Area B
Rone Branch
Drains Area
Drains Area
Stream Class *
C
C
Stream Index Number *
11-138-4
11-138-4
Total Drainage Area (sf)
509468
359354
On -site Drains Area (sf)
459507
359354
Off -site Drainage Area (sf)
49961
0
Proposed Impervious Area**
s
223102
208145
% Impervious Area** total
44%
58%
Im ervious"" Surface Area
On -site Buildings/Lots (sf)
-D—rainage Area A
I —Drainage Area B
Drainage Area —
Drainage Area —
On -site Streets (sf)
On -site Parking (sf)
On -site Sidewalks (sf)
Other on -site (so
203217
208145
Future (sf)
Off -site (sf)
19885
0
Existing BUA*** (sf)
Total (sf):
223102
208145
v K,nw, cµ,, ,,c ucterTnineu ar: nrry/!?X?t?ai.)[Cde!lrrs►OUehfw �pS�CSfI%CIaS51JCRtiDt15
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version Oct. 31, 2013 Page 3 of

'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. Off -site impervious
area was measured from available survey and GIS information
Proieets 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 1 SA 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 ham://oortat.nedenr arg/web/wq/ws/su/bMgn nual.
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
htt : r qWe—ar-9-rZLweb/Kq/ws/su/ 4ftw ME 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 htty://portal ncd -nr.ore/web/wo/ws/cu /mane i
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
httn:/lyortal.ncdenr or lweb/wq/ws/su/statesw/forms does.
1. Original and one co Initials
gi 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) (Seated, 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
htlp://www envhetp org pages/onestopexpress hunt 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/management for
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 1/2 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 &J" 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.
Form SWU-101 Version Oct. 31, 2013 Page 4 of 6

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.
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).
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 verifij the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book:1263 Page No: 811
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 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.
httn:/'www.secrejM.state.nc.us/Corporations/CSearc, h.asp
x
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 hip_://portal ncdenr org/weht�r/State
stormwater-forms does. 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 p otective covenants fo m while the applicant is responsible for ensuring
that the deed restrictions are recorded. W Zd ava
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:Ion Aldridge. PE
Consulting Firm: McAdams
Mailing Address:3430 Toringdon Wav Suite 110
City:Charlotte State:NC Zip:28277
Phone: (704 ) 527 0800 Fax: (919 ) 361 2269
Email:aldridL,[e-mail]
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or hype name of person listed in Contact Information, item 2a) Paula Buie Hamilton 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) Brian igoemnta wit /(grin or name of organization listed in
Contact Information, item 1a) Broadstreet Homes to h currently proposed.
Form SWU-101 Version Oct. 31, 2013 Page 5 of 6

;.cf l�.r�_.-s. �._.+5�__ l ;•j HJ Y t a;�/.aE'ts'�.
Dater--/D�v2D
l' Notary Public f r the State oft ounty of
do hereby certi y that personally appeared
before me this day of - M=7-�and acknowledge the due execution of the pli 'on fo;
a stormwater permit. Witness my hand and official i
SEAL
My commission expires
X. APPLICANT'S CERTIFICATION
1, (print or type name of person listed in Contact Information, item 1a) Brian Iagnentma
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 stormwater rules under 15A NCAC 2H .1000 and any other applicable state stormwater
reouirempnft
�ZWWLure' .r+ • Date: 2! 24-- 2 a
1' a otary Public for the State ofSDLAelarollin
do hereby c that ounh' of
_ ___ personally appeared
before me thisi��ay of �d� and acknowledge the due eXecutio t application for
a stormwater permit. Witness my han and official seal i AL, o /i 1_
SEAL
My commission expiro ' �-!
Form SWU 101 Version Oct. 31, 2013 Page 6 of 6

North Carolina Secretary of State Search Results
Page 1 of 1
• File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online • Add Entity to My Email
Notification List • View Filings • Print a Pre -Populated Annual Report form • Print an Amended a Annual Report form
Business Corporation
Legal Name
Broadstreet Homes, Inc.
Information
Sosid: 1355491
Status: Current -Active
Date Formed: 1/8/2014
Citizenship: Domestic
Fiscal Month: December
Annual Report Due Date: April 15th
CurrentAnnuat Report Status:
Registered Agent: lagnemma, Brian M.,
Addresses
Mailing
1312 Camp Creek Road
Lancaster, SC 29720
Officers
President
Brian M lagnemma
9705 Agile Circle
Waxhaw NC 28173
Stock
Class: Common
Shares: 10000
No Par Value: Yes
Principal Office
1312 Camp Creek Road
Lancaster, SC 29720
Reg Office
9705 Agile Circle
Waxhaw, NC 28173
Reg Mailing
9705 Agile Circle
Waxhaw, NC 28173
https://www.sosnc.gov/online_services/searchBusiness_Registration_Results 4/3/2020