SW8060534_CURRENT PERMIT_20200101

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
sw�0L234
DOC TYPE
c— CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

o�O�- wArERQ�
j r
W7,
July 20, 2006
Mr. Noah K. Duncan, Manager
The Bluffs Land Company, LLC
117 Edinburgh South, Suite 203
Cary, NC 27511
Subject: Stormwater Permit No. SW8 060534
Crystal Bluffs Rehabilitation Center
High Density Project
Carteret County
Dear Mr. Duncan:
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimck, P.E. Director
Division of Water Quality
The Wilmington Regional Office received a complete Stormwater Management Permit
Application for Crystal Bluffs Rehabilitation Center on July 7, 2006. 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. We are forwarding Permit No.
SW8 060534 dated July 20,2006, for the construction of the subject project.
This permit shall be effective from the date of issuance until July 20, 2016, and shall be subject
to the conditions and limitations as specified therein. 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 sixty (60) 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, P.O. Drawer 27447, Raleigh, NC 27611-7447. 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 Robert Gordon, or me at [phone].
Sin ere'yl ,
64-
Edward Beck
Regional Supervisor
Surface Water Protection Section
ENB/rdg: S:1WQSISTORMWATIPERMIT1060534.ju106
cc: Bill Daniel, PE
Katrina Marshall, Carteret County Building Inspections
Robert Gordon
Wilmington Regional Office
Central Files
NOneh��ullna
Yturrr!!y
North Carolina Division of Water Quality 127 Cardinal Drive Extension Phone [phone] Customer Service 1-877-623-6748
Wilmington Regional Office Wilmington, NC 28405 Fax [phone] Internet: www.ncwaterquality.org
An Equaf Opportunity/Affirmative Action Employer— 50% Recycledll0% Post Consumer Paper

State Stormwater Management Systems
Permit No. SW8 060534
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
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
Mr. Noah K. Duncan & The Bluffs Land Company, LLC
Crystal Bluffs Rehabilitation Center
4004 Bridges St. Ext., Morehead City - Carteret County
FOR THE
construction, operation and maintenance of 6 infiltration basins 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 Water Quality and
considered a part of this permit.
This permit shall be effective from the date of issuance until July 20, 2016, and shall be
subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
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 on page 3 of this permit. The stormwater
controls have been designed to handle the runoff from the following impervious
areas: Bpsin 1 - 19,428 ft , Bgsin 2 -- 27,312 ft , Bgsin 3—14,767 ft, Basin 4 —
35,850 ft , Basin 5 — 15,899 ft , Basin 6 — 19,950 ft . The overflow/bypass runoff
from each basin must be directed to a 50' vegetated filter.
3. The tract will be limited to the amount of built -upon area indicated on page 3 of
this permit, and per approved plans. There is no allocation of built -upon area for
future development in this permit.
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 areas of this
project must be directed into the permitted stormwater control system.
Page 2 of 8

