SW5121101_CURRENT PERMIT_20130103

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW�I
DOC TYPE
� CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
a&30&�i
YYYYMMDD

to A
MODE I R
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
Mr. Owen Strickland, Mayor
Town of Bailey
6260 Main Street
Bailey, North Carolina 27807
Division of Water Quality
Charles Wakild, PE
Director
December 2, 2012
Subject: Stormwater Permit No. SW5121 101
High Density Commercial Wet Pond Project
Bailey Community Park
Nash County
Dear Mr. Strickland:
Dee Freeman
Secretary
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for Bailey
Community Park on November 20, 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
2006-246. We are forwarding Permit No. SW5121101, dated December 2, 2012, for the construction, operation and
maintenance of the subject project and the stormwater BMPs.
This permit shall be effective from the date of issuance until December 1, 2020 and shall be subject to the conditions
and limitations as specified therein, and does not supersede any other agency permit that may be required. 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 perm it, and renewing the
permit. Failure to establish an adequate system for operation and maintenance of the stormwater management system,
to record deed restrictions, to follow the procedures for transfer of the permit, or to renew the permit, will result in
future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an
adjudicatory 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. Per NCGS 143-215(e) the petition
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.
This project will be kept on file at the Raleigh Regional Office. if you have any questions, or need additional
information concerning this matter, please contact Mike Randall at [phone]; or mike.randall@ncdenr,gov.
Sincerely,
for Charles Wakild, PE, Director
cc: Raleigh Regional Office
SPU Files
Netlands and Slow ieiater Branch
1617 I.1ail 5ervicc Ceme:, Raleigh, Nntlh Carolina 276K 161
LocaC; n 312 N. SalisbuRl St. Falelgh, North Carol;na -17604
Pirnne, ::1g-80 31001. cAX- 91-807-6494
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State Stormwater Permit
Permit No. SW5121101
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEME
HIGH DENSITY DEVELOPMENT
JAN -- 3 2013
NG DENR
Raleia+PUtonal Office
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
Bailey Community Park
Stoney Hill Church Road, Bailey, Nash County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with
the provisions of 15A NCAC 2H .1000 and S.L. 2006-246 (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 December 1, 2020, and
shall be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. 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 1.7 of this permit. The stormwater control has been
designed to handle the runoff from 196,020 square feet of impervious area.
3.. The tract will be limited to the amount of built -upon area indicated in Section 1.7
of this permit, and per approved plans.
4. 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.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The built -upon areas associated with this project shall be located at least 50 feet
landward of all perennial and intermittent surface waters.
Page 1 of 6

I i _______r_ _ i
55TO 3
ea }0 ►6n, 59 dl i9tsff

State Stormwater Permit
Permit No.SW5121101
7
The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a
I
Drainage,4rea, acres:
Onsite, ft
Offsite, ft2:
Total Impervious Surfaces, ft2:
Buildings ft2:
Roads/Parking, ft2:
Other, ft2'
Offsite, ft2:
Pond Depth, feet:
TSS removal efficiency:
Design Storm:
Permanent Pool Elevation, FMS�:
Permitted Surface Area @PP ft
Permitted Storage Volume, ft:
Storage Elevation, FMSL:
Controlling Orifice:
Permanent Pool Volume, ft3:
Forebay Volume, ft3:
Receiving Stream/River Basin:
Stream Index Number:
Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
18.0
784,080
0
196,020
1,500
80,789
29,225 (sidewalks)
0
3
90%
1.0 inch
213.50
16,158
18,687 at temporary pool
214.50
2.5" O pipe
38,573
7,355
Big Branch of Turkey Creek/ Neuse
27-86-3-6
"C & NSW"
During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. 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.
4. 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.
5. The stormwater treatment system shall be constructed in accordance with the
approved plans and specifications, the conditions of this permit, and with other
supporting data.
Page 2 of 6

