SW7060802_CURRENT PERMIT_20191209

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW�C%LOl��(��
DOC TYPECURRENT
PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
aiDA��9
WYYMMDD

WaP,0
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Director
NORTH CAROLINA
Environmental Quality
December 9, 2019
Stonebriar Commercial Finance LLC
Attention: Mr. Dirk Stock, Vice President
5601 Granite Parkway, Suite 1350
Plano, TX 75024
Subject: Stormwater Permit No. SW7060802 Ownership Change
Academi —Warehouse
High Density Stormwater Project
Camden County
Dear Mr. Stock. -
The Washington Regional Office received a Stormwater Management Permit
Application for ownership change of the subject project on October 28, 2019. Staff
review of the application has determined that the permit can be reissued. We are
forwarding PermifNo. SW7060802 dated December 9, 2019, for the continued
operation of the subject project.
This permit, upon its effective date, will replace all previous State Stormwater permits for
this project. This permit shall be effective from the date of issuance until August 29, 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 Operation and Maintenance requirements in this permit. Failure to establish an
adequate system for operation and maintenance of the stormwater management system
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 upon written request within thirty (30)
days following receipt of this permit. This request must be in the form of a written petition,
conforming to Chapter 150B of the North Carolina General Statutes, and filed with the
Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714.
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 me at [phone].
Sincerely,
Roger K. Thorpe
Environmental Engineer
North Carolina Department of EnOronmentaiQuality ; Division of Energy, Mineral and Land Resources
t::�:�QEQ" Washington Regional Off ce 1943 Washington Square Mall i Washington. North Carolina 27889
NORTH
252?4b.b48i

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
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
Stonebriar Commercial Finance LLC
ACADEMI — Warehouse
located at 850 Puddin Ridge Road, Moyock, NC
Camden County.
FORTHE
construction, operation and maintenance of a wet detention pond 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 Energy, Mineral, and
Land Resources (Division) and considered a part of this permit.
This permit shall be effective from the date of issuance until August 29, 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 1.6 of this permit. The stormwater control has
been designed to handle the runoff from 4.85 acres of impervious area over the
8.15 acres of drainage area for this project.
3. 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.

4. The runoff from all built -upon area within the permitted drainage area #1 of this
project must be directed into the permitted stormwater control system per
approved plans.
5. The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a. Drainage Area, acres:
8.15
b. Total Impervious Surfaces, acres:
4.85
C. Design Storm, inches:
1.0
d. Pond Depth, feet:
4.50
e. TSS removal efficiency:
90%
f. Permanent Pool Elevation, FMSL:
10.50
g. Permanent Pool Surface Area, ft2:
57,770
f.
h. Permanent Storage, Volume, ft3:
180,378
i. Permitted Forebay Volume, ft3:
33,623
i. Temporary Storage Elevation, FMSL:
11.00
I. Temporary Storage Volume, ft3:
29,443
k. Controlling Orifice:
3.0" � pipe
I. Receiving Stream/River Basin:
Tull Creek I Pasquotank
M. Stream Index Number:
30-1-2-2-5-1-1
n. Classification of Water Body:
"B; Sw"
li. SCHEDULE OF COMPLIANCE
1. 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.
2. 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 the Division. The records will indicate the
date, activity, name of person performing the work and what actions were taken.
5.
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.
Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and'P�jgL,,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 device,
and prior to occupancy of the facility.
8.
Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
9. 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.

