SW8940822_Current Permit_20110916

r&DENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
September 16, 2011
Jim Steele, Site Director
NC Department of Cultural Resources
1610 Fort Fisher Boulevard, S.
Kure Beach, NC 28449
Subject:State Stormwater Management Permit No. SW8 940822 Mod.
Fort Fisher State Historic Site
Low Density Stormwater Project
New Hanover County
Dear Mr. Steele:
Dee Freeman
Secretary
The Wilmington Regional Office received a complete, modified Stormwater Management Permit Application for Fort
Fisher State Historic Site on August 15, 2011. Staff review of the plans and specifications has determined that the
project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A NCAC 2H.1000. We are
forwarding Permit No. SW8 940822 dated September 16, 2011, for. the construction, operation and maintenance of
the built -upon areas and veaetated conveyances associated with the subject project.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the conditions and
limitations as specified therein, and does not supercede any other agency permit or approval that may be required.
Please pay special attention to the requirements for Operation and Maintenance, limited built -upon area, prohibition
of extensive piping, recorded deed restrictions, and permit transfer procedures. Failure to establish an adequate
system of maintenance, to stay below the permitted amount of built -upon area, to keep the piping to a minimum, to
record the deed restrictions or to follow the prescribed permit transfer process will result in future compliance
problems.
The modifications covered by this permit include:
Identification of the 68 acre project area.
The addition of 4,792 square feet of new 6 wide sidewalk to provide for mobility impaired access to the
monuments and beach access points of the site.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an
adjudicatory hearing by filing a petition with the Office of Administrative Hearings (OAH). The petition must conform
to Chapter 150B of the North Carolina General Statutes, and must be filed with the OAH within thirty (30) days of
receipt of this permit. A petition is considered filed when it is received in the Office of Administrative Hearings during
normal office hours. The OAH accepts filings Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m.,
except for official state holidays. The petition may be filed by facsimile (fax) or electronic mail by an attached file
(with restrictions) - provided the signed original, one (1) copy and a filing fee (if a filing fee is required by NCGS
§1506-23.2) is received in the OAH within seven (7) business days following the faxed or electronic transmission.
Unless such demands are made this permit shall be final and binding. You should contact the OAH with all questions
regarding the filing fee and/or the details of the filing process. The mailing address, telephone and fax numbers for
the Office of Administrative Hearings are: 6714 Mail Service Center, Raleigh, NC 27699-6714. Telephone 919-733-
2698. FAX [phone].
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 ne
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 W� C Carolina
Internet: www.ncwaterquality.org antra!!

State Stormwater Management Systems
Permit Number SW8 940822 Mod.
If you have any questions, or need additional information concerning this matter, please contact Linda Lewis at (910)
796-7301.
Sincerely,
57.m Coleen H. Sullins, Director
Division of Water Quality
GDSlarl: S:IWQS1StormwateAPermits & Projects119941940822 LD12011 09 permit 940822
cc: J. Clark Hipp, RA, Hipp Architecture & Development
Town of Kure Beach Inspections
Beth E.-Wetherill, New Hanover County Engineering
Robb Mairs, Division of Coastal Management
Wilmington Regional Office Stormwater File
Page 2 of 6

State Stormwater Management Systems
Permit Number SW8 940822 Mod.
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
LOW DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules and Regulations
PERMISSION IS HEREBY GRANTED TO
NC Department of Cultural Resources
Fort Fisher State Historic Site
1601 Fort Fisher Boulevard, Kure Beach, New Hanover County
FOR THE
construction, operation and maintenance of a 30% low density development in
compliance with the provisions of 15A NCAC 2H .1000 (hereafter referred to as the
"stormwater rules") and the approved stormwater management plans and
specifications, and other supporting data as attached and on file with and approved by
the Division of Water Quality and considered a part of this permit.
The Permit shall be effective from the date of issuance until rescinded and shall be
subject to the following specific conditions and limitations:
I. DESIGN STANDARDS
1. This permit covers a total of 356,757 square feet of built -upon area, of which
351,965 square feet is existing and previously permitted, and 4,792 square feet
is proposed new sidewalk construction.
2. Per the 2008 rules, this site is vested to the 1994 low density limit of 30% within
the original 68 acre project area. The overall tract built -upon area percentage for
the 68 acre project area must be maintained at or below 30%, as required by
Section .1005 of the stormwater rules.
3. The only runoff conveyance systems allowed will be vegetated conveyances
such as swales with minimum side slopes of 3:1 (H:V) as defined in the
stormwater rules and approved by the Division.
4. No piping is allowed except that minimum amount necessary to direct runoff
beneath an impervious surface such as a road or to provide access.
5. The project shall provide and maintain a 30-foot wide vegetated buffer between
built -upon area and surface waters, measured horizontally from and
perpendicular to the normal pool of impounded structures, the top of bank of both
sides of streams and rivers and the mean high water line of tidal waters.
6.' Roof drains must terminate at least 30 feet from surface waters.
Page 3 of 6

