SW8010647_CURRENT PERMIT_20020322

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT
NO.
SW_fl���
DOC TYPE
/L� CURRENT PERMIT
C ❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
22-
YYYYMMDD

Michael F. Easley, Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. TYgrpe, Ph.D., Acting Director
F_ Division of Water Quality
Wilmington Regional Office
March 22, 2002
Mr. Patrick A. Thomas, Town Manager
Town of Surf City
PO Box 2475
Surf City, NC 28445
Subject: Permit No. SW8 010647
Soundview Park
High Density Stormwater Project
Pender County
Dear Mr. Thomas:
The Wilmington Regional Office received a complete Stormwater Management Permit Application for Soundview
Park on March 20, 2002. Staff review of the plans and specifications has determined that the project, as proposed,
will comply with the Stormwater Regulations set forth in Title 15A NCAC 2H.1000. We are forwarding Permit
No. SW8 010647 dated March 22, 2002, for the construction of Soundview Park.
This permit shall be effective from the date of issuance until March 22, 2012, and shall be subject to the conditions
and limitations as specified therein. Please pay special attention to the Operation and Maintenance requirements
in this permit. Failure to establish an adequate system for operation and maintenance of the stormwater management
system will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an
adjudicatory hearing upon written requesfwithin thirty (30) days following receipt of this permit. This request must
be in,the form of a written petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed
with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demands
are made this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please contact Linda Lewis, or
me at (910) 395-390.0.
Sincerely,
Rick Shiver
Water Quality Regional Supervisor
RSS/arl:. S:IWQSISTORMWATIPERMIT1010647.MAR
cc: Keith BulIa, P.E.
Town of Surf City Building Inspections
Division of Coastal Management
Linda Lewis
Wilmington Regional Office
Central Files
N.C. Division of Water Quality 127 Cardinal Drive Extension Wilmington, N.C. 28405 [phone] Fax [phone] Customer Service
800-623-7748

State Stormwater Management Systems
Permit No. SW8 010647
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
Town of Surf City
Soundview Park
Pender County
FOR THE
construction, operation and maintenance of an overall low density project with ten infiltration basins to treat the
runoff from the parking lot, in compliance with the provisions of 15A NCAC 2H .1000 (hereafter referred to as the
"stormwater rules') and the approved stormwater management plans and specifications and other supporting data
as attached and on file with and approved by the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until March 22, 2012, 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 on page
3 of this permit, the Project Data Sheet. The stormwater controls have been designed to handle the runoff
associated with a 1.5" rainfall over 49,572 square feet of impervious area. The overflow from each basin
must be directed through a 50' vegetated filter prior to discharge.
Approved plans and specifications for this project are incorporated by reference and are enforceable parts
of the permit.
4. The overall tract built -upon area percentage for the project must be maintained at 25%, as required by
Section .1005 of the stormwater rules. The drainage area for each basin will be limited to the amount of
built -upon area indicated,nn page 3 of this permit, and per 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.
6 The runoff is proposed to sheet flow into the proposed infiltration basins. There is no piping proposed.
2

State Stormwater Management Systems
Permit No. SW8 010647
Project Name:
Permit Number:
Location:
Applicant:
Mailing Address:
Application Date:
Name of Receiving Stream/Index #:
Classification of Water Body:
Basin Number:
Basin Depth:
Bottom Elevation, FMSL:
Drainage Area, acres:
Total Impervious Surfaces, ft':
Offsite Area entering Pond, ft':
Required Storage Volume, ft':
Provided Storage Volume, ft':
Temporary Storage Elevation, FMSL:
Type of Soil:
Expected Infiltration Rate:
Seasonal High Water Table Elevation
Time to draw down:
11VISION OF WATER QUALITY
ROJECT DESIGN DATA SHEET
Soundview Park
SW8 010647
Pender County
Mr. Patrick A. Thomas, Town Manager
Town of Surf City
PO Box 2475
Surf City, NC 28445
March 20, 2002
Cape Fear /Topsail Sound / 18-87-10
"SA"
1
2 3
4
5
611
611 611
6"
1 f
2.0
2.0 2.0
2.0
2.5
4,218
5,405 5,895
2,582
1,560
2,670
3,380 4,507
1,494
1,110
None,
per engineer, for all basins
353
481 579
200
144
670
550 712
211
547
2.5
2.5 2.5
2.5
3.5
Sand
6" per hour
1.5 FMSL
<1 hour 1 hour
1 hour 1.2 hours 4 hours
3

State Stormwater Management Systems
Permit No. SW8 010647
Project Name:
Permit Number:
Location:
Applicant:
Mailing Address:
DIVISION OF WATER QUALITY
PROJECT DESIGN DATA SHEET
Soundview Park
SW8 010647
Pender County
Mr. Patrick A. Thomas, Town Manager
Town of Surf City
PO Box 2475
Surf City, NC 28445
Application Date: March 20, 2002
Name of Receiving Stream/Index #: Cape Fear /Topsail Sound/ 18-87-10
Classification of Water Body: "SA"
Basin Number:
Basin Depth:
Bottom Elevation, FMSL:
Drainage Area, acres:
Total Impervious Surfaces, ft2:
Offsite Area entering Pond, ftz:
Required Storage Volume, ft3:
Provided Storage Volume, fta:
Temporary Storage Elevation, FMSL:
Type of Soil:
Expected Infiltration Rate:
Seasonal High Water Table Elevation
Time to draw down:
N
6
7
8
9
10
611
6"
6"
6"
1'
2.0
2.5
2.0
2.0
2.5
14,490
24,205
4,387
5,062
3,466
7,412
20,905
788
863
1,936
None, per engineer, for all basins
1,014
2,656
138
160
261
1,750
11,072
641
888
414
2.5
3.5
2.5
2.5
3.5
Sand
6" per hour
1.5 FMSL
<1 hour
1.7 hours
<1 hour
<1 hour
<1 hour
4

State Stormwater Management Systems
Permit No. SW8 010647
II. SCHEDULE OF COMPLIANCE
The stormwater management system shall be constructed in it's 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.
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.
C. Maintenance of all slopes in accordance with approved plans and specifications.
f. Debris removal and unclogging of the basins and vegetated filter.
g. Access to the infiltration basins must be available at all times.
4. Records of maintenance activities must be kept and made available upon request to authorized personnel of
DWQ. The records will indicate the date, activity, name of person performing the work and what actions
were taken.
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.
6. Upon completion of construction, prior to issuance of a Certificate of Occupancy, and prior to operation of
this permitted facility, a certification must be received from an appropriate designer for the system installed
certifying that the permitted facility has been installed in accordance with this permit, the approved plans and
specifications, and other. supporting documentation. Any deviations from the approved plans and
specifications must be noted on the Certification. A modification may be required for those deviations.
7. If the stormwater system was used as an Erosion Control device, it must be restored to design condition prior
to operation as a stormwater treatment device, and prior to occupancy of the facility.
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.
C. Further subdivision, acquisition, or sale 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.
9. 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.
10. The permittee shall notify the Division of any name, ownership or mailing address changes within 30 days.
5

State Stormwater Management Systems
Permit No. SW8 010647
11. The permittee must maintain compliance with the proposed built -upon area and ensure that the runoff from
all the built -upon is directed into the permitted system.
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.
13. Filling in or piping of any vegetative conveyances (ditches, swales, etc.) associated with the permitted
development, except for average driveway crossings, is strictly prohibited by any persons.
111. GENERAL CONDITIONS
This permit is not transferable. In the event there is a desire for the facilities to change ownership, or there
is a name change of the Permittee, a formal permit request must be submitted to the Division of Water
Quality accompanied by an application fee, documentation from the parties involved, and other supporting
materials as may be appropriate. The approval of this request will be considered on its merits and may or
may not be approved. Responsibility for compliance with all permit conditions remains with the Permittee
until such time as the Division approves the formal permit request.
2. Failure to abide by the conditions and limitations contained in this permit may subject the Permittee to
enforcement action by the Division of Water Quality, in accordance with North Carolina General Statute 143-
215.6A to 143-215.6C.
3. The issuance of this permit does not preclude the Permittee from complying with any and all statutes, rules,
regulations, or ordinances which may be imposed by other government agencies (local, state, and federal)
which have jurisdiction.
4. In the event that the facilities fail to perform satisfactorily, including the creation of nuisance conditions, the
Permittee shall take immediate corrective action, including those as may be required by this Division, such
as the construction of additional or replacement stormwater management systems.
5. The permittee grants DENR Staff permission to enter the property during normal business hours for the
purpose of inspecting all components of the permitted stormwater management facility.
6. The permit may be modified, revoked and reissued or terminated for cause. The filing of a request for a
permit modification, revocation and reissuance or termination does not stay any permit condition.
7. Unless specified elsewhere, permanent seeding requirements for the stormwater control must follow the
guidelines established in the North Carolina Erosion and Sediment Control Planning and Design Manual.
Permit issued this the 22nd day of March, 2002.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Gregory J. Thorpe, Ph.D., Acting Director
1-0-1-1 Division of Water Quality
By Authority of the Environmental Management Commission
0