14. 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 fora 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
1. 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 formal permit transfer request to the Division, 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.
2. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division, in accordance with
North Carolina General Statute 143-215.6A to 143-215.6C.
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.
5. The permittee grants DEQ Staff permission to enter the property during normal
business hours for the purpose -of inspecting all components of the permitted
stormwater management facility.
6. 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.
7. 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 of any name, ownership or mailing
address changes within 30 days.
10. This permit shall be effective from the date of issuance until August 29, 2020.
Application for permit renewal shall be submitted 180 days prior to the expiration
date of this permit and must be accompanied by the processing fee.
Permit issued this the 9th day of December 2019.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for
S. Daniel Smith, Director
Division of Energy, Mineral, and Land Resources
By Authority of the Environmental Management Commission
Permit No. SW7060802

State of North Carolina
Department of Environment and Natural Resources
Division of water Quality
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
1. CURRENT PERMIT INFORMATION
swinsnani
1. Stormwater Management Permit Number.
BlackW*ter USA - warahouse
2. Project Name:
RECEIVED OCT
ACADEMT Real $state Holdings, L.L.C.
3. Current Permit Holder's Company Name/Organization:
4. Signing Official's Name: AC'"0E"'I i:Lc
5. Mailing Address: 850 Quddin Ridge Road
Title: Manager
City: N1pypck State _uc Zip:
27958-B679
y aK �aAe
6. Phone:( '5'-
j
Fax: _ )
11. PROPOSED PERMITTEE 1 OWNER / PROJECT l ADDRESS INFORMATION
This request is for: (please check all that apply)
❑ Name change of the owner (Please complete Item:; 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 telow)
® Change in ownership of the property/company (Please complete items 1, 2, 3, and 4 below)
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1- Proposed permittee's company name/organization: Stonebriar Commercial Finance LLC
2. Proposed permittee's signing official's name: Dirk',tmk
3. Proposed permittee's title: yjce PMsident
4. Mailing Address: 5601 Granite Parkway, Suitt 1350
City: Plano 13tate: TX Zip: 75024
Phone: 4d9 609-8500 Fax.:
5. New Project Name to be placed on permit:
Please check the appropriate box. The proposed pern, ittee listed above is:
❑ HOA or POA (Attach documentation showing that : he HOA or POA owns„ controls, or has a
recorded easement for all areas that contain storm ovater system features. Print name of HOA or
POA in #1 above and provide name of HOAJPOA's author%zed representative in #2 above)
❑ The property owner
n Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
® Purchaser (Attach a copy of the pending sales agrmment. Final approval of this transfer will be
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information err page 4)
SSW N/0 Change Rev248ept2o12 Page 1 e' 4

I It
III. REQUIRED ITEMS
A request to transfer a permit will not'be approved by the Division of Water Quality (DWQ).unless all
of the applicable'required items listed below are included with the submittal. Failure to provide the
listed Items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed by both the
current permit holder and,the new applicant lf.this is a change of ownership.
2. Legal documentation of the property transfer to a new owner.
3. A" copy: of. any recorded: deed restrictions,covenants, or easements, if required by the permit'
4. The designers certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and`if not already submitted to DWQ.
5. if the proposed permittee is a firm, partnership, association, institution, corporation,. limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the -proposed permittee.
6. The $40.00 processing fee: If this is an initial transfer from the original permittee the processing
fee is not required, Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the aertificadon below that statement:
❑ Check here if the current permittee is only changing his/herlits name, the project name, or mailing
address, but will retain the permit I,.. the current
permittee, hereby notify the DWQ that I am changing my name and/or I am c anging my mailing
address and/or. I amchanging the name of the permitted project. I further attest that this.applicatian
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will.be returned as
incomplete.
0 Check here if current permittee is transterring the property to a new owner and will not retain
r,eishi of thep�nnit.
cp►n� Rea state Holdings, L . L. c the current permittee, am-submittin this application
for a transfer o ownership for perm # SW7060802 I hereby notXve
DWQ o)q the sale or
other legal transfer of the stormwater system associated t this permit. provided a copy of
the most recent permit, the.designei's certification for each BMP,,any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement; past maintenance records, and the most -recent DWQ
stormwater inspection report to the proposed permittee named in Sections 11 and V of'this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that If all required parts of this application are not completed or if all
required supporting information and attachments listed above are not Included, this application
package wifI be returned as incomplete. I assr"gn all,rights and obligations as permittee to the
proposed permittee named in Sections Il and V of this form. l understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility Is in compliance with the
permit.
Signature,
N
mmm
1, CAr'Z F-1E J'AN.E Cq PPS , a Notary Public for the State of
V R E71N/ I N , County of FAIa2 A. � , do hereby certify that
GEAUID MOORS
personally appeared before me this the
10"Y day of SEPTE M-R E1Z , 20iL and acknowledge the due
forIeOA
gin . Witness my hand and official seal,
ota Si e
SSW N/0 Change Rev24Sept2012 Page 2 of
execution of the
..81 i/7 '�Y I
yYS�
� ,►�� ... ,A1,,(Notary Seal)

