SW8120913_CURRENT PERMIT_20121030

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

A P15%
MC®NR
North Carolina Department of Environment and
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E.
Governor Director
October 30, 2012
Natural Resources
Mr. Charles A. Thomas, President
Eastern Pride, Inc.
2405-F Nash Street
Wilson, NC 27896
Subject: Stormwater Management Permit No. SW8120913
Burgaw— Family Dollar
High Density Commercial Constructed Wetlands Project
Pender County
Dear Mr. Thomas:
Dee Freeman
Secretary
The Wilmington Regional Office received a complete Stormwater Management Permit Application for Burgaw —
Family Dollar on October 26, 2012, Staff review of the plans and specifications has determined that the project, as
proposed, will comply with the Stormwater Regulations set forth in Session Law 2008-211 and Title 15A NCAC
2H.1000. We are forwarding Permit No. SW8120913, dated October 30, 2012, for the construction, operation and
maintenance of the BMP's and built -upon area associated with the subject project.
This permit shall be effective from the date of issuance until October 30, 2020, 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 by filing a written petition with the Office of Administrative Hearings (OAH). The written petition
must conform to Chapter 150E of the North Carolina General Statutes, and must be filed with the OAH within thirty
(30) days of receipt of this permit. You should contact the OAH with all questions regarding the filing fee (if a filing
fee is required) and/or the details of the filing process at 67,14 Mail Service Center, Raleigh, NC 27699-6714, or via
telephone at 919-431-3000, or visit their website at www.NCOAH.com. 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 Kelly Johnson, at
[phone].
Sincerely,
`-For hones �akild, P.E., Director
Division of Water Quality
GDSlkpj: &: WQS1StormwatehPermits & Projects120121120913 HD1201210 permit 120913
cc: Marie Peedin, PE
Inspector, Pender County Inspections
Division of Coastal Management
Wilmington Regional Office Stormwater File
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405
Phone: [phone] FAX: [phone] DEN Assistance: 1-877-623-6748
fntemet: www.ncwalerquality.org
Nne
orthCarolina
Aaturallrf
An Equal Opportunity 1 Affirmative Action Employer

State Stormwater Management Systems
Permit No. SW8120913
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
Eastern Pride, Inc.
Burgaw — Family Dollar
US Hwy 117, just South of NC 53, Burgaw, Pender County
FOR THE
construction, operation and maintenance of one (1) constructed wetland in compliance with Session Law 2008-211
and the provisions of 15A NCAC 2H .1000 (hereafter collectively 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 October 30, 2020 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 1.7 of this permit.
3. The application form, supplement forms, approved plans and specifications for this project are incorporated
by reference and are enforceable parts of the 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 project shall maintain a 50' wide vegetated buffer adjacent all surface waters, measured horizontally
from and perpendicular to the normal pool of impounded structures, the top of bank of each side of rivers
and streams and the mean high water line of tidal waters.
6. All runoff being directed into wetlands shall flow into and through those wetlands at a non -erosive velocity of
2 fps or less.
Page 2 of 7

State Stormwater Management Systems
Permit No. SW8 120913
The following design elements have been approved for this constructed wetlands stormwater facility, and
must be provided in the system at all times:
DA1 sa
a. Drainage Area, acres:
1.17
Onsite, 112:
50,965
Offsite, ft2:
0
b, Total Impervious Surfaces, ft2:
28,818
Buildings, ft2:
8,320
Roads/Parking, ft2:
18,649
Sidewalks, ft2;
1,849
Offsite, ft2:
0
c. Plant Depth, feet:
0.8
d. TSS removal eff., %:
85
e. Design Storm, inches:
1.5
f. Permanent Pool Elevation, FMSL;
43.75
g. Permitted Wetland Surface Area, ft2:
4,280
h. Shallow Land Area, ft2:
1,566
L Shallow Water Area, ft2:
1,684
_L Deep Pool Area, ft2;
1,030
k. Permitted Temporary Storage Volume, ft3:
3,560
I. Temporary Storage Elevation, FMSL:
44.59
m. Controlling Orifice 0":
1
n. Trees
0
o. Shrubs
64
Herbaceous Plants
900
Receiving Stream I River Basin
Trib to Burgaw
Creek
r. Stream Index Number:
18-74-39
s. Classification of Water Body:
C; SW
II. SCHEDULE OF COMPLIANCE
1, No person or other legal entity shall alter the approved stormwater management system, or fill in, alter, or
pipe any drainage feature, including swales, shown on the approved plans as part of the stormwater
management system, unless and until the permittee submits a modification to the permit and receives
approval from the Division.
2. The permittee is responsible for verifying that the proposed built -upon area for the entire project does not
exceed the allowable built -upon area.
3. 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.
Page 3 of 7