State Stormwater Permit
Permit No.SW5121101
6. 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.
7. 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 d viceOL)
and prior to occupancy of the facility.
8. Access to the stormwater facilities shall be maintained via appropriate HA
easements at all times. m
9. The permittee shall submit to the Director and shall have received approva for.
revised plans, specifications, and calculations prior to construction, for any , U0
modification to the approved plans, including, but not limited to, those liste _
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.
10. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
11. 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.
12. 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 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 completed Name/Ownership Change form, to the. Division of Water
Quality, signed by both parties, and accompanied by supporting documentation
as listed on page 2 of the.form. The project must be in good standing with the
Division. The approval of this request will be considered on its merits and may or
may not be approved.
Page 3of6

r m.4 AI0U_1 I)[ikS
f

State Stormwater Permit
Permit No.SW5121101
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request.
3. 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.
4. 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.
5. 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.
6. 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.
7. The permit issued shall continue in force and effect until revoked or terminated.
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.
8. 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,
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revolting and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 21-1.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division of any name, ownership or mailing
address changes at least 30 days prior to making such changes.
12. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 2Id day of December, 2012.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMP
jor unarles WaKlla, Ft:, uirector
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No. SW5121101
Bailey Community Park
Stormwater Permit No. SW5121101
Nash County
Designer's Certification
1, , as a duly registered
in the State of North Carolina, having been authorized to observe (periodically/ weekly/
full time) the construction of the project,
Bailey Community Park
(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
9
SEAL

State Stormwater Permit
Permit No. SW5121101
Certification Requirements:
17
2
Cl
11
12
13
14
15
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.
All the built -upon area associated with the project is graded such that the
runoff drains to the system.
All roof drains are located such that the runoff is directed into the system.
The outlet/bypass structure elevations are per the approved plan.
The outlet structure is located per the approved plans.
Trash rack is provided on the outlet/bypass structure.
All slopes are grassed with permanent vegetation.
Vegetated slopes are no steeper than 3:1.
The inlets are located per the approved plans and do not cause short-
circuiting of the system.
The permitted amounts of surface area and/or volume have been
provided.
Required drawdown devices are correctly sized per the approved plans.
All required design depths are provided.
All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
The required system dimensions are provided per the approved plans.
Please submit this Designer's Certification to: Raleigh Regional Office
Surface Water Protection
3800 Barrett Drive
Raleigh, NC 27609
Page 6 of 6

Compliance Inspection Report
Permit: SW5121101 Effective:12/02/12 Expiration: 12/01/20
Project: Bailey community Park
Owner: Town of Bailey
County: Nash Adress: Stoney Hill Church Rd
Region: Raleigh
City/StatelZip: Bailey NC 27807
Contact Person: Owen Strickland Title: Phone: [phone]
Directions to Project:
From hwy 2646 exit nc hwy 231 towards middlesex turn north on nc 231 turn east on stoney hill church rd travel 2.6 mi
Type of Project: State Stormwater - General Permit
Drain Areas:
On -Site Representatives):
Related Permits:
Inspection Date: 12/0412018 EntryTime: 11:15AM Exit Time: 11:50AM
Primary Inspector: Thaddeus W Valentine
Secondary lnspector(s):
Phone:
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: State Stormwater
Facility Status: Compliant ❑ Not Compliant
Question Areas:
State Stormwater
(See attachment summary)
page: 1

Permit: SW5121101 Owner - Project: Town of Bailey
Inspection Data: 12/04/2018 Inspection Type Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
Everthing looks good
File Review Yes No NA NE
Is the permit active? 0 ❑ ❑ ❑
Signed copy of the Engineer's certification is in the file? ❑ ❑ ❑
Signed copy of the Operation & Maintenance Agreement is in the file? ❑ ❑ ❑
Copy of the recorded deed restrictions is in the file? ❑ ❑ ❑
Comment: OK
Built Upon Area Yes No NA NE
Is the site BUA constructed as per the permit and approval plans? ■ ❑ ❑ ❑
Is the drainage area as per the permit and approved plans? N ❑ ❑ ❑
Is the BUA (as permitted) graded such that the runoff drains to the system? 0 ❑ ❑ ❑
Comment: Built as designed
SW Measures Yes No NA NE
Are the SW measures constructed as per the approved plans? 0 ❑ ❑ ❑
Are the inlets located per the approved plans? 0 ❑ ❑ ❑
Are the outlet structures located per the approved plans? 0 ❑ ❑ ❑
Comment: All measures are installed per the plan
Operation and Maintenance Yes No NA NE
Are the SW measures being maintained and operated as per the permit requirements? 0 ❑ ❑ ❑
Are the SW BMP inspection and maintenance records complete and available for review or provided to ❑ ❑ ❑
DWO upon request?
Comment: The BMP is newly constructed and is still establishing itself
Other Permit Conditions Yes No NA NE
Is the site compliant with other conditions of the permit? ❑ ❑ ❑
Comment: OK
Other WQ Issues Yes No NA NE
Is the site compliant with other water quality issues as noted during the inspection? ■ ❑ ❑ ❑
Comment: OK
page: 2

