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Home My WebLink AboutSW6201202_Application_20201210DEMLR USE ONLY Date Received Fee Paid Permit Number Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction (select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan ❑ Other WQ M mt Plan: 11 State of North Carolina Department of Environment and Natural Resources Division of Energy, Mineral and Land Resources 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.): Faithwill Farms Subdivision 2. Location of Project (street address): Wade -Stedman Road City:Stedman County: Cumberland Zip:28391 3. Directions to project (from nearest major intersection): 0.87 mi north along Wade -Stedman Road from intersection with Maxwell Road 4. Latitude:35° 04' 29.55" N Longitude:78° 42' 02.82" 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 DEMLR 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: 5.83 ac of Disturbed Area ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: httl2://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 ❑NPDES Industrial Stormwater ❑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: 5. Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6