20200784 Ver 1_401 Application_20200614

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
April 11, 2020 Ver 3.1
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
C Yes IT No
Change only if needed.
BIMS # Assigned
20200784
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Reviewing Office *
Wilmington Regional Office - [phone]
Information for Initial Review
1a. Name of project:
The Healing Place of New Hanover County
1a. Who is the Primary Contact?*
Bob Zarzecki
1b. Primary Contact Email:*
[e-mail]
Date Submitted
6/14/2020
Nearest Body of Water
Silver Stream Branch, 18-76-1-1
Basin
Cape Fear
Water Classification
C;Sw
Site Coordinates
Latitude:
34.1982
A. Processing Information
County (or Counties) where the project is located:
New Hanover
Is this a NCDMS Project
r Yes IT No
Longitude:
-77.9310
Is this project a public transportation project?*
r Yes r No
1a. Type(s) of approval sought from the Corps:
W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Version#*
1
What amout is owed?*
IT $240.00
r $570.00
Select Project Reviewer*
Robb Mairs:eads\rlmairs2
1c. Primary Contact Phone:*
[phone]
1b. What type(s) of permit(s) do you wish to seek authorization?

W Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes C No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
39 - Commercial/Institutional Developments
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
F- 401 Water Quality Certification - E)press
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
C Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
C Yes C No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
C Yes r No
1j. Is the project located in a designated trout watershed?
C Yes r No
F. Applicant Information
1d. Who is applying for the permit?
fJ Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes C No
2. Owner Information
2a. Name(s) on recorded deed:
New Hanover County
2b. Deed book and page no.:
Book: 38 Page:170
2c. Responsible party:
Avril Finder (Deputy County Manager)
2d.Address
Street Address
230 Government Center Drive, 190
Address Une 2
city
Wilmington
Postal / Zip Code
28403
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
C Unknown
State / Rovince / Region
NC
Country
United States
2f. Fax Number:
r- Yes r No
r Yes r No
u

4. Agent/Consultant (if applicable)
4a. Name:
Bob Zarzecki
4b. Business Name:
Soil & Environmental Consultants, PA
4c.Address
Street Address
8412 Falls of Neuse Road, Suite 104
Address Line 2
City
Raleigh
Postal / Zip Code
27615
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
12958_Agent Authorization. pdf
C. Project Information and Prior Project History
1. Project Information
State / Province / Fbgion
NC
Country
United States
4e. Fax Number:
[phone]
1b. Subdivision name:
(d appropriate)
Lakeside Park
1c. Nearest municipality/ town:
Wilmington
2. Project ctct Identification
2a. Property Identification Number:
2b. Property size:
R06018-003-047-000
8.70
2c. Project Address
Street Address
1000 Medical Center Drive
Address Line 2
city
State / Province/ Region
Wilmington
NC
Postal / Zip Code
Country
28401
United States
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Silver Stream Branch, 18-76-1-1
3b. Water Resources Classification of nearest receiving water:*
C;Sw
3c. What river basin(s) is your project located in?*
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300050503
4. Project Description and History
424.77KB
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
Ebsting conditions on the site consist of heavily wooded land. Medical Center Drive bounds the property to the west and other related health care businesses bound the property to the
North and South. The general vicinity of the project consists of commercial development and wooded/undeveloped land.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)