State Stormwater Management Systems
Permit Number SW8 940822 Mod.
II. SCHEDULE OF COMPLIANCE
1. The permittee is responsible for verifying that the proposed built -upon area does
not exceed the allowable built -upon area.
2. The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made.
3. Prior to the subdivision and/or sale of this project, in whole or in part, the
permittee shall have submitted a permit modification and received a permit at
least 30 days prior to the final sale.
4. Construction of additional impervious areas such that low -density requirements
are no longer met will require a permit modification prior to construction. An
engineered system may be required to collect and treat the runoff from all built -
upon area associated with the project, including that area permitted under the
low density option.
5. Filling in, piping or altering any vegetative conveyance (ditches, swales, etc.)
associated with the permitted development, except for minimal driveway
crossings, is strictly prohibited by any persons.
6. Projects within CAMA's Area of Environmental Concern (AEC) are subject to a
reduction of the permitted amount of built -upon area due to CAMA jurisdiction
within the AEC. The more restrictive of the two calculated BUA's shall govern.
7. Prior to the development of any future area or additional phase noted on the
approved plans for which an allocation of built -upon area has been made, a
permit modification must be submitted to and approved by the Division. The
modification must demonstrate that the built -upon area does not exceed the
maximum amount permitted under this permit and that it meets the intent of low
density development per the stormwater rules and available guidance.
8. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to the approved plans, regardless of size.
b. Redesign or addition to the approved amount of built -upon area.
c. Further development, subdivision, acquisition, or sale of any, all or part of the
project area. The project area is defined as all property owned by the
permittee, for which Sedimentation and Erosion Control Plan approval was
sought or for which a CAMA Major permit was issued.
d. Filling in, altering or piping any vegetative conveyance shown on the
approved plan.
e. Development within the designated future development areas.
9. Swales and other vegetated conveyances shall be constructed in their entirety,
vegetated, and be operational for their intended use prior to the construction of
any built -upon surface.
10. During construction, erosion shall be kept to a minimum and any eroded areas of
the swales or other vegetated conveyances will be repaired immediately.
Page 4 of 6

State Stormwater Management Systems
Permit Number SW8 940822 Mod.
11. The permittee shall at all times provide the operation and maintenance
necessary to operate the permitted stormwater management systems at optimum
efficiency to include:
a. Inspections
b Sediment removal.
C. Mowing, and re -vegetating of the side slopes.
d. immediate repair of eroded areas.
e. Maintenance of side slopes in accordance with approved plans and
specifications.
12. Within 30 days of completion of the project, the permittee shall certify in writing
that the project has been constructed in accordance with the approved plans.
13. The permittee shall submit all information requested by the Director or his
representative within the time frame specified in the written information request.
III. GENERAL CONDITIONS
Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to an enforcement action by the Division of Water Quality,
in accordance with North Carolina General Statutes 143-215.6A to 143-215.6C.
2. The permit issued shall continue in force and effect until modified, revoked or
terminated.
3. The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and re -issuance, or
termination does not stay any permit condition.
4. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules, and regulations contained in Title 15A of the North
Carolina Administrative Code, Subchapter 2H.1000; and North Carolina General
Statute 143-215.1 et. al.
5. This permit is not transferable to any person or entity except after notice to and
approval by the Director. The Director may require modification or revocation and
re -issuance of the permit to change the name and incorporate such other
requirements as may be necessary. At least 30 days prior to a change of
ownership, or a name change of the permittee or of the project, or a mailing
address change, the permittee shall submit a completed and signed
Name/Ownership Change form to the Division of Water Quality accompanied by
the required documentation as listed on the form. The approval of this request
will be considered on its merits, and may or may not be approved.
6. The permittee is responsible for compliance with all permit conditions until the
Director approves a transfer of ownership. Neither the sale of the project in whole
or in part, nor the conveyance of common area to a third party, constitutes an
approved request to transfer the stormwater permit.
7. The permittee grants permission to DENR Staff to enter the property during
normal business hours, for the purpose of inspecting all components of the
stormwater management facility.
8. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may .be imposed by
other government agencies (local, state and federal), which have jurisdiction.
Page 5of6