State Stormwater Management Systems
Permit No. SW8 060534
The following design criteria have been provided in the infiltration basins and
must be maintained at design condition:
f � ✓ i i-'G'E ."Y'Y
, E
Units
�X_
1 infiltration Basin_#1
ilhfiltrbtion Basin #2
Drainage Area
Onsite
Offsite
ft2
26,920
26,920
0
35,893
35,893
0
Total Impervious Surfaces
ft2
19,428
27,312
Basin Depth
feet
2.5
2.0
Design Storm
inches
1.5
1.5
Seasonal High Water Table
FMSL
22.0
22.0
Bottom Elevation
FMSL,
24.5
25.0
Permitted Surface Area @Bottom
ft2
528
1,041
Permitted Storage Volume
ft3
2,468
3,450
Storage/Bypass Elevation
FMSL
27.0
27.0
Expected Infiltration Rate
inlhr
8.95
8.95
Time to Draw Down
hours
6
4.2
Type of Soil
;`?
Sand
ReceivingStream
a��g}�R"., 3
� '10 i,, _�..
Bo ue Sound
g
River Basin
:'-0; 'a, js
White Oak
Stream Index Number
1
20-36-(8.5)
Classification of Water Body
".�.�-
;,'�:ry
Units
��Infltration,Basin #3
R32,017
InfiltrationaBasm #4';_
Drainage Area
Onsite
Offsite
Acres
ft2
ft2
32,017
0
50,530
50,530
0
Total Impervious Surfaces
ft2
14,767
35,850
Basin Depth
feet
2.0
2.0
Design Storm
inches
1.5
1.5
Seasonal High Water Table
FMSL
22.0
22.0
Bottom Elevation
FMSL
24.0
24.0
Permitted Surface Area @Bottom
ft2
1,055
2,432
Permitted Storage Volume
ft3
3,171
7,742
Storage/Bypass Elevation
FMSL
26.0
26.0
Expected Infiltration Rate
inlhr
8.95
8.95
Time to Draw Down
hours
2.7
2.4
Type of Soil`':_
'`i¢,:.
Sand
Receiving Stream
Bogue Sound
River Basinar-
White Oak
Stream Index NumberV
20-36-(8.5)
Classification of Water Body
SA;HQW
Page 3 of 8

State Stormwater Management Systems
Permit No. SW8 C60534
w
UnEts
°lnfil#ra#�on,Basih #5
s
,;Infiltration Basin #6:
-,<r,>v4
Drainage Area
Onsite
Offsite
Acres
ft2
ft2
21,780
21,780
0
27,530
27,530
0
Total Impervious Surfaces
ft2
15,899
19,950
Basin Depth
feet
2.5
2.5
Design Storm
inches
1.5
1.5
Seasonal High Water Table
FMSL
22.0
22.0
Bottom Elevation
FMSL
24.5
24.5
Permitted Surface Area @Bottom
ft2
350
528
Permitted Storage Volume
ft3
2,067
2,468
Storage/Bypass Elevation
FMSL
27.0
27.0
Expected Infiltration Rate
in/hr
8.95
8.95
Time to Draw Down
hours
7.4
6.1
Type of Soil
Sand
Receiving Stream
Bogue Sound
River Basin
E er•.°
White Oak
Stream Index Number`9
s
20-36-(8.5)
Classification of Water Body
l;"sa
SA;HQW
11. 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. Mowin.9 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 bypass structure, infiltration media, flow
spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass 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 facilities shall be constructed as shown on the approved plans. This pe rmit
shall become voidable unless the facilities are constructed in accordance with
the conditions of this permit, the approved plans and specifications, and othier
supporting data.
Page 4 of 8

State Stormwater Management Systems
Permit No. SW8 C60534
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 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.
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.
lll. 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 mu st
submit a formal permit transfer request to the Division of Water Quality,
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.
Page 5 of 8

State Stormwater Management Systems
Permit No. SW8 060534
2. 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.
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 DENR 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 any name, ownership or mailing address
changes within 30 days.
Permit issued this
stthe 20t' day of July, 2006.
NORT CAROLINA NVIR MENTAL'MANAGEMENT COMMISSION
or Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 6 of 8

State Stormwater Management Systems
Permit No. SW8 060534
Crystal Bluffs Rehabilitation Center
Stormwater Permit No. SW8 060534
Carteret County
Designer's Certification
I, , as a duly registered
in the State of North Carolina, having been authorized to observe (periodically/ weekly/
full time) the construction of the project,
(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
SEAL
Page 7 of 8

State Stormwater Management Systems
Permit No. SW8 060534
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 bypass structure weir elevation is per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the 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.
11. The permitted amounts of surface area and/or volume have been
provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Katrina Marshall, Carteret County Building Inspections
Page 8 of 8