USGS Map.pdf
254.35KB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
SS Map.pdf 378.03KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.238
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project,*
The purpose of this project is to construct "The Healing Place", a substance use treatment center, and associated infrastructure.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The overall project consists of an Administration / Education Building, Detox Building, Men's Residential Center Building, Women's Residential Center Building, and
Dining/Shelter/Storage Building, along With associated internal roads, parking lots, emergency vehicle access, garden/courtyard, utilities and SCM's. Specifically, there is one (1) impact
associated With lot fill. Equipment typically used for construction and earthwork such as backhoes, bulldozers, excavators, graders, pavers etc. will be utilized for this project.
4j. Please upload project drawings for the proposed project.
HTW - Impact Maps (5-4-2020).pdf 1.72MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No C Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
SAW-2012-00084
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Bob Zarzecki
Agency/Consultant Company: Soil & Environmental Consultants, PA
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
USACE site visit and field verification was completed by John Policarpo on September 27, 2016.
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes C No
7b. If yes, explain.
All phases are shown on the attached plans. The only future building proposed is the "Future Storage Building" ad associated parking lot on the north side of the project.
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
No, no impacts are proposed for the future phases of development and all future phases will be contained within the property boundaries of the PJD. The wetlands along the southern
property boundary not otherwise requested for impacts will be avoided.
D. Proposed Impacts Inventory U
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands F Streams -tributaries ❑ Buffers
F Open Waters r" Pond Construction
2. Wetland Impacts
2a. Site # (?) 2a1 Reason (?) 2b. Impact type (?) 2c. Type of W. 2d. W. name 2e. Forested 2f. Type of 2g. Impact
Jurisdicition*(?) area*
1 Lot Fill P Bottomland Hardwood Forest W1 Yes Both 0.007
(acres)

Hardwood Forest
(acres)
2g. Total Temporary Wetland Impact
0.031
2g. Total Wetland Impact
0.038
2h. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.007
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
S&EC completed a wetland delineation for the entire property in order to identify natural resources so that impacts could be avoided & minimized to
the maximum extent practicable. Impact 1 is proposed wetland fill for parking. Proposed impacts include permanent and temporary wetland impacts,
temporary impacts are necessary for construction activities and grading. A retaining wall has also been proposed to minimize impacts. The roadway
and parking lot designs and assocaited wetland impacts are in part necessary to provide emergency vehicle (fire truck) access to the back of the
Administration & Education building. All temporary wetland impacts will be brought back to pre -construction contours and re -vegetated with a wetland
seed mix.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Typical measures such as silt fence, tree protection fencing and sediment basins will be required for this project.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
r Yes
r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Total wetland impacts for the project are less than .10 of an acre.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes
If no, explain why:
r No
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15ANCAC 02H .1003(2)?
r Yes r No
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater
program?
r Yes r No
r N/A - project disturbs < 1 acre
2d. Which of the following stormwater management program(s) apply:
W Local Government F State
Local Government Stormwater Programs
W Phase II r NSW r USMP r Water Supply
Please identify which local government stormwater program you are using.
City of Wilmington & DWR Coastal Stormwater Management Plan
Comments:
The property is part of the Lakeside Park Stormwater Plan. I've attached an email Kelly Johnson from NCDENR sent on this project. Basically, the County is allowed to have up to
312,129 SF of impervious area on this property under the terms of that Stormwater Plan.
G. Supplementary Information U
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*

C' Yes C No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
This project involves essentially and in -fill development on an existing lot with appropriate zoning, and is not anticipated to result in any additional
development that could impact nearby downstream water quality.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated
at a treatment plant, list the capacity available at that plant.
Wastewater from the project will discharge to and be treated by the City of Wilmington sanitary sewer system and treatment plant. The City and DWR
will ensure that adequate capacity exists.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
r Yes r No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
r Yes r No
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this activity on the property.
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The NC Natural Heritage Programs Data Explorer Map was used to search for elemental occurrences of federally protected species listed within and
within 1-mile of the project boundaries. It was determined based on the search that there are three (3) elemental occurrences that are listed as
federally Threatened/Endangered within or within 1-mile of the project boundaries. These include the American Alligator, Northern Long Eared Bat
and the Magnificent Rams Horn. References: NC Natural Heritage Program. 2020. Geographic Information System (GIS) data. NCDNCR, Raleigh, NC.
Available at hftp://www.ncnhp.org/. (Accessed: April 6, 2020).
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes f• No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
The NOAA Habitat Conservation/Habitat Protection: National Marine Fish Service; Essential Fish Habitat Mapper website was referenced. No Essential
Fish Habitat was identified near the project.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?*