State Stormwater Management Systems
Permit No. SW8120913
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.
During construction, erosion shall be kept to a minimum and any eroded areas of the system will be repaired
immediately. Infiltration systems should not be used as erosion control devices, due to the potential
clogging. 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.
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 the approved plans, regardless of size.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area.
e. Further subdivision, acquisition, 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.
7. The Director may determine that other revisions to the project should require a modification to the permit.
8. 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.
9. The permittee shall at all times provide the operation and maintenance necessary to assure that all
components of the permitted stormwater system function at optimum efficiency. The approved Operation
and Maintenance Plan must be followed in its entirety and maintenance must occur at the scheduled
intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of side slopes.
d. Maintenance of the wetlands plants and replacement of dead plants.
e. Immediate repair of eroded areas.
f. Maintenance of side slopes in accordance with approved plans and specifications.
g. Trash and debris removal and unclogging of the wetlands, outlet structure, orifice, catch basins and
piping.
h. Access to all components of the system must be available at ail times.
10. 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.
11. Permanent seeding requirements for the stormwater control must follow the guidelines established in the
North Carolina Erosion and Sediment Control Planning and Design Manual,
12. Prior to transfer of the permit, the stormwater facilities will be inspected by DWQ personnel. The facility must
be in compliance with all permit conditions. Any items not in compliance must be repaired or replaced to
design condition prior to the transfer. Records of maintenance activities performed to date will be required.
13. This permit shall become voidable unless the facilities are constructed in accordance with the conditions of
this permit, the application, approved plans and specifications, and other supporting data.
Page 4 of 7

State Stormwater Management Systems
Permit No. SW8120913
14. Built upon area includes, but is not limited to, structures, asphalt, concrete, gravel, brick, stone, slate,
coquina and parking areas, but does not include raised, open wood decking, or the water surface of
swimming pools.
Ill. GENERAL CONDITIONS
This permit is not transferable to any person or entity except after notice to and approval by the Director. At
least 30 days prior to a change of ownership, or a name change of the Permittee or of the project, or a
mailing address change, the permittee shall submit a completed and signed "Name/Ownership Change
Form" to the Division of Water Quality, accompanied by the appropriate documentation as listed on the
form. The project must be in good standing with DWQ. The approval of this request will be considered on its
merits and may or may not be approved.
2. The permittee is responsible for compliance with all of the terms and conditions of this permit until such time
as the Director approves the transfer request. Neither the sale of the project area in whole or in part, nor the
conveyance of common area to a third party, constitutes an approved permit transfer.
3. 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.
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)
which have jurisdiction.
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.
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,
Permittee grants permission to staff of the DWQ to access the property for the purposes of inspecting the
stormwater facilities during normal business hours.
8. The permittee shall submit a permit renewal application and processing fee at least 180 days prior to the
expiration date of this permit.
9. A copy of the approved plans and specifications shall be maintained on file by the Permittee at all times.
Permit issued this the 30sh day of October 2012.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
forC aries WaOld, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 5 of 7

State Stormwater Management Systems
Permit No. SW8 120913
Burgaw — Family Dollar
Stormwater Permit No. SW8120913
Pender County
Designer's Certification
Page 1 of 2
I, , as a duly registered in the State of North Carolina,
having been authorized to observe (pedodicallylweeklylfull 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 are a part of this Certification.
Noted deviations from approved plans and specifications:
Signature
Registration Number
Date
SEAL
Page 6 of 7