OFFICE USE ONLY
Date Received
Fee Paid
Permit Number
2S
� oo
0 0Co 0 S 3
U—
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 INFORNIATION
1. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
THE BLUFFS LflNp (OMPANI , LLC
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
3. vlailing Address for person listed in item 2 above:
Ill , SL.IITE 103
City. Cf��`( 4 _ w State: NC- Zip: .27-5 1 {
Telephone Number: ( q l q )
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications. letters. operation and maintenance agreements, etc.):
CZ%(STAL BLUFr-s [UP-tAGIL-1_TA-MO&I CIEW E2
5. Location of Project (street address):
400q Nzlobes S-TZE-eT ExTC-t4s►01A
City: M0+-1-H t= A�> CITY County: CPuZTEikeT
6. Directions to project (from nearest major intersection):
- KQRTIk 51 D15 0F $RI D WES 519.eer EXTENSION
IMO FT. eas-r of FQlE-uoLH 1004D
T. Latitude: 340 43t 30" Longitude: 74�- UK 30' of project
8. Contact person who can answer questions about the project:
Name: 6ILL [>AN11=L_ Telephone Number: Q19 46:1^41109
it, PERMIT INFORNIATION:
1. Specify whether project is (check one): K New Renewal Modification
Form SWU-101 Version 3.99 Page I of 4

2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number N IP, and its issue date (if known)
3. Specify the type of project (check one):
Low Density )(__High Density Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
_CAMA Major _Sedimentation/Erosion Control _404/401 Permit x NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
III. PROJECT INFORMATION
1. In the space provided below, summarize how Stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project.
5TogM \A/ -T iZ Ru}4ol~ F FgoM 1 Z " t emr FXO NA PFIoPOSEA
=MPFIZViouS AReA ON— 51TC \ iLJ_ St UUTED -ro
51YShlGIc,T1Zi4MON 13AS)NS , -
2. Stormwater runoff from this project drains to the WArr DAV_ River basin.
3. Total Project Area: 5.02.. acres 4. Project Built Upon Area: 6 5.12W.
-
6. How many drainage areas does the project have? (-0
6. Complete the following information for each drainage area. If there are more than two 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 I
Drainage Area 2
Receiving Stream Name
1130(00a SO tS ND
1306u cG Soump
Receiving Stream Class
Sit
5�
Drainage Area
2la `12 D SF
35 Oct 3 SF
Existing Impervious* Area
D SF
0 SF
Proposed Impervious*Area
�q , 4 z SF
.��` 31 Z SF
% Impervious' Area (total)
12 , n ��
7te. G 9 'o
Impervious* Surface Area
Drainage Area I
Drainage Area 2
On -site Buildings
9, 414 SF
(010% SF
On -site Streets
p Sp
O SF
On -site Parking
$ 3 20 S F
I a '& ZD SIr
On -site Sidewalks
i 3Q4 SF
1 3q4 SF
Other on -site
O Sfi
0 SF
Off -site
n 4Tr
O SF
Total: 15 LiZS Sr-
Total: 24 312- SF
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Conn SWU-101 Version 3.99 Page 2 of 4

