HomeMy WebLinkAboutSW6200501_2020-04-30 NCDEQ Stormwater Submittal_5/7/2020Curl'
ENGINEERINGL
TRANSMITTAL FORM
TO: Michael Lawyer
Environmental Program Consultant
NCDEQ- Fayetteville Regional Office
Energy Mineral & Land Resources
225 Green Street, Suite 714
Fayetteville, NC 28301
910-433-3394
mike.lawyer@ ncdenr.g_ov
SUBJECT: Medlin Self -Storage
CURRY PROJECT NO: 2020-010
We are sending you the following items:
COPIES ITEM
2 Application
1 Check
1 Deed
2 Plans
1 Stormwater Calculations
1 Document
Forms
DATE: April 30, 2020
SENT BY: Ed Loeffler
DESCRIPTION
Stormwater Management Permit Application (one original & one copy)
Application Fee ($505.00)
Copy of Property Deed
Hard Copies of Plans (Dated 4/24/20201
Stormwater & EC Narrative
Secretary of State Documentation
Supplement Forms and 0&M Agreements
These are transmitted as checked below:
For Information Approved as Noted — Revise and Resubmit
As Requested — Not Approved — Revise and Resubmit
x For Review and Comments For Record and File
For Revision x Submittal
x For Approval For Recording
Approved — For Signature, then return to:
REMARKS:
T (9191 552-0849 205 S. Fuquay Avenue
F (919) 552-2043 Fuquay-Varina, NC 27526
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DEMLR USE ONLY
Date Received Fee Paid
Permit Number
Applicable Rules: ❑ 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 Mgmt 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.):
Medlin Self -Storage
2. Location of Project (street address):
NC 210
City:Angier County:Harnett Zip:27501
3. Directions to project (from nearest major intersection):
From intersection of NC-55 and NC-210, head southwest for 1.3 miles.
4. Latitude:35° 29' 46" N
II. PERMIT INFORMATION:
Longitude:780 45' 27.5" W of the main entrance to the project.
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
tRenezoals with modifications also requires SVVU-102 - Renezoal 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
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, 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
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: X.XX ac of Disturbed Area
0404/401 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:Sedimentation/Erosion Control through Fayetteville Regional Office
5. Is the project located within 5 miles of a public airport? ®No ❑Yes
If yes, see S.L. 2012-200, Part VI: littl2:j�2ortal.ncdenr.org/web/Ir/ruies-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 towns the project):
Applicant/Organization:DSM Investment Properties, LLC
Signing Official & Title:Sheri Medlin, Member
b. Contact information for person listed in item 1a above:
Street Address:802 Holland Road
City:Fuquay-Varina
Mailing Address (if applicable).802 Holland Road
State:NC
Zip:27526
City:Fuquay-Varina _ State:NC Zip:27526
Phone: (919 ) 201-3662 Fax:
Email:sherirmedlin@gmail.com
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/
Signing Official & Title:
b. Contact information for person listed in item 2a above:
Street Address_
City:
Mailing Address (if
City:
Phone: ( ]
State:
State:
Fax: ( )
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 & Title:
b. Contact information for person listed in item 3a above:
Mailing Address:
City:,
Phone:
4. Local jurisdiction for building permits: Town of Anti
State: Zip:
Fax:
Point of Contact:Sean Tohnson Phone #: 919
Form SWU-101 Version Oct. 31, 2013 Page 2 of 6
331-6702
IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Storm drainage will be collected via ditches and enclosed 12i2e system to 12rol2osed Wet Pond SCM.
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 Cape Fear River basin.
