SW6200904_Application_20201006

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
Applicable Rules: ❑ CoastaI SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
El Other WQ Mgmt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
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.):
Timberland Ranch
2. Location of Project (street address):
Callowav Road
City:Ouewiffle County:Hoke Zip:28376
3. Directions to project (from nearest major intersection):
The project is located 2,360 ft. from the intersection of Calloway Road and NC Highway 211 going west
towards Sumner Lane.
4. Latitude:35° 00' 42" N Longitude:79° 19' 03" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
tRenewals 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 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
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 11.24 ac of Disturbed Area
0404/401 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:
5. Is the project located within 5 nniles of a public airport? ®No ❑Yes
If yes, see S.L. 2012-200, Part VI: http://portal.ncdenr.org/web/wows/su/statesw/rules laws
Form SWU-101 Version 06Aug2012 Page l 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:Timberland Ranch, LLC
Signing Official & Title:Ralph Huff -President
b. Contact information for person listed in item 1a above:
Street Address:2919 Breezewood Avenue, Suite 400
City:Fayetteville State:NC Zip:28303
Mailing Address (if applicable):
City:
Sta
Phone: (910 ) 486-4864 Fax:
Email: [e-mail]
Zip:
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. (Thus is the
person who owns the property that the project is located on):
Property Owner/Organization:T.B. Upchurch, Inc.
Signing Official & Title: John Hasty -President
b. Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if applicable):P.O. Box 1559
City:Raeford
State:
State:NC
Phone: (910 ) 864-3232 Fax:
Email:[e-mail]
Zip:
Zip:28376
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:
Signing Official & Title:
b. Contact information for person listed in item 3a above:
Mailing Address:
City: State:
Phone: ( 1 Fax: ( )
4. Local jurisdiction for building permits: Hoke County Planning/Zoning
Point of Contact:Robert Farrell Phone #: (r910 ) 875-8407
Form SWU-101 Version 06Aug2012 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Stormwater runoff from the developed areas of the site will be captured and treated in a stormwater
vegetative swales.
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 Lumber & Cape Fear River basin.
4. Total Property Area: 524.7 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area+:524.7 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 High Water (NHM line or Mean High Water
(MHM line, and coastal wetlands landward from the NHW (or MHM line. The resultant project area is used to
calculate overall percent built upon area (B UA). 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 = 4.43 %
9. How many drainage areas does the project have?2 (For high density, count I for each proposed engineered
stormwater BMP. For low density and other projects, use I 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 2
Drainage Area _
Drainage Area _
Receiving Stream Name
Mill Creek
Buffalo Creek
Stream Class *
C
C
Stream Index Number *
18-31-11
14-2.5
Total Drainage Area (sf)
4,311,926
18,523,414
On -site Drainage Area (sf)
4,311,926
18,523,414
Off -site Drainage Area (so
Proposed Impervious Area** s
461,858
548,685
% Impervious Area** total
10.71
2.96
Im ervious' Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
On -site Buildings/Lots (sf)
380,000
520,000
On -site Streets (so
70,735
28,685
On -site Parking (so
5,077
On -site Sidewalks (sf)
6,046
Other on -site (so
Future (so
Off -site (sf)
Existing BUA*** (so
Total (so:
1 461,858
548,685
Stream Class and Index Number can be determined at: http.aortal.nctlenr.org oebAt)q&s/csat/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 BUA that
is to be removed and which will be replaced btj new BUA.
Form SWU-101 Version 06Aug2012 Page 3 of 6

11. How was the off -site impervious area listed above determined? Provide documentation.
Proiects in Union County: Contact DPVQ 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 15A NCAC 02B . 0600.
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
fromh!M://12ortal.ncdenr.org/web/3yq/ws/su/bmp-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 ho://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 http:/ /portal.ncdenr.org/web/wq/ws/su/mates.)
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 fromhtW://12ortal.ncdenr.org/web/wq/ws/su/statesw/`forms_docs.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. .r <) 4
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, 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
http://www.envhelp.orgLpages/onestgpexpress.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.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
the project This is required in addition to the brief summary provided in the Project
Information, item 1.
6. 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 1/2 mile of the site boundary, include the 1/2
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 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 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.
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).
Ji-14
3Lu
SL 1i
Form SWU-101 Version 06Aug2012 Page 4 of 6

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 verifij the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book:133 Page No:184
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 1a, 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.
hgp://www.secretaly.state.nc.us/C000rations/CSearch.asRx
VII. 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.org/web/wq/ws/su/statesw/forms_docs. 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:Matt Lowder, PE
Consulting Firm: Triangle Site Design, PLLC
Mailing Address:4004 Barrett Drive, Suite 101
City:Raleigh State:NC Zip:27609
Phone: (919 ) 553-6570 Fax:
Email:[e-mail]
DC. 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) Tohn Hashj , certify that I
own the property identified in this permit application, and thus give permission to (print or hjpe name of person
listed in Contact Information, item 1a) Ralph Huff with (print or type name of organization listed in
Contact Information, item Ia) Timberland Rancli, LLC 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 SWU-101 Version 06Aug2012 Page 5 of 6