r Yes O No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
The NC State Historic Preservation Office HPOWEB GIS Service interactive map was referenced on April 3, 2020, no historic listings or study list
entries or determined eligible listings were identified within the property boundaries. Additionally, no structures epst within the property boundaries.
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes f• No
8c. What source(s) did you use to make the floodplain determination?*
NC Flood Risk Information System Floodplain Mapping Program was referenced on April 6, 2020.
r
Miscellaneous U
Comments
Miscellaneous attachments not previously requested.
Lakeside Park Stormwater Plan_DEQ Email_18March2016.pdf
5.98MB
Signature C^U
W By checking the box and signing below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Bob Zarzecki
Signature
Date
6/14/2020

Environmental Consultants,
8412 Palls of Neuse Road, Suite 104, Raleigh, NC 27615 • Phone: [phone]
sandec.com
PROPERTY OWNER CERTIFICATION / AGENT AUTHORIZATION
Project Name/Description: 1000 Medical Center Drive S&EC Project #
Date: 2016
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
69 Darlington Avenue
Wilmington, NC 28403
Attn: John PalicaMo Field Office: USACE Wilmington Regulatory Field Office
I, the undersigned, a duly authorized owner of record of the property/properties identified herein, do
authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps) and Soil &
Environmental Consultants, PA (S&EC) staff (as my agent) to enter upon the property herein described
for the purpose of conducting on -site investigations and issuing a determination associated with Waters
of the U.S. subject to Federal jurisdiction under Section 404 of the Clean Water Act and/or Section 10 of
the Rivers and Harbors Act of 1899. This document also authorizes S&EC (as my agent) to act on my
behalf and take all actions necessary for the processing, issuance and acceptance of a permit or
certification and any and all associated standard and special conditions.This notification supersedes any
previous correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only for government
officials to enter the property when accompanied by S&EC staff. You should call S&EC to arrange a site
meeting prior to visiting the site.
PID.:
R06018-003-047-000
Site Address:
1000 Medical Center Drive, Wilmington, New Hanover Co., NC
Map Book/Page:
38/170 Deed Book/Page: 5197/2789
Lat/Long:
34.198263/-077.931089
Watershed:
Silver Stream Branch, 18-76-1-1, "C;Sw", Cape Fear 03030005
PROPERTY OWNER INFORMATION
Name: New Hanover County
Address: 230 Government Center Drive, 190, Wilmington, NC 28403
Phone No.: (9,t) )7qk - 7/9z/ Fax No.: ( ) Mobile No.: ( )
Email: c4nv lily"
Property Owner (plea e print) U v Date'
Property
We hereby certify the above information submitted in this application is true and accurate to
the best of our knowledge.

Project Number:
BZProject Manager:
1" = 625'Scale:
8/1/16Date:
Map Title:
Source:
Figure 2 - Soil Survey Map
1000 Medical Center Dr Site
New Hanover County, NC
New Hanover County
Soil Survey Sheets 18 & 19
¯0 625 1,250
Feet
12958.W1