STORMWATER MANAGEMENT PERMIT APPLICATION FORM
ADDITIONAL DRAINAGE BASIN DATA
,.s
Basin Informafioii �4z'; : t �: S,NY3�
Drainage A ea 3 '"� -
f,
'� � Drainage Area ;l _ :'
Receiving Stream Name
6060E $Qj D
3060e ouNp
Receiving Stream Class
5K
SA
Drainage Area
32, 011 SF
So S 30 SF
Existing Impervious* Area
O SF
0 SF
Proposed Impervious* Area
14 *(o-+ 5¢
35i 850 SF
Impervious* Area (total)
41o,12 %
-4O. 95 0/Q
Impervious* Surface!Area , _` :r '
, � ; �n Drainage Area�3�'...., ,1
qTM
On -site Buildings
ti, 139 SP
I'q , 33 5F
On -site Streets
D SF
0 SF
On -site Parking
a,�y3 SF
15 4Zo SP
On -site Sidewalks
t, }g{, Sr
3 Oq3 SF
Other on -site
p SP
0 SF
Off -site
SF
0 SP
Total: SF
Total: 35' SO
.D,,,
,.,,.,•
� �d a - , ,
Impervious �Suiface„?►iea� i _ _
n rr k - .f �•�+ `� f�� '� �,.
ru„y:,� s,Drainage Area 5_,, .
, � f �' u � ,�� ° «"', A, � fir,-�eFq
3_DraiizageAroa.6 _';
On -site Buildings
(v o55 SF
4 *14 $F
On -site Streets
0 SF
0 SP
On -site Parking
3Zo SF
4 $$(o Sr -
On -site Sidewalks
11524 SF
11 3So SP
Other on -site
0
0 ST_
Off -site
v SF
0 Sr
Total: i5' B gq SF
Total: lq qso sF
* Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas. etc.

7. How was the off -site impervious area listed above derived? W. A
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
The following italicized deed restrictions and protective covenants are required to be recorded for all.
subdivisions, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly�a table
listing each lot number, size and the allowable built -upon area for each lot must be provided as an attach;- e7rttt..
L The following covenants are intended to ensure ongoing compliance with state stormwater management permit number
as issued by the Division of Water Quality. These covenants may not be
changed or deleted without the consent of the State.
2. No more than 114 7, 3 R S square feet of any lot shall be covered by structures or impervious materials.
Impervious materials include asphalt, gravel, concrete, brick, stone, slate or similar material but do not include wood
decking or the water surface of swimming pools.
3. Swales shall not be filled in, piped, or altered except as necessary to provide driveway crossings.
4. Built -upon area in excess of the permitted amount requires a state stormwater management permit modification prior to
construction.
5. All permitted runoff from outparcels or future development shall be directed into the permitted stormwater control
system. These connections to the stormwater control system shall be performed in a manner that maintains the integrity
and performance of the system as permitted.
By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, 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 State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each
BIMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the status
and availability of these forms.
Form SWU-102
Wet Detention Basin Supplement
Form SWU-103
Infiltration Basin Supplement
Form SWU-104
Low Density Supplement
Farm SWU-105
Curb Outlet System Supplement
Form SWU-106
Off -Site System Supplement
Form SWU-107
Underground Infiltration Trench Supplement
Form SWU-108
Neuse River Basin Supplement
Form SWU-109
Innovative Best Management Practice Supplement
Form S%VU-i0l Version 3.99 Page 3 of 4

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. The complete application package should be
submitted to the appropriate DWQ Regional Office.
L Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
Initials
• Original and one copy of the Stormwater Management Permit Application Form
• One copy of the applicable Supplement Form(s) for each BMP _
• Permit application processing fee of $420 (payable to NCDENR) C PAt D
• Detailed narrative description of stormwater treatment/management
• Two copies of plans and specifications, including:
Development/Project name
- Engineer and firm A lbo 1l t W eck:
-Legend
North arrow
Scale M4/u,CfGM�h� C�LV(��4cJ�
- Revision number & date
Mean high water line Si�rmwar l�lo�ce
Dimensioned property/project boundary
Location map with named streets or NCSR numbers
- Original contours, proposed contours, spot elevations, finished floor elevations
Details of roads, drainage features, collection systems. and stormwater control measures
Wetlands delineated, or a note on plans that none exist
Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations
Drainage areas delineated
Vegetated buffers (where required)
VII. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section.
Designated agent (individual or firm): Lt t-Lr1AXA "1>1N "lE L , ? E _
Mailing Address: l 1 Sy 5, C L7 �?'p 4 rD
City: Gla 2State: ►,A _ Zip: z r7 S l 1
Phone: I ". 4 `l 4 & tZ • _ 1-7 06_ Fax: ( 9 1 9 L 4 (o O - I-a�
VIII. APPLICANT'S CERTIFICATION
I. (print or type name of person fisted in General Information, item 2)
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 15A
NCAC 2H .1000.
Signature: Date: 5 3 0(a
Form SWU-101 Version 3.99 Page 4 of

