SW8011215_CURRENT PERMIT_20020409

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT
NO.
SW�DG
DOC TYPE
rXD CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
f�P�/1.�17dI
YYYYMMDD

Michael F. Easley, Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D., Acting Direcior
Division of Water Quality
Wilmington Regional Office
April 9, 2002
Mr. James T. Street II, Manager
Alpha Development Group, LLC
5306-101 Six Forks Road
Raleigh, NC 27609
Subject: Permit No. SW8 011215
CVS Carolina Beach
High Density Stormwater Project
New Hanover County
Dear Mr. Street:
The Wilmington Regional Office received a complete Stormwater Management Permit Application for CVS Carolina
Beach on March 19, 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 011215 dated April 9, 2002, for the construction of CVS Carolina Beach.
This permit shall be effective from the date of issuance until April 9, 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 request within 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 Noelle Lutheran,
or me at [phone].
Sincerely,
Rick Shiver
Water Quality Regional Supervisor
RSS/nml: S:IWQSISTORMWATIPERMIT1011215.MAR
cc: Anthony Giacoia, P.E.
Carolina Beach Building Inspections
Division of Coastal Management
Noelle Lutheran
Wilmington Regional Office
Central Files
Aw
tNMEN t
N.C. Division of Water Quality 127 Cardinal Drive Extension Wilmington. N.C. 28405 [phone] Fax[phone] Customer Service
800-623-7748

State Stormwater Managementkystems%,
Permit No. SW901 1215'
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 1S HEREBY GRANTED TO
Alpha Development Group, LLC
CVS Carolina Beach
New Hanover County
FOR THE
construction, operation and maintenance of two infiltration basins in compliance with the provisions of 15A NCAC
2H A 000 (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 April 9, 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
from 48,190 square feet of impervious area. The infiltration basins are designed to store and infiltrate twice
the design storm; therefore, no by-pass is required.
Approved plans and specifications for this project are incorporated by reference and are enforceable parts
of the permit.
4. The tract will be limited to the amount of built -upon area indicated on page 3 of this permit, and per approved
plans.
5. All stormwater collection.and treatment systems must be located in either dedicated common areas or
recorded easements. The final plats for the project will be recorded showing all such required easements, in
accordance with the approved plans.
6. The runoff.from all built -upon area within the permitted drainage area of this project must be directed into
the permitted stormwater coritrol system. A permit modification must be submitted and approved prior to
the construction of additional built -upon area from outside of the approved drainage area.
2

State Stormwater Management Systems
ti Permit No. SW8 011215
DIVISION OF WATER QUALITY
PROJECT DESIGN DATA SHEET
Project Name:
CVS Carolina Beach
Permit Number:
SW8 011215
Location:
New Hanover County
Applicant:
Mr. James T. Street II, Manager
Mailing Address:
Alpha Development Group, LLC
5306-101 Six Forks Road
Raleigh, NC 27609
Application Date:
April 9, 2002
Name of Receiving Stream/Index #:
Cape Fear / Snow's Cut / 18-87-3.5
Classification of Water Body:
"SC"
Basin Number:
1 2
Basin Depth, feet:
5.8 4
Bottom Elevation, FMSL:
23.2 24
Drainage Area, acres:
0.98 0.28
Total Impervious Surfaces, ft2:
36,715 11,475
Offsite Area entering Pond, f12:
None, per engineer
Required Storage Volume, ft2:
6,060 1,839
Provided Storage Volume, ft2:
23,392 5.610
Temporary Storage EIevation, FMSL: 25.46 26.11
Controlling Orifice:
NIA
Soil Type:
Sand Sand
Seasonal High Water Table:
. 21.2 21.75 -
Expected Infiltration Rate:
6" per hour 2" per hour
Time. to Draw Down, days:
0.29 1.48
3