Project Number:
BZProject Manager:
1" = 625'Scale:
8/1/16Date:
Map Title:
Source:
Figure 1 - USGS Map
1000 Medical Center Dr Site
New Hanover County, NC
NC 2016
Wilmington Quadrangle
¯0 625 1,250
Feet
12958.W1
219 N. Boylan AvenueRaleigh, North Carolina 27603t. 919.833.5400www.isdesignpa.comKey PlanProfessional SealsSheet TitleSheet NumberDescriptionNo.Date10/9/2018 2:50 PM H:\The SITE Group\Projects\HTW\Dwg\HTW-SITEBASE.dwg
All reproduction & intellectual property rights reserved © 2018Project Code:ProjectClientOriginal drawing is 36 x 24 Do not scale contents of this drawingTHE HEALING PLACE OFNEW HANOVER COUNTY1000 MEDICAL CENTER DRWILMINGTON, NCTRILLIUM HEALTHRESOURCES16HTWILMINGSCHEMATIC DESIGNEXISTING CONDITIONSPLANSITE 1001SCHEMATIC DESIGN SUBMITTAL06/19/2018NH:\The SITE Group\Projects\HTW\Dwg\HTW-SITEBASE.dwg, 10/9/2018 2:50:01 PM, Justin Jones
SILVER STREAM LANEEX-1.1
SILVER STREAM LANEEX-1.0
1
Bob Zarzecki
From:Johnson, Kelly <[e-mail]>
Sent:Tuesday, August 2, 2016 10:06 AM
To:[e-mail]
Cc:Snider, Holley
Subject:SW8 960605, Lakeside Park, Lot #2
Attachments:Master Permit_Lakeside Park.pdf; 20160802_093531.jpg; Master Permit_Lakeside Park_PE
Certification.pdf
Sam,
Here is a link to all of the stormwater application forms that we talked about, http://deq.nc.gov/about/divisions/energy-
mineral-land-resources/energy-mineral-land-permits/stormwater-permits/forms. You will need to apply for an offsite
permit for your development on Lot 2 to drain to Pond 2 of master permit SW8 960605 (Lakeside Park) which allocates
your lot 312,129sf of impervious (which is 85% of Lot 2’s lot area). I have attached the master permit. Section I(3)
shows the 85% requirement. Attachment A shows the exact data per lot. I also attached a photo of the vicinity of Pond
2 on the plans. If you want to come look through the file for the specifics for the design, just let me know. We try to
schedule those rather than having drop-ins because we only have one file review room for several agencies.

The application form, SWU-101, lists the paperwork submittal requirements permits in its Section VI. This is a list of
common things for all permits, but since you are an offsite permit you don’t need all of those things. You can omit #2,
#6, and #9. The supplement that you will need (#3 on the application’s list) is the offsite supplement which is on the
same website. That form will ask you to initial that some things have been completed for the master. It will ask you for
the PE Certification (attached), if the master permit has NOVs (it doesn’t), if the master permit is in compliance (leave
that blank, we will have to do an inspection), and if the deed restrictions have been recorded (also leave that blank
because I need to go through the file to find them). The other thing to be aware of is that we will need original
signatures rather than copies for all applicable areas. Also, the person signing the forms has to have signature authority
to do so. That means that if it is an LLC, then the person signing has to be a manager of a manager-managed LLC, a
member of a member-managed LLC, or the VP or President of an Inc. The NC Secretary of State lists the appropriate
parties, https://www.sosnc.gov/corporations/. Look for “search by corporation”.

If you have further questions, please let me know.

Kelly

Kelly Johnson
Kelly Johnson
Environmental Engineer

NC Division of Energy, Mineral and Land Resources
Stormwater Permitting
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
Office: 910.796.7331
Fax: [phone]