Date Received I Fee Paid I
/ Permit Number
-1— U ,Pe,(. ZO SW 8 0/0
l{_2-Ul Or�i�2i�
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. Applicants name (specify the name of the co oration, individual, etc. who owns the project):
I.C.-) r, �F 5Urr r..' �,
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
r � G �- A Tlno �.� �O w ✓1 Gc.
3. Mailing Address for person listed in item 2 above:
-- 2_1 q --tJ • New 12.,ver Drl'rc _I2.O. Sox 2Y75
City: _ �f)V r F C i 4-,, State: C . Zip: 51515
Telephone Number: f 1 1 O ] 329 - W 131 _
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
oL,rdy e.w F' k
5. Location of Project (street address):
�N. C . _4 -'h w� V So � . 70DW." i t �u sA i'o
City: 7C�r'F l�i�v County:_ P�✓1�e,r
Directions to project (from nearest major intersection):
7. Latitude: S P Z s t N Longitude: 7 7 33 ,- LAZ of project
8. Contact person who can answer questions about the project:
k.-rkom.,, Telephone Number: ( 9 10 13 1
11. PERMIT INFORMATION:
1. Specify whether project is (check one): X New Renewal Modification
Form SWU-101 Version 3.99 Page 1 of 4

. f
2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number and its issue date (if known)
t
3. Specify the type of project (c ck one):
Low Density High Density Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
✓LAMA Major _Sedimentation/Erosion Control 404/401 Permit NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project.
2. Stormwater runoff from this project drains to the Oe-,` __„ River basin.
3. Total Project Area: Jr.� acres 4. Project Built Upon Area: 1q • `'i�
5. How many drainage areas does the project have? 1.0
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
Basin Informaf�on
DainageAiea 1 >�DauageArea2-"
Receiving Stream Name
sc'n
Receiving Stream Class
Drainage Area
Existing Im ervious* Area
. -2A L
Pro osed hn ervious*Area
. g7 �v
hn ervious* Area (total)
I q.
lara�nage Areal �Dsasnag Area
xITII erVlOuS Surface Area, L e ei stxs �a,a>
On -site Buildings 00 305
On -site Streets ,
20 zr2 f
On -site Parking (0 29 0 55 Ff 2
On -site Sidewalks O
Other on -site O
Off -site O
Total: 1. 13f3 Total: 4 It 572 ig z
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 3.99 Page 2 of

7. How was the off -site impervious area listed above derived? r`
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
The following italicized deed restrictions and protective covenants are required to be recorded for all
subdivisions, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a
table listing each lot number, size and the allowable built -upon area for each lot must be provided as an
attachment.
The following covenants are intended to ensure ongoing compliance with state stormwater management permit
number _ _ _ as issued by the Division of Water Quality. These covenants may
not be changed or deleted without the consent of the State.
2. No more than square feet of any lot shall be covered by structures or impervious materials.
Impervious materials include asphalt, gravel, concrete, brick, stone, slate or similar material but do not include wood
decking or the water surface of swimming pools.
3. Swales shall not be filled in, piped, or altered except as necessary to provide driveway crossings.
4. Built -upon area in excess of the permitted amount requires a state stormwater management permit modification prior to
construction.
5. All permitted runoff from outparcels or future development shall be directed into the permitted stormwater control
system. These connections to the stormwater control system shall be performed in a manner that maintains the
integrity and performance of the system as permitted.
By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, that the covenants will be binding on all parties and
persons claiming under them, that they will run with the land, that the required covenants cannot be changed or
deleted without concurrence from the State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for
each BMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the
status and availability of these forms.
Form SWU-102
Wet Detention Basin Supplement
Form SWU-103
Infiltration Basin Supplement
Form SWU-104
Low Density Supplement
Form SWU-105
Curb Outlet System Supplement
Form SWU-106
Off -Site System Supplement
Form SWU-107
Underground Infiltration Trench Supplement
Form SWU-108
Neuse River Basin Supplement
Form SWU-109
Innovative Best Management Practice Supplement
Form SWU-101 Version 3.99 Page 3 of 4

VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. The complete application package should be
submitted to the appropriate DWQ Regional Office.
Please indicate that you have provided the following required information by initialing in the space
provided next to each item.
Initials
• Original and one copy of the Stormwater Management Permit Application Form iK f a
• One copy of the applicable Supplement Form(s) for each BMP Kea
• Permit application processing fee of $420 (payable to NCDENR) kp lP B
• Detailed narrative description of stormwater treatment/management kpf�
• Two copies of plans and specifications, including:
- Development/Project name
- Engineer and firm
Legend
- North arrow
- Scale
- Revision number & date
- Mean high water line
- Dimensioned property/project boundary
- Location map with named streets or NCSR numbers
- Original contours, proposed contours, spot elevations, finished floor elevations
- Details of roads, drainage features, collection systems, and stormwater control measures
- Wetlands delineated, or a note on plans that none exist
- Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations
- Drainage areas delineated
- Vegetated buffers (where required)
VII. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section.
Designated agent (individual or firm): 2. i 7k,% cc.Pis
0� - Mailing Address: _ _ _ A a-004
City: C.AJ . , 1AA,yt s ),.t ^^^ � State:_ Zip: ZSY4S
Phone: ( 110 ) 7`I / " 41 72 Fax: (_ 41 O } 5_0't- �t S
VIII. APPLICANT'S CERTIFICATION
I, (vrinf or tune name of verson listed in General Information. item 2) pa,41 c)- --rkoL&.O, t. s
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of 15A
NCAC 2H .1000.
Signature:
Date: Z/�!D Z
Form SWU-101 Version 3.99 Page 4 of 4

Permit -,No. Stk) 9,UIU6 ¢+il.
(lobe provided by DWQ)
r r State -of North Carolina , . ; , f: , ,, .• .,
Department of Environment and'Natural Resources r ,:� ': r _ ► ,
Division of Water Quality s. 1}4 � . ►111
oh'.._, STORMWATER MANAGEMENT PERMIT APPLICATION,FORM' c1 +,• t,:.
INFILTRATION BASIN' SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:" -
A complete stormwater management plan submittal includes a. stormwater management permit application, an
infiltration basin supplement for each system, design Icalcula'tions, soils 1report and• p- lans and specifications
showing all stormwater conveyances and system details."
I. PROJECT INFORMATION ,
Project Name
Contact Person:" 'i' , T;4
OVW�E�.Sr'- ` Phone Number: ''{ `AID ) ' `3 Z g';- Y /.3 I
. , . , r: r , I . . - , . J;.r • -'," I
-
This worksheet applies to: Basin No. I in Drainage Area
r ,l.r� , J ;•.... �. �- li. Ala. '�'• l ti
• �' (as idenfifled on pions) ' `� ' (from Form SWU-101) _
II. _ ,DESIGN INFORMATION;• - Attach supporting calculations/documentation., The.soils report must be
based upon an actual, fietd,investigation and soil, borings. County soil mapsiare not an acceptable source
of soils information. All elevations shall be in feet mean sea level (frnsl). ,
J •rl -+; ia= ,:f 't'1 . ir' ' ' 1.'. «. 10, JI .-, .N .•r, �• r, ,
Soils Report Summary,
Soil Type ! 1 ;,,,,;, .'Scr►..� C,NwE�
Infiltration Rate %.D QhAr Cf/hr/sf (circle appropriate units)
1 v t t1r " +
SHWT E e a ion` ! 5 � �fniSl (Seasonal High Water. Table elevation) - -- -
Basin Design•Parametersf. J --
Design Storm I , 5 inch (1.5 inch event for SA waters, I inch event far others)
Design Volume
Drawdown Time :. 1 + - days)
!•-'J' I ! 1!, rl�',{i(i'•.'. .`i !i _� fi�'+I"r•S l!1 ;i � ..i' .. C
Basin Dimensions
Basin Size RI. ITJ-" ' � • ft. x - O ft. = 54. ft. (bottom dimensions) '
Basin Volume Provided af. • - - — " �
( `•l, 1 - ill ..•1'J+�� ':1J. +r 'F I l
Basin Elevations
Bottom Elevation frnsl
Storage Elevation Z • 5frnsl I r!
Top EIevation 3.0 fmsl
Form SWU-103 Rev 3.99 Page 1 of 3

