SW8121018_CURRENT PERMIT_20121102

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

K-3
RUNERR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E. Dee Freeman
Governor Director Secretary
November 2, 2012
James Griffith, Vice President
AutoZone Development Corporation
123 South Front Street, 311 Floor
Memphis, TN 38103
Subject: State Stormwater Management Permit No. SW8121018
AutoZone — Cedar Point
High Density Commercial Wet Detention Pond Project
Carteret County
Dear Mr. Griffith:
The Wilmington Regional Office received a complete Stormwater Management Permit Application for AutoZone —
Cedar Point on November 1, 2012. 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 21-1.1000 and Session Law 2008-
211. We are forwarding Permit No. SW8 121018 dated November 2, 2012, for the construction, operation and
maintenance of the BMP's and built -upon areas associated with the subject project.
This permit shall be effective from the date of issuance until November 2, 2020, and shall be subject to the conditions
and limitations as specified therein. Please pay special attention to the conditions listed in this permit regarding the
Operation and Maintenance of the BMP(s), recordation of deed restrictions, certification of the BMP's, procedures for
changes of ownership, transferring the permit, and renewing the permit. Failure to establish an adequate system for
operation and maintenance of the stormwater management system, to record deed restrictions, to certify the BMP's,
to transfer the permit, or to renew the permit, 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 1508 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 6714 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 Chris Baker, at (910)
796-7215.
Sincerely,
For Charles Wa il�dj, E., Director
Division of Water Quality
GDS/csb: S:=&Stormwater\Permits & Projects120121120018 HD12012 11 permit 121018
cc: Matthew Lowder, P. E., Triangle Site Design, PLLC
Carteret County Building Inspections
Wilmington Regional Office Stormwater File
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 One
Phone: [phone] FAX: [phone] Customer Service. /-877-623-6748 NorthCarolina
Intemet: www.ncwaterquality.org ;Vatuyra &

State Stormwater Management Systems
Permit No. SW8 121018
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY COMMERCIAL 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
AutoZone Development Corporation
AutoZone — Cedar Point
Cedar Point Boulevard, Cedar Point, Carteret County
FOR THE
construction, operation and maintenance of an infiltration basin in compliance with the
provisions of Session Law 2008-211 and 15A NCAC 2H .1000 (hereafter collectively
and separately 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 November 2, 2020, and
shall be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. 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 1.8 on page 3 of this permit. The stormwater
control has been designed to handle the runoff from 33,778 square feet of
impervious area.
3. The tract will be limited to the amount of built -upon area indicated in Section 1.8
on page 3 of this permit, and as shown on the approved plans.
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 area of this
project must be directed into the permitted stormwater control system.
Page 2of7

State Stormwater Management Systems
Permit No. SW8 121018
6. The project shall provide a 50' wide vegetated buffer adjacent surface waters,
measured horizontally from and perpendicular to the normal pool of impounded
structures, the top of bank of both sides of streams and rivers, and the mean high
water line of tidal waters.
7. The following design criteria have been permitted for the infiltration basin and
must be provided and maintained at design condition:
a. Drainage Area, Acres:
Onsite, ft:
Offsite, ft2:
b. Total Impervious Surfaces, ft2:
Onsite, ft :
Offsite, ft2:
C. Design Storm, inches:
d. Basin Depth, feet:
e. Bottom Elevation, FMSL:
f. Bottom Surface Area, ft2:
g. Bypass Weir Elevation, FMS�:
h. Permitted Storage Volume, ft :
i. Predevelopment 1 yr 24 hr peak flow, cfs:
j. Post -development 1 yr 24 hr peak flow, cfs
k. Type of Soil:
I. Expected Infiltration Rate, in/hr:
M. Seasonal High Water Table, FMSL:
n. Time to Draw Down, fours:
o. Receiving Stream/River Basin:
p. Stream Index Number:
q. Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
1.05
45,740
NIA
33,778
33,778
NIA
3.66
2.5
22.0
2,665
24.5
9,482
817
9,964
Wando Sand
5
19.5
8.4
Boathouse Creek I White Oak
20-31
"SA; HQW"
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. Mowing 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. The facilities shall be constructed as shown on the approved plans. This permit
shall become voidable unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other
supporting data.
Page 3 of 7

State Stormwater Management Systems
Permit No. SW8 121018
5. 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.
6. 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.
7. Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and
what actions were taken.
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. A
modification may be required for those deviations.
9. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
10. 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 development, subdivision, acquisition, lease or sale of any, 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.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to 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.
III. GENERAL CONDITIONS
1. 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 project or of the permittee 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 approval of this request will be considered on its merits
and may or may not be approved.
Page 4 of 7

State Stormwater Management Systems
Permit No. SW8 121018
2. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
3. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request. Neither the sale of the project
in whole or in part, nor the conveyance of common area to a third party shall
constitute an approved transfer request.
4. 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.
5. 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.
6. 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.
7. 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.
8. The permit issued shall continue in force and effect until revolted or terminated.
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.
9. Unless specified elsewhere, permanent seeding requirements for the stormwater
controls must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revolting and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2008-
211, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et. al.
11. The permittee shall submit a permit renewal application at least 180 days prior to
the expiration date of this permit. The renewal request must include the
appropriate documentation and the processing fee.
Permit issued this the 2nd day of November, 2012.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
w-iznaries. vaKua, r. t., uirector
Division ofVVater Quality
By Authority of the Environmental Management Commission
Page 5 of 7