r
NCD NR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E.
Governor Director
June 26, 2012
Mr. Christian Lloyd, President
Lakeside Park Owners Association, Inc.
PO Box 56
Hampstead, NC 28443
Subject: State Stormwater Management Permit No. SW8 960605
Lakeside Park
High Density Commercial Wet Detention Pond Project
New Hanover County
Dear Mr. Loyd
Dee Freeman
Secretary
The Wilmington Regional Office received a complete, modified Stormwater Management Permit Application for
Lakeside Park on June 14, 2012. 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 and Session Law 2008-
211. We are forwarding Permit No. SW8 960605 dated June 26, 2012, for the construction, operation and
maintenance of the BMP's and built -upon areas associated with the subject project.
This permit shall be effective from the date of issuance until November 3, 2020, and shall be subject to the conditions
and limitations as specified therein. Please pay special attention to the conditions listed in this permit regarding the
Operation and Maintenance of the BMP(s), recordation of deed restrictions, procedures for changes of ownership,
transferring the permit, and renewing the permit. Failure to establish an adequate system for operation and
maintenance of the stormwater management system, to record deed restrictions, to transfer the permit, or to renew
the permit, will result in future compliance problems.
The following modifications are included and covered by this permit: Lot 16 has been subdivided into two portions
separated by S 63°22'16"W. The portion of the lot southeast of this line was previously covered by this master
permit. It has been removed because documentation has been provided that it was developed in its current
configuration before January 1, 1988 and therefore it is not subject to stormwater requirements. The remaining
1.58ac portion is still covered by this master permit. If any parts, requirements, or limitations contained in this permit
are unacceptable, you have the right to request an adjut icatory hearing by filing a written petition with the Office of
Administrative Hearings (OAH). The written 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. You should contact the OAH
with all questions regarding the filing fee (if a filing fee is required) and/or the details of the filing process at 6714 Mail
Service Center, Raleigh, NC 27699.6714, or via telephone at 919-431-3000, or visit their website at
www.NCOAH.com. Unless such demands are made this permit shall be final and binding. If you have any questions,
or need additional information concerning this matter, please contact Kelly Johnson, at [phone].
Smcfrely, c
�F i �.l
or Charles akild, P.E., Director
Division of Water Quality
GDSI kpj: S:IWQS1StormwateAPermits 8 Projecls119961960605 HM2012 06 permit 960605_2
cc: David Hollis, PE
Inspector, New Hanover County Building Inspections
Beth E. Wetherill, New Hanover County Engineering
Division of Coastal Management
Wilmington Regional Office Stormwater File
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 One
Phone: [phone] FAX: [phone] DENR Assistance: 16776236748 NorthCarolina
Internet: www.ncwaterquallf .org
An Equal Opportunity l Affirmative Action Employer

State Stormwater Management Systems
Permit No. SW8 960605
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH 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
Lakeside Owner's Association, Inc.
Lakeside Park
Medical Center Drive, Wilmington, New Hanover County
FOR THE
construction, operation and maintenance of 2 wet detention ponds in compliance with
the provisions of 15A NCAC 2H .1000, effective September 1, 1995 (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.
This permit shall be effective from the date of issuance until November 3, 2020, and
shall be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.6 on page 3 of this permit. The stormwater
controls labeled as Pond 1 and Pond 2 have been designed to handle the runoff
from 959,931 square and feet 988,703 square feet, respectively, of impervious
area.
3. The tract will be limited to the amount of built -upon area indicated in Attachment
A, and per approved plans. Each lot in the subdivision is limited to a maximum of
85% of its lot area as built -upon area.
All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
Page 2 of 8

State Stormwater Management Systems
Permit No. SW8 960605
6. The following design criteria have been provided in the wet detention ponds and
must be maintained at design condition:
Pond Number:
a. Drainage Area, acres:
Onsite:
Offsite:
b. Total Impervious Surfaces', ft2:
C. Design Storm:
d. Pond Depth, feet:
e. TSS removal efficiency:
f. Permanent Pool Elevation, FMSL:
g. Permitted Surface Area, ft:
h. Permitted Storage Volume, ft3:
i. Temporary Storage Elevation, FMSL:
j. Controlling Orifice:
k. Permitted Forebay Volume, ft3:
I. Receiving Stream/River Basin:
M. Stream Index Number:
n. Classification of Water Body:
"As documented in Attachment A
II. SCHEDULE OF COMPLIANCE
El
POND 1 POND 2
25.6
25.23
25.6
24.28
0
0.95
959,931
988,703
ill
1"
7.5
7.5
90%
90%
10.0
10.0
40,370
42,890
77,225
87,760
11.5
11.50
4"0
4"0
28,000
18,000
Greenfield Lake /
Cape Fear
CPF17 18-76-1
"C Sw"
The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
The permittee shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater system functions at optimum
efficiency. The approved Operation and Maintenance Plan must be followed in
its entirety and maintenance must occur at the scheduled intervals including, but
not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device, flow
spreader, catch basins and piping.
g. Access to the outlet structure must be available at all times.
Records of maintenance activities must be kept and made available upon
request to authorized personnel of DWQ. The records will indicate the date,
activity, name of person performing the work and what actions were taken.
Page 3 of 8