III.. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requiremcnts,per'tihe Stormwater Best Management Practices Manual
(N.C. Department of Environment,,Health *add Natural. Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008. 1F f' ; 46:3 r; d f -1 : o;. , 1
Initial in the space provided toindicate'.tliat the/following design,'requirements,''have'beeri met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may.initial below.. Attach. justification if a regpirement has not been met.
Applicants Initials
pQ a.
System is located 50 feet from class SA waters and 30 feet! from- other, surfa&,watcrs'. `
�F. �t� r�{+r � C' r f �r' , •. P� r. , 1'.'r. r . , r'.� ,� .,�. ,• _ b" System is located'at least' l00 feet from water supply wells.
,:. ..Jill '. .. Ind
C.
'.,,Ir I1r,; ,r +, t i .:1 tt•9.' ,' ,
Bottom of system is at least 2 feet above the.seasonal,high water table.;,:
) PP d.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
OR e.
System is not sited on or in fill material or DWQ approval has been obtained.
-Q f._.
System is located in a recorded drainage easement for the purposes of operation -and ,••
maintenance and has recorded access easements to the nearest public right-of-way. t
g.
Drainage area for the device is less than 5 acres.
^pB h:
,,�. ''tL.'f[i.�f •-,1 -./ � i'S:r� •[f r.lt"rf'`: ,
,Soils Have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
f/^�7 i•'r lt. ,�
!C� r i.
•P: � ., , n t••f.7;^: r, � -'ri ' ' �� fll � 'fry t
System captures and infiltrates'the runoff from the first 1�.0-inch`of rainfall (1.5;inch'cventffor
Ct el J'JJI; ftr'
r ,1. r 111 1 ',ri I r+= t rrr 'I - ', If `sf .if Yr.r.1
areas draining to'SA waters ).- bes;gn volume and infiltration calculations attached.'
��
�••`i.I i 1._ „ 1 .'.•".: 9_.ut 11M , I. . ' 1
j.
System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations; attached: i%,
P8 k.
All side slopes stabilized with vegetated cover are no steeper -than 3:1 (H: V).
I.
A pretreatment device suchlas a catch basin, +grease trap, filter strip, grassed Swale or
sediment trap is provided.
1P8 m.
Bottom of the device is covered with a layer of clean sand to an average depth,of,4 inches.or
dense vegetative cover is provided.
K PP n. Vegetated filter is provided for overflow nd deftiH (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o.
Flow distribution mechanism within the basin', is provided.
p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
K- q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
10 r. System is designed to draw down the'design storage.volUme to the proposed bottom
elevation under seasonal high water conditions within five days. A soils 'report and all
�/ b pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or l
restored) upon initial operation once the project is complete and the entire drainage'area is
stabilized. i 1 6• • I . '�'�
r0 ;+t 11 4 ' . !'J .. ,
Form SWU-103 Rev 3.99 Page 2 of 3
I 1 1 Jr.f 11 7 . ' I f/

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
I . After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads N R feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H A000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. 1 agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title:_ _ _ 4r,&CK A. _ Myw w 4 5 ic�,,r,J 1V,, ,V,4GEiZ-
Address: _ - - R O. Adk W7.S SseeF &p-,1 Ale Z F04 -
Phone: 9/0 - 3 & ef13 / Date: /+9,4,eCW /Q Z.LiO Z
Signature:
Note: The legally responsible party should not be a homeowners association unless more than 50% of the lots have been sold and a
resident of the subdivision has been named the president. _f
1, T4 k" ,'_ , aN"ottary Public for the State of _ /i�3/4elke [.` , County of
�^'�� , do hereby certify that Ooif-r (-� Uc A, lk rnn 4 personally appeared before me this l�
day of 17j44a_ ____, 2-40-' 1 and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal, 1;6ft, r
SEAL My commission expires 10 19-� 104
Form SWU-103 Rev 3.99 Page 3 of 3

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PermitNo.'•.. t ,
(to be provided by DWQ)
'r State of North Carolina
r ". ,E Department of Environment;and Natural, Resources',
Division of Water Quality
;, 4 +'. STORMWATER MANAGEMENT -PERMIT APPLICATION•FORM'. r
INFIL-TRATION'BASIN' SUPPLEMENT' ' r
This form may be photocopied for use as an original
DWQ Stormwater Management'Plan Review:-,.- ' ; . ' r, --r ' •. ' '
A complete stormwater management plan submittal includes a.st1.ormwater,management permit application, an
infiltration basin supplement for cash system, design calculations, soils report and plans and specifications
showing all stormwater conveyance's andlsystem details'
I. PROJECT INFORMATION
' !. . ill ' , : ._. '�. r •,+% rst. �- 1, it ;? -—• -
Proj ect Name . es GY d -e u� pa;r
Contact Peiso"m P r; c: Tyw;�:�:�>i 4 Phone Number:
This worksheet applies to: Basin No. Z in Drainage Area
+ ' ? -(as identified on plans) T' f " 1! ' t i ' (from Form SWU-101)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. ,County soil maps are not an acceptable source
of soils information. All elevation`s shall be in fect'mean sea level (frnsi).
1,
Soils Report Summary' a _ ;, • -
Soil Type JJ w O
Infiltration Rate G in/hr or cf/hr/sf (circle appropriate units)
SHWT Elevation • Jr fmsl '(Seasonal High Water'Tablee!evation) -
P.
r,
Basin' Design Parameters
Design Storm 7 + Jr inch (l.S.inch event for SA waters, I inch, event far others)
i1' �'n t- I ' .i i, ,. ii.' `i 1 • I i'•'1. „ ,f, i :.• !. I. ?;r � 5 5
Design Volume 415' �. C.f -5. 5r- f r; 1 .�
Drawdown Time i days
jr
Basin Dimensions
Basin Size $ ft, x t t _ ft. — di 0 sq. ft. (bottom dimensions)
If •4 . ;.n� k )[ 14r( Js' rr ,� ,� :i: ,- .I ,;. 'A J•
Basin Volume Provided J�'SQ c.f.` `
Basin Elevations
Bottom Elevation 2 imsl
r ,
�•
Storage Elevation 2 . S fmsl
Top Elevation 3 • D fmsl
_ r• : .Y n
Form S) U-103 Rev 3,99 Page I of 3

III, REQUIRED ITEMS CHECKLIST
The following checklist outlines design rcquiremenis'per the Stormwater Best Management Practices Manual
(N.C. Department of Environment,,Health'and Natural,- Resources', February f1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space.provide'd't6Iin&ate'thdt the following_design`requiiements•have b,66'met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial -below. Attach justification if a requirement has not been met.
Applicants Initials
�P a. System is located 50 feet from class SA waters and-30 feet fromr other suiface,waters.'
b.1•.System is located at least 1�00 feet `from'water rsupply wells: " `' '' �`'
eft.tCj{....: I�
c. Bottom of system is at least 2 feet above the: seasonalhigh,water table,;{.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval h'as been obtained. ` ?. '
f. System is located in a recorded drainage easement for the purposes of operation -and
_ maintenance and has recorded access easements to the nearest public right-of:way.,
08 g. Drainage area for the device is less than 5 acres.
. , , fi.i' i _' - ' r i i'; .,,"I" {' r.Ui ; h.,, Soils have minimum hydraulic conductivity. of 0.52 inches per hour and�soN report is
V attached.
ti Qg' "{i. System captures and'infiltrates'the'runoff from the first`1.0 inch of rainfall (I.S inch event for
areas draining 6 SA'waters }. -Design volume arid-irifiltration calculations attached:'
p8 j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached! ..
k.
All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V). -�'l
1.
A pretreatment device such as a catch basin, grease trap, -filter strip, grassed swale or
sediment trap is provided.
�Pb
m.
Bottom of the device is covered with a layer of clean sand to an aver_age;depth of 4.•inches,or
dense vegetative cover is provided.
l+ n.
Vegetated filter is provided for overflow (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o.
Flow distribution mechanism within the basin is provided.
p.
A benchmark is provided to determine the sediment accumulation in the pretreal!tmen■t■ device.
q.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided). r,
r.
System is designed to draw down the design storage volume to the
proposed,bottom
elevation under seasonal high water conditions within five days. A soils report' and'all f 11 '
pertinent draw -down calculations are attached.
p�
s.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire arainage''a'rea'is'J
stabilized.
Form SWU-l03 Rev
3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads N Ift feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H A000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title: Parl lae A. 7Wg w4 5. MIA) N 4NAGE2
Address: P. 4. &011 407S^ geie 4Sg Ivc Z.F441J`
Phone: 4/0 - 3Z8 - e113 /
Signature:
Date: /47 Z'LiD Z
Note: The legally responsible party should not be a homeowners association unless more than 50% of the lots have been sold and a
resident of the subdivision has been named the president.
1, T , a Notary Public for the State of re County of
do hereby certify that 006_Tr0'UC & -Marn'-s personally appeared before me thi'
day of M -r t,�4— , U 0,1 and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL
1?dtL_ fla�
My commission expires f 0 ¢y- o
Form SWU-103 Rev 3.99 Page 3 of 3

Permit: No.� s , !� t•
(to be provided by DWQ)
+,State-ofNorth Carolina,
a,} ;{• 1 r, . Department of Environmentiand Natural Resources.,, L,r
Division of Water Quality +
'J `:'I. .. ST.ORMWATER MANAGEMENT PERMIT APPLICATION- FORM
INFILTRATION BASINSUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management'Plan Review:, P • r
A complete stormwater management plan, submittal, includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater'conveyances and system details.';
I. PROJECT INFORMATION .,.
Project Name'. f 'u
Contact Persozi:'' ' - tr`t`
`� � � � ,w�cs ` "Phone Nurribei: ' 410
This worksheet applies to:, Basin No. 3 . in Drainage Area
(a:ridenhfedanpIans)'' �" r'' I'' (from F(irmSWU-1R1) -
II.. DESIGN INFORMATION, - Attach supporting,calculationsldocumentation. The soils report must be
based upon,an actual field investigation and soil borings.. County soil maps,are not,an acceptable source
of soils information. All elevations shali be in feet mean sea level (fmsl).
.[1. t; r , rr+
Soils Report Summary . ' - . . •• ' ..,' , -
Soil Type axMJ U".)g,' -,,
Infiltration Rate 7 0.0 in/hr or cf/hr/sf (circle appropriate units)
SHWT Elevation f r �J� Ernst J (Seasonal high Water Table elevation)
Basin Design Parameters'.' �� •� ` , ,:I ; T`�
Design Storm 7 s inch (1.5,inch event for SA waters, 1 inch event for others)
Design Volume - 7•9 c f.
Drawdown Time lot _days,
f".1'r I. �, rlr Irif;'1;..! 1'. i1 •I 1 ,. 'r ''
Basin Dimensions
Basin Sizc
:ft.-X" 11Q, r,-' ft. �'', t2ro`J sq. ft. (bottom dimensions)
Basin .Volume}Piovided �'!',�.. 'c.£. ' •j r�'.=, J. rc_r
•.ii _ .r ,,r1, '.' ,
Basin Elevations
Bottom Elevation Z • p fmsl ,
r ,s'; . ,
Storage Elevation 2 • S fmsl
Top Elevation 3 fmsl
Form SWU-103 Rev 3.99 Page 1 of 3