Permit No. o U w0e),?-4
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : CR`(s-rAL B uPF S RCmA13JL1TATIo*4 Cr=- 9TE-IZ
Contact Person: SIM 6LRMIDLJt4 Phone Number: (919 ) of i - &,B(e
This worksheet applies to: Basin No. in Drainage Area --L
(as idenrifred on plans) (from Form SWU-101)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type C poup i (SAKD)
Infiltration Rate B•95 mlhr cffhrlsf (circle appropriate units)
SHWT Elevation 22` Mrtx• fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm 1.15 inch (1.5 inch event for SA waters, I inch event for others)
Design Volume 2355 c.f. CREQ,D)
Drawdown Time • 25 days ( (0 Q-)
Basin Dimensions
Basin Size VARi ES ft. x V A•RI S ft. = 5 2S sq. ft. (bottom dimensions)
Basin Volume Provided 24(oa c.f.
Basin Elevations
Bottom Elevation 2+f•S fmsl
rage c-
Top Elevation 5� o ro-c
2�• ra fmsl
Form SWU-103 Rev 3.99 Page I of 3

III. REQUIRED ITEivIS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that 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. Attach justification if a requirement has not been met.
Applicants Initials
=ffi!:2 a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
-=;Z;;7;' b. System is located at least 100 feet from water supply wells,
a c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval has been obtained.
f. System is located in a recorded drainage easement for the purposes of operation and
►44� maintenance and has recorded access easements to the nearest public right-of-way.
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
!~�_ j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
1. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
G n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
a _ o. Flow distribution mechanism within the basin is provided.
►-i�I� _ _ p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
-�� q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-l03 Rev 3.99
Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at ldast monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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 and Title: M QAk K. L? u 1-4G &
Address: t17 Cr>i"KLc2G14 S L&T 4 , StA.t'r 7.'V5 L?=Y. kS _ zr7671
Phone: q l 4417 •5684/1 Date: -5-z2-
Signature: 11_;Z� K
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, _ pr} T . �� (` 4(,11(1 , a Notary Public for the State of �'I� o1 lorO�tnC. , Countyof
\&Ltx4(_e do hereby certify that NCO) }, . t)Ql1CGn personally appeared before me thisZl�
day of fti _zQ06 , and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness rls�°17 acid bl}��i'�eat,
p TAb'1
SEAS �-�; � !'n7j w My commission expires 01 O
Form 54Vtj-+�o�. ,01Rev,5,.Wtiti�`' Page 3 of 3
•Fi1�R��

F ! �' � � 1
s .
.. —�
.. _ .'.

PermitNo-60 WT:234
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWO Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : CR`fSTAL BL.uPF S REHA31L1rA7T10,V Cr=34 ER —
Contact Person: 3IM 54{MIDL.II4 Phone Number: 019 ) N61 - 8{a8tc
This worksheet applies to: Basin No. z in Drainage Area z
(as identified on plans) (from Form SWU-10I)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type GpouP J
Infiltration Rate B.Q5 tnlhr cf/hr/sf (circle appropriate unils)
SHWT Elevation 2ZfN(AY-)fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm 1. S' inch (1.5 inch event for SDI waters, 1 inch event for others)
Design Volume 32-44 c.f. (RWD)
Drawdown Time • 15 days (4.2 I4R)
Basin Dimensions
Basin Size VARieS ft. XyAR1 ES ft. = 1041 sq. ft. (bottom dimensions)
Basin Volume Provided 345 D c. f.
Basin Elevations
Bottom Elevation 25-0 fmsl C—n�
_ Pp.- Co h J
Top Elevation Jpra�- 24.o fmsi 7) 11
Form SWU-103 Rev 3.99 Page t of 3