State Stormwater Management Systems
Permit No. SW8120913
Certification Requirements:
Page 2 of 2
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 wetland zone elevations are per the approved plan.
6. The wetland is located per the approved plans.
7. A trash rack is provided on the outlet 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 wetland zone surface area and volume have been provided.
12. Required drawdown devices are correctly sized and located per the approved plans,
13. All required design depths are provided.
14. All required parts of the system are provided.
15. The required number of wetlands plantings have been provided.
cc: NCDENR-DWQ Regional Office
Inspector, Pender County Building Inspections
Page 7 of 7

DWQ USE ONLY
Date Recpive4
Fee Paid
Permit Number
�z'
�j �J r" --'eel2
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Constr ction
(select all thaf apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
..e
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.):
Burgaw - Family Dollar
2. Location of Project (street address):
US Hwy 117 just south of NC 53 intersection
City:Bur aw County:Pender Zip:28425
3. Directions to project (from nearest major intersection):
Approximately 450 If south along US 117 from the intersection of US 117 and NC 53 located on the east
4. Latitude:34° 33' 34" N Longitude:77° 55' 15.8" 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 ®Sedimentation/Erosion Control:1.17 ac of Disturbed Area
❑NPDES Industrial Stormwater 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 miles of a;public airport? ®No ❑Yes
If yes, see S.L. 2012-200, Part VI; htti2://j2ortai.ncdenr.org/weblwqlws/­­su/statesw I wo
SEP 2 5 202
I:orm SWU-101 Version 06Aug2012 Page I of
pV:

a
IM CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer; properly owner, lessee,
designated government official, individual, etc. who owns the vroiectl:
Applicant/Organization; fagern Pride. lnc.
SigningOificial&rTide: Charles A. Thomas, President
b.Conlact information for person listed in item la above:
Street Address: F Ngh Street
City:Wilson Statet& - ,,,,,_ Zip:278%
Mailing Address (if applicable):
City: State: Zip
Phone: L252--- -) 230-0P2 -- - - -- - Fax:
Email:
c. Please check the appropriate box. The applicant listed above is:
❑ The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
® Purchaser* (Attach a copy of the pending sales agreement and complete Contact information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization Geo S chuk
Si ;nmg Official & Title:t,eo= ghm chuk, Owner _
b. Contact information for person listed in item 2a above.
Street Address:l Glenbrook Court
City: NftLmn, State:k - - Zip:0T981
Mailing Address (if applicabk):
City Stag: Zip:
Phone: ( ) Fax: L ) ._
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 projects
Other Contact Person/Organization
Signing Official & Title:
b.Contact information for person listed in item 3a above:
Mailing Address:
City Site Zip:
Phone. f 1 Fax:
Email:
4. Local jurisdkction for building permits: Pender Co.
Point of Contact:Tommy Garria Phone #: f910 _ . 259-1201
CEIV
Form SWU-101 Version 06Aug2012 Page 2 of SEP 2 5 2012
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IV: PROJECT INFORMATION
1. In the space provided below, briefiy summarize how the stormwater runoff will be treated.
Stormwater runoff from teh development sahll be treated through a created wetland prior to overflowing into
an existing side ditch which is a tributary to Burgaw Creek
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:
Fj 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 Cape Fear _ _ River basin.
4. Total Property Area:1.17 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+:1.17 acres
+ Total project area shall be calculated to exclude thefollowing: the normal ool of imp�'ounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHWJ line or Mean High Water
(MHW) line, and coastal wetlands landward front the NHW (orA4HM line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 56.5 %
9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered
stormwater BMP. For low densihj 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
Draina a Area 1
Drainage Area _
Drainage Area
Drainage Area
Receiving Stream Name
Trib to Burgaw
Ck
Stream Class
QSW
Stream index Number *
18-74-39
Total Drainage Area (so
50965
On -site Drainage Area (sf)
50965
Off -site Drainage Area (so
0
Pro used Impervious Area'* (s_0
28818
% Im ervious Area** total
56.5
Impervious** Surface Area
Drainage Area 1
Drainage Area
Drainage Area
Drainage Area
On -site Buildings/Lots (so
8320
On -site Streets (so
0
On -site Parkin (so
18649
On -site Sidewalks (so
1949
Other on -site (so
0
Future (so
0
Off -site (sf)
0
Existing BUA*** (sf)
0
s�
Total (sf):
28818
* Stream Class and Index Number can be determined at: liLtp.Ilportal.ticdetir.orgzwebABdpslcstilclassijicaticws
linpervious area is defined as the built upon area including, but not Iimited to, buildin roskqp199xs,
sidewalks, gravel areas, etc.
BY:
Form 5WU-101 Version 06Aug2012 Page 3 of 6