III. REQUIRED ITEMS CHECKLIST
,1 , 1," ,,v , ,;,, .;T, ,,
The following checklist outlines design requir'ernents�pbt,the�Stormwater Best Management Practices Manual
(N.C. Department of Environment,. Healthjanil'Natural•1Resources, February'1999) and Administrative Code
Section: l5 A NCAC 2H .1008.
Initial in the space-piovided=toJindicate that the following design,'requiremcnts'have':been met and supporting
documentation is attached. if the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initialibelow. -Attach, justification if a requirement has not been met.
Applicants Initials
p� a.
System is located 50 feet from class SA waters and30 feet'from'other;surface waters.:
,,.­ i �i'
K PB b, ,
-. •' 1 f J -, 1 �YI f- 'r III J��tYI J•, T al • r 1•.i )Jr �1 i�I, J J'
Systremis' Iocated at least l00 feet from watoer s, up ply wells.
`- c.
,
Bottom of system is at least 2 feet above the seasonal high.waterrtable.;
;,,Y
d.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
�!PR e.
System is not sited on or in filI material or DWQ approval has been ohfained,"-
K PA f.
System is located in a recorded drainage easement for the purposes of operation arid.
maintenance and has recorded access easements to the nearest public. right -of way,.-,
^
B g.
Drainage area for the device is less than 5 acres.
P h.
Soil's have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
Pal r.
System captures and' infiltrates the runoff from'the first 1.0 inch of rainfall (1.5, inch for
V.
revert
areas draining to SA waters ).' Design volume'and infiltration calculations attached.
j.
System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Caleulations.attached.
f S k.
All side slopes stabilized with vegetated cover are.no steeper.than 3:1 (H: V).
1.
A pretreatment device such,asa,catch basin, grease trap; filter strip, grassed Swale or
sediment trap is provrdea. --
P� m.
Bottom of the device is covered with a layer of clean sand to an average:depth of4.inches or
dense vegetative cover is provided.
i U n.
Vegetated filter is provided for overflow (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
-' o.
Flow distribution mechanism within the basin is provided.__
p.
A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided). .
p8 r.
System is designed to draw down the design storage.volume to the proposed. bottom/,
elevation under seasonal high water conditions within five days. A soils report and"all"'" `
pertinent draw -down calculations are attached.
s.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area i's'
stabilized. r
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title: PArglee 5, ioc%y N?4NAGEr2
Address:.. PC',..gdid W7S J%ezr 4�1M NC
Phone:
Signature:
Date: IVWZCAt /V,_ Z414 Z
Note: The legally responsible party should not be a homeowners association unless more than 50% of the lots have been sold and a
resident of the subdivision has been named the president.
1, To e li., r '_ —a nN""ottary Public for the State of r Ago l •` -. County of
e�'�e✓ —,do hereby certify that 00& r<<cCc ig . 21a n a personally appeared before me this �
day of 'L4tj-- , ZdOL, and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL. My co ission expires _ f ell 10 �
Form SWU-103 Rev 3.99 Page 3 of 3

PermifNo.,' a
(to be provided by DWO
State of -North Carolina.. -
Department of Environment' and Natural. Resources t i l r
Division of Water Quality
{ STORMWATER-,MANAGEMENT-P.ERMIT APPLICATION FORM
' INFILTRATION -BASIN SUPPLEMENT
This form may be photocopied for use as an original ir
DWQ Stormwater Management, Plan Review: I' - _ ► ' . ',: 0 ,
A complete stormwater management plan submittal includes a stormwater.management permit application, an
infiltration basin supplement for .each system, design, calculations, soils report and plans and specifications
showing all stormwater-conveyances'and systeni'details. :r -
1. PROJECT.INFORMATION .. }.�y n• . , r
Project Name: -� 1, 'UhC1 VLL-
ContactPerson:' p,,, PhoneNumber`:''10 ZA — 4YA3%
This worksheet applies to: Basin No. Y r in Drainage Area !
(as identified on p1d u) r �' , r ' (from Form SWU-101)-
11. DESIGN INFORMATION, - Attach supporting.calculations/documentation.. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Ifni • ' • i. ,1 ! . . - 1, ,: t
Soils Report Summary -
Soil Type ' i G--4 X1w
Infiltration Rate 7 6 .O in/hr or ef/hr/sf (circle appropriate units)
SHWT Elevation Jr fmsl (Seasonal High Water Table elevation) r.Ic
BasinDesign Parameters " F
,r: • . ;; - •i..:: � ; „: is
Design Storm 7 1 S inch (1. S inch event for SA waters, I inch event for others)
., tr: r 1
Design Volume zoo. c.f. t 1• r"
Drawdown Time I I days, • ,rrl
Basin Dimensions
Basin `Size
B asin! V olumc. Proyided l
Basin Elevations
ft. X C5 fir. •32S Sq. ft. (bottom dimensions)
2 0 ,msl
Bottom Elevation lf J . ' .�
Storage Elevation L • 5 fmsl
Top Elevation S - 0 fmsl
t i
Form SWU-103 Rev 3.99 Page 1 of 3

LII. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirer6ents per`ihe Storrriwater Best Management Practices Manual
(N.C. Department of Environment; Health'andlNatural►Resources,')February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided W indicate that'the following designirequi'ren"iehfs'have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may, initial below.l Attach justification iFa requirement has not been met.
1
Applicants Initials
KPF3 a. System is located 50 feet from class SA waters and 30 feet,from other'surface.waters:
'iC pall: b. ' System'is located'at'least 100 fee't'frorn' water stipply Wells. '_ '
�l ,• i, ,J. ."' . �- '1 1 1",§ ,' 1 I 'o 11i1;. .. h. . J.1 111':YE.'i'
c. Bottom of system is at least 2 feet above,the seasonal, high, water table. ;
_ K PR d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
_ }C PA _ e. System is not sited on or in fill material or DWQ approval has been obtained.
P� f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
- _. - . ' -. -1. 1 it., - "ii'E -_ —_ -. " . _
g. Drainage area for the device is less than 5 acres.
P h.. Soils have"a minimum hydraulic- conductivity of 0.52 inches per hour and soils report is
attached.
a
, i. ' System captures and infiltrates the runoff from the first 1-.0'inch of rainfall (1.5-inch event for
'"areas drait�iri9 to SA'waters ). Design volume'and'infiltrdtiori' calculattons'attaclied:'
Qg j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations'attached!
POD k. All side slopes stabilized with vegetated cover area no steeper than 3:1 (H:V).
1. A pretreatment device suchasa catch basin, grease trap; filter strip, grassed�swale or L
sediment trap is provided
m. Bottom of the device is covered with a layer of clean sand to an average depthiof�4;inches;or
dense vegetative cover is provided.
p n. ' Vegetated filter is provided for overflow (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o. Flow distribution mechanism within the basin is provided. -�,rrT "' ?•
p. A benchmark is provided to determine the sediment accumulation in the pretreattment device.
q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).,
r. Systern is designed to draw down the design storage volume to the proposed bottom ,
elevation under seasonal high water conditions within five days. A soils Ye' Port 'and all`''
pertinent draw -down calculations are attached.
1� N s. Plans ensure that the installed system will,meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage'aiea'is
stabilized. :y '
Farm SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads N feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title:_ PimcK A._ _/NON1A5, %,p�✓,J Iy14m4aez
Address: _ OO, gos! Z419S Siv,eA, &rT; /1/C Z8440-
Phone
Signature:
V/0 -
- 4//S / ,­=4 Date: /�,4,eCA1 /Q Z40 Z.
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, 4 anNotary Public for the State of At' V-LRfa t!` � ,County of
do hereby certify that 4' f,� `7d personally appeared before me this '
day of M 4•rt-l- U Vand acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL My commission expires _ IO 1 ¢`F 104 ^_
Form SWU-103 Rev 3.99 Page 3 of 3