State Stormwater Management Systems
Permit No. SW8 960605
Decorative spray fountains will be allowed in the stormwater treatment system,
subject to the following criteria:
a. The fountain must draw its water from less than 2' below the permanent
pool surface.
b. Separated units, where the nozzle, pump and intake are connected by
tubing, may be used only if they draw water from the surface in the
deepest part of the pond.
c. The falling water from the fountain must be centered in the pond, away
from the shoreline.
d. The maximum horsepower for a fountain in pond 1 is 1/4 horsepower and
pond 2 is 1/3 horsepower.
6. The facilities shall be constructed as shown on the approved plans. This permit
shall become voidable unless the facilities are constructed in accordance with
the conditions of this permit, the approved plans and specifications, and other
supporting data.
7. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A
modification may be required for those deviations.
8. If the stormwater system was used as an Erosion Control device, it must be
restored to design condition prior to operation as a stormwater treatment device,
and prior to occupancy of the facility.
9. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
10. 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 any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of 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 or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. A copy of the approved plans and specifications shall be maintained on file by
the Permittee for a minimum of ten years from the date of the completion of
construction.
Page 4 of 8

State Stormwater Management Systems
Permit No. SW8 960605
13. Prior to the sale of any lot, deed restrictions must be recorded which limit the
built -upon area per lot to the amount as shown on the Project Data Sheet, per
Section I, Part 2. The recorded statements must follow the form:
a. The maximum built -upon area per lot is 85% of the lot area. The allotted
BUA amount includes any built -upon area constructed within the lot
property boundaries, and that portion of the right-of-way between the front
lot line and the edge of the street pavement. Built upon area includes, but
is not limited to, structures, asphalt, concrete, gravel, brick, stone, slate,
coquina and parking areas, but does not include raised, open wood
decking, or the water surface of swimming pools.
b. The covenants pertaining to stormwater may not be altered or rescinded
without the express written consent of the State of North Carolina,
Division of Water Quality.
C. Alteration of the drainage as shown on the approved plans may not take
place without the concurrence of the Division of Water Quality.
d. The State of North Carolina is made a beneficiary of these covenants to
the extent necessary to maintain compliance with the Stormwater
Management Permit.
e. These covenants are to run with the land and be binding on all persons
and parties claiming under them.
f. The connection into the pond must be made such that short-circuiting
does not occur.
g. All runoff on the lot must drain into one of the permitted systems.
h. Each lot whose ownership is not retained by the permittee, is required to
submit a separate stormwater permit application to the Division of Water
Quality and receive a permit prior to construction.
14. A copy of the recorded deed restrictions must be submitted to the Division within
30 days of the date of recording the plat, and prior to selling lots. The recorded
copy must bear the signature of the Permittee, the deed book number and page,
and stamp/signature of the Register of Deeds.
15. 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.
III. GENERAL CONDITIONS
This permit is not transferable to any person or entity except after notice to and
approval by the Director. In the event of a change of ownership, or a name
change, the permittee must submit a formal permit transfer request to the
Division of Water Quality, accompanied by a completed name/ownership change
form, documentation from the parties involved, and other supporting materials as
may be appropriate. The approval of this request will be considered on its merits
and may or may not be approved. The permittee is responsible for compliance
with all permit conditions until such time as the Division approves the transfer
request.
Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
Page 5 of 8

State Stormwater Management Systems
Permit No. SW8 960605
3. 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) having jurisdiction.
4. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and reissuance or
termination does not stay any permit condition.
Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
8. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
9. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes within 30 days.
Permit issued this the 26th day of June 2012.
CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Division of Water Quality
By Authority of the Environmental Management Commission
Page 6 of 8

State Stormwater Management Systems
Permit No. SW8 960605
Lakeside Park
Stormwater Permit No. SW8 960605
New Hanover County
Designer's Certification
Page 1 of 2
I, , as a duly registered
in the State of North Carolina, having been authorized to observe (periodically/ weekly/
full time) the construction of the project,
(Project)
for (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 7 of 8