I
III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that 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. Attach justification if a requirement has not been met.
Applicants Initials
==j?:;2 a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
� b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
_ d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
cz:Qe-_� e. System is not sited on or in fill material or DWQ approval has been obtained.
f. System is located in a recorded drainage easement for the purposes of operation and
C ...� maintenance and has recorded access easements to the nearest public right-of-way.
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
_ i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
J. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.'
v� k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H. V).
1.
A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
m.
Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
n.
Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o.
Flow distribution mechanism within the basin is provided.
9,/,& p.
A benchmark is provided to determine the sediment accumulation in the pretreatment device.
--�.�+--? q.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
7 r.
System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
a. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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 and Title: NIQA4 4 V r] t t ►�1G ,�►.1 _ __
Address: 117 Lr>i kA Lw ug_6(4_ SauTu , Stu.t-rE. 2,057 G&L?=Y & Cr a+76-11
Phone: °l 1Iq - 4-4i • SGB� Date: s 2 A G
Signature: '1�
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, r 3 , WCILL110 a Notary Public for the State of MprMa (2cg-yjtt & Countyof
1AI L , do hereby certify that N10kh� , DQACGr1 personally appeared before me this2n
day of 200(o , and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
+
Witness Pl d.6d1 &i%;,cal,
0 TA
SEAt. A%'� My commission expires $ l .2c) I O
:A y
;• 1
Form 5�00ol �+.++ Page 3 of 3
l Prl Jf" .. 7 .•.4\4�
3.

1
r•^ ! 0 rr.
.tip~ � ,..se.Y, "�j ,^a,r':•
Sti 1 .�
. i,� • ila.f ir'�' V
i .�t

Permit No
Suk D U
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may he photocopied for use as an original
DW Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report -and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORI'VIATION
Project Name: CR`!S-rq L &UPF 5 REMA31LiTATICN C1=,9iER_
Contact Person: I M S4f N J DLl h. Phone Number: C91 `t ) Flo - 8{ 8(0
This worksheet applies to: Basin No.
3
(as identified on plans}
in Drainage Area J
{prom roan avrv-rut)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type GQ0uP i (5AKU)
Infiltration Rate 1?-96 tn/hr Cf/hr/sf (circle appropriate units)
SHWT Elevation 2z' OVIM- f nsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm 1.5 inch (1.5 inch event for SA waters, 1 inch event for olhers)
Design Volume 2153 c.f. CRJ50`D)
Drawdown Time -1 1- days (2. -� RR,)
Basin Dimensions
Basin Size VARIES ft. X VARY ES ft. = 10SS sq. ft. (bottom dimensions)
Basin Volume Provided 31-41 c.f.
Basin Elevations
Bottom Elevation 24xd fmsl
Pei Coy-J -
Top Elevation�for 0.8k- 21P • o fmsl
Form SWU-103 Rev 3.99 Page I of 3

t
Ill. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that 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. Attach justification if a requirement has not been met.
Applicants Initials
=9:2 a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
�_ e. System is not sited on or in fill material or DWQ approval has been obtained.
f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
1. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
<L_� k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
1. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o. Flow distribution mechanism within the basin is provided.
14 Z& . _ p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV, INFILTRATION BASIN OPERATION A.ND MAINTENANCE AGREEICENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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 and Title:
Address: ll7 �ntU6u2�1-1 Sourt�-(, Sut-r-G 2,03. G�.I�-'�r1S(' 275'11
Phone: °i 1 1+4q • SGv4� Date, -5f f Z Z G
Signature:
Note: The legally responsible parry 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, IV+ 3 , M C NAI n a Notary Pubic four the State of 401% cm%C, County of
mcge , do hereby certify that j��fxh K • 1.JUAUACI personally appeared before me this2nd
day of4QAd I P14441J.-Ff , 100 , and acknowledge the due execution of the forgoing in6ttration basin maintenance requirements,
Witne$%%ng�nd-a d }66; seal,
TA
My commission expires 8 14 20 10
? =•off �`
Form `+ jN ,V""Qo Page 3 of 3