V. PROPOSED PERMITTEE CERTIFICATION ; (This section must be completed by the
Proposed Permittee for all transfers of ownership)
I, StonebriarCommemial Finance LLC b Dirk Stock . , hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system. l
acknowledge and attest that I have received a copy of: (check all that apply to this permit)
12 the most recent permit
the designer's certification for each BM
❑ any recorded deed restrictions, covenants, or easements
❑ the DWQ approved plans and/or approved as-t ullf plans
[] the approved operation and maintenance agreement
epast maintenance records from the previous permittee (where required)
DWQ stormwater inspection report showing compliance within 90 days prior to this transfer
have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and approved plans. I acknowledge and agree that I will
operate and maintain the system pursuant to the requirements listed in the permit and in the
operation and maintenance agreement. I further attest that this application for a name/ownership
change Is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed or If all required supporting information and attachments listed
above are. no
t included, this application package will b3 returned as incomplete.
Signature: .jk for Stone' t iar Commercial Finnice LLC Date:
I, Carrie Stovall . a Notary Public for the State of
Texas County of Collin , do hereby certify that
Dirk Stock
personally appeared before me this the
9ti day of _August, 20 19 --, and acknowledge the clue execution of the
forgoing instrum t. Witness my hand and official seat,
a
OVALL
Ot i g naturB �� t17'�958b
my commisswn Expires
NovemberS.2019
Additional copies of the original permit and the approved Operation and Maintenance agreement can
be obtained from the appropriate Regional Office of tha Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Cerollna Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed abo>43 is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee / developer and the property
owner will appear on the permit as permittees.
SSW N/Q Change Rev24Sept2012 Page 3 cf 4

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections Il and V of this form is not the Property Owner, the
Property Owner must provide hisJher Contact Information below and sign this fonn:
Printed Name:
Organization:
Title within the Organization:
Street Address:
City:
State:
Zip:
Mailing Address:
(if different from street address)
City: State: Zip:
Phone:
Fax:
Email:
I certify that I own the Property identified in this permittransfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, tease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWQ Stormwater permit. As the proper owner, it is my responsibility to notify
DWQ by submltdng a completed Name/Ownership Change Form within 30 days of procu ng a
developer, lessee or purchaser for the property. I understand that failure too operate and maintain the
stonnwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner
Date:
1, , a Notary Public for the State of
County of
do hereby certify that
personally appeared before me this the
day of 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
Notary Signature
SSW WO Change Rev24Sept2012 Page 4 of 4
(Notary Seal)

State Stormwater Management Systems
Permit No. SW7060802
Blackwater USA — Warehouse
Stormwater Permit No. SW7060802
Camden County
Designer's Certification
ICED OCJ 4 ��19
tF
I Sean C. Robey, PE , as a duly registered Engineer
in the State of North Carolina, having been authorized to observe
fl-te�-thE construction of the project,�ST�-
Blackwater USA - Warehouse
(Project)
for ACADEMI (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:
SEAL
Signature 1Z;N�N\ GARo �y�i�i
Registration Number `BSJ O V '�FS�'0•'' 9
1 Q� ('
Date
s�A�
i�,l basso
.''•.FN{�hyEOP r
sFgH C. Viol����``�\`
rfr�nn+
Page6of7

State Stormwater Management Systems
Permit No. SW7060802
Certification Requirements:
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.
71. The permitted amounts of surface area and/or volume have been
provided.
12. Required drawdown devices are correctly sized per the approved plans.
i� 13. All required design depths are provided.
14, All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
ier-1- 15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Camden County Building Inspections
Page 7 of 7

