SW3200401_Application_20200408

'DEMLR USE ONLY
Date Received
Fee Paid
Permit Number
Applicable Rules: Coastal SW - 1995 Coastal SW - 2008 Ph Il - Post Construction
(select all that apply) Non -Coastal SW- HQW/ORW Waters Universal Stormwater Management Plan
Other WQM t 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. PrQ] ect Name (subdivision, facility, or establishment name -should be consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
Village at Granite Quarry - Phase 2
2. Location of Project (street address):
3040 Faith Road
City: Salisbury
County:
3. Directions to project (from nearest major intersection):
Zip:28146
the property IS located between exits 11 and /4 off 1-85 on the west Side of Faith Road (INCL)OI S.R.
1006)
4. Latitude:35 ° 36' 23.8896" N Longitude:80 ° 27' 53.6832" W of the main entrance to the project.
11. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ENew DModification Renewal w/ Modificationt tRenewals with
modifications also requires SWLI-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 / numberits issue date (if known) and the status of construction: ANot
Started UPartially Completed* Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑LowDensity Density al)rains to an Offsite Stormwater System AOther
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 propos
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):
C]CAMA Major C]Sedimentation/Erosion Control: ac of Disturbed Area
Form SWU-IOI Version Oct. 31, 2013 Page

[XNPDES Industrial Stormwater U404/401 Permit: Proposed
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?
Ifyes, see S.L. 2012-200, Part Vl'http://portal.ncdenr.org/web/Ir/rules-and-regulations
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111. 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:LGI
Signing Official & Title:Jeff Webb - VP of Land Dev
b. Contact information for person listed in item la above:
Street Address:3037 Sherman Drive
City:Lancaster
State:
LLC
Mailing Address (if applicable): Same
Above
City:
State:
Phone: )
[e-mail]
Zip:
Fax: ( ?
Homes
Zip:29720
as
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:LGI Homes NC LLC
Signing Official & Title: eff Webb
b. Contact information for person listed in item 2a above:
Street Address:3037 Sherman Drive
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City:Lancster
State: SC Zip:29720
Mailing Address (if applicable): Same
Above
City:
State: Zip:
Phone: (844 ) 566-4300 Fax: (.
(844
Email:
3. a. (Optional) Print the name and title of another contact such as the prQject'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:
State:
Phone:
Fax:
Email:
Zip:
4. Local jurisdiction for building permits: Town of Granite Quarry
Point of Contact: Steve Blount Phone #: [phone] ext 204
as
Iv.PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
The stormwater runoff is collected into storm driange systems that release into stormwater BMPs, one wet
pond and one sand filter
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 Il Post Construction
Form SWU-IOI Version Oct. 31, 2013 Page 3

3. Stormwater runoff from this project drains to the Yadkin -Pee
Dee River basin.
4. Total Property Area: 107.9 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 2.58 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area+:105.3 acres
+ Total project area shall be calculated to exclude the following: the normal 001 of impounded structures, the area
between the banks of streams and rivers, the area below the Normal Hi h ater (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NV-IW (or MH" line. The resultant project area is used
to date overall built (DI -IA). Novi cua6tal avethatA landa,tud (f MIW (o, Mfl W) line may be included in the total
project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 12.31
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 I Draina e Area 7 I Draina e Area 8 IDraina e Area Draina e Area
Receiving Stream Name
Stream Class
Stream Index Number
Crane Creek I Crane Creek
C C
12-115-(2) 12-115-(2)
Total Drainage Area (so
1,132,560
283,140
On -site Drainage Area (sf)
1,132,560
283,140
Off -site Drainage Area (sf)
0
0
Pro osed lm ervious Area S
487,001
101,930
% lm ervious Area total
43.00%
36.00%
Impervious" Surface Area
Drainage Area
7
Drainage Area
8
Drainage Area
Drainage Area
On -site Buildings/ Lots (sf)
303,890
69,115
On -site Streets (sf)
117,130
On -site Parking (SD
0
On -site Sidewalks (sf)
42,450
7,200
Other on -site (sf)
0
0
Future (sf)
0
0
Off -site (sf)
0
Existing (SD
Form S)NII-IOI Version Oct. 31, 2013 Page 4 of 9

Total (sf): 463,470 100,959
x Stream Class and Index Number can be determined at: h.IW://portal.ncdenr.org/web/wg//ps/csu/classifications
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Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
***Report only that amount of existing BLIA that will remain after development. Do not report any existing BLIA
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 ifthe project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 1514 NCAC 02B
.0600.
V. SUPPLEMENT AND 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://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://portal.ncdenr.org/web/wq/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
http://portal.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 packagefrornhttp://Mortal.ticdear.urg/web/wg/ws/su/slatesw/twins dues.
Initials
l . 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.htmI 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 '/2 mile of the site boundary, include the
i/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.
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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.
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.
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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"xl 1" 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 visitfor DEMLR to verify the SHI/VT prior to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 1297 Page No: 258
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.
http://www.secretaU state.nc. us / Corporations / CSearch.aspx
Vll. 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/Ir/statestormwater•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 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.
Vlll. 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:H V. N en PE
Consulting Firm: DPR
Mailing Address:420 Hawthorne
City: Char
State:NC Zip:28204
Phone: (704 ) 332-1204 Fax: (704 ) 332-121
Email:[e-mail]
IX. PROPERTY OWNER AUTHORIZATION (ifC0fltact Information, item 2 has been filled out, complete this section)
1, (print or type name of person listed in Contact Information, item 2a) e Webb - VP o Land Dev. certify that
I own the property identified in this permit application, and thus give permission to (print or type name
ofperson listed in Contact Information, item la) e Webb VP o Land Dev.
with (print or type name of organization listed in Contact Information, item la) LGI Homes NC LLC
to develop the project as currently proposed. A copy of the lease agreement or pending
SWU-IOI Version Oct. 31, 2013 Page 7 of 9

property sales contract has been provided with the submittal, which indicates the parry responsible for the
operation and maintenance of the stormwater system.
Form
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;
action mcivam wQ-gsessment or civu penalties or up to 4)/-,),uuu per aay, pursuant to iNuut) 14J-/t).b.
�.
Date: � , .✓ ... ,7
a Notary Public for the State of�''�®�rCounty of
5 do hereby certify that "1V is '° b _ personally appeared
before me this °"ih
day of /�?J "` 1, g & ftp'�3j'jafM
_ e- and acknowledge the due execution of for
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 includin t assessment of civil penalties of up to
$25,000 per day, pursuant to NCGS 143-215.6.
a stormwater permit. Witness my hand and official seal,
Iris C Jefferson
Notary Public
Mecklenburg County
North Carolina
M Commission Ex ires 12021
X. APPLICANT'S CERTIFICATION
SEAL
My commission expires
252.0
I, (print or type name ofperson listed in Contact Information, item la) [elf Webb - VP of Land Dev.
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 21-1 .1000 and any other applicable state
stormwater requirements.
SWU-IOI Version Oct. 31, 2013 Page 8 of 9

Date: 3 1`�
County of
1, jt# td, lj'L, 11
a Notary Public for the State of 71'4
61 ') 14 j 4'/"
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,
Iris C Jefferson
Notary Public
Mecklenburg County
North Carolina
M Commission Ex ires 12021
Form
SEAL
My commission expires
fj2
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