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 DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/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 C General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of ci enalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature: Date:
I a Notary Public for the State of I County of
do hereby certify that ,ice ` T�-1 C - personally appeared
before me this Jam. day of 'mil and a nowle e the execution of he application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
X. APPLICANT'S CERTIFICATION
s - a i - aQos
I, (print or type name of person listed in Contact Information, itent la) Ralph Huff
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project wi4 be constructed in conformance with the approved plans, that the required deed restrictions
and protec0v�e cov�nants will be recorded, and that the proposed project complies with the requirements of the
applicableto;mwerul¢s un4qt 15,tA NCAC 2H .1000 and any other applicable state stormwater requirements.
Signature:
Date: 9-14-2020
I J 1 y a Notary Public for the State of No ✓-t-h C0-vo L& n bounty of
(L<,✓h kt' 606 , do hereby certify that U 0 h H a4f personally appeared
before me this i 9 day of �fPj2t"entbe� , a0,2 and ac owledge the due execution of the application for
s'
a stormwater permit. Witness my hand and official seal,
N0TA,gy
cof4rNs
8%+*s
CS
9� UBuc
O C00%
SEAL
My commission expires,
e-3-2o L s
Form SWU-101 Version 06Aug2012 Page 6 of 6

September 10, 2020
NCDEQ
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301
To Whom It May Concern:
Timberland Ranch, LLC is authorized to submit a sanitary sewer septic system review, a building permit
review, a driveway permit review, a land disturbance permit review, a stormwater management permit
review and commence land disturbing activity for a proposed Timberland Ranch project on the property
owned by T.B Upchurch, Inc. The specific property is found at Calloway Road in Hoke County and has
the PIN Number 594060001097 as described in the Hoke County records.
Yours Truly,
-Y a,Notary Public for the State of
County of _ �� do hereby certify that
personally appeared before me this 4A— day of
and acknowledge the due execution of this authorization to submit a
land disturbance permit application. Witness my hand and official seal,
SEAL
My commission expires 'S-ai ~ a UO

Low Density Residential Subdivisions
Deed Restrictions & Protective Covenances
In accordance with Title 15 NCAC 2H.1000 and S.L. 2006-246, the Stormwater Management
Regulations, deed restrictions and protective covenants are required for Low Density Residential
Subdivisions where lots will be subdivided and sold. Deed restrictions and protective covenants are
necessary to ensure that the development maintains a "built -upon" area consistent with the applicable
regulation governing the density level.
I, Ralph Huff acknowledge and affirm by my signature below, that I will cause the
following deed restrictions and protective covenants to be recorded for Timberland Ranch
prior to the sale of any lot:
1. The following covenants are intended to ensure ongoing compliance with State Stormwater
Management Permit Number , as issued by the Division of Energy, Mineral and
Land Resources under the Stormwater Management Regulations.
2. The State of North Carolina is made a beneficiary of these covenants to the extent necessary to
maintain compliance with the stormwater management permit.
3. These covenants are to run with the land and be binding on all persons and parties claiming
under them.
4. The covenants pertaining to stormwater may not be altered or rescinded without the express
written consent of the State of North Carolina, Division of Energy, Mineral and Land Resources.
5. Alteration of the drainage as shown on the approved plan may not take place without the
concurrence of the Division of Energy, Mineral and Land Resources.
6. The maximum allowable built -upon area per lot is see attached square feet. This allotted
amount includes any built -upon area constructed within the lot property boundaries, and that
portion of the right-of-way between the front lot line and the edge of the pavement. Built upon area
includes, but is not limited to, structures, asphalt, concrete, gravel, brick, stone, slate, and
coquina, but does not include raised, open wood decking, or the water surface of swimming pools.
7. In the case of a lot within CAMA's regulated AEC, where the Division of Coastal Management
calculates a different maximum allowable built -upon area for that lot than is shown herein, the
governing maximum built -upon area for that lot shall be the most restrictive of the two.
8. Filling in or piping of any vegetative conveyances (ditches, swales, etc.) associated with the
development except for average driveway crossings is strictly prohibited by any persons.
9. Each lot will maintain a 30* foot wide vegetated buffer between all impervious areas and surface
waters.
10. All roof drajns _shall teitninate at least 30* foot from the mean high water mark of surface waters.
FOR .. -
a Notary Public in the
State of Wvt+i County of cd
do hereby certify that D- t j./ti fig-1'F I� personally appeared
before me this the ``� day of 5P_prer-klo W 20 2 o , and acknowledge
the due execution of the foregoing instrument. Witness
My Commission expires `33- 2 02�)"
Form DRPC-5 Rev.2 05Nov2009 Page 1 of I
X T icial seal,
i
NoTARy DEAL
MY a
COMM1E "RES £
V
�'' :NO.0

6 The maximum Built -Upon Area per lot, in square feet, is as listed below:
Lot #
BUA (sf)
Lot #
BUA (sf)
Lot #
BUA (sf)
1
15,000
27
12,000
49
6,000
2
15,000
28
12,000
50
6,000
3
15,000
29
12,000
51
6,000
4
15,000
30
12,000
52
6,000
5
15,000
31
12,000
53
6,000
6
15,000
32
12,000
54
6,000
7
15,000
33
12,000
55
6,000
8
15,000
34
12,000
56
6,000
9
15,000
35
12,000
57
6,000
10
15,000
36
12,000
58
6,000
11
15,000
37
12,000
59
6,000
12
1 15,000
38
12,000
60
6,000
13
15,000
39
12,000
61
6,000
14
15,000
40
12,000
62
6,000
15
155 000
41
12,000
63
6,000
16
15,000
42
12,000
64
6,000
17
15,000
43
12,000
65
6,000
18
15,000
44
12,000
66
6,000
19
15,000
45
12,000
67
6,000
20
15,000
46
12,000
68
6,000
21
15,000
47
12,000
69
6,000
22
15,000
48
12,000
70
120,000
23
15,000
24
15,000
25
15,000
26
15,000