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'Report only that amount of existing BUA that will remain after development. Do not report any existing .BETA that
is to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. n/a
Proiects in Union County: Contact DWQ 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 15,4 NC,4C 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
from http://12ortal.ncdenr.org/web/wgjws/suLbmp-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 htty://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/webjwq/­ws/su/mal2s.)
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 from http:/ /portal.ncdennorg/web/wq/.ws/su/statesw/forms . docs.
T
Is
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (f required as per Part VIl below)
3. Original of the applicable Supplement Form(s) (sealed, sinned and dated) and O&M n2 el
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http://www.envhelp.org/paees/ones topexpress.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/management for
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.
I. 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 4 s�
qualified person. Provide documentation of qualifications and identify the perso ` C E N Imo..
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calc tioo 2012
o. Drainage areas delineated (included in the main set of plans, not as a separate do ent .
p. Vegetated buffers (where required).
BY:
Form S WU-101 Version 06A ug2012 Page 4 of 6

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9. Copy of any applicable soils report with the associated SHWI' elevations (Please identify
elev bons ' a dditi iA--ell of th bo ' 1 th the
m a on depths) as w as a map a rag ocatnons wi exrstn6
elevations and boring logs. Include an 8.5"xil" copy of the MRCS 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 verify the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book 835 Page No. 861
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 211.1003(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.
hM I L www. secretax'_y. state.tic.usl CoraorationssiCSearch.aspx
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outpareels, 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
hgg:/ Iporta-mcdenr.org/web/wq/ws/su/statesw/fornts does. 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 holders) certify that the recorded property restrictions and
protective covenants for this project, V required, shall include all the items required In the permit and listed
on the forms available on the wrebsite, 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.
VUL 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 F.ngineer:Marie U. Peedin
Consulting Firm: Pamlico Engineer U Services. PLLC
Mailing Address•128 Abbey Lane _
City -Was State -.NC Zip
Fax: (252 ) 974-7618
DL PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has beenfidled out, complete tlos
section)
I, (print or type now of person listed ire Contact Information, item 2a) GeoW ShrudWk , certify that I
own the property identified in this licatian d thus give permission to (print or type recmu of person
Gated in Contact Information, item ia)�r l� 5 A 'f'hon s with (fit or type name of organization listed in
Contact Information, item Ia) Eastern Pride. Inc _ 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 styormwater system.
ra
EC;EB VE.
SEP 2 5 2012
Form SWU-101 Version WAuO012 Page 5 oft
BY:

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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.Marie U. Peedin PE
Consulting Firm: Pamlico Engineering Services, PLLC _ ^
Mailing Address:128 Abby Lane--
City:Washington - _ State:NC Zip:27889
Phone: (252 ) 945-2983_
[e-mail]
Fax: (252_ _ ) 974-7618 _
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type natne of person listed in Contact hrforntation, item 2a). George Shevchuk , certify that I
own 2-te property identified in this permit appl cation, and thus give perpiission to (print or type trarne oflxrson
listed in Contact Information, item 1a) Am7rtrB i+:Okr riC-5 with (print or type name of organization Iisted in
Contact Information, item 1b) Eastern Pride Inc. 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.
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 3-225.1 and may result in appropriate enforcement action including
the assessment of civil RC
of up to $ `',9W per dad, pur-4ant to NCGS-143-215.6.
Date: V-1 r %Z
1 Lpa a //�� Notary Public for the State of ounty of
6'ry Ido hereby certify that l� Sh h personally appeared
before me this day of ,.and c owledge the du execution of the application for
a stormwater permit. Witness my hand and
official seal,
SEAL Michelle A Read
Notary Public
New Jersey
My Commission Expires 3-1-17
My commission expires
nEGEWE)l
SEP252012
BY:
Form SMM-101 Version 07July2009 Page 6 of 7