PermitNo.'.,',
(to be provided by DWQ)
��;a{..•ryc .`:,fia-"' .'rr r'+ 7:,r State:of-North,Carolina;j
Department.of Environment, and Natural Resources
Division of Water Quality �' i ''�� ' r=�•
3F~ r •!' r. r STORMWATER,MANAGEMENT PERMIT APPLICATION,FORM :'js^, ::'l [ c.l
'IN'FIL-TRATiON'BASIN-SUPPLEMENT
This form may be photocopied for use as an original
ENO Stormwater Managemen0lan Review:... r, fr
A complete stormwater management plan submittal includes a. stormwater, management permit application, an
infiltration basin supplement for each system., design. calculations, soils report and plans and specifications
showing all stormwater conveyance's' and Vkerri'detail s:
.r ON u , °F. [,I , ) , t_ ii :
I. PROJECT. INFORMATION, r . t� i !' ((// ►��)). , ', ; t rt �t.��,' �� ,��:� ' : 1
Project Name '.r , ;fl if't�, S,q V-"% 4,
Contact Person ' i.= FU o fr' i C.i�''' + hotvv.G. s"' Phone Number: (_YIO) 32� y131
't'.'r. r1 .,," ' ',F{t ,_,: .. ,Cry it -, •,
This worksheet applies to: Basin No. in Drainage Area
_.i-�:.. r ,It ?i' -
(as idenliled on plans} (from Form SWU-101) - - -
1., t '•;.IIJ,
. II.r. DESIGN INFORMATION. - Attach. supporting, calculations/documentation. The, soils report must be
based upon;an actual Jfield,investigation and soil borigs n. County, soil maps,are not an acceptable soizree
of soils information. All elevations shall be in feet mean sea level (fmsl).
� jj l:'�.t'I_: �� ,r�rt•,�li,rl' r ,r! Jr.! ?.: !:�N'. �'Cf '''f.''r'� _ � .. .t" i.' k ..`�� --•
Soils Report, Summiry'')`"
Soil Type . _ ; J , ; _' , ':
Infiltration Rate 7 (G• O inlhr or of/hr/sf (circle appropriate units)
Vt iL•.r. r' Ts; 1'. ',t 1 .�. ,= t .r ! i F'.},' t r;_
SHWT )~levation fhW (Seasonal High Water. Table elevation)
Basin•De'sign'Parameters"
rill)
Design Storm ` i# r { i` j •, inch (1 S; nch event for SA waters, 1 inch,event four others)
Design Volume 1.!� „ T' c':f: rrj� ; '. ;,_ :' r' . r'
Drawdown Time days ;;, t f r ,. r r r> , t ti fi _
'asin "' 'tlrDi,;i m,e4• ...' .'' ;,i ..[ �•,lr., 'r,_.i�. - }F!t :,� [', ?f., .� -Jltl.�il'�:'i ,iw f'':i_,,,,r. t� .'#
Bnsions
.lt: '`)�', ��_ .•r; •J� 'I'_. "r tt! r i"i: lkt i[J �.. ':ii;`Ir: ,,
Basm Size ` �% 2 ' S ft. x (o ft. !=!� 7 ►� sq. ft.
99 (bottom dimensions)
Basin Volume Provided �``� 7,
c.£-
�S'i li..+ E �' I r a ,u... ,�' It., . a;:'. ,i"U: rF.r»�,,r•, . �i.1r,.ii :�Fili -
Basin Elevations
.[ i, ,I. :•',. •,: ,., r .r, � ','i, il, �i:.t•:r, t'll'r ,,r Ili ',i.': " i � `, '
Bottom Elevation fmsl
.ar .r. r f'I ' .rnl�,J
Storage EIevation - 3 O fmsl
Top Elevation 3.O fmsl
Form SWU-103 Rev 3,99 Page l of 3

III. REQUIRED ITEMS CHECKLIST
y'• r1i5. 't•1
The following checklist outlines design requirements per ihc'Stormwater Best Management Practices Manual
(N.C. Department of Environment,, Health iand Natural:Resourceg, February:1999Y and Administrative Code
Section: 15 A NCAC 2H .100$. ..: r , . ,•, ' 'o; , , , •,! J; r
Initial in the space provided to iiidicate that the following designtreguitementsehave,been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may -initial below. -Attach justification if a -requirement has not been met.
Applicants Initials
�CP14 a. System is located 50 feet from class SA waters and-30 feetlfrom other surface waters' ;•
p b. System is located II' least' 100. feet fr'om'watet supply wells. '`=
c. Bottom of system is at least 2 feet above the seasonal, kigb, watertable.
P d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
p e. System is not sited on or in fill material or DWQ approvalhas been obtained.
)LPB f. System is located in a recorde.d-drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest -public right-of-way. k , .
P8 g. Drainage area for the device is less than 5 acres.
jt PAh' Soils have a minimum hydraulic conductivity of 0.52 inches per hour and`soils reportis`
attached.
P� ' i. ' System cAOtur'es and infil6ktes-the'runoff fr6m th'e first T.0 inch�of rainfall'(1.5 inch event
ar'eas'draining to SA'water`s ).--'Design volume'and'iiifil&r tion calculations'atiached`
` .. I , :' ' ." i' . P . 1' !' 1f.'r` i •if i .:1 ', 1
P+� j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached. ,• ' :.�:
p k. All side slopes stabilized with vegetated cover ate no steeper than 3:1 (H:V).
1. A pretreatment device such as a catch+basin,,grease trap, filter strip, grassed swaie or
sediment trap is provided.
iPQ m. Bottom of the device is covered with a layer of clean sand to an average, depth,of4:inches.or
dense vegetative cover is provided.
PiQ n. Vegetated filter is provided foe overflow (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o. Flow distribution mechanism within the basin is provided.
p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q. Runoff in excess of the design volume bypasses offaine systems (bypass detail provided).,
�$ r. System is designed to draw down the design storage volume to the proposed bottom �
elevation under seasonal high water conditions within five days. A soils report and'all�'''' }
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire'drainage'ar`ea'is '
stabilized. ,
Form SWU-143 Rev 3.99 Page 2 of 3
;. t . 1... 'ni- ..;.. . ;r ,

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads N LA feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. if the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title: AiralGr A, TNa^q s, Tac✓ W4A1AGe-/2
Address: A 0 1 &d)d Z.u?S lsi,eF & /1rC ZJF44ES-
Phone:
Signature:
Date:. 1,V eCW /Q Z40 Z.
Note: The legally responsible parry should not be a homeowners association unless more than 50% of the lots have been sold and a
resident of the subdivision has been named the president.
1, ; k: ,'_ , a�nNottary Public for the State of A 4,CAfe Z �t.G County of
Qw'�v� do hereby certify that 00#42U�: '4 - -Morn" S personally appeared before the this
day of M,4-re-1-- , 7-00L and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal, 9�9�
SEAL My commission expires LO
Form SWU-103 Rev 3.99 Page 3 of 3

(to be provided by DWQ)
,;State of North -Carolina.-, sM�.r :.0 ' 1'Lo ...
c47 ' .,rr ` Departrnent.of Environment and,Natural Resources' .
Division of Water Quality r' - r
1"P h `.,,,STORMWATER-MANAGEMENT PERMIT APPLICATION'.FORM _
INFI'LTRATION•BASIN SUPPLEMENT' '
This form may be photocopied for use as an original
DWQ Stormwater Management,Plan Review: , ' ',:" k'? • ,} .ci n'7 . .,
A complete stormwater management plansubmittalincludes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater"conveyances"and system details.,
I. PROJECT. INFORMATION,
ProjectNamc: ��- '),
Contact Person:'
This worksheet applies to: Basin No. �P _ _ in Drainage Area
7 _ (as identified on ptairi)' ' - A r (from Form SWIl--101)
nyi• ,+
II. DESIGN INFORMATION - Attach supporting calculations/doculmentation.. The soils report must be
'r , / ' r . t ,. 11 „, ,' 1' ',, .,. , . l J' , .,J . '1: I�
based Upon an.actual field,investigation, and,soil,b.prings. , County soil maps are.not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fTnsl).
Soils Report Summary' '�, _ ;•r,,' ,
Soil Type ,' �j. !i.. ii ,,,•!' ,., ,, u: r, ;, ,,`' - .
Infiltration Rate 7 (a • 0 in/hr or ef/hrlsf (circle appropriate units)
SHWT Elevation' .' Jf fmsl" {Seasonal High Water Ta61e elevation)
. . ,.,'
Basin Design' Parameters
Design Storm
�! - inch (1.5 inch event for Sri waters, I inch event for others)
Design Volume
1 D+I.' fT. c.f. r',•'
Drawdown Time
r,, „ days, ,t
W. ,
Basin Dimensions
.t, :lir' ll...jfr �11,r •i
Basin Size ' ''
�J`r .. ,� 'i r�i1, i, _. - �r
1 ft. x ,17 5 'A. —
2'6 2s sq. ft. (bottom dimensions)
Basin Volume Provided
175b c.f.,
`
Basin Elevations
't+' ,:: :r, ..r,;} it -f:ri 3:.tr
Bottom Elevation
.,}r. �, +, ,r . f, ,' 1 .-
2' •'o' fmsl,
�r.� ' r r•
_. , �, , �r11
_ :� •.•,'p ., ,.=r � i r.i,;•. ,, .
F 'C.t•+ r•r. . ,�, .
Storage Elevation
2 • S fmsl
Top Elevation
.3. O _ fmsl
Form SWU-103 Rev 3.99
Page t of 3
i

III, REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per-thc Stormy water Best Management Practices Manual
(N.C. Department of Environment,. Health andNatural;Resources,':February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space ,provided'to indicate -that the following: design'requirements'have'beeri.met and supporting
documentation is attached. if the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial -below: Attach justification if arequirement has not been met.
Applicants Initials
�plg a. System is located 50 feet from class SA waters and 30 feet: from other, surface waters. i ' . c +
�a8 b'. System is located'at ieasi:' 10o feet from water supply wells:
�.�'' r''f.;, :, 'if .i.'i. •:_ •G' r. , .. T": i ,f(r( :, .. r ..•'IF.i
c. Bottom of system is at least 2 feet above the. seasonal hiA water..table. , .{ r , , , ,•
CPB d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
, ..
�t'P8 e. System is not sited on or in fill material or DWQ approval,has been olitained. ' T -
P f. System is located in a recorded drainage easement for the purposes of operation and :41
maintenance and has recorded access easements to the nearest public'right-of-way..
P13 g.
Drainage area for the device is less than 5 acres.
A$^ h.
Soils have a minimum hydraulic conductivity of,0.52 inches per hour and soils report s,
attached.
is
System captures and infiltrates the runoff from the first i .0 inch of rainfall'(1.5 inch'event'for
areas'draining to SA �vatei•s-).;'Designvolume 'and'infilirdtion calcul♦ation's'attached'�
pf3 j.
System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached. +_
pQ k.
All side slopes stabilized with vegetated cover are no steeper than 3.1 (H: V).
I.
A pretreatment device sucha catch basin, grease trap, filter strip, grassed swale,or,
�as
sediment trap is provided.'
KA8 m.
Bottom of the device is covered with a layer of clean sand to an average depth of 4. inches, or
dense vegetative cover is provided. f,Q
A% n.
-Vegefated fitter is'provided for overflow (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o.
Flow distribution mechanism within the basin is provided.
` p.
A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q.
r, sa
Runoff in excess of the design volume bypasses off-line: systems (bypass detail provided).,
x Ad r.
System is designed to draw down the design storage volurrie to the proposed bottom
r
elevation under seasonal high water conditions within five days. A soils report and'a11'('
pertinent draw -down calculations are attached.
y
P�
k c
!� s.
Plans ensure that the installed system will meet design specifications (constructed on
restored) upon initial operation once the project is complete and the entire 'dr'ainage`area is'
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
l . After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads Jl A feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title: _ PAr,¢-lcK A. 7Wd w4 S, Taws /y1.4nlAGE2
Address:- _ P O, 8o)d ?-07S Siee , &? _ /Pt ZF4o(-VJ-
3�&_- el/3 / _ —.� Date: 1-YAeC-/ /Q _ Z60 Z
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, T I0- ' , r a Notary Public for the State of %7r �E LAr- . County of
Q^'0.941- do hereby certify that 044111'c & 7-1niia s personally appeared before me this
day of I�?r4 �e.� 2-00Z -. and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL My commission expires
Form SWU-103 Rev 3.99 Page 3 of 3

' Permit No:. {. t:
(to be provided by DWQ)
1 �' .,.� �•_ Jii f,;ill �;s ,., ',rj�r �• ie.,.-,State 'of North,Car_olina, IT . ••, , , ,I _ _ - -'r', .
i)rDepartment of Environinent'and`Natuural Resources
Division of Water Quality i"t 01.
STORMWATERiMANAGEMENT PERMIT APPLICATION, FORM'Jas+ r Ic.il r.
.4, , +' . . , � n I., �13! i' .'1r. %t .j I , jt or,:' ,r i [' .'.t I':1 as _ i .
:t -°I,;INFILTRATIOIV'BASIN SUPPLEMENT r"
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:;
A complete stormwater management plan submittal includes a' stormwater, management permit application, an
I.+r .• •.- 1, .,.l, r .. �u�. »•: n., .
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances'and'syste'm"raetaiiiR-1;
. ) ,-. •T i_ rf J+, .`1 .l� ri. ., 'J[� r•i l ... r . .'!r ..Il. 'r,,I� i _
I. PROJECT INFORMATION t;
.� ', l ,,,.. .,. ,ry'•7r�,; I , Tn
Project Namc'. _ -.--'. OCy1n Vc`p� -� 1011.r- le s +
Contact Person '__ -' Yci.1�+r`r'`c:�C' '�j►v'i %s'' "` Phoric Number:
This worksheet applies to: Basin No.. -7 in.Dminage Area -
.,rl��, 1r4' -1 +i •f'1!. !�'I,� ii - / �1ilJ -ii r, r,. . i 1 rr1 I _.. _
(as ideniified on plans) (from Form SWU-101}
,
If., , DESIGN INFORMATION E -; Attach supporting calculations/documentation,, The soils report must be
r ,� r. ' '- p I '. IT ' i.r .• it, e . r-
-
based uponran actual field investigation.and soil �borings.�County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Siimulary C 5,1 ,.rrr ff.
" JI e. +, r•..��': ,';. - -
Soil Type ' ..., .0 1u��, :1 w A
Infiltration Rate k 7 6 .0 in/hr or cf/hr/sf (circle appropriate units)
'. sr _ I,l r..+ .I - I• '+ . ,1, Firlrr .-',i r.r.
SHWT Elevation t r`'S - 'fmsl (Seasonal.;.High Water Tabler elevation)
Basin;lj sign'Par'ameters• 111'
❑esign Storm inch (1.5 inch event for SA waters, I inch event far others)
rr J'llt-Itr-. �'�Y 1J 's4,, :r+c j , -y . r ' .. + : ' ' • .:I j ' .) r ---
Design Volume ZCti c'f .t ' , 1••I ,,, . r ...
Drawdown Time 1- days +
! .( „r{; r rl•i ...la r' )1
Basin Dimenslons y '
' 'Vri ��'. 'r� it • �) Cia_'.r , {f' �• l_, err '1 dt' .. I. 1'++"
Basin Size 1 S ft. x Zr 5. = 3z�s SQ. fT. (bottom dimensions)
j: r Url I,• I'7.1 I'r,; , ^r ,,f ,r ..''.�li I 5 i. _ `, f .l
Basin Yoliime Provided1 1% O Z c f- -
' +' 1'f 1 r .31r.r+Jli)i•'.' .r .�., i? .. fit''. - {.rlyr
Basin Elevations
r 'e l.r ftt I.fi'' ..".f �J...Jt�'t _. 1 r irk.lr_ t :�. 'Ia .. Ir1 • .! I.. yr ,
Bottom Elevation fmsl
- ({ + 1 11 r fit I i'_ "I 1.• III, 1' , , r ")IL1 .'
Storage Elevation 3. O f'nsl
Top Elevation 3 .4 fmsi
Form SWU-103 Rev 3.99 Page I of 3

III. REQUIRED ITEMS CHECKLIST
o%'% . .'
The following checklist outlines design requieements per'lthe-Storm'water Best Management Practices Manual
(N.C. Department of Environment, - Health: and Natural Resources, February r 1999) and Administrative Code
Section. 15 A NCAC 2H .1008.
Initial in the space1provided'to indicate that the,•following-'design)--requiierrients have been -met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below.. -Attach justification if a requirement has not been met.
Applicants Initials
a. System is located 50 feet from class SA waters and 30 feet from other; surface waters.
i � 'k• ri +t ,rcrt r j r- I r ! ;f I rr Y ., � 'r•.1FiC .I)Jif if l'.,J t
P ; k b. System is, ocated at least 100 feet from water's6pply wells. a
:'! i.: 'I 'l';,: r r•_ f. i. ""1 '+-' rVi .
c. Bottom of system is at least 2 feet above the .seasonal high, water table..
p d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval"h. b . n'obtained.
f. System is located in a recorded drainage. -easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right -of way., ► jf .'r )
P g. Drainage area for the device is less than 5 acres.
i' A8. h. Soils have a minimum hydraulic conductivity.of 0.52 inches per hour and soils "report is
attached.
1.' '-System capiures and infiltraies'tlie runoff from•the-first` 1',0 inch`of rainfall "(1.5 irich-event-for
areas draining to SA -waters )'.1 D'esign volume 'and infiltration' calculations�atta fil6d."
�s -- •�! � rr c:_ i• i`"' .{. i. •,: ' .�. r�, ,'. .C.�1; i. i'I 1J1 ; •''•i.
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations;attached:
P� k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H: V). + '
basin, grease trap, filter strip, grassed swale.or 1. A pretreatment device such as a catch
sediment irap is provided.•
p� m. Bottom of the device is covered with a layer of clean sand to an avera_ ge_depth of,4}inches_.or
dense vegetative cover is provided.
xPB fir :'.
n. Vegetated filter is provided for overflow (Required minimum
length is 50 feet for SA waters, 30 feet for other waters). I
o. Flow distribution mechanism within the basin is.provided. ,r ri'.
p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
r. System is designed to draw down the design storage volunic io the proposed bottom
'
elevation under seasonal high water condition -within five days. A soils`report arid'all
pertinent draw -down calculations are attached.
P s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage -area is
stabilized. , a:
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads N k feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title: PAT,uCK A. TDMJA S, iowx) ^gA1, 66-1Z
Address:^ _ _ p O' ��s[ L(�?.S 5jVeF &Ui AIC Z.'40(4riS-
9/o-3ZR_ 4_1'13/
Signature:
Date: /VA?,eCN /Q ZOO Z
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, P �. allottary Public for the State of 1 a County of
21-4 , do hereby certify that Pliro`et- ,Q . 7� Pvzs __ personally appeared before me this I?
day of 1�t4 / c.�— 260C—.- and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL
c
My co ission expires f ¢�Lo
Form SWU-103 Rev 3,99 Page 3 of 3