State Stormwater Management Systems
Permit No. SW8 960605
Certification Requirements:
Page 2 of 2
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Trash rack is provided on the outlet/bypass structure.
8. All slopes are grassed with permanent vegetation.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
New Hanover County Building Inspections

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1- F

State Stormwater Management Systems
Permit No. Sw8 960605
Lakeside Park
Stormwater Permit No. SW8 960605
New Hanover County
E ngineer's Certification
1, 'av cj� S. 4,C5 l l k S , as a duly registered Professional Engineer ill the State of
North Carolina, having been authorized to observe (period/weekly/full time) the construction of the
project,
for L L?SCd-o- Cis , (_L-C, (Project Owner) hereby state that, to the best of my abilities, due
care and diligence was used in the observation of the project construction such that the construction was
observed to be built within substantial compliance and intent of the approved plans and specifications.
Noted deviations from approved plans and specification:
�xcaSl GHQ (�c2L1 �tt' { i2Ci ���•�.�.�
CA
y`sa 2CoCa�P- z -T.-Acs - Dt-i t�OEESs
J` SEAL
t 20007
� '• FN Signatu__L- ----�.'•.�q.,�IN�;
-,, 'U S. Nv- 0-
Registration Number 2 —] ""11;mW
tIANOVER DESIGN SERVICE$, pi
319 WALNUT STREET
Date WILMINGTONNG 2Mj
( e
R ILA A -LA --tic
ECEIVE
JUN 0 5 2012

a State Stomma!erNianagemem Svsreets
L L- C Permit No. SW
:5cuC) CD(ooc�05
Certification Requirements: -22 -(�
✓ 1. The drainage area to the system contains approximately the permitted acreage.
✓2. The drainage area to the system contains no more than the permitted amount of built -upon area.
✓ 3. All the built -upon area associated with the project is graded such that the runoff drains to the system.
The outlet/bypass structure elevations are per the approved plan.
The outlet structure is located per the approved plans.
----6. Trash rack is provided on the outlet/bypass structure.
�7. All slopes are grassed with permanent vegetation.
✓fi. Vegetated slopes are no steeper than 3:1.
✓9. The inlets are located per the approved plans and do not cause short-circuiting of the system.
--'10. The permitted amounts of surface area and/or volume have been provided.
I. Required drawdown devices are correctly sized per the approved plans.
12. All required design depths are provided.
✓. All required parts of the system are provided, such as a vegetated shelf, and a forebay.
The overall dimensions of the system, as shown, on the approved plans, are provided.
cc: NCDENR-DWQ Regional Office
Tony Roberts, New Hanover County Building Inspector
7
I woo DESIGN SENCES, PA
319 WALNUT STREET
WILMINGTON NC 2MI

S LAG State Storniwater Manaeement Sysmeis
t Permit No. SW
'Z-
Certification Requirements: ' �2 ` C
✓ 1 . The drainage area to the system contains approximately the permitted acreage.
�. The drainage area to the system contains no more than the permitted amount of built -upon area.
�3. All the built -upon area associated with the project is graded such that the runoff drains to the system.
�4. The outlet/bypass structure elevations are per the approved plan.
✓i. The outlet structure is located per the approved plans.
�. Trash rack is provided on the outlet/bypass structure.
✓ 7. All slopes are grassed with permanent vegetation.
�. Vegetated slopes are no steeper than 3:1.
�9. The inlets are located per the approved plans and do not cause short-circuiting of the system.
✓10. The permitted amounts of surface area and/or volume have been provided.
Required drawdown devices are correctly sized per the approved plans.
/12. All required design depths are provided.
'__�13. All required parts of the system are provided, such as a vegetated shelf, and a forebay.
1':. o if•rall dimensions of the system, as shown on the approved plans, are provided.
cc: NCDENR-DWQ Regional Office
Tony Roberts, New Hanover County Building Inspector
FUN M DENO'N SERVICES, PA
7 319 WALNUT STREET
W4MINVON NO 28401