State Stormwater Management Systems
Permit No. SW8 011215
11. 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:
d. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of side slopes and vegetated filter.
d. Immediate repair of eroded areas.
C. Maintenance of side slopes in accordance with approved plans and specifications.
f. Debris removal and unclogging of the filter media, catch basins and piping.
g. Access to 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.
5. Decorative spray fountains will not be allowed in the stormwater treatment system.
6. 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.
7. 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.
8. 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.
9. The permittee shall submit to the Director and shall have received approval for revised plans, specifications,
and calculations priorto construction, for any modification to the approved plans, including, but not limited
to, those listed below:
a. Any revision to any item shown on the approved plans, including the stormwater management
measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership..
d. Redesign or addition to the approved amount- of built -upon area or to the drainage area.
e. Further subdivision, acquisition, or sale ofthe project area. The project area is defined as all property
owned by the permittee, for which Sedimentation and Erosion Control Plan approval was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the approved plan.
10. The permittee shall submit final site layout and grading plans for any permitted future areas shown on the
approved plans, prior to construction. If the proposed BUA exceeds the amount permitted under this permit,
a modification to the permit must be submitted and approved prior to construction.
4

State Stormwater Management Systems
Permit No. SW8 011215
11. A copy of the approved plans and specifications shall be maintained on file by the Permittee for a minimum
of ten years from the date of the completion of construction.
12. The permittee shall notify the Division of any name, ownership or mailing address changes within' 30 clays.
13. Prior to the sale or lease of any portion of the property, the permittee shall notify DWQ and provide the
name, mailing address and phone number of the purchaser or leasee. An access/maintenance easement to the
stormwater facilities shall be granted in favor of the permittee if access to the stormwater facilities will be
restricted by the sale or lease of any portion of the property.
14. The permittee is responsible for verifying that the proposed built -upon area does not exceed the allowable
built -upon area.
15. 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.
111. GENERAL, CONDITIONS
1. 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 withNorth Carolina General Statute 143-
215.6A to 143-215.6C.
The issuance of this permit does not preclude the Permittee from complying with any and all statutes, rules,
regulations, or ordinances which may be imposed by other government agencies (local, state, and federal)
which have jurisdiction.
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 9th day of April, 2002.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
l r_lL 1. _� -n_till A—L-1`1 -
Gregory J. Thorpe, Ph.D., Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission
5

State Stormwater Management Systems
Permit No. SW8 011215'
CVS Carolina Beach
Stormwater Permit No. SW8 Ol 1215
New Hanover County
Designer's Certification
1, , as a duly registered in
the State of North Carolina, having been authorized to observe (periodically/weekly/full time) the construction of
the project,
(Project)
for (Project Owner) hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the project construction such that the construction was observed to be
built within substantial compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
6

State Stormwater Management Systems
Permit No. SW8 011215
Certification Requirements:
l . The drainage area to the system contains approximately the permitted acreage.
2. The drainage area to the system contains no more than the permitted amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the runoff drains to the system.
4. The outlet/bypass structure elevations are per the approved plan.
5. The outlet structure is located per the approved plans.
b. Trash rack is provided on the outlet/bypass structure.
7. All slopes are grassed with permanent vegetation.
8. Vegetated slopes are no steeper than 3:1.
9. The inlets are located per the approved plans and do not cause short-circuiting of the system.
10. The permitted amounts of surface area and/or volume have been provided.
11. Required drawdown devices are correctly sized per the approved plans.
12. All required design depths are provided.
_13. All required parts of the system are provided.
_14. The overall dimensions of the system, as shown on the approved plans, are provided.
cc: NCDENR-DWQ Regional Office
Carolina Beach Building Inspections
7

f � ' .e�raJ:A' U? =X e
Date Received Fee Paid Permit Number
:L- - 4 O° Za ZS � 0 ti � Z j
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 corporation, individual, etc. who owns the project):
Alpha Development GrrauV 1 LI-C.
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
James T. Street II
3_ Mailing Address for person listed in item 2 above:
5306-101 Six Forks Road
City: Raleigh State: NC Zip: 27609
Telephone Number: 1 7 8 2 -- 2 7 2 7
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
CVS Carolina Beach
5. Location of Project (street address):
901 Dow Road
City: Carolina Beach County: New Hanover
6_ Directions to project (from nearest major intersection):
Corner of US Hwy. 421 and Dow Road, Southwest quadrant
7. Latitude: 3 3° 3 5' 01 " N Longitude: 8 50 3 3' 1 2" W
8. Contact person who can answer questions about the project:
Name: Anthony Giacoia Telephone Number:
It. PERMIT INFORMATION:
1. Specify whether project is (check one): X New Renewal
of project
7 1548-7300
Modification
Form SWU-101 Version 3.99 Pagel of4