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number: SW7060802
2. Project Name: Blackwater USA - warehouse
3. Current Permit Holder's Company Name/Organization:
4. Signing Official's Name: ACADEMI LLC
5. Mailing Address:
850
City: Moyock
Puddin Ridge Road
6. Phone: ( 252 ) 435-2488
5V
Lv {�
RECEIVED M4R 2 7 2019
E&J Holdings, L.L.C.
Title: Manager
State: NC
Fax
Zip: 27958-8679
II. PROPOSED PERMITTEE / OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
F Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
❑ Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1. Proposed permittee's company name/organization: ACADEMI Real Estate Holdings, L.L.C.
2. Proposed permittee's signing official's name: ACADEMI LLC
3. Proposed permittee's title: Manager
4. Mailing Address:
City:
Phone: �)
5. New Project Name to be placed on permit:
State: Zip:
Fax: (
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
0 The property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
❑ Purchaser (Attach a copy of the pending sales agreement. Final approval of this transfer will be
granted upon receipt of a copy of the recorded deed)
❑ Developer (Complete Property Owner Information on page 4)
SSW N/O Change Rev24Sept2012 Page 1 of 4

III. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed and signed form. This certification must be completed and signed! by both the
current permit holder and the new applicant if this is a change of.ownership..
2. Legal documentation of the property transfer to anew owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement:
® Check here if the current permittee is only changing his/her/its name, the project name, or mailing
�ldn��
address, but will retain the permit. I, C+ ,J C. L• G- , the current
permittee, hereby notify the DWQ that I am changing my name and/or I am changing my mailing
address and/or I am changing the name of the permitted project. I further attest that this application
for a name/ownership change is accurate and complete to the best of my knowledge. I understand
that if all required parts of this application are not completed or if all required supporting information
and attachments listed above are not included, this application package will be returned as
incomplete.
❑ Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
I, , the current permittee, am submitting this application
for a transfer of ownership for permit # . l hereby notify DWQ of the sale or
other legal transfer of the stormwater system associated with this permit. I have provided a copy of
the most recent permit, the designer's certification for each BMP, any recorded deed restrictions,
covenants, or easements, the DWQ approved plans and/or approved as -built plans, the approved
operation and maintenance agreement, past maintenance records, and the most recent DWQ
stormwater inspection report to the proposed permittee named in Sections II and V of this form. I
further attest that this application for a name/ownership change is accurate and complete to the best
of my knowledge. I understand that if all required parts of this application are not completed or if all
required supporting information and attachments listed above are not included, this application
package will be returned as incomplete. I assign all rights and obligations as permittee to the
proposed permittee named in Sections II and V of this form. I understand that this transfer of
ownership cannot be approved by the DWQ unless and until the facility is in compliance with the
permit.
Signature. +- VW SF- JK, Date: 3 - -/u —I '7
A&AUGFAi LILGI
I
a Notary Public for the State of
�o In Cao l,trva { ^, County of C�am&n,_ , do hereby certify that
KALrint_ E_ Mc-V-ort_ t- \k—A _ personally appeared before me this the
day of Moxc,1 % , 2011, and acknowledge the due execution of the
OWS111111110/,
forgoin instrument. Witness my hand and official seal, .r�pA R. y,.�Notary Seal)
Notary Signatur eJ •NOTARY•��
Mq GomrniSsivn Wims, jri1 IS, ?.oZ2
n'•• PUBLIC ;C
SSW N/C Change Rev24Sept2012 Page 2 of 4%92'4•••.•• N.�`•,'
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V. PROPOSED PERMITTEE CERTIFICATION: (This section must be completed by the
Proposed Permittee for all transfers of ownership)
I, , hereby notify the DWQ that I have acquired
through sale, lease or legal transfer, the responsibility for operating and maintaining the permitted
stormwater management system, and, if applicable, constructing the permitted system. I
acknowledge and attest that I have received a copy of: (check all that apply to this permit)
Hthe most recent permit
the designer's certification for each BMP
❑ any recorded deed restrictions, covenants, or easements
❑ the DWQ approved plans and/or approved as -built plans
❑ the approved operation and maintenance agreement
❑past maintenance records from the previous permittee (where required)
DWQ stormwater inspection report showing compliance within 90 days prior to this transfer
I have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and approved plans. I acknowledge and agree that I will
operate and maintain the system pursuant to the requirements listed in the permit and in the
operation and maintenance agreement. i further attest that this application for a name/ownership
change is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed or if all required supporting information and attachments listed
above are not included, this application package will be returned as incomplete.
Signature:
I
Date:
a Notary Public for the State of
County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
(Notary Seal)
Notary Signature
Additional copies of the original permit and the approved Operation and Maintenance agreement can
be obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee / developer and the property
owner will appear on the permit as permittees.
SSW N/O Change Rev24Sept2012 Page 3 of 4

VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections II and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name:
Organization:
Title within the Organization:
Street Address:
City:
Mailing Address:
City:
Phone:
Email:
State:
(if different from street address)
State:
Fax:
0
Zip:
certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify
DWQ by submitting a completed Name/Ownership Change Form within 30 days of procuring a
developer, lessee or purchaser for the property. I understand that failure to operate and maintain the
stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner
Date:
I, , a Notary Public for the State of
, County of , do hereby certify that
personally appeared before me this the
day of , 20 , and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
Notary Signature
(Notary Seal)
SSW N/O Change Rev24Sept2012 Page 4 of 4

Pen -nit No.
(to he provided by DWQ)
State of North Carolina
`%! 1"J a q�) Department of Environment and Natural Resources
Division of Water Quality
AUG — ? 200s STORMWATER MANAGEMENT PERMIT APPLICATION FORM
UUVQ-IPJARO WET DETENTION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWO Stonnwater Management Plan Review:
A complete stonnwater management plan submittal includes an application form, a wet detention basin
supplement for each basin, design calculations, and plans and specifications showing all basin and outlet
structure details.
1. PROJECT INFORMATION
Project Name: ?LACX_'y k7E?- WAP= "USE
Contact Person: ToNY VEeJuo AJ Phone Number: S -Z'.bB
For projects with multiple basins, specify which basin this worksheet applies to: 4A
elevations
Basin Bottom Elevation ft.
Permanent fool Elevation ly.Sb ft.
Temporary Pool Elevation If. Do ft.
(door of the basin)
(elevation of the orifice)
(elevation of the discharge structure ovealow)
areas
Permanent Pool Surface Area 5-7, T70 sq. ft. (water surface area at the orifice elevation)
Drainage Area $ 15 ac. (on -site and off .rite drainage to the hasin)
Impervious Area q-9c- ac. (on -site and off -site drainage to the basin)
volumes
Permanent Pool Volume
Temporary Pool Volume
Forebay Volume
Other parameters
SA/DAl
Diameter of Orifice
Design Rainfall
Design TSS Removal 2
180.378 cu. ft. (coi biped volume of main asin andforebay)
-P;-88 �'� c u,ft. (volumU. e detained abo he�permaa ennt pool)
339Q-3 cit. ft. (approximately 20% of'total volume)
$• 3 (sanface area to drainage area ratio from DWQ table)
3 in. (2 to 5 day temporary pool draw -down required)
J iEf.
�1 % (minimum 85% required)
Form SWU-102 Rev 3.99 Page l of 4

I
footnotes:
When using the Division SA/DA tables, the correct SA/DA ratio for permanent pool sizing should be computed based upon the
actual impervious %and permanent pool depth. Linear interpolation should be employed to determine the correct value for non-
standard table entries.
2 In the 20 coastal counties, the requirement for a vegetative filter may be waived if the wet detention basin is designed to provide
90% TSS removal. The NCDENR BMP manual provides design tables for both 85% TSS removal and 90% TSS removal.
II. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of I?nvirontnent, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 21-I . I008.
Initial in the space provided to indicate the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. if a requirement has not been met, attach justification.
Applicants Initials
L a. The permanent pool depth is between 3 and 6 feet (required minimum of 3 feet).
b. The forebay volume is approximately equal to 20% of the basin volume.
04- c. The temporary pool controls runoff from the design storm event.
d. The temporary pool draws down in 2 to 5 days.
N1A e. If required, a 30-foot vegetative filter is provided at the outlet (include non -erosive flow
calculations)
NIA
f. The basin length to width ratio is greater than 3:1.
g. The basin side slopes above the permanent pool are no steeper than 3:1.
h. A submerged and vegetated perimeter shelf with a slope of 6:1 or less (show detail).
i. Vegetative cover above the permanent pool elevation is specified.
J. A trash rack or similar device is provided for both the overflow and orifice.
k. A recorded drainage easement is provided for each basin including access to nearest right-
of-way.
1. If the basin is used for sediment and erosion control during construction, clean out of the
basin is specified prior to use as a wet detention basin.
In, A mechanism is specified which will drain the basin for maintenance or an emergency.
III. WET DETENTION BASIN OPERATION AND MAINTENANCE AGREEMENT
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 (cheek one) 0 does does not incorporate a vegetated filter at the outlet.
This system (check one) 0 does kdoes not incorporate pretreatment other than a forebay.
Form SWU-102 Rev 3.99 Page 2 of 4

Maintenance activities shall be performed as follows:
1. After every significant runoff producing rainfall event and at least monthly.
a. Inspect the wet detention basin system for sediment accumulation, erosion, trash accumulation,
vegetated cover, and general condition.
b. Check and clear the orifice of any obstructions such that drawdown of the temporary pool occurs within
2 to 5 days as designed.
2. Repair eroded areas immediately, re -seed as necessary to maintain good vegetative cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash as needed.
3. Inspect and repair the collection system (i.e. catch basins, piping, swales, riprap, etc.) quarterly to maintain
proper functioning.
4. Remove accumulated sediment from the wet detention basin system semi-annually or when depth is
reduced to 75% of the original design depth (see diagram below). Removed sediment shall be disposed of
in an appropriate manner and shall be handled in a manner that will not adversely impact water quality (i.e.
stockpiling near a wet detention basin or stream, etc.).
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 3,4 feet in the main pond, the sediment shall be removed.
When the permanent pool depth reads 3.4 feet in the forebay, the sediment shall be removed.
BASIN DIAGRAM
(fill in the blanks)
_t
0 Permanent Pool Elevation !0• s D
Sediment Re oval E.I. ir
Sediment Removal Elevation 7. i 2S 75%
Bottom Ele anon ---------------------- J----------------------125%
-- --
Bottom Elevation b
FOREBAY MAIN POND
5. Remove cattails and other indigenous wetland plants when they cover 50% of the basin surface. These
plants shall be encouraged to grow along the vegetated shelf and forebay berm.
6. If the basin must be drained for an emergency or to perform maintenance, the flushing of sediment through
the emergency drain shall be minimized to the maximum extent practical.
Fora, SWU-102 Rev 3.99 Page 3 of

7. All components of the wet detention basin system shall be maintained in good working order.
I acknowledge and agree by my signature below that I am responsible for the performance of the seven
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print name: 6ikzv C. /iGI�SbN
Title: AE3,vCaT
Address:_ .Go pu.n� �ipctgpA� p.-lYi��QC r.NL Z��TF _
Phon
Sigm
Date
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.
1, (�z "l-, PCAy U, I a Notary Public for the State of k)Cr ,
County of w (I-- do hereby certify that
personally appeared before me this 16 71- day of ^­k , and acknowledge the due
execution of the forgoing wet detention basin maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires { P-4 1S+ ')ercj 7
RECEIVED
JUN 1 9 2006
ARCADIS Geraghty & Miller
Form SWU-102 Rev 3.99 Page 4 of