4. Total Property Area: 9.59 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+:9.59 acres
+ Total project area shall be calculated to exclude Lire following the normal pool of impounded structures, tlae area
beta;een the banks of streams and rivers, they area below the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal zvetlands Iawhoard front the NHW (or MHW) line. The resultalrt project area is used to
calculate ozrerall percent built upon area (B LIA). Nora -coastal zrreflatids lanrilzi,ard of the NHW (or MHWj Bite )mail
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 62.9 %
9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered
stormzater BMP. For lozv densihj and other projects, use 1 for the whole properhj 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 _
Drainage Area
Drainage Area _
Drainage Area _
Receiving Stream Name
Hector's Creek
Stream Class
WS-IV
Stream Index Number *
18-16-(0.7)
Total Drainage Area (sf)
372,439
On -site Drainage Area (sf)
372,439
Off -site Drainage Area (so
0
Proposed Impervious Area**((sf)
234,267
Impervious Area** total
62.9
Impervious' Surface Area
Drainage Area _
Drainage Area _
Drainage Area _
Drainage Area _
On -site Buildings/Lots (sf)
On -site Streets (sf)
On -site Parking (so
On -site Sidewalks (sf)
Other on -site (sf)
172,934
Future (sf)
61,333
Off -site (sf)
0
Existing BUA*** (so
0
Total (so,
234,267
* Stream Class and Index Number can be determined at: htol.4ortal.nrcdennorgAoehfifrr as�cstr/clrrss2frcatiorrs
* Irnt �cr ttiotrs area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
si euvalks, 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 ally 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. measured in CAD
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 httq://vortal.ncdenr.orLy/web/wa/ws/su/bmii-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
h ortal.ncdt,nr.or web w 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://portaLncdenr.org/ web/ wq/ ws/su/ maps.)
Please indicate that the following required information have been provided byinitialer 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 http:/ /portal.ncdennorg/web/wq/ws/su/statesw/forms_docs.
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 N A
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (seated, signed and dated), and O&M f/
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
ht4T)-/Zwww,envlielp.gKg/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/management
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.
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).
for
Form SWU-101 Version Oct. 31, 2013 Page 4 of
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"xll" 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, (910) 796-7378.)
10. A copy of the most current property deed. Deed book: 3789 Page No: 0468
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.
htt www.secretary.state.nc.us/Cori2orations/CSearch.as 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 httn://portal.iicdenr.orgjweb/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:Donald L. Curry,PE
Consulting Firm: The Curry Engineering Group, PLLC
Mailing Address:205 S. Fuquay Ave. _
City:Fuquay-Varina
State:NC
Phone: ( 919 ) 552-0849 Fax:
Em a il: don@curryeng. a m
Zip:27526
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) NIA , 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 la) 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 Tessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Date: L)- off /- 'zo?
0� nr
a Notary Public for the State of County of
�i do hereby certify that -S[T f i} 1�L personally appeared
before me this v� day of _�' i and acknowledge the due execution of the application for
a Stormwater ermit. Witness my hand and official sea 1,�.�, U.L� L
F.. .,,
SEAL
My commission expires ffi3w O Z3
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact hifornzation, items 1a) 5lrcri A110tilili ,
certify that the information included on this permit application form is, to the hest 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.
Date: `IL;2 2,2 J
I, L+ CrCL e , (t a Notary Public for the State of County of
�- C1 do hereby certify that 91
personally appeared
before me this (Zf day of dDr i�, and acknowledge the due execution o 7le
application for
a stormwat;,pemn3it,Witness my hand and official seal,
SEAL
My commission expires LAU
Form SWU-101 Version Oct. 31, 2013 Page 6 of 6
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rA ° NORTH CAROLINA
Department of the Secretary of State
To all whom these presents shall come, Greetings:
I, Elaine F. Marshall, Secretary of State of the State of North Carolina, do hereby certify
the following and hereto attached to be a true copy of
ARTICLES OF ORGANIZATION
OF
DSM INVESTMENT PROPERTIES, LLC
the original of which was filed in this office on the 24th day of January, 2020,
IN WITNESS WHEREOF, I have hereunto set my
hand and affixed my official seal at the City of
Raleigh, this 24th day of January, 2020.
NO
:n to verify online.
Certi6calion# C202001500507-1 Reference# C202001500507-I Page. 1 of 3 Secretary of State
Verify Ellis certificate online at http://www.smnc.gov/verification
SOSID: 1941214
Date Filed: 1/24/202012:27:00 PM
Elaine F. Marshall
State of North Carolina North Carolina Secretary of State
Department of the Secretary of State �_ _ ..__. C2020 015 00507
Limited Liability Company
ARTICLES OF ORGANIZATION
Pursuant to §5713-2-20 of the General Statutes of North Carolina, the undersigned does hereby submit these Articles
of Organization for the purpose of forming a limited liability company.
1. The name of the limited liability company is: DSM Investment Properties, LLC
(See Item lof the Instructions for appropriate entity designation)
2. The name and address of each person executing these articles of organization is as follows: (State whether each
person is executing these articles of organization in the capacity of a member, organizer or both by checking
all applicable boxes.) Note: This document trust be signed by all persons listed.