' DWQ USE ONI Y '
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 M mt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This farm may be photocopied for iise as an original
I. GENERAL INFORMATION
'L Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Bailey Community Park
2. Location of Project (street address):
Stoney Hill Church Road
City: Bailey County: Nash Zip:27807
3. Directions to project (from nearest major intersection):
From Hwy 264 exit at NC Hwy 231 towards Middlesex. Turn North on NC 231. Turn East on Stoney Hill
Church Road, Travel 2.6 miles.
4. Latitude:350 48' 24" N Longitude:78° 08' 38" W of the main entrance to the project.
11. PERMIT INFORMATION:
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 number , its issue date (if known) , and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* "provide a designer's certification
2. Specify the type of project (check one):
❑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 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: 32.77 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,
issue date and the type of each permit:Bailey Community Park - Phase 1, Nash - 201-
kUk�lVJ1t LNOV202012
XW
2013 &
Form SWU-101 Version 07Jun2010
G_:_
1 Pap o NC DENR
aL „__ ___,

III. CONTACT INFORMATION
'La. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/ Organization:Town of Bail
Signing Official & Title:Owen Strickland, Mayor of Bailey
b.Contact information for person listed in item la above:
Street Address:6260 Main Street
City:Bailey State:NC Zip:27807
Mailing Address (if applicable):
City: State: Zip:
Phone: (252 ) 2354977 Fax: (252 } 235-5762
Email:Town of Bailey©ripline.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/Organization:
Signing Official & Title:
b. Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if applicable):
City:
Phone: ( )
Email:
State:
State:
Fax:
M
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/ Organ ization:Withers & Ravenel
Signing Official & Title:Loftee Smith, Project Engineer
b.Contact information for person listed in item 3a above:
Mailing Address:111 MacKenan Drive
City;Cary State:NC Zip:27511
Form S WU-101 Version 07Jun2010 Page 2 of 7

Phone: [phone]
Email:lsmith@ivithersra veriel.coni
Fax: [phone]
4. Local jurisdiction for building permits: Nash Coun
Point of Contact:Nancy Nikon
IV. PROJECT INFORMATION
Phone 4: 252 459-1210
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
The project will be treated with a_ wet pond and level spreader.
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 Neuse River basin.
4. Total Property Area: 65.46 acres
5_ Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 2.28 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area- 63.18 acres
Total project area shall be calculated to exclude thefollowing: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal Higgh 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 = 11.5 %
9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered
stonuwater BMP. For low density and other projects, use 2 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.
Form SWU-101 Version 07Juo2010 Page 3 of 7

Basin Info'raiation;
DraiiaELA`rca1
_.
D'rairi�i e E1rea.....,
—
,Drama e,A'rea, —
D`raina r"e Area,:::: .
—
Receiving Stream Name
Big Branch of
Turke Creek
Stream Class
C; NSW
Stream Index Number *
27-86-3-6
`total Drainage Area (so
784,080
On -site Drainage Area (so
784,080
Off -site Drainage Area (so
0
Proposed Impervious Area** (so
196,020
Impervious Area** total
25%
Im ervno>isweSurface Area a ,,,. ,,;
Drama eurea- .,
;Drama e Area.. �a
;Drama e Area ,,,
Drama e•Areat�;
On -site Buildings[Lots (so
1500
On -site Streets (so
24,787
On -site Parking (so
56,002
On -site Sidewalks (so
29,225
Other on -site (so
0.0
Future (so
84,506
Off -site (so
0.0
Existing BUA*** (so
0.0
Total (so:
196,020
* Stream Class and Index Number can be determined at: hft ortaI.ticdenr.oroebftvg6L5Lcstilclassifications
** Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
*** Report only that amount of existing BUA that will remainafter development. Do not report any existing BUA that
is to be removed and which will be replaced by new B UA.
11. How was the off -site impervious area listed above determined? Provide documentation. Autocad - Man
Enclosed
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 .0500.
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 htty://Dortal.ncdenr.ore/web/wCp/ws/su/bmD-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 http.Z portal.ncdenr.org/web/wq/ws/su/statesw/forms _docs. 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 at littp://portil,ncdenr.org/web/wq/ws/sti/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://portit.nccienr.org/web/wq/ws/su/­stitesw/fornis—docs.
Initials
I - Original and one copy of the Stormwater Management Permit Application Form. v�J
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part V11 below)
3. Original of the applicable Supplement Form(s) (sealed signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to �F1/t1
http://www.eiivhelp.org/pages/onestopex-press.html for information on the Express program
Form SWU-101 Version 07Jun2010 Page 4 of 7