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'X. APPLICANT'S CERTIFICATION
I, (print or hjpe name of person listed in Contact Information, item 2) Charles Thomas
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable �s}tormwater rules under 15A NCAC 21-1.1000, SL 2006-246 (Ph. II - Post Construction) or SL 2008-211.
Signature: l -��� j p - Date: 4/oZOA6 Z
I, �iie��S54 5 �oneg a Notary Public for the State of 90ek eamUfs*. County of
do hereby certify that C AAE'S A • Aor+tuf S personally appeared
before me this 10 day of and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, s�5• __ 5
� f
SEAL
My commission expires
EGEN,c-
SEP 2 5 2012
BY:
Form SWU-101 Version 07July2009 Page 7 of 7

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NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WETLAND SUPPLEMENT
This,form must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all the required information.
I. PROJECT INFORMATION
Project name 'BURGAW FAMILY DOLLAR
Contact name MARIE U PEEDIN
Phone number
Date
Drainage area number
II. DESIGN INFORMATION
Site Characteristics
252-945-2983
Revised 10/23/12
1
Drainage area
50,965.00 -Je
impervious area
28,818.00 ft2
Percent impervious
56.5% %
Design rainfall depth
1.50 inch
Peak Flow Calculations
1-yr, 24-hr rainfall depth
3.43 in
1-yr, 24-hr intensity
0.14 inlhr
Pre -development 1-yr, 24-hr runoff
0.07 ft3lsec
Post -development 1-yr, 24-hr runoff
0.11 ft3/sec
PrelPost 1-yr, 24-hr peak control
0.04 fi3lsec
Storage Volume: Non -SA Waters
Minimum required volume
3,558.00 ft3
Volume provided (temporary pool volume)
3,621.00 ft3
Storage Volume: SA Waters Parameters
1.5' runoff volume
ff3
Pre -development 1-yr, 24-hr runoff volume
ft1
Post -development 1-yr, 24-hr runoff volume
ft3
Minimum volume required
fe
Volume provided
It,
Outlet Design
Depth of temporary pool/ponding depth (Dpbrie)
12.00 in
Drawdown time
2.00 days
Diameter of orifice
1.00 in
Coefficient of discharge (Ca) used in orifice diameter
D.60 (unitless)
calculation
Driving head (Hp) used in the orifice diameter calculation 1.50 ft
0
OK
OK
CA
SEAL
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Drawdown orifice diameter may be insufficient. Please provide
adequate supporting calculations.
er-'b
OK'- t
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Form SW401-Wetland-Rev.6-11116/09 Pans I and il. Project Design Summary, Page 1 of 3