State Stormwater Management Systems
Permit Number SW8 940822 Mod.
9. Unless specified elsewhere, permanent seeding requirements for the swales
must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
10. Approved plans and specifications for projects covered by this permit are
incorporated by reference and are enforceable parts of the permit. The permittee
shall maintain a copy of the approved plans and the application documents on
file at all times.
Permit modified and reissued this the 16th day of September 2011
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
- ------ ---------'----------------------
Colee . Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 6of6

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
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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 Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORIVEATION
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, ag�nt-etc.):
Handicap Accessibilitv Site Imorovements - f &4 l is5/a. — VzA? T II L ono: S AP_
2. Location of Project (street address):
Fort Fisher State Historic Site, 1610 Fort Fisher Blvd, S
City:Kure Beach County:New Hanover Zip:28449
3. Directions to project (from nearest major intersection):
From intersection of Hwy 132 and Hwv 421, follow 421 South, through Town of Carolina Beach and Kure
Reach. Site is just outside the southern town limas of Kure Beach NC.
4. Latitude:33* 58' 18.30" N Longitude:77° 55' 03.34" W of the main entrance to the project.
II. PERMIT INFORMAY'ION:
1. a. Specify whether project is (check one): ❑New ®Modification
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numberSW8 940822 , its issue date (if known)Oct 4.1994 , and the status of
construction: ❑Not Started ❑Partially Completed* Z Completed* *provide a designer's certification
2. Specify the type of project (check one):
ffLow Density ❑High Density ❑Drains to an Offsite Stormwater System
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
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: 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:
JUL 21 2011
Form SWU-101 Version 07Jun2010 Page 1 of 6

A
III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/OrganizatiomFort Fisher State Historic Site. NC Dent of Cultural Resources
Signing Official & Title:lim Steele, Site Director
b. Contact information for person listed in item 1a above:
Street Address:1610 Fort Fisher Blvd, S.
City:Kure Beach State:NC Zip:2M01 ,29qyl
Mailing Address (if applicable):
City:
Phone: L910 ) 458-5538
Email:[e-mail]
State: Zip:
Fax: (910 ) 458-0477
Please check the appropriate box. The applicant listed above is:
Z 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): 1 n -I-,- _ --
Property Owner/Organization:State of North Carolina
Signing Official & Title: im Steele Site Director J U L 2 1
b. Contact information for person listed in item 2a above: 11 $ Y:
Street Address:1610 Fort Fisher Bvd S
City:Kure Beach State:NC Zipa8491 Z 9449
Mailing Address (if applicable):
City:
Phone: (910 ) 458-5538
Email:][e-mail]
State: Zip:
Fax: (910 ) 458-2477
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:T. Clark Hipp, Hipp Architecture &Development, PC
Signing Official & Title j. Clark Hipp, President
b. Contact information for person listed in item 3a above:
Mailing Address:228 N Front St, Suite 202A
City: Wilmington State:NC Zip:28401
Phone: 910 ) 763-8968 Fax: (910 ) 763-1799
Email:[e-mail]
4. Local jurisdiction for building permits: State of NC property managed by the State Construction Office
Point of Contact:Dalton Holmes Phone #: ;919 ) 807-4133
Form SWU-101 Version 07Jun2010 Page 2 of 7

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
New concrete sidewalks will have a slight cross slope allowing rainwater to drain to areas immeidately
adjacent to the new sidewalk. New wood slatted walkways (referred to as Hatteras Ramps) will be built to
allow rainwater to drain through the wood slats to grade below.
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: SW Permit #SW8 940822 Date: Oct 4.1994
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 River basin.
4. Total Property Area: 68 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+: 68 acres
+ Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 12 %
9. How many drainage areas does the project have?1 (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
Drama Area _
Drama a Area _
Drama a Area _
Drama a Area _
Receiving Stream Name
Atlantic Ocean
Stream Class *
SB
Stream Index Number *
99-(3)
Total Drainage Area (sf)
2,962,080
On -site Drainage Area (sf)
2,962,080
NA -
Off -site Drainage Area (sf)
Proposed Impervious Area** (sf)
356,757
% Impervious Area** (total)
12
Impervious" Surface Area
Drama a Area _
Drainage Area _
Drainage Area _
Diaina e Area _
On -site Buildings/Lots (sf)
NA
On -site Streets (sf)
NA
On -site Parking (sf)
NA
On -site Sidewalks (sf)
4,792 (new)
Other on -site (sf)
NA
Future (so
NA
Off -site (sf)
NA
Existing BUA*** (sf)
351,965 see notes
Total (so:
356,757
* Stream Class and Index Number can be determined at: http:l/normal nc gcr org,/ OpI442s/csu/classifiications
Form SWU-101 Version 07Jun2010 Page 3 of 7

