20181245 Ver 2_App 9_11_20_20200911

DEMLR USE ONLY
Date Received Fee Paid Permit Number

Applicable Rules:  Coastal SW – 1995  Coastal SW – 2008  Ph II - Post Construction
(select all that apply)  Non-Coastal SW- HQW/ORW Waters  Universal Stormwater Management Plan
 Other WQ Mgmt Plan:

Form SWU-101 Version Oct. 31, 2013 Page 1 of 6
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources

STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Tinsel Town Properties - Ferguson Street Development
2. Location of Project (street address):
21 Ferguson Street
City:Sylva County:Jackson Zip:28779
3. Directions to project (from nearest major intersection):
Project is on the Northwest coner of the intersection of Ferguson Street and US 74.

4. Latitude:35 23’ 32.48” N Longitude:-83 11’ 7.77” W of the main entrance to the project.

II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): New Modification Renewal w/ Modification†
†Renewals with modifications also requires SWU-102 – Renewal Application Form
b. If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numberWQC004191 , its issue date (if known)6/11/19 , 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
DEMLR requesting a state stormwater management permit application, list the stormwater project number,
if assigned, and the previous name of the project, if different than currently
proposed, .
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
CAMA Major Sedimentation/Erosion Control: ac of Disturbed Area
NPDES Industrial Stormwater 404/401 Permit: Proposed Impacts
b. If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:N/A

5. Is the project located within 5 miles of a public airport? No Yes
If yes, see S.L. 2012-200, Part VI: http://portal.ncdenr.org/web/lr/rules-and-regulations
Form SWU-101 Version Oct. 31, 2013 Page 2 of 6
III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official’s name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:Tinsel Town, LLC
Signing Official & Title:Billy D. Smith, President
b. Contact information for person listed in item 1a above:
Street Address:51 Bridge Street
City:Sylva State:NC Zip:28779
Mailing Address (if applicable):N/A
City: State: Zip:
Phone: (828 ) 269-0253 Fax: (N/A )
Email:N/A
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: State: Zip:
Mailing Address (if applicable):
City: State: Zip:
Phone: ( ) Fax: ( )
Email:

3. a. (Optional) Print the name and title of another contact such as the project’s construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:Alec Stillwell, Stillwell Engineering, PA
Signing Official & Title:Alec Stillwell, Site Engineer
b. Contact information for person listed in item 3a above:
Mailing Address:PO Box 838
City:Sylva State:NC Zip:28779
Phone: (828 ) 586-6066 Fax: (N.A )
Email:[e-mail]
4. Local jurisdiction for building permits: Jackson County Permitting and Code Enforcement
Point of Contact:Doug Painter Phone #: (828 ) 586-7560

Form SWU-101 Version Oct. 31, 2013 Page 3 of 6
IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
A portion of stormwater for the site will be generated high density development treated by a bioretention
area. The remaining stormwater for the site will be low density development.

2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
Approval of a Site Specific Development Plan or PUD Approval Date:
Valid Building Permit Issued Date:
Other: Date:
b. If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
Coastal SW – 1995 Ph II – Post Construction
3. Stormwater runoff from this project drains to the Little Tennessee River basin.
4. Total Property Area: 22.31 acres 5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: 3.33 acres
7. Total Property Area (4) – Total Coastal Wetlands Area (5) – Total Surface Water Area (6) = Total Project
Area+: 18.98 acres
+ Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non-coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 46 %
9. How many drainage areas does the project have?2 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information Drainage Area 1 Drainage Area Drainage Area Drainage Area
Receiving Stream Name Scott Creek Scott Creek
Stream Class * C; Tr C;Tr
Stream Index Number * 2-79-39 2-79-39
Total Drainage Area (sf) 100624 140699
On-site Drainage Area (sf) 100624 140699
Off-site Drainage Area (sf) 0 0
Proposed Impervious Area** (sf) 21,941 102366
% Impervious Area** (total) 22% 73%

Impervious** Surface Area Drainage Area 1 Drainage Area 2 Drainage Area Drainage Area
On-site Buildings/Lots (sf) 7776 18800
On-site Streets (sf) 11573 0
On-site Parking (sf) 2592 62928
On-site Sidewalks (sf) 0 5638
Other on-site (sf) 0 15000
Future (sf) 0 0
Off-site (sf) 0 0
Existing BUA*** (sf) 0 0
Total (sf): 21941 102366
* Stream Class and Index Number can be determined at: http://portal.ncdenr.org/web/wq/ps/csu/classifications
** 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 remain after development. Do not report any existing BLLA that
is to be removed and which will be replaced by new BLIA.
11. How was the off site impervious area listed above determined? Provide documentation Site is bordered on
North West and South by Streams. East side borders Fed uson Road which runoff is diverted off site.
Projects in Union Count v: Contact DES Central ice staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15A NCAC 02B .0500.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and. maintenance (O&M) fortes
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from hftp://portal.ncdenr.org/web/wq/ws/su/bmp-ma-nuaL
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
h orLal.ncdenr.or web w ws su statesw forms docs. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map at h :1 ortaI.ncdenr.or web w ws su rna s.)
Please indicate that the following re uired 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- portaI.ncdenr.org/web/wq/ws/su/statesw/Forms docs.
Initals
I. Original and one copy of the Stozmwater Management Permit Application Form_
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) sealed si ed and dated and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
h /www.envheln-oEg/ a es onesto ress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting_)
S. A detailed narrative (one to two pages) describing the stormwater treatment/management
5. A -USGS map identifying the site location If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1h mile of the site boundary, include the 1h
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including.
a. Development/Project name.
b. Engineer and firm..
c. Location reap with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
■ Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i_ Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned-
k Existing contours, proposed contours, spot elevations, finished floor elevations.
L Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist; (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easement$, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
for Ik
4-/
Farm SWU-141 Version Oct. 31, 2013 Page 4 of 6

p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify --kk --
elevauums 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 NR[S 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 DFMLR to verify the SHWT prior
to suumuraI, (9J 796-7378.}
10. A copy of the most current property deed. Deed book 2198 Page No: 333,336
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 hiformatiox , item la, 2a, and/or 3a per 15A NCAC 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
h wTrw.secre!gry.state-nc.us/ Co orations CSearch.as x
VI1. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot if lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be
provided as an attachment to the completed and notarized deed restriction form. The appropriate deed
restrictions and protective covenants forms can be downloaded from http:[(portal.ncdenr :or webllr/state-
stormwater-farms flocs. 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 signatures) 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 DIAMR, 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:Alec Stillwell
Consulting Firm: Stillwell HpVneerm& PA
Mailing Address:PO Box 838
City:Sylva -
Phone: (828 ) 586-6066 ^�
EmaiL•w.stillwefl§stdlwellen ee n .net
State:NC Zip:28779
Fax: A
M PROPERTY OWNER AUTHORIZATION (if Contact Infirmation, item 2 has been filled out complete this
section)
L (print or type 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 persona
listed in Contact Information, item 1a) with (print or hype name of organization listed in
Contact Information, item 1 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.
Form SV,U-101 Version Oct. 31, 2013 Page 5 of

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR immediately and
submit a completed Narxie/Ownership Change Form within 30 days; otherwise I will be operating a stormwater
treatment facility without a valid permit I understand that the operation of a stormwater treatment facility
without a valid permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement
action including the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature:
a Notary Public for the State of
do hereby certify that
before me this day of
Date:
County of
personally appeared
and acknowledge the due execution of the application for
a stormwater permit. Witness any hand and official seal,
SEAL
My commission expires
X. APPLICANT'S CERTMCATION
I, (print or hjpe name of person listed in Contact Information, item 1a) My D. Smith
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 uno I er 15A NC -AC 2H .1000 and any other applicable state stormwater requirements.
Signature: Date: �ODO
a Notary Public for the State of County of
do hereby certify that 1 �L Yli1 personally appeared
efore me this5 day of C��-, and ac owledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, _S Y
SEAL
My commission expires 'r 1 � — as��
Form SWU-101 Version Oct. 31, 2013 Page 6 of 6