State Stormwater Management Systems
Permit No. SW8 121018
AutoZone Cedar Point
Stormwater Permit No. SW8 121018
Carteret County
Designer's Certification
1, , 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 6 of 7

0
State Stormwater Management Systems
Permit No. SW8 121018
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
Carteret County Building Inspections
Page 7 of 7

►I)
State'7water Management Systems
Permit No. SW8 121018
AutoZone Cedar Point
Stormwater Permit No. SW8 121018
Carteret County
Designer's Certification
I, z . y,,,,..) �oln1�P„i , as a duly registered f 2 %4 FN ,urr� in the
State of North Carolina, having been authorized to observe eriodi atly 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 _ W,�w a
Registration Number ,V4V
Date ¢ -18-13
Sgi
SAE.
a
1 24434
rM
ECEIVE
.R APR 19 200
M- r_ ,r-7

State Stormwater Management Systems.'
Permit No. SW8 121018
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
Carteret County Building Inspections
Dom, ^ 7nf7

DWQ USE ONLY
Date Feceived
Fee Paid
Pqmit Number
Applic ble Rules: ❑ Coastal SW - 1 5 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters []Universal Storm water Management Plan
❑ Other WQ M mt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
'Phis fonn 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.):
AutoZone - Cedar Point, NC
2. Location of Project (street address):
NC Highway 24 (Cedar Point Boulevard)
City:Cedar Point County:Carteret Zip:28584
3. Directions to project (from nearest major intersection):
Project located 280 feet West of the intersection of NC Highway 24 (Cedar Point Blvd) and Sherwood Avenue
4. Latitude:34° 41' 07" N Longitude:77° 04' 44" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System []Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 1.6 ac of Disturbed Area
❑404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
Form SWU-101 Version 07Jun2010 Page 1 of 6
DECEIVED
OCT 3 0 201Z
�.� Y.

Ill. CONTACT INFORMATION
I. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:AutoZone Development Corp.
Signing Official & TitleJames Griffith - Vice -President
b.Contact information for person listed in item 1a above:
Street Address:123 South Front Street 3rd Floor
City:Mem his State:TN Zip:38103
Mailing Address (if applicable):
City:
State: Zip:
Phone: (901 ) 495-870"1 _ Fax: [phone]
Email:[e-mail]
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:Sound Banking Company
Signing Official & Title:Andrea M. Benton - Senior Vice -President _
b.Contact information for person listed in item 2a above:
Street Address:5039 Executive Drive
City:Morehead City State:NC Zip:28557
Mailing Address (if applicable):
City: State: Zip:
Phone: (252 ) 247-1938 Fax:
Email:abenton©soundbanking.com
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/ Organ ization:Wade Davis - AutoZone Development Corporation
Signing Official & Title:
b.Contact information for person listed in item 3,1 above:
Mailing Address:]23 South Front Street
City:Memphis _ State:TN Zip:38'103
Phone: [phone] Fax: [phone]
l?niail:wade.davis©au tozone.com
4. Local jurisdiction for building permits: Town of Cedar Point
Point of Contact -.Chris Seaberg Phone #: [phone]
t -CECEI VED
OCT 302012
Form SWU-101 Version 07Jun2010 Page 2 of
gY
L

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Stormwater from the site will be treated within a sand infiltration basin at the rear of the proposed AutoZone
store. Runoff from the impervious areas of the site associated with the AutoZone development will drain
into the or000sed sand infiltration basin.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid. Building Permit Issued Date:
❑ Other: Date-
b. If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph Il - Post Construction
3. Storm water runoff from this project drains to the White Oak River basin.
4. Total Property Area: 2.66 acres 5. Total Coastal Wetlands Area: 0.0 acres
6. Total Surface Water Area: 0 acres
Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area+:2.66 acres
Total project area shall be calculated to exclude the following tine normal pool of innporunded strrrctrrres, the area
between the banks of streants and rivers, the area below the Nornnal High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landivard front the NNW (or MHW) line. The resultant pproject area is used to
calculate overall percent built upon area (B UA). Not -coastal wetlands landward of the NHW (or MHW) line 7nay
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 29.2 %
9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drainage Area 1
Drainage Area _
Drainage Area _
Drainage Area _
Receiving Stream Name
Boathouse Creek
Stream Class *
SA; HQW
Stream Index Number *
20-31
Total Drainage Area (so
45,740
On -site Drainage Area (so
45,740
Off -site Drainage Area (so
0
Proposed Impervious Area** (so
33,778
% Impervious Area** total
73.8
Impervious** Surface Area
Drainage Area 1
Drainage Area
Drainage Area _
Drainage Area
On -site Buildings/Lots (so
7,315
On -site Streets (so
0
On -site Parking (so
24,569
On -site Sidewalks (so
1,894
Other on -site (so
0
Future (so
0
Off -site (SO
0
Existing BUA*** (so
0
Total (so:
33,778
* Streann Class and Index Nutuber call be determined at: littl7://portal.nrcdetir.ot,gweb/i{) 7,,;Zc., lass [cations
" Imppervious area is defined as the built upon area including, but not limited to, buildings, roads, prirkitTg�areas,
sirleioalks, gravel areas, etc. A�+-S� "EI EI
OCT 3 0 Z01Z
Font SWU-101 Version 07Jun2010 Page 3 of 6
P,Y:

*** Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. NIA
Projects in Union County: Contact DIYQ Central Offtce 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 NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from htt//portal.ncdenr.org/�ti_ebLi��/�s[su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package in all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from http://L)ortal.iicdenr.org/web/wgJi�,s/su/states%,/fortns_docs. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office maybe
found by locating project on the interactive online map at http://portal.ncden.r.,org/iveb/wgjws/su/maw.)
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 bttp://pot-tal.ncdeiii-.org/web/wq/ws/su/statesw/foi-ms
does.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
► V-
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
PJIA
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
411L _
agreements) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
+MStL
http://www.envhelp.org/pages/onestopexpress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
Ma
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as,class SA or the
WIJL
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.
►MIL
& Two sets of plans folded to 8.5" x-14" (sealed, signed, & dated), including:
iY11L
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 MFIW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
RECRivF�
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
O C l 3 0 z012
Form SWU-101 Version 07Jun2010 Page 4 of 6 BY:

Copy of any applicable soils report with the associated SHWT elevations (Please identify IM1 L
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x11" copy of the NRCS County Soils map with the
project area dearly 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: 1388 Page No: 111 MgL-
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC rXii-
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 NCAC 2H.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
h ttp: / /www.secretary.st-,ite.nc.us/Cori2orations/CSearcii.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the ailowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
http://i2ortal.ncdenr.org/web/wn/ws/su/statesw/forms 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 holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
tinder them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting EngineenMattlew Lowder, PE
Consulting Firm: Triangle Site Design, PLLC
Mailing Address:4006 Barrett Drive, Suite 203
City:Raleigh _ State:NC Zip:27609
Phone: (919 ) 553-6570 Fax:
Eiiiail:[e-mail]
trianglesitedesign.com
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
1, (print or type name of person listed in Contact Information, item 2a) Sc-,LldRxXn G4t.0 certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item 1a) lames Griffith with (print or type name of organization listed in
Contact Information, item 1a) AutoZone Development Corp 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.
F3RVOCT
I�TED
02012Force SWU-101 Version 07Jun2010 Page 5 of 6

its 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 NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature: (i��(� �' Yli ri�l J V t' _ Date:
I, ZC061-�k- --,Dlfi'1t E' l a Notary Public for the State of N01- l N� It 4 County of
C-o ` s�±� do hereby certify that ?%Ld l' FA k personally appeared
before me this L,,kL day of �—{:�—��c-� ��.�__,_a.nd acknowledge the due execution of the application for a
storwater mi,6,Witness my hand and official seal,
SEAL
My commission expires
r
X. APPLICANT'S CERTIFICATION
I, (print or type name of person fisted in Contact Information, item 7a) lames Gri{fr_'fh
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 2H .1000, SL 2006-246 (Ph. II — Post Construction) or SL 2008-211.
Signature: Date:
1, , a Notary Public for the State of , County of
do hereby certify that
before me this _ day of
personally appeared
_ and acknowledge the due execution of the application for a
stormwater permit. Witness my hand and official seal,
SEAL
My commission expire
Fonn SWU-101 Version 073un2010 Page 6 of 6
E C EIV ED
OCT 302012
BY:

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 NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature:
Date:
games D. Anderson
I, , a Notary Public for the State of }rS,�.lN�Si�� ,County of
do hereby certify that Ta-" Gs C. (ter•. •t- —,-(n personally appeared
before me this. day of ttGTak.^... I 2VIX and acknowledge the�due �ecu of the application for
a stormwater permit. Witness my hand and official seal,
`� �`' Atlr •'L.
1EtAol PO4
s'yFtBY.G�J���?��,
X. APPLICANT'S CERTIFICATION
SEAL
My commission expires Lr La i0 ;x
I, (print or hjpe mire of person lister[ in Contact Information, item 1 a) amen Gri th
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, an at the proposed project complies with the requirements of the
applicable stormwater rules CAC 2H .1000, SL 2006-246 (Ph. II - Post Construction) or SL 2008-211.
Signature:
I JiM491D. Ande
Date: o
a Notary Public for the State of q%rNC.stEE County of
5t ")i do hereby certify that Z.MWS C. 6r."(4,74 personally appeared
before me this 01-0day of ceTn)w. , OV1,7, , and acknowledge the due_;ecution of the application for
a stormwater permit. Witness my hand and official seal,
Fonn SWU-101 Version 07Jun2010
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