Permit No. s W , V 1 [h6M
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT LNFORNIATION
ProjectName: BLUFFS RE",a,31L-rrA4TioiV CI<<W-ER_
Contact Person: :TIM Phone Number: (919 ) U�j - B(o8U
This worksheet applies to: Basin No. in Drainage Area 4
(as identified on plans) (from Form 5WU-1 a1)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (find).
Soils Report Summary
Soil Type CpOL)p i (Sar tD�
Infiltration Rate 8•95 in/hr cflhr/sf (circle appropriate units)
SHWT Elevation 2Z'NICK• fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm 1.5 inch (1.5 inch event jar SA waters, 1 inch event for others)
Design Volume q 349 c. f. C REQ' 0
Drawdown Time • 10 days (2.4 NIZ)
Basin Dimensions
Basin Size VARI ES ft. x VARIES ft. = 243Z sq. ft. (bottom dimensions)
Basin Volume Provided -4-442-. c.f.
Basin Elevations
Bottom Elevation 2LI.o fmsl
��� ^ �2!
f' GOrt
Top Elevation 1 ` C"-"� 21v, o fmsl �j U 1
Form SWU-103 Rev 3.99 Page 1 of 3

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that 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. Attach justification if a requirement has not been met.
Applicants Initials
a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
IE�i` b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval has been obtained.
£ System is located in a recorded drainage easement for the purposes of operation and
Cam.►'-4 1 maintenance and has recorded access easements to the nearest public right-of-way,
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
1.
A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
in.
Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
.� n.
Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o.
Flow distribution mechanism within the basin is provided.
p.
A benchmark is provided to determine the sediment accumulation in the pretreatment device.
.*t-- q.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
—� r.
System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99
Page 2 of 3

IV. [NFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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 [dame and Title: LtQA4u 1/�, 1,2 [�t I•il' /st.l
Address: l 17 t;n t ►.I ML& re.&H Sbu.t1-4 , S u.t T6_ Zo 3 G/� P�IS C� _ 2,'76'11
Phone: 611 Ll • 4-4q • S686 Date: SZZ 167 G
Signature: "n&�
Note: The legally responsible party should not be a homeowners association unless more than 50% of the lots have been sold and a
�p resident of the subdivision has been named the president. , `
1, _ fjpr-� C,t wn _ , a Notary Public for the State of A(+{ County of
1A�la1e� , do hereby certify that Nok6 K , l JAC&A personally appeared before me this
day ofM(iysr:.,1, .too and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness [ny:hand andof�it�wi seal,
TA
a '!
SfAL.• ` �•� IJ1My commission expires f 144/201 O
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Permit No
(to be provided by WQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROTECT INFORMATION
Project Name : CRYSTAL BLUFFS P,EHA 31LITATI ON Cr=,µTEP—
Contact Person: SI M 64-R ` I DLri4 Phone Number: (919 ) Libi -'B aB(o
This worksheet applies to: Basin No. S in Drainage Area S'
(as identified on plans) (from Form SIVU-101)
II. DESIGN IVFOWMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type GiDOUP 1 (SAt40)
Infiltration Rate 8•95 tn/hr cf/hr/sf (circle appropriate units)
SHWT Elevation 22' Mr4% f nSl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm
•S
inch
(1.5 inch event for SA waters, 1 inch event for others)
Design Volume
1923
c.f.
CRECVt7)
Drawdown Time
. 3 l
days
(f. Ll HQ)
Basin Dimensions
Basin Size
VARIES
f#. x
VARi ES ft. = 350 sq. ft. (bottom dimensions)
Basin Volume Provided
20 (O-q
c.f.
Basin Elevations
Bottom Elevation 24•S fmsl
Top Elevation 21. 0 fmsl V -7 )
11
Form SWU-l03 Rev 3.99 Page 1 of 3