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/managennentfor 719,A)
the project. This is required in addition to the brief summary provided in the Project
Information, item I.
6. A USGS map identifying the site Iocation. If the receiving stream is reported as class SA or the �h�^'
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the
mile radius on the map.
7. Sealed, signed and dated calculations. T
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 MI-IW (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).
p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x11" copy of the NRCS County Soils map with the
Project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHW7 prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 2500 Page No: 533 S?_
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 NCAC 2H.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http://www,secretary.state.nc.us/Corporations/CSearch.aspx
Form SWU-101 Version 07Jun2010 page 5 of

VII. DEED RESTRICCIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
http://12ortal.ncclenr.org/web/wq/ws/su/statesw/formsdocs. 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:Loftee Smith
Consulting Firm: Withers & Ravenel
Mailing Address:111 MacKenan Drive
City:Cary T
Phone: [phone]
Email:[e-mail]
S to te: NC Zip:27511
Fax: (919 . < < )_ . 467-6008 .,
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or hype name of person listed in Contact Information, item 2a) , certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item 1a) with (print or hype name of organization listed in
Contact Information, item ]a) 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.
Four SWU-101 Version 07Jun2010 Pace 6 of 7

X. APPLICANT'S CERTIFICATION
1, (print or type name of person listed in Contact Information, item 1a) Owen Strickland
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 21-1.1000, SL 2006-246 (Ph. II - Post Construction) or SL 2008-2-I1.
Signature: c,, /,LLti_ Date:is�y d Q ! l
I, — . ( V a Notary Public for the State of = �+ i -YO CVVk -, County of
do hereby certify that wp-o S+f ' C. k )i a, I y'-( personally appeared
before me thisq+)ay of _P io and a knowledge the due execution of the application for
a stormwater permit. Witness my hand and official sea],
o-�-
SEAL
My commission expires - J
Form SWU-101 Version 07.iun2010 Page 7 of 7

Permit No.
L t. (to be provided by DWOJ
PIMA
= 1A
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be 6ffed out, printed and submitted.
The Required Items Checklist (Part Ili) must be printed, Sled out and submitted along with all of the required information.
I. PROJECT, INFORMATION,
Project name Bailey Community Park I
Contact person Loftee Smith
Phone number 91S-469-3340
Date IOf2912012
Drainage area number BMP-1
II. _DE=SIGNJNFORMATION
Site Characteristics
Drainage area 784,046 ft'
Impervious area, post -development 196,020 h2
% impervious 25.00 %
Design rainfall depth 1.0 in
Storage Volume: Non -SA Waters
Minimum volume required 17,969 ft3
Volume provided 18,687 ft3
Storage Volume: SA Waters
1.5" runoff volume NIA ft3
Pre -development 1-yr, 24-hrrunoff ft3
Post -development 1-yr, 24-hrrunoff ft3
Minimum volume required ft3
Volume provided ft3
Peak Flow Calculations
Is the pro/post control of the )yr 24hr storm peak flow required?
Y (Y or N)
1-yr, 24-hr rainfall depth
2.9 in
Rational C, pre -development
(unitless)
Rational C, post -development
(unitless)
Rainfall intensity; 1-yr, 24-hr storm
inihr
Pre -development 1-yr, 24-hr peak (low
9.15 ft3lsec
Post -development 1-yr, 24-hr peak flaw
6.54 ft3lsec
PrelPost 1-yr, 24-hr peak flow control
-2.61 ft3lsec
Elevations
Temporary pool elevation
214.50 fmsl
Permanent pool elevation
213.50 fmsl
SWWT elevation (approx. at the perm. pool elevation)
fmsl
Top of 1 Oft vegetated shelf elevation
214.00 fmsl
Bottom of 10ft vegetated shelf elevation
213.00 fmsl
Sediment cleanout, top elevation (bottom of pond)
210.00 fmsl
Sediment cleanout, bottom elevation
209.001msl
Sediment storage provided
1.00 ft
Is there additional volume stored above the state -required temp. pool?
N (Y or N)
Elevation of the top of the additional volume f si
g�gQ�1
nn
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1
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Form SW401-Wet Detention Basin-Rev.9 11811
Ill Dl
OK, volume provided is equal to or in excess of volume required.
12c�� eoc
NOV 2 0 2012
Parts I. & U, Design Summary, Page 1 of 2