.Permit No.
(to be provided by DWQ)
u:+• r •,Y, s a', State of.North Carolina
,rr.. ., r •;,. rf ti, . Department of Environment and Natural, Resources, ,rs:' {'
Division. of Water Quality 1�' a-
•"0111 ;f I I.: . ,-, STORMWATER•MANAGEMENTPERMIT APPLICATION.FORM - I, fit,
IV,
!,r. J. ,, ,. , 1 +" rf„ .'[it�r`1;7:-
`' "` ''� ''•''''' ' `INFIL'TRATION'BASINSUPPLEMENT'
This farm may be photocopied for use as an original
DWQ Stormwater -Mana - ement Plan Review: „f t
A complete stormwater management plan,submittal includes a stormwater, management, permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwatef conveyances'and sy5t6n'details.'
•1, ,� ,,,)- �1f , I� ', ,. 'r i.._ •!, t ti e,
I. PROJECT INFORMATION
Project Name :` 7 ..,SdV V i��,t,J ar , 1 ,' I:. ' r
4/O) J , ~
Contact Person: c[.�1`i_�._ ��1oMrs•5 Phone Number: 1!� r'J3213
This worksheet applies to:.
Basin No. a in Drainage Area ..
•, , rl'1 , , . r
., (as tdenNfed of plans) '' ~' ' ' r I �' '' '' (from For, SWU-101). -- • — -
I1.DESIGN INFORMATION -,Attach, supporting calculations/documentation. The.soils report must be
based,upon an actual
field investigation and, soil borings. ,County soil maps are not an acceptable source -
of soils information.
All elevations shall be in feet mean sea level (f nsl).
?far' i ;v
of . i, + `t s ,—
Soils Report'Sumrnary
Soil Type
���-d �w,J '„ '.
,, ,
r;r; , �J . • .. r �- . ,
Infiltration Rate
7 G • 0 in/hr or cf/hr/sf (circle appropriate units)
SHWT Elevation r'
:r. r'G,'r, r' ;.,'rj err �.,. '
• j • fmsl (Seasonal High Water Table elevation).-
r,
Basin"=Design •Parameters''
r. ,
7 y
Design Storm
+ inch (1.5, inch event for SA waters, I inch event for others)
Design Volume
l,3 r a
Drawdown Time
i. i r days'' .. r, r+ 'srr•'.a + zl „ '<.y:! ,
Basin Dimensions -
Basin Size+ it 1
J 2 ft. X, ft. _ ra sq. ft. (bdttom dimensions)
Basin Voiuirie Provided
c.f.
•t:s.r.
, ,j.1I + , . ,, lees, L'+ , : i' 1, ,,tj1 I, 1 ol1, _ t
Basin Elevations
'1', •� ,
Bottom
.'+� rrO•_ J'..�� ; .'t, ..,i .,.r. .. 1, .r,•-.. a,,. ',
Z • fmsl -
-Elevation
Z S
Storage Elevation
• fmsl
Top Elevation
3.0 finsi
,s ' c'�' . , '• , ., ,
Form SWU-103 Rev 3.99
Page L of 3

III. REQUIRED -ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, -,Health and FNatural.:Resodrees;'February'1999) and Administrative Code
Section: 15 A NCAC 2H .1008, y ,; l .,:. � � , , . ; � 1 ,• , �;
Initial in the space pfovidW'folindicatd1hat tlie,following design,requitements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may +initial (below,- ,Attacks justification if a requirement has not been met.
Applicants Initials
C PB a. System is located 50 feet from class SA waters'and'30 feet, •from,othersuiface.waters'
S. r System' is located 'at least 100 feet' fromwater supply wells:''
1: 0 , , 15 r.- .,. r'_ ,.1 it.l_ . ,-J_ � 'J'J ." ,' , , : I, ,i , :'),
c+ Bottom of system is at least 2 feet aboye the,seasonal high water.table;
B d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
p e. System is not sited on or in fill material or DWQ approval lfas been`bb'tained.
P f. System is located in a recorded drainage easement for the purposes of operation -and. r
maintenance and has,reeorded access easements to the nearest public right-of-way.;; _
g. Drainage area for the device is less than 5 acres.
AB h'. Soils have a minimum hydraulic conductivity of 0.52 niches per hour"and soils -report rs
attached.
8 i.= ' System captures and infilt'rate`s�the ninoff from the first 1'.0'inch`of rainfall (1.5 inch event for
areas draining to SA waters ). ' Design`volume and infiltration calculations' attaclied:''
08 ' "li l r •- .- : Ir IJ. '• f .,'.f lr+,'.•' J l.r r'it
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached:
8 k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
— 1. A pretreatment device such assa catch basin, grease trap, filter strip, grassed swale or
sedimerit trap is provided. -_. - - -
m. Bottom of the device is covered with a layer of clean sand to an average•depth of 4 inches,or
dense vegetative cover is provided.
11 A's r
pa n. ' Vegetated filter is pro"vidcd for overflow s (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o. Flow distribution mechanism within the basin is provided._
p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
` — q.' Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
Pa r. Systerri is designed'to draw down the design storage volume to the proposed bottom ,
elevation under seasonal high water conditions within five days. A soil's report' and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire ikrainage'area,i's SA
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
I. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads N la feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title:QAroyice A, 7W4,w4 S, TDw,J 01AVA9E2
Address:__. P O, 9o. 7_07S Siezr &Ef NC ZFVW-
Phone: Q/O .. 3Z8 - 4,/3 / _ Dater ^A,eC,w /Q� ZL Z
Signature:
Note; The legally responsible parry should not be a homeowners association unless more than 50% of the lots have been sold and a
resident of the subdivision has been named the president.
I. T k4" ,'_ , allotary Public for the State of %� �e , Countyof
E^'�� , do hereby certify that .10
9_1 r"Cr�, __ /9 ' 7AO_� s personally appeared before me this
day of IT 114tIl — 2-eJOL-1 and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL My commission expires _ to [ ¢-Y_ 0
Form S WIC-103 Rev 3.99 Page 3 of 3

Permit:No. ' F'f"
(to he provided by DWQ)
State of. North,Caroiina„",,,1 . t' r
:: 113 Departrnent,of Environment-andNatural Resources r• I .1
Division of Water Quality
STORMWATER MANAGEMENT, PERMIT APPLiCATION'FORM
,,• � + , , ' ram• ., • , , ,. .!, - .rr • r ,Jr .. E'
. li,' ;!. •i:,l, ,.'i 7' '„� - +J t J", i" _,L. C1,1� _ Cl r , i J _ ,ir' .._ i•
INFILTRATIOMBASIN SUPPLEMENT'
This form may be photocopied for use as an original
DWQ Stormwater ManagementlPlan Review: 1 .' .: �'.: , ' +'. : i�:r','• #
A complete stormwater management, plan ;submittal. includes alstormwater_management permit application, an
infiltration basin supplement for each system, design calculations, soils report ' and plans and specifications
showing all stormwater'conveyances'and'syke"m`details:'''-
I. PROJECT INFORMATION ,
Project Name.
Contact Person`' '' �U.-�i'i tile- � '1/V�at1S - 'Phone Namber: r(`g/+7) ` '328 -!JI31
This worksheet applies to: , Basin No. _ in Drainage Area 1 _
1 , 1 (vs ident f ed on pl 6) + r ! , 1 t' !' ,, •r' ' f • • (from Form SWU--101)
„II.Ft DESIGN INFORMATION:- Attach.supporting,calculations/documentation.• The soils report must be
based uponian actual field investigation and soil borings. County soil mapsare not .an accepfable source
of soils information. All elevations shall be in feet mean sea level (f-msl).
r.
i .F, •17r1;i 7.#i�-' r,.' r'r i � ii !I.,,S� �, � ,+ T ,+-
Soils Report .Summary'.
J r�. .: 1,�' r•. •m ;� r;1 _ ,I..! :� . ! 1-
Soil Type ,'J,l r, i : rs„ r MW `,.ri J r i.��.�, �c�' ;: !• : • 7 - ry
Infiltration Rate 7 % • % in/hr or cflhr/sf (circle appropriate units)
��.. '' 'ItrF3 # _l i� • I .:7�,.,) s`' 1 j r ..� �.•,., '1JSft r
SH WT Elevation I • S finsl (Seasonal'High Water Table elevation) -
Basin' Design Parameters
.!)'t)[•1V'.'t.•; ]7frJ,'.Iil.,1' !'��r =cs'�u
Design Storm 7 rr 5 inch (1.5 inch event for SA waters, I inch event far others)
f .�' ,. - r •). rr �• i.r •, '1A) if h4:`J7•I-:,r• .J-,- ..r' I,r �i': .r'• ._ -
Design Volume (00 c.f.. ,r:r 'r �+ rr,.• {1'.
Drawdown Time days
17 ' " •I r' _ 7 , I. t'!, i , , ,; , r„ . r: , . W.
Basin Dimensions "
Basin Size _ 1 7 ft. x 'ft. = �6 3 2 sq. ft.- (hottom dimensions)
T f, I '1 j'.e �,,- I - r. la •!•. 'r ) I"1. ti t',F..1 � �'.—'r.•.l. ! 't.'.• 1/ -
Basin•Volume Provided 8 3 c.f.` ,
'!cr rJ,, l: V!,.,�., .!t f4 .... ., , r- •''�, ;1 :1's !,P 1 -�., ,2•. #: J. t]'y I• 11-i , -..:
1, •ri .•,. rip •i
Basin Elevations _
Ti il',j31!rl.'f,'t1 •r 'Gi,s�' r `lt� !I,.'1 l:Fsf 'r �''sil :1• +' '!',) �', ?i'F!
Bottom Elevation Z D i- isl F.
Storage Elevation 2 fins]
Top Elevation 3.0 fmsl
Form SVIU-103 Rev 3.99 Page I of 3

III, REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirementslperthe rStorniwater Best Management Practices Manual
(N.C. Department of Environment,, Health:aitd NaturaI'Resources, 'February,19.99) and Administrative Code
Section: 15 A NCAC 2H .1008. • ':': • I' .' t� )i.
Initial in the space provided,to indicate that'the.foll'owing•designirequirdnii fits hda ,c-been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification Aif a requirement has not been met.
Applicants Initials
>�F.8 a. System is located 50 feet from class SA waters and.30 .feet from other -surface -waters'
• � r it t. ,h `f: -• „:r• !`�: -l-1! i i r
b. ' 'System is located at least" ] 00 feet from water supplyF wells:
c. Bottom of system is at least 2 feet above,the,seasonal high'water table.,. .,. , ,
KPR T d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
fJQ� e. System is not sited on or in fill material or DWQ approval .has been olitained.
f. _ System is located in a recorded drainage easement for the purposes of operation and . _ .i
maintenance and has recorded access easements to the nearest public right-of-way.
g. Drainage area for the device is less than 5 acres.
h. Soils have a inimmum hydraulic conductivity of 0.52 inches per Hour and soil's report is
attached.
is System captures and infiltrates'the runoff from -the first 1.0 inch -of rainfall '(1.5 inch event for
area's draining to SA'waters )'. Design volume'and infiltration calculations attached.
. is -... r , rt �� I � •t�t .r. ••, r.., r!�•
_KPj. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations -attached:
1_1P$ k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H: V).
1.
A pretreatment device such as a catIV.ch basin, grease trap, filter strip, grassed swale or
sediment trap'is provided. - -
pQ in.
Bottom of the device is covered with a layer of clean sand to an average depth of.4 inches,or
dense vegetative cover is provided. .
P.8
Q
n.
Vegctated� filter'is provided for overflow Required minimm�
length is 50 feet for SA waters, 30 feet for other waters):
o.
Flow distribution mechanism within the basin is provided..
p.
A benchmark is provided to determine the sediment accumulation in the pretreatment device.
_ — q.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).,
1P.(3 r.
System is designed to draw down tli design storage volume to the proposed, bottom
elevation under seasonal high water conditions within five days. A soils report' and all
pertinent draw -down calculations are attached.
s.
Plans ensure that the installed system will meet design specifications (constructed, or
restored) upon initial operation once the project is complete and the entire drainage�area`w
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3
. it � I.t'I

W. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
I . After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads N P� feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H A 000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title: A.4z&CK A. 7;Z^45, iow,y IrIANAGE�2 __
Address: P D, do id Zu7S 5".e r (/irf; /✓C L.FV4d-
Phone: Q/D - 3ZB - S:i3 // _— Date: I�1AOCw /Q Z00 Z
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. _' f
I, T'Jq t✓'- k- I t , allotary Public for the State of %1.�3fA�e t!`_ , County of
211� �_ T —do hereby certify that 40'9_1(Y U-_ . 7`TdYnQ� personally appeared before me this
day of W &6--1-- , 2-00L —, and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal, (;�4 Alt,
SEAL My commission expires 1019.-Y- �
Form SWi3-103 Rev 3.99 Page 3 of 3

'',.Permit No. t '
(to be provided by DWQ)
State of North Carolina,,
r .'
Department. of Environment and Natural Resources
Division of Water Quality '
STORMWATER MANAGEMENT PERMIT APPLICATION FORM *' r
'INFILTRATION'BASIN• SUPPLEMENT
This form may be photocopiers for use as an original
DWQ Stormwater,Management Plan Review:
A complete stormwater management plan submittal includes a stormwater, management permit application, an
infiltration basin supplement for each system, design calculations, Isoils�i-eport and plans and specifications
showing all stormwater conveyances and systeni'detaiis.
I. PROJECT, INFORMATION.
Project Name . grit. .. .�,'•, ItSav►Vi eta ` IP .. r.+ ,
Contact Pcrson:`'"r"' ' Pa: ":'Ph o'ne Number: ( 4/0 j' ,32�3 - �(!3./
This worksheet applies to:, Basin No. D in Drainage Area �.
. r ; • +r ; r , ,: h , ., . i� �! ; f (as identified an ptai) "(from Form SWU--101).
' 1 i
1I. DESIGN INFORMATION, - Attach supporting calculations/documentation. The soils report must be
based upon.an.actual field,ir vestigation and soil borings. County soil maps are not an acceptable source
of soils information. Al! elevations shall be in feet mean"sea level (fn'slj.
Soils Report -Summary' ' . •-f' ' _; i r _.. _
Soil Type �Iw �� , , • r,
Infiltration Rate 7� . D_ in/hr or cf/hr/sf (circle appropriate units)
SH WT Elevation f n'sl (Seasonal High Water Table elevation) "
Basin•Design'Parameters'
Design Storm _ 7 ! inch (1.5 inch event for SA waters, I inch event for others)
Design Volume 2 6Y c,.f
Drawdown Time days ,. , !,: U0. ' _' . 1+,1 1
,, l• .. �-r ,•r r�ir :!•{, ' r 'r•. if. .I • ' ��;J.• ' '1• ..1. .1 •' 1 ". ,
Basin Dimensions
r r ;
Basin Size ` _ T,�$ —ft: x ? f' = D sq. ft. (bottom dimensions)
Basin.Volume Provided' -
Basin Elevations
fir•,-r , it. .i! 'Y i rr' �.i ,- ,' , 't.. �.�i .,1 • 1 • ,
Bottom Elevation 2 • 5 fm­11.sl. I ,
Storage Elevation 3. O frnsl
Top Elevation 3.0 fmsl
Form SWU-103 Rev 3.99 Page 1 of 3

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirementslpei the'Stormwater Best Management Practices Manual
(N.C. Department of Environment;)Health'andrNatural'Rcsourees, fcbruary-1999) and Administrative Code
Section: 15 A NCAC 2H .1008. ;t, :' 9 • '1,;1. ! s( 1,)'.;; -.4 +
Initial in the space.provid'ed`.toiindicate'that the.following design requirerreft&have beenr met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. -,Attach justification if'a requirement has not been met.
1,r•41
Applicants Initials
a. System is located 50 feet from class SA waters:and 30 feet1from` otherrsurface waters':. (i f•'' '
- - jf 1"f, }' r ti f. f- 'r , `.'Ij . •, )f, '�'f� j+'' ,I'', f
b. System is' located at least' l oo,feet from water supply well's.
I' , I"..1 :1, � 7i1. • I")I . 1 iT .. 't.7 i, i ,J. •11! �t.:I,T, itt, { ",.
c. Bottom of system is at least 2 feet above the seasonal,high •water table. ..,,;, ;
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in f11 material or DWQ approval'lias been obtained.,"'
�$ f. System is located in a recorded drainage easement for, he purposes of operation and
- maintenance and has recorded, access easements to the nearest public right -of -,way.. J fl'a
Drainage area for the device is less than 5 acres. r
� �".�, i..•'' i� ✓1•��:'7rl
h. - ,Soils have a minmrium hydraulic -conductivity of 0.52 incheIls ��:. per hour and soils report is
attached.
._rSf,' ,',I• tr,�. .., �..'. T,� ra�F.. �,
F_i. System captures and infiltrates the runoff from th'e first T'.0'inch of rainfall (1'.5'mch event for
areas draining to SA waters ):' -Design'volume and'infiltr"at ion'calculation's'attached:
.i.e., U, '1'-I .., .fJ.?• . :-,j E ! i{.J II . .S
P j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached. "_: e;
k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
` 1. A pretreatment device such as'
a catch basin, grease trap, filter strip, grassedr swale o, t ; .�.
sediment trap is provided: —` - -
_� � m. Bottom of the device is covered with a layer of clean sand to an average;depth;0f,4 inches or
dense vegetative cover is provided. y
P .•�,i'..,,. . 1 .•t ... •, . ,.;1 [].'fc_`-_
n. Vegetated'fiiter is provided for overflow s (Required minimum
Iength is 50 feet for SA waters, 30 feet for other waters). �; r+Ilr, : +,,='r•
o. Flow distribution mechanism within the basin is.provided. f' € ;),.� r r
4 p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
q. Runoff in excess of the design volume bypasses off line.systems (bypass detail provided). ,
Wrl
P(� r. System is designed to draw down the design storage volume to the proposedbottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
P� s. Plans ensure that the installed system will meet design specifications (constructed or!
restored) upon initial operation once the project is complete and the entire }drainage'arearist'
stabilized.
Eorrn SWU403 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
f . After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads NIA -T feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and. constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print Name and Title: Pwrelce A. /Wa^4 A,— I AV.4GE2
Address: Q A. 6o z z4e7S Siezr- nTi; /✓C Zr444 — -
Phone:
Signature:
c//_ T /
Date: 1VA0CAe /QV ZW Z.
]Vote: 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, e- k' r V_ , a Notary Public for the State of A(Y �I__Ljre [•{ A - , County of
do hereby certify that P'f}� ���C1c i� . 724dm5s ^ _ personally appeared before me this —rL-
day of Mil-f c l - and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL
QL'5,jr
My commission expires
Form SWU-103 Rev 3.99 Page 3 of 3