Name Business Address Capacity
Linda Funks Johnson P.O. Box 446, Fuquay Varina, NC 27528 []Member K Organizer
3.
The name of the initial registered agent is: Sheri R. Medlin
[]Member ❑Organizer
Member []Organizer
4. The street address and county of the initial registered agent office of the limited liability company is:
Number and Street 802 Holland Road
City Fuquay Varina
State: NC Zip Code: 27526 County: Wake
5. The maiiingaddress, if different from the street address, of the initial registered agent office is:
Number and Street P.O. Box 866
city Fuquay Varina State: NC Zip Code: 27526 County: Wake
6. Principal office information: (Select either a or b.)
a. ❑ The limited liability company has a principal office.
The principal office telephone number:
The street address and county of the principal office of the limited liability company is:
Number and Street:
City:
State: Zip Code: County:
BUSINESS REGISTRATION DIVISION P.O. BOX 29622
(Revised A ugust. 2017)
Certification# C202001500507-1 Reference# C202001500507- Page: 2 of 3
Raleigh, NC 27626-0622
Form L-01
The waif inP_ address, if different from the street address, of the principal office of the company is:
Number and Street:
City. State: Zip Code: County:
b. W1 The limited liability company does not have a principal office.'
7. Any other provisions which the limited liability company elects to include (e.g., the purpose of the entity) are
attached,
8. (Optional): Listing of Company Officials (See instructions on the importance of listing the company officials in the
creation document.
Name Title Business Address
Sheri R. Medlin Member P.O. Box 866, l=uquay Varina, NC 27526
Dennis Medlin Member P.O. Box 866, Fuquay Varina, NC 27526
9. (Optional): Please provide a business e-mail address:
The Secretary of 5tate's Office will e•maiI the business automatically at the address provided above at no cost when a
document is filed, The a -snail provided will not be viewable on the website. For more information on why this service is
offered, please see the instructions for this document.
10. These articles will be effective upon filing, unless a future date is specified:
This is the 14 day of January 2020
os stmam Pft"Jtkes, LLC
AW N4k qR�N
gnature
Linda Fw*e Johnson, Organizer
Type or Print Name and Title
The below space to be used if more than one organizer or member is listed in Item #2 above.
Signature
Type and Print Name and Title
gnature
Type and Print Name and Title
NOTE:
1. Filing fee is $125. This document must be filed with the Secretary of State.
BUSINESS REGISTRATION DMSION P.O. BOX 29622
(Revised August. 2017)
Raleigh, NC 27626-0622
Form L-01
Certification# C202001500507-1 Reference# C202001500507- Page: 3 of 3
B3789 - P 468
HARNETT COUNTY TAX ID #
040683 0206 11
040683 0206 10
03-05-2020 BY: SB
For Registration Kimberly S. Hargrove
Register of Deeds
Harnett County, NC
Electronically Recorded
2020 Mar 05 03:40 PM NO Rev Stamp: $ 650.00
Book: 3789 Page: 468 - 469 Fee: $ 26.00
Instrument Number: 2020003519
submitted electronically by "Newman & Newman Attorneys at Law"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Harnett county Register of Deeds.
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: $ 650.00
Parcel Identifier No. 0406.83 0206 11 & verified by County on the day of� 20,_,_
By: ONofo-b_i 0.2n40 I'n - —
Mail/Box to.-NelyMN 4& N Raleigh, NC 276QI
This instrurnent was prepared by:- Elizabeth Newman-Attom2y at Law._304 FastJones Street, Raleigh. NC_2760.1
Brief description for the index: LOT I & 2, Larry and Jackie Barnes
THIS DEED made this 5th day of March , 2020 , by and between
GRANTOR
Larry E. Barnes Jr. and wife,
Jackie B. Barnes
239 Millwood Lane
Angier, NC 27501
GRANTEE
DSM Investment Properties, LLC
Mailing: 802 Holland Rd,
Fuquay Varina, NC 27526
Property: N NC 210 Hwy
Angier, NC 27501
Ether in appropriate block for each Grantor and Grantee: name, mailing address, and, if appropriate, character of entity, e.g.
corporation or partnership.
The designation Grantor and Grantee as used herein shall include said parties. tbeirheirs, successors, and assigns, and shall include singular,
plural, masculine. feminine or neuter as re4uired by context.
W 1TNBSSETH. that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged., has and by
these presents does grant, bargain, sell and convey unto the Grantee in fee simple. all that certain lot, parcel of land or condominium unit
situated in the City of _- FIrouay Narirgt __ Township, County,
North Carolina and more particularly described as follows:
BEING all of Lot Nos. 1, containing 3.336, more or less, and Lot 2, containing 6.253 acres, more or less, as shown on map
of survey entitled, "Boundary Survey for Larry E. Barnes, Jr. and Jackie B. Barnes" dated February 17, 2020, drawn by
Mauldin -Watkins Surveying, PA, and recorded in Map Book 2020, Page 63, Harnett County Registry, reference to which is
hereby made for greater certainty of description.
The property hereimbuve described was acquired by Grantor by instrument recorded in Book 2421_ page 652&655
All or a portion of the property herein conveyed X includes or _,_,_ does not include the primary residence of a Grantor.
A map showing the above described property is recorded in Plat Book 2020 page 63
Page t of 2
NC Bar Association form No. 3 9 1976. Revised Sl 1977, 2102, 2013 This rwndard form has been eftmved by:
Primed by Agreement with the NC Our Association —1991 North Carolina Dar Mwiaturn —1\C Bar Farm No, 3
B3789 - P 469
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in fee
simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in fee
simple. that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the lawful
claims of all persons whomsoever, other than the following exceptions:
Subject to Restrictions, Easements and Rights -of -way of record.
Subject to the 2020 ad valorem taxes not yet due and payable.
IN WITNESS WHCREOI the Grantor has duly executed the foregoing as of the day and'lear fi re written.
SL'AL i
(Lenity,Name) ifI'ype Naine: Larry E. Barnes Jr.
E y l
Printll'ype Marne 'I isle: - e r'f AR y''' � PrindTJpe Name: Jackie R_ Rnrnca
Bv-
Printlfype Naine & Title:
By:
Printfl'ype Name & Title:
PUB
(SEAL)
Print/Type Name:^ T
PrintClype Name:
State of North Carolina — - County or City of Wake
1. the undersigned Notary Public of the County or City of Wake and State aforesaid, certify that
Larry E. Barnes Jr. and Jackie B. Barnes personally appeared before me this day and acknowledged the due
execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial stamp or seal this Sth day of
March .20 20
My Commission Expires: September 14, 2023 Elizabeth Newman Notary Public
(Affix Seal) No(an-'s Printed or Typed Nalnc
State of North 'ar_ olina - County or City of _ Wake__ _ _ _ _ _
I, the undersigned Notary Public of the County or City of Wake and State aforesaid, certify that
personally appeared before me this day and acknowledged the due
execution of the foregoing instrument for the purposes therein expressed. Witness my hand and Notarial Stamp or Seal this Sth day of
2U_
My Commission Expires: September 14. 2023
(Affix Seal)
Elizabeth Nek3man Notary Public
Notan's Printed or Typed Name
State of - County or City of
I. the undersigned Notary Public of the County or City of and State aforesaid, certify that
personally came before me this day and acknowledged that
_he is the of a North Carolina or
corporation/limited liability company/general partnership/limited partnership (strike through the
inapplicable), and that by authority duly given and as the act of such entity, _he signed the foregoing instrument it) its name on its
behalf as its act and deed. Witness my hand and Notarial stamp or seal, this day of , 20T.
My Commission Expires:
(Affix Seal)
Notary's Printed or Typed Name
Notary Public
Page 2(if 2
N(' Bar Associatiom form No. 3 Q) 1976, Revised @) 1977. 2002. 2013 This uandard form has heen approved by:
Primed by Agreement with the N(: Bar Association — 1981 Minh Camline Bar Association -- NC Bar form No. 3
Uperatlon & maintenance Agreement
Project Name:
Project Location:
Medlin Self -Storage
NC-210, Angier, NC
Cover Page
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 & c(
Bioretention Cell
Quantity:
Dry Detention Basin
Quantity:
Grassed Swale
Quantity:
Green Roof
Quantity:
Infiltration Basin
Quantity:
Infiltration Trench
Quantity:
Level SpreaderNFS
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 tables will
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
be aatlea automatica
I northwest corner of Drooertv 1
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 NCDENR of any problems with the system or prior to any
changes to the system or responsible party.
Signature:.
* Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Email:
DSM Investement Properties, LLC -Sheri Medlin
Manager
802 Holland Road
Fuquay-Varina, NC 27526
919-201-3662
sherirmedlin@gmail.com
_ Date: _
I, �� { f Q C y a Notary Public for the State of
County of do hearby certify that �jL /�'yIr
personally appeared before me this day of�and
acknowledge the due execution of the Operations and Maintenan e A`grre'jem nt .
Witness my li ii� aj�}�(1jd-official seal,
a=
_ _7.�
Seal My commission expires
rnonn C7 AMniw
Wet Detention Pond Maintenance Requirements
The wet detention basin system is defined as the wet detention basin, pretreatment including forebays and the vegetated filter if
one is provided.
Important maintenance procedures:
Immediately after the wet detention basin is established, the plants on the vegetated shelf and perimeter of the
basin should be watered twice weekly if needed, until the plants become established (commonly six weeks).
No portion of the wet detention pond should be fertilized after the first initial fertilization that is required to
establish the plants on the vegetated shelf.
Stable groundcover should be maintained in the drainage area to reduce the sediment load to the wet detention
basin.
If the basin must be drained for an emergency or to perform maintenance, the flushing of sediment through the
emergency drain should be minimized to the maximum extent practical.
- Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected once a month and within 24 hours after every storm event
greater than 1.0 inches (or 1.5 inches if in a Coastal County). Records of operation and maintenance should be kept in a
known set location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired immediately
BMP element:
Potential problem:
How I will remediate the problem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the BMP
Areas of bare soil and/or
Regrade the soil if necessary to remove the gully, and then plant a
erosive gullies have formed.
ground cover and 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 if necessary to smooth it over and provide erosion
swale.
control devices such as reinforced turf matting or riprap to avoid future
problems with erosion.
Stone verge is clogged or
Remove sediment and replace with clean stone
covered in sediment (if
applicable).
The forebay
Sediment has accumulated to
Search for the source of the sediment and remedy the problem if
a depth greater than the
possible. Remove the sediment and dispose of it in a location where
original design depth for
it will not cause impacts to streams or the BMP.
sediment storage.
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. If pesticide is used, wipe it
on the plants rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional practices
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.
Weeds are present.
Remove the weeds, preferably by hand. If pesticide is used, wipe it
on the plants rather than spraying.
rnonn_G7 a1'2n10f
Wet Detention Pond Maintenance Requirements Continued
The main treatment area
Sediment has accumulated to
Search for the source of the sediment and remedy the problem if
a depth greater than the
possible. Remove the sediment and dispose of it in a location where
original design sediment
it will not cause impacts to streams or the BMP.
storage depth.
Algal growth covers over 50%
Consult a professional to remove and control the algal growth.
of the area.
Cattails, phragmites or other
Remove the plants by wiping them with pesticide (do not spray).
invasive plants cover 50% of
the basin surface.
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and consult a professional to remove
beaver activity is present.
beavers.
A tree has started to grow on
Consult a dam safety specialist to remove the tree.
the embankment.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair. (if applicable)
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
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.
The measuring device used to determine the sediment elevation shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
rnPM-P:7 dizn19r
Wet Detention Pond Design Summary
WET POND ID FOREBAY MAIN POND
Permanent Pool El. 308 Permanent Pool El. 308
Temporary Pool El: 309.25 Temporary Pool El: 309 25
Pretreatment other No Clean Out Depth: 2 Clean Out Depth: ! 4
than forebay? Sediment Removal El: 306 Sediment Removal El. 304
Has Veg. Filter? No Bottom Elevation: 305 Bottom Elevation: 303
WET POND ID FOREBAY MAIN POND
Permanent Pool El. Permanent Pool El.
Temporary Pool El: Temporary Pool El:
Pretreatment other Clean Out Depth: 0 Clean Out Depth: 0
than forebay?El Sediment Removal El Sediment Removal El:
Has Veg. Filter? Bottom Elevation: Bottom Elevation:
Tr)PU-F7 diznnr
SUPPLEMENT-EZ COVER PAGE
FORMS LOADED
PROJECT INFORMATION
1 Project Name
2 1 Project Area (ac)
4 1 Surface Water Area ac
5 Is this project High or Low Density?
6 Does this project use an off -site SCM?
Medlin Self Storage
9.59
0
0
No
COMPLIANCE WITH 02H.1003(4).
7 1 Width of vegetated setbacks 2rovided (feet) 15
B lWill the vegetated setback remain vegetated? Yes
9 _ Is BUA other that as listed in .1 003(4)(c-d) out of the setback? Yes
10 Is streambank stabilization proposed on this project? No
NUMBER AND TYPE OF SCMS:--
11
Infiltration System
0
12
Bioretention Cell
0
13
Wet Pond
1
14
Stormwater Wetland
0
15
Permeable Pavement
0
16
Sand Filter
0
17
Rainwater Harvesting RWH)
0
18
Green Roof
0
19
Level S reader -Filter Strip LS-FS)
0
20
Disconnected Impervious Surface DIS)
0
21
Treatment Swale
0
22
D Pond
0
23
Storm Filter
Silva Cell
Ba Alter
0
0
_ 0
24
25
26
Filterra
0
FORMS LOADED
DESIGNER CERTIFICATION
27 Name and Title:
28 Organization:
29 Street address:
Phone
Email:
_Andrew S Petty - VP /Senior E
CL7Iy Engineering Group, P
205 S. Fuauav Avenue
NC 27526
andy@curyeng.com
Certification Statement:
I certify, under penalty of law that this Supplement-Fl form and all supporting information were prepared under my direction or
supervision; that the information provided in the forth is, to the best of my knowledge and belief, true, accurate, and complete; and that
the engineering plans, specifications, operation and maintenance agreements and other supporting information are consistent with the
information provided here.
3-
_- , a SEAL'
36823 - -
IS
Sign to of Des gn r
4)/,mm
DRAINAGE AREAS
1 Is this a hi h density ra ect7 Yes
2 If so, number ofdrainage areas/SCMs 1
Is all/part of this project subject to previous rule
3 versions? t No
FORMS LOADED
DRAINAGE AREA INFORMATION
Entire Site
1
4
Type of SCM
Wet Detention
Basin
5
Total BUA in project (sq ft
234353 sf
6(sq
New BUA on subdivided lots (subject to permitting)
ft
sf
7permitting)
New BUA outside of subdivided lots (subject to
s
sf
8
Offsite - total area (sq ft
sf
9
Offsite BUA (sq ft
sf
10
i
Breakdown of new BUA outside subdivided lots:
Parking (sq ft
172933 sf
Sidewalk (sq ft
Roof (sq ft
Roadway s ft
j Future (sq ft
' - Other, please specify in the comment box
below (sq ft
61420 sf
11
New infiltrating permeable pavement on
subdivided lots (sq ft])
New infiltrating permeable pavement outside of
subdivided lots (sq ft)
sf
12
sf
13
Exisitng BUA that will remain (not subject to
ermittin!g) (sq ft
sf
14
Existing BUA that is already permitted (sq ft
sf
15
Existing BUA that will be removed (sq ft
sf_
16
Percent BUA
63%
17
Design storm (inches)
1 in
18 i
Design volume of SCM (cu ft)
19122 cf
19 Calculation method for design volume Average Depth
,ADDITIONAL INFORMATION
Please use this space to provide any additional information about the
20 drainage area(s):
Drainage area includes BUA allocation for future development
IDRAINAGE AREA INFORMATION Entire Site
7
4
Type of SCM N/A
5
Total BUA from project (sq ft)
6
j 1995 rules
SL 2006-246
2008 rules
2017 rules
7
New BUA on subdivided lots (subject to
permitting) (sq ft)
1995 rules
SL 2006-246
2008 rules
2017 rules
8
New BUA outside of subdivided lots (subject to
permitting) (sf)
1995 rules
SL 2006-246
_
2008 rules
2017 rules
9
Offsite -total area (sq_ft)
f 1995 rules
SL 2006-246
2008 rules
2017 rules
10
Offsite BUA (sq ft)
1995 rules
SL 2006-246
2008 rules
2017 rules
11
Design storm (inches)
1995 rules
SL 2006-246
2008 rules
2017 rules
12
Breakdown of new BUA:
Parking (sq ft
Sidewalk (sq ft
[
I
Roof (sq ft
Roadway (sq ft)
- Futures ft
Other, please specify in the comment box
below (sq ft
New infiltrating permeable pavement on
13 subdivided lots (sq ft)
New infiltrating permeable pavement outside of
14 subdivided lots (sic ft)
15permitting)
Exisitng BUA that will remain (not subject to
s ft
16
Existing BUA that is already permitted (sq. ft
17
Existing BUA that will be removed (sq ft
18
Percent BUA
19
Design volume of SCM cu
20 I
Calculation method for design volume
ADDITIONAL INFORMATION
Please use this space to provide any additional
21 information about the drainage area(s):
WET POND
1 Drainage area number
2� Design volume of SCM (cu fl)
_ 19122 cf
GENEliAL1NDCt7tFMIF102H J= _
31 Is the SCM sized to treat the SW from all surfaces at build -out?
Ye6_
4 Is the SCM located away from contaminated soils?
Yes
5 What are the side slopes Of the WC (H:V)?
3:1
Does the SCM have retaining walls, gabion walls or other engineered
6 side slopes?
No
,Are the inlets, outlets, and receiving stream protected from erosion i
7; (10-year storm)?
Yes
Is there an overflow or bypass for inflow volume in excess of the
8Ydesign volume?
Yes
9
What is the method for dewatering the SCM for maintenance?
Pump (preferred)
10
Wappllcablp, wIA the § hOtkatied out aRsr consirtieli in7
Yes
11
Does the maintenance access.cvmply with Genera! MDC (8)?
Yes
12
Hoes.thedrainage easement comply wilhGeneral MOC (9)?
_
-Yes
If the SCM is on a single family lot, does (will?) the plat comply with
13
General MDC (10)?
14
Is there an O&M Agreement that complies with General MDC (11)?
Yes
15 Is there an C&M PIsM that complies with General MDC- (12)?
Yea
161Dues the SCM follow the devic- speyriC MDC7
Yes
171 Was the SCM designed by an NC licensed professional?
Yes
WET POND MDC FROM 0214-AM
181
Method used
SA/DA
f 19
Has a.stagelstarage table been prdvlded In the cakvietions?
Yes
20.
Elevation of the excavated main pool depth (bottom of sediment
removal) (fmsl)
303.00
21. Elevation of the main pool bottom -(top of sediment removal) (fmsl)
304.00
Elevation of the bottom of the vegetated shelf (fmsl)
307.50
23
Elevation of the permanent pool (fmsl)
308.00
24
Elevation of the top of the vegetated shelf (fmsl)
308.50
25
Elevation of the temporary pool (fmsl)
309.25
26
ce area of the main permanent pool' (square feet)
9953:1
27
Volume of the main permanent pool (cubic feet)
30408 Cf
28
Rverage th of the main pool (feet)
3:57 ft
29
Average depth equation used
Equation 2
30
If using equation 3, main pool perimeter (feet)
504.0 ft
31
If using equation 3, width of submerged veg. shelf (feet)
32
Volume of the forebay (cubic feet)
5854 cf
3311s
this 15-20°Ic of the volume in the main pool?
Yes
34(
Clean-out depth for forebay (inches)
24 in
35
Design volume of SCM (cu ft)
19343 cf
361
Is the outlet an orifice or a weir?
Oriftce
371
If orifice, orifice diameter (inches)
2 in
381
If weir, weir height (inches)
3§1
If weir, weir length (inches)
401
Drawdown time for the temporary. orary pool (days)
3.3
41
Are the inlet(s) and outlet located in a manner that avoids short-
circuiting?
Yes
42
Are berms or baffles provided to improve the flow path?
Yes
43
Depth of forebay at entrance (inches)
361n
44
Depth of forebay at exit (inches)
24 in
451
Does water flow out of the forebay in a non -erosive manner?
Yes
46i
Width of the vegetated shelf (feet)
6 ft
47'
Slope of vegetated shelf (H:V)
6:1
48
Does the orifice drawdown from below the top surface of the
permanent pool? Yes
49
Does the pond minimize impacts to the receiving channel from the 1-
yr, 24-hr storm? _ Yes
Are fountains proposed? (If Y, please provide documentation that
MDC(9) is met.) No
50
51
Is a trash rack or other device provided to protect the outlet system? Yes
521Are the dam and embankment planted in non -clumping turfgrass? f Yes
53 Species of turf that will be used on the dam and embankment _ Fescue or Centipeed
541 Hasa planting plan been provided for the vegetate�sheff? Yes
ADDITIONAL INFORMATION
Please use this space to provide any additional information about the
55 wet pond(s):
Wet Pond 1 3:09 PM 4/30/2020