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Permit No
(to be provided by DWQ)
Ill. DESIGN INFORMATION
Surface Areas
Area, temporary pool
19,877 fe
Area REQUIRED, permanent pool
12,153 1t
SAIDA ratio
1,55 (unitless)
Area PROVIDED, permanent pool, 9�m
16,158 ft`
OK
Area, bottom of 1 Oft vegetated shelf, /�, �,
12,934 ft'
Area, sediment cleanout, lop elevation (bottom of pond), r,,
8,037 fl'
Volumes
Volume, temporary pool
18,687 fe
OK
Volume, permanent pool, 4,m P,
36,573 fe
Volume, forebay (sum of forebays if more than one forebay)
7,355 W
Forebay % of permanent pool volume
19.1 % %
OK
SAIDA Table Data
Design TSS removal
90
Coastal SAIDA Table Used?
N (Y or N)
tvlountain/Piedmont SAIDA Table Used?
Y (Y or N)
SAIDA ratio
1.55 (unitless)
Average depth (used in SAIDA table);
Calculation option 1 used? (See Figure 10-2b)
N (Y or N)
Volume, permanent pool, \�,,r _poc,
38,573 ft'
Area provided, permanent pool, A,.r _P,
16,158 W
Average depth calculated
11
Need 3 ft min.
Average depth used in SAIDA, 4,,, (Round to nearest 0.5ft)
ft
Calculation option 2 used? (See Figure 10-2b)
Y (Y or N)
Area provided, permanent pool, 4e,m M
16,158 W
Area, bottom of 10ft vegetated shelf, Pst,,
12,934 fe
Area, sediment cleanout, top elevation (bottom of pond), & pond
8,037 f�
"Depth" (distance b/w bottom of 1 Oft shelf and top of sediment)
3.00 ft
Average depth calculated
3.29 ft
OK
Average depth used in SAIDA, d,,, (Round to down to nearest 0.51)
3.5 ft
OK
Drawdown Calculations
Drawdown through orifice?
Y (Y or N)
Diameter of orifice (lf circular)
2.50 in
Area of orifice (if -non -circular)
in'
Coefficient of discharge (Co)
0,60 (unitless)
Driving head (F�)
1.00 ft
Drawdown through weiO
N (Y or N)
Weir type
(unitless)
Coefficient of discharge (C,,)
(unitless)
Length of weir (L)
ft ,
Driving head (N)
It
Pre -development 1-yr, 24-hr peak flow
h'Isec
Post -development 1-yr, 24-hr peak flow
ft'/sec
Storage volume discharge rate (through discharge orifice or weir)
ft3lsec
Storage volume drawdown time
2.19 days
Additional Information
Vegetated side slopes
3 :1
Vegetated shelf slope
10 A
Vegetated shelf width
10.0 ft
Length of flowpath to width ratio
3 :1
Length to width ratio
3.0 :1
Trash rack for overflow & orifice?
Y (Y or N)
Freeboard provided
0-6 ft
Vegetated filter provided?
N (Y or N)
Recorded drainage easement provided?
Y (Y W N)
Capures all runoff at ultimate build -out?
Y (Y or N)
Drain mechanism for maintenance or emergencies is:
Pump
OK, draws down in 2-5 days.
OK
OK
OK
OK
OK
OK
Insufficient freeboard, minimum of 1-ft required
OK
OK
OK
Form SW401-Wet Detention Basin-Rev.9-4118112 Parts I. a 11. Design Summary, Page 2 cf 2