2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number N11 A and its issue date (if known)
3. Specify the type of project (check one): '
Low Density X High Density Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
_CAMA 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 .
On -site stnrmwater_ will
piped to two (2) on -site non-bypaas in_.fi ad-rati rm basins
2. Stormwater runoff from this project drains to the N/ A River basin.
3. Total Project Area: 1.66 acres 4. Project Built Upon Area: 78, %
5. How many drainage areas does the project have?� 2
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.
u a1 n- An
Basin Information
Drainage Area 1
Drainage Area 2 F'
Receiving Stream Name
5 -5 Cf
oafs (j4"
Receiving Stream Class
SC— NIA
S
Drainage Area
41 200. _ .95.
Existing Impervious* Area
17000_
_
Proposed Impervious *Area
- _ {
;11, 475
Impervious Area (total)
Impervious* Surface Area. '
Drainage Area 1 .
Drainage Area'2
On -site Buildings
On -site Streets
On -site Parking
' 23 835.
11" 175 SF
On -site Sidewalks
2000 SF
300 SF
Other on -site
0 SF
0 SF
Off -site
0 SF
0 SF
Total: 36,715 SF
t Total:: SF
* Impervious area is defined as the built upon area including, but not Bruited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 3.99 Page 2 of 4
/ 7-

i� �7 7'� .i, !'J'_S ,fie FI ��. it l.� s � i � .�. � A i. �� � +.. 'r��'.. J.

7. How was the off -site impervious area listed above derived? N/A
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS N/A
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.
7. 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
constrtiction.
5. A!/ 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 perforated 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 wilt 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
Forth 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.
• Original and one copy of the Stormwater Management Permit Application Form
• One copy of the applicable Supplement Form(s) for each BMP
• Permit application processing fee of $420 (payable to NCDENR)
• Detailed narrative description of stormwater treatment/management
• 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): I{jm1eyHnrn_ and As ciates .,__In
Mailing Address: 4607 Franklin Avenue, Sni to 227 _
City:_ Wilmington _ State: NC Zip: 28403 -
Phone: ( 91 0 _ ) 79 2 —1 0 4 0 _ Fax:
VIII. APPLICANT'S CERTIFICATION
I, (print or type nanze of person listed in General Inforrnation, item 2) ,Tamps; T , ISt reet TT
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 21-1.1000.
Signature:
Form SWU-101 Version 3.99 Page 4 of 4
Date:— (a ) S�

Permit No. 5 0 � f 21
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name: CVS Carolina Beach_
Contact Person: Anthony Giacoia Phone Number: ( 757 )_ 548-7300
This worksheet applies to: Basin No
1
(as identified on plans)
in Drainage Area
1
urufn r(Jnn arru-iui)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type sand
Infiltration Rate + inlhr or cf/hr/sf (circle appropriate units)
SHWT Elevation 21 .2 fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
2 * inch (1.5 inch event for SA waters, 1 inch event for others)
6,060 c.f.
0129 days
irregular ft. x
21 392 c.f.
23.20 fmsl
2 5 - 45 ^_ fmsl
0 fmsl
If, ieg dIS"ssrp.J c.)
L r, is A t.6t� t -% ua
04 11.1b•orl
ft. = 1 , 770 sq. ft. (bottom dimensions)
Form SWU-103 Rev 3.99 Page 1 of 3

_ .Ir

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. System is not sited on or in fill material or DWQ approval has been obtained.
N/A f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
g. Drainage area for the device is less than 5 acres.
h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
62_4_n
i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached. ( 2— �M)
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: l (H:V).
1. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided. C..."&
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. 4b r?-�c (,�Le L." L.,i" J
nnn_byp :9. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
N/A o. Flow distribution mechanism within the basin is provided.
p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
non—hypasgl. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
. 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. 1✓92—= ',Z, (PT
� C87 = 3,�' Fe"' G�a�a,a, P. . 5/7/0 L
When the design depth reads feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that 1 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: ----Mr. James T. Street IT
Address: