SWG010033_20002 SWM Application Signed_20200918

N.C. DIVISION OF WATER QUALITY
SURFACE WATER PROTECTION SECTION
STATE STORMWATER NOTICE OF INTENT (NOI)
SWG010000 - GENERAL PERMIT FOR SINGLE FAMILY RESIDENCES
FOR AGENCY USE ONLY
Date Received
Year Month Da
Certificate of Covera e
Check M Amounl
Permit Assigned to
State Stormwater Management Application Notice of Intent for coverage under the General Stormwater
Management Permit for a Single Family Residence.
For the construction, operation and maintenance of impervious areas associated with a single family
residence.
(Please print or type)
1. Mailing address of owner/developer: (The address to which all permit correspondence will be mailed.)
Owner/Developer Name Eric L. Blue & Jennifer E. Blue
Street Address 20 Woodside Drive
City
Telephone No.
Brevard State
[phone]
2. Proposed Project Information:
Project Name Blue Property - Residence & Pasture
Street Address
of the Project 3825 Reserve Road
NC
Fax
ZIP Code 28712
City Pisgah Forest State NC ZIP Code 28768
County Transylvania
Contact Person Epps Engineering Associates, LLC Attn: Allan E. Epps, P.E.
Mailing Address P.O. Box 1638
City Travelers Rest State SC ZIP Code 29690
Telephone No
( 864) 444-6063 Fax ( ) --
3. Physical Location Information:
Please provide the street address of the project and describe how to get to the project, using street names,
state road numbers, and the distance and direction from the nearest major intersection:
From intersection of US 276 Greenville Hwy & Wilson Rd, travel E on Wilson Rd for 1.3 mi. Turn RT on
Williamson Creek Rd for 2.2 mi. Turn LT on Kentwood Ln for 0.9 mi. Turn RT on Reserve Rd for 0.3 mi
to 3825 Reserve Rd. Driveway on RT.
4. What is the name of the receiving stream? unnamed tributary of Williamson Creek 6-32
5. River Basin French Broad Receiving Stream Classification
6. This Certificate of Coverage is being submitted as a result of:
C; Tr, HQW
5 New or proposed project ❑ Modification to an existing project
Existing COC or Permit Number:
Date project is scheduled to begin construction September 1, 2020 pasture. Home const. commenced Jan 2020
under building perms
7. What is the total project area above mean high water? 528,394 ft2
Includes road r/w
8. What is the total amount of built -upon area proposed at this site?
27,796 ft'
Includes road r/w
18,796 sf site only
SWU-113.14JAN2010 Page 1 of 3

9. Has the built -upon area been minimized to the extent practicable?
[YES ❑ NO
10. Is the runoff from the built -upon area outside the vegetative buffer directed away from surface waters, to the
e ent practicable?
YES ❑ NO
11. Is the project within 575' of the Mean High Water line of clas ORW waters?
❑ YES (Please show the 575' AEC line on plans) 2O
(It yes, total built -upon area must be less than or equal to 25% of the total project area within the AEC above mean high water.)
12. Are there any wetlands on the site? BYES (please delineate on the plans) ❑ NO
Name and affiliation of person making this determination: Clearwater Environmental Consultants, Inc.
13. Please list all Best Management Practices employed at this site:
Low -density drainage implementation. Built -upon area is limited, dispersed flow is maximized,
impervious area is disconnected. conveyances are vegetated exceot for driveway culverts.
14. Certification:
North Carolina General Statute 143-215.613 (i) provides that:
Any person who knowingly makes any false statement, representation, or certification in any application, record, report, plan,
or other document filed or required to be maintained under this Article or a rule implementing this Article: or who knowingly
makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article; or who falsifies,
tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be operated or
maintained under this Article or rules of the Commission implementing this Article shall be guilty of a Class 2 misdemeanor
which may include a fine not to exceed $10,000. (18 U.S.C. Section 1001 provides a punishment by a fine of not more than
$10,000 or imprisonment of not more than 5 years, or both, for a similar offense.)
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit will
constitute the permit requirement for the project and is enforceable in the same manner as an individual permit.
I certify that I am familiar with the information contained in the application and that to the best of my knowledge and
belief such information is true, complete, and accurate.
Printed name of person signing:
Eric L. Blue & Jennifer E. Blue
Title: Owners t�
(Signal re of Applicant) (Date signed)
A check or money order must accompany this Notice of Intent for $505.00, made payable to: NCDENR.
Your application will be returned unprocessed unless all of the following items are submitted:
This completed form
Two sets of site and grading plans
A check for $505.00
A USGS map with the project clearly located on it.
Mail the entire package to: NCDENR Division of Water Quality
Surface Water Protection Section — Stormwater
at the Appropriate Contact Address (see the following page)
Note:
The submission of this document does not guarantee the issuance of a Certificate of Coverage under the General
Permit.
SWU-113-14JAN2010 Page 2 of 3