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Surface Areas of Wetland Zones
Surface Area of Entire Wetland
4,514.00 fe
OK
Shallow Land
1,566.00 fe
OK
The shallow land percentage is:
35% %
Shallow Water
1,880.00 ft,
OK
The shallow water percentage is:
42% %
Deep Pool
Forebay portion of deep. pool (pretreatment)
538.00 ftz
OK
The forebay surface area percentage is:
12% %
Non-forebay portion of deep pool
530.00 fe
OK
The non-forebay deep pool surface area percentage is:
12% %
Total of wetland zone areas
4,514.00 fe
OK
Add or subtract the following area from the zones
0.00 ft2
Topographic Zone Elevations
Temporary Pool Elev Wn.(TPE)
Shallow Land (top)
44.00 ft amsl
Permanent Pool Elevation (PPE)
Shallow Water/Deep Pool (top).
43.00 ft amsl
Shallow Water bottom
42.50 ft amsl
Most shallow point of deep pool's bottom
41.00 it amsl
Deepest point of deep pool's bottom
40.00 ft amsl
Design must meet one of the following two options:
This design meets Option #1,
y or N)
Top of PPE is within 6" of SHWT, If yes:
SHWT (Seasonally High Water Table)
42.50 ft amsl
OK
This design meets Option #2,
n (Y or N)
Wetland has liner with permeability < 0.01 inlhr, If yes:
Depth of topsoil above impermeable liner
in
Topographic Zone Depths
Temporary Pool
Shallow Land
12.00 in
OK
Permanent Pool
Shallow Water
6.00 in
OK
Deep Pool (shallowest)
24.00 in
OK
Deep Pool (deepest)
36.00 in
OK
Planting Plan
Are cattails included in the planting plan?
n (Y or N)
OK
Number 2f.Plants recommended in Shalom Water Area:
Herbaceous (4'cubic-inch container)
500
re
Number of Plants recommended in Shallow Land Area:
Herbaceous f4'cubic-inch er1�
400
Shrubs (1 gation or larger
tR
— 64
OCT 2 6 2012
Trees (3 gallon or larger) and Herbaceous (4+ cubic -inch)
8 and
320
Number of Plants Rrovided in Shallow Water Area:
BY:
Herbaceous (4'cubic-inch container)
500
OK
Number of Plants A oMv ded in Shallow Land Area:
Herbaceous Woubic-inch container) OP,
400
OK
Shrubs (1 gallon or larger) O R
64
OK
Trees (3 gallon or larger) and
0
More required if not planting herb. arbor shrubs.
Grasslike Herbaceous (4+ cubic -inch)
0
More recommended if planting trees.
Form SW401-Wedand-Rev,6-11/16/09 Parts I and 11. Project Design Summary, Page 2 of 3

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Additional Infoir ration
Can the design volume be contained?
y —(Y (Y or N)
OK
Does project drain to SA waters? If yes,
n (Y or N)
Excess volume must pass through filter.
What is the length of the vegetated filter?
ft
Are calculations for supporting the design volume provided in the
y (Y or N)
OK
application?
Is BMP-sized to handle all runoff from ultimate build -out?
y (Y or N)
OK
Is the BMP located in a recorded drainage easement with a
y (Y or N)
OK
recorded access easement to a public Right of Way (ROW)?
The length to width ratio is:
11.00 :1
OK
Approximate wetland length
220.00 ft
Approximate wetland width
20.00 ft
This approx. surface area is within this number of square feet
Approximate surface area using length and width provided
4,400.00 it z
of Be entire wetland surface area reported above:
Will the wetland be stabilized within 14 days of construction?
y —(Y or N)
OK
'
OCT 26 4312
BY'
Form SW401-Wetiand-Rev.5-11118109 Parts r and ir. Project Design Summary. Page 3 of 3

'j'
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Permit No.
(to be provided by DWQ)
III. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Initials Page/ Plan
Sheet No.
C4 ° z 1. Plans (Y - 5lY or larger} of the entire site showing:
- Design at ultimate build -out,
- Off -site drainage (if applicable), --- N l /�
- Delineated drainage basins (include Rational C coefficient per basin),
- Wetland dimensions (and length to width ratio),
-Pretreatment system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROW),
- Overflow device, and 'DO k&-A st-e —4
C° d L' 2. Plan details (1' = 50' orlarger)for the wetland showing:
- Wetland dimensions (and length to width ratio) -
- Pretreatment system,
- Maintenance access,
+ - Design at ultimate build -out,
- Overflow device, and
- E3aun ades_QLdrAnaUA easement
° 3. Section view of the wetland (1' = 20' or larger) showing:
- Side slopes, 3:1 or lower1 S�� wT
- Wetland layers D
Ai! wetlands: Shallow land depth, shallow water depth, deep pool depth
Option 1, no day liner: SLWT depth
Option 2, day liner: Depth of topsoil on top of liner, liner specifications
o Y > 4. A detailed planting plan (1' = 29 or larger) prepared by a qualified individual showing: ;
- A variety of several suitable species (not including cattails), . Q
- Sizes, spacing and locations of plantings, .00 C, � TISA
- Total quantity of each type of plant specified, ✓
- A planting detail, ✓ Off,
- The source nursery for the plants, and ✓ /
- Fertilizer and watering requirements to establish vegetation✓
5. A construction sequence that shows how the wetland will be protected from sediment until the entire
drainage area is stabilized.
f
(k' 6. The supporting calculations {including drawdown calculations}. ✓
7. A copy of the signed and notarized operation and maintenance (O&M) agreement. V
VV 8. > b
9. A soils report that is based upon an actual field investigation and soil borings. County soil maps are not
an acceptable source of soils information.
SW401-Wetland-Rev.6-11116109 Part ill, page 1 of 1