III. REQUIRED ITEiNIS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that 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. Attach justification if a requirement has not been met.
Applicants Initials
a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
��,.—` b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
-- e. System is not sited on or in fill material or DWQ approval has been obtained.
f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
7 1. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
-� m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
l n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o. Flow distribution mechanism within the basin is provided.
►l�,c� _ p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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 and Title:&lOAk V. L2LAt.11'
Address: 11 7 t= nt Ll e Lk FZA[4 S42U_T- -(; Su-1-r3�-= 7a3l
Phone: °l t • 4-G7 • �'�� Date: .5-zZ za _--
Signature:
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 n/
I, � C'6 a Notary Public for the State of Npc L'ort1lt�G County of
\�ave_ , do hereby certify that ROfih �,. DUf1CLAr1 personally appeared before me this Xlj
day of ,�p0 (p , and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witne a d d4 fjcial seal,
SAL :•� 1Q�: iviy commission expires
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Foif�}�S J-1w.••ite�C3. ��.` Page 3 of 3
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I
Permit NoSlA J . Uom
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWO Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT LNFORNIATION
Project Name : CRYsTAL BLUFFS P-,E"A31UT'ik'T1o,V
Contact Person: S1 M SL-f MI I)LI Phone Number: 91 q lO - $ia8to
This worksheet applies to: Basin No. G in Drainage Area (a
(as identified on plans) {from Form 3WU-1 d1)
II. DESIGN LNFORNIATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type C.QouP i (SAKD)
Infiltration Rate 8•q5 in/ - cf/hr/sf (circle appropriate units)
SHWT Elevation ZZr fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm 1.5 inch (1.5 inch event for SA waters, 1 inch event for others)
Design Volume Zy I (p c.f. Nevv)
Drawdown Time- , xS days ((,,I t•1R-)
Basin Dimensions
Basin Size
VARIES
ft. X
YPt121 eS ft. = 526 sq. ft. (bottom dimensions)
Basin Volume Provided
24GIB
c.f.
1
Basin Elevations
Bottom Elevation
z'f 5
fmsl
S
2 •9
fmsl
Cprt v .
To Elevation 1 ���
p ��0
2}, O
fmsl
�
Form SWU-103 Rev 3.99 Page 1 of 3

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that 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. Attach justification if requirement has not been met.
Applicants Initials
a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval has been obtained.
f. System is located in a recorded drainage easement for the purposes of operation and
�F maintenance and has recorded access easements to the nearest public right-of-way.
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
�� k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
7 I. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
-
sediment trap is provided.
m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
,«-- n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o. Flow distribution mechanism within the basin is provided.
p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
7 r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Fonn SWU-103 Rev 3.99 Page 2 of 3

IV. fNL FILTRATION BASIN OPERATION AND MAINTENANCE AGRMMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in d manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
7. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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 and Title: Mp,414 l�. r�l 1,4_ ,-
Address: i t 7 Saur'W , SLA t TC-_ Z,0 5 G�, P�IIS C S 176.1 /
Phone: °I l 4-GZ • $6rQ� Date: 5 21 /a G
Signature:
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, _ c,t± 1 ti' Da"(' , a Notary Public for the State of qo(4-t CoMt %t r, , County of
�Ar.11p_ , do hereby certify that __lochh V , )I udl-mc� personally appeared before me this
day of , M , and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witnes,�Py`h�a 5,n 'Mji l seal,
• '4 !
5aL �� Y R j �' My commission expires 8� LJf 20l
•�
. A
Forrif.F!i,- •rbn....-€���j'�%�:99��` Page 3 of 3
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