Permit Number:
(to be provided big DIt"Q)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BIvIP. This maintenance record will 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 removal efficiency of the BMP.
The wet detention basin system is defined as the wet detention basin,
pretreatment including forebays and the vegetated filter if one is provided.
This system (check one): CD
❑ does ® does not incorporate a vegetated filter at the outlet. m
y
This system (check one):
❑ does ® does not incorporate pretreatment other than a forebay.
Important maintenance procedures:
— immediately after the wet detention basin is established, the plants on the l
vegetated shelf and perimeter of the basin should be watered twice weekly if
needed, until the plants become established (conurtonly 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 basil.
— 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:
Potentialproblem:
How 1 will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the wet
Areas of bare soil and/or
Regrade the soil if necessary to
detention basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer appl.icaLion.
Vegetation is too short or too
Maintain vegetation at a height of
long.
approximately six inches.
a
F5
Form SW401-Wet Detentim Basin O&M-Rev.4 Page 1 ol'4

liduLn

Permit Number:
(to he Provided hl- MVQ)
Draina-e Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
rrhe pipe is clogged.
Unclog the pipe. Dispose of the
Swale
sediment off -site.
The pipe is cracked or
Replace the pipe,
otherwise damaged.
1.rosion is occurring in the
Regrade the Swale if necessary to
swMe.
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible, Remove the sediment and
sediment storage.
dispose of it in a location where it
will not cause impacts to streams or
the 13MP.
Provide additional erosion
Erosion has occurred.
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
theplant-; rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional
show that pruning is needed
practices
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. 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.
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sedimentand remedy the problem if
original design sediment
possible. Remove the sediment and
storage depth.
dispose of it in a location where it
will not cause impacts to streams or
the 13MP.
Algal growth covers over
Consult a professional to remove
50% of the area.
and control the algal growth.
Remove the plants by wiping them
Cattails, pliragmites or other
invasive plants cover 50% of
with pesticide (do not spray).
the basin surface.
Form SW401-Wet Detention Basin O&N-Rev.4 Page 2 ot�4

Permit Number:
(to he provided hr UIVQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
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 re lace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Division of
damage have occurred at the
Water Quality Regional Office, or
outlet.
the 401 Oversight Unit at 919-733-
1786.
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.
When the permanent pool depth reads 3.5 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 3.5 feet in the forebay, the sediment
shall be removed.
BASIN DIAGRAM
(Jill in the blanks)
Sediment Removal El. 210 Pe manefl�
-------------- --- Volume
Bottom Elevatioi 209 -ft Mill.
Sediment
Storage
FOREBAY
Pool
Permanent Pool Elevation 213,5
Sediment Removal Elevation 210 Volume
-------- -----
Bottom Elevation 209
MAIN POND
1-ft n.
Sediment
Storage
Form SW40i-Wet Detention Basin 0&,M-Rev.4
Page 3 ol-4

Permit Number:
(to be, provicicd bY DIVA)
f
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of anv
problems xvith the system or prior to any changes to the system or responsible party.
Project name:Town-of Bailey Park
BIIP drainage area number: Wet Pond 1
Print name: (Obif-,.
Title: !t'l jLk, a r fj
Address: , l/9 M� n S / ' [" Q ba i_ Vo IV C, c 2 7ed 7
Phone: o7 5a - 3L3 -'3- ' y61''I1
Signature:
Date: (Itt, Co)_p /.I—
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I,�.QIJP'y- , a Notary Public for the State of
N oyi r�QYlj� i YvU, , County of N Q 0h , do hereby certify that
t7l,a"l1 �� r �1� Q Vic personally appeared before me this
-la'l
day of Ala_ DJ- , and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my ]land and official
seal,
• Ir•ti'T1'i-, �1
u
$. A.,:.-
My commission expires ff, 013
Form SW40I-Wet Detention Basin O&M-Rev.4 Page 4 of 4