.44 WAY sop w

Permit Number:µJ�������
(to be provided by DWQ)
Drainage Area Number: '
Stormwater Wetland Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a log in a
known set location. Any deficient BMP elements noted in the inspection will be corrected, repaired or
replaced immediately. These deficiencies can affect the integrity of structures, safety of the public, and
the removal efficiency of the BMP.
Important maintenance procedures:
— Immediately following construction of the stormwater wetland, bi-weekly inspections will be
conducted and wetland plants will be watered bi-weekly until vegetation becomes established
(commonly six weeks).
— No portion of the stormwater wetland will be fertilized after the first initial fertilization that is
required to establish the wetland plants.
— Stable groundcover will be maintained in the drainage area to reduce the sediment load to the
wetland.
— Once a year, a dam safety expert should inspect the embankment.
After the stormwater wetland is established, I will inspect it monthly and within 24 hours after every
storm event greater than 1.0 inches (or 1.5 inches if in a Coastal County). Records of operation and
maintenance will be kept in a known set location and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired
immediately.
BMP element:
Potential roblem:
How I will remediate theproblem:
Entire BMP
Trash/debris is present.
Remove the trash/debris.
Perimeter of wetland
Areas of bare soil and/or erosive
Regrade the soil if necessary to remove the
gullies have formed.
gully, and then plant a ground cover and
water until it is established. Provide lime
and a one-time fertilizer application.
Vegetation is too short or too long.
Maintain vegetation at an appropriate
height.
Inlet device: pipe or
The pipe is clogged (if applicable).
Unclog the pipe. Dispose of the sediment
swale
offsite.
The pipe is cracked or otherwise
Replace the pipe.
damaged if applicable).
Erosion is occurring in the swale (if
Regrade the swale if necessary to smooth
applicable).
it over and provide erosion control
devices such as reinforced turf matting or
riprap to avoid future problems with
erosion.
E G E I
SEP 2 5 2012
Form SW401-Wetland O&M-Rev.4 BY: Page 1 of 3

Permit Number:
(to be provided by DWQ)
BMP element: Potentialproblem:
Forebay Sediment has accumulated in the
forebay to a depth that inhibits the
forebay from functioning weII.
Deep pool, shallow water
and shallow land areas
Embankment
Erosion has occurred.
Weeds are present.
Algal growth covers over 50% of the
deep pool and shallow water areas.
Cattails, phragmites or other invasive
plants cover 50% of the deep pool and
shallow water areas.
Shallow land remains flooded more
than 5 days after a storm event.
Plants are dead, diseased or dying.
Best professional practices show that
pruning is needed to maintain optimal
plant health.
Sediment has accumulated and
reduced the depth to 75% of the
original design depth of the deep
pools.
A tree has started to grow on the
embankment.
An annual inspection by appropriate
professional shows that the
embankment needs repair.
Evidence of muskrat or beaver activity
is present.
Micropool Sediment has accumulated and
reduced the depth to 75% of the
original design depth.
Outlet device ! Clogging has occurred.
The outlet device is damaged
Receiving water Erosion or other signs of damage have
occurred at the outlet.
How I will remediate the problem:
Search for the source of the sediment and
remedy the problem if possible. Remove
the sediment and dispose of it in a location
where it will not cause impacts to streams
or the BMP.
Provide additional erosion protection such
as reinforced turf matting or riprap if
needed to prevent future erosion
Remove the weeds, preferably by hand. If
a pesticide is used, wipe it on the plants
rather than spraying. _
Consult a professional to remove and
control the algal growth.
Remove invasives by physical removal or
by wiping them with pesticide (do not
sorav) - consult a professional.
Unclog the outlet device immediately.
Determine the source of the problem:
soils, hydrology, disease, etc. Remedy the
problem and replace plants. Provide a
one-time fertilizer application to establish
the eround cover if necessarv.
Prune according to best professional
practices.
Search for the source of the sediment and
remedy the problem if possible. Remove
the sediment and dispose of it in a location
where it will not cause impacts to streams
or the BMP.
Consult a dam safety specialist to remove
the tree.
Make all needed repairs.
Consult a professional to remove muskrats
or beavers.
Search for the source of the sediment and
remedy the problem if possible. Remove
the sediment and dispose of it in a location
where it will not cause impacts to streams
or the BMP.
Clean out the outlet device. Dispose of the
sediment off -site.
Repair or replace the outlet device.
Contact the NC Division of Water Quality
401 Oversight Unit at 919-733-1786.
SEP252012
Form SW401-Wetland O&M-Rev.4 Rge 2 of 3
BY:

Permit Number:
{Po he provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the performance of the
maintenance procedures listed above. 1 agree to notify DWQ of any problems with the system or prior
to any changes to the system or responsible party.
Project nameTamily Dollar Burgaw _ ^
BMP drainage area number:
Print name:Charles Thomas
Title: President
Address:2405-F Nash Street Wilson, NC 27896
Phone:[phone]
Signature:
Date:
Note: The legally responsible party should not be a homeowners association unless more than 50% of the lots have been
sold and a resident of the subdivision has been named the president.
I, ffio'mpi S. T a Notary Public for the State of
NOA Nfbti na , County of GASor1 , do hereby certify that
�prt�s 1 1f►om&g 44
personally appeared before me this ad- day of
15�!: rhba.r 2O1 a , and acknowledge the due execution of the forgoing stormwater wetland
maintenance requirements. Witness my hand and official seal, +s•`i° ws
SEAL
My commission expires 5(t� to, aao(3_ _
F9V"E
SEP 2 5 2012
0.
Form SW401-Wetiand O&M-Rev.4 Page 3 of 3

i
Fr„ .

State Stormwater Management Systems
Permit No. SW8 120913
Burgaw — Family Dollar
Stormwater Permit No. SW8120913
PenderCoun
Designer's Certification
Page 1 of 2
1�
I, u, ����� as a duly registeredi'^e-e r in the State of North Carolina,
having been authorized to observe ( eriadicall 1 eklylfull time) the construction of the project,
(Project)
for ?(, D E- (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 are a part of this Certification.
Noted deviations from approved plans and specifications:
Signature
Registration Number :20 i Z-
Date"".,f
i
�`�y412Pot
1:dd1J!!
o Q` � OFE551O,jjgC'•y ��
:-.SEAL"
1 •.
G E N,
JUN 03 2013
_.. —
Paae 6 of 7

State Stormwater Management Systems
Permit No. SW$ 120913
Certification Requirements: Page 2 of 2
1. Thedrainage area to the system contains approximately the ermined acreage.
ag Y PP Y P 9
-vL4
✓3
The drainage area to the system contains no more than the permitted amount of built -upon area.
All the built -upon area associated with the project is graded such that the runoff drains to the
system.
All roof drains are located such that the runoff is directed into the system.
The wetland zone elevations are per the approved plan.
The wetland is located per the approved plans.
A trash rack is provided on the outlet structure.
All slopes are grassed with permanent vegetation.
Vegetated slopes are no steeper than 3:1.
The inlets are located per the approved plans and do not cause short-circuiting of the system.
The permitted amounts of wetland zone surface area and volume have.been provided.
Required drawdown devices are correctly sized and located per the approved,plans.
All required design depths are provided.
All required parts of the system are provided.
5. The required number of wetlands plantings have been provided
cc: NCDENR-DWQ Regional Office
Inspector, Pender County Building Inspections
0
Page 7 of 7