Im ervious 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 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. NA
Projects in Union County: Contact DWQ 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 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 httu: / /Dortal.ncdenr.ore/web/wa /ws/su/bmv-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from htU2://12ortal.ncdenr.org/web/wil/mZguZstateaw/fgrms does. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map athttp://12ortal.ncdenr.org/web/wq/ s/su/mal2s.-)
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 http://portal.ncdenr.org/weh/EvA/ws/su/­statesw/forms dots.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. i}Gi�►
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (tf required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
N11-
agreement(s) for each BMP.
4. Permit fee
l'
application processing of $505 payable to NCDENR. (For an Express review, refer to
http: / /www.envhelp.org/pages/onestQpe=ress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
� G �'
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within lh mile of the site boundary, include the 1h
mile radius on the map.
!v% (W)
7. Sealed, signed and dated.calculations.
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.
7ED
h. Identify all surface waters on the plans by delineating the normal pool elevati n ofimpounded structures, the banks of streams and rivers, the MHW or NHW ' of ti1L 21
waters, and any coastal wetlands landward of the MHW or NHW lines.
e Delineate the vegetated buffer landward from the normal pool elevation oLu
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 07Jun2010 Page 4 of 7

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 PIA
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.
(Infiltra'--ion Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHWT prior
to submittal, [phone].) /
10. A copy of the most current property deed. Deed book: 0886 Page No: 0607 V
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC 'UA
Secretary of State or other official decum--ntation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 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.
htU2://www.secretary.state.nc.us/Corporatiors/CSearch.asl2x
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
htU2://12ortal.ncdenr.org/web/wq/ws/su/statesw/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 DWQ, 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:l. Clark Hipp, Architect
Consulting Firm: Hipp Architecture & Development. PC
Mailing Address:228 N Front St, Suite 202A
City:Wilmingion State:NC Zip:28401
Phone: (910 ) 763-8968
Email:[e-mail]
Fax: (910 ) 763-1799
RECEIVED
JUL 21 ZOII
BY:
Form SWU-101 Version 073un2010 Page 5 of 7

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) Tim Steele, Site Director , certify that I
own the property identified in tt'-is permit application, and thus give permission to (print or type name of person
listed in Contact Information, item 1a) T. Clark Hipp, Architect with (print or
type name of organization listed in Contact Information, item 1a) Hipp Architecture & Development, PC to develop the
project as currently proposed. A copy of the lease agreement or pending property sales contract has been
provided wiffi the submittal, which indicates the party responsible for the operation and maintenance of the
stormwater system.
As the legal property owner I ac'_cnowledge, 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 DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility witheut a valid -er-r it. 1,mderstand `.'_gat &.e operation of a storrrw ater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,0g0 per day, pursuant to NCGS 143-215.6.
Date: )
I, ^, IN— M M 8vr a Notary Public for the State of County of
IlLg A 0% WIP , do hereby certify that 2ut�CS C • ,j'�.Q�j� �� personally appeared
before me this -u4ay of 1 '*�LA � I, and acknowledge due exec ti of the application for
a stormwater permit. Witness my hand and official seal, J
SEAL
My commission expires (y 1 .�� -Zs Li l 1
RECEIVED
JUL 21 Z011
BY:
Form SWU-101 Version 07Jun2010 Page 6 of 7

X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 1a) Tim Steele, Site Director
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 stormwate�les under 15A NCAC 2H .1000, SL 2006-246 (Ph. II — Post Construction) or SL 2008-211.
Date:
I, kt;.I Iv ca o,. AJ d,/J (m AA!HSm a rotary Public for the State of vnV1 eu J�` L+, County of
A1114. 4t--n cAru do hereby certify that 1&vn& s C • 5 tie hL personally appeared
. and acknowledge a due ecut' of the application for
before me this A" ay of
a stormwater permit. Witriess my hand and official seal,
SEAL
My commission expires t I $` L -',/ 6
RECEIVED
JUL 21 2011
BY:
Form SWU-101 Version 073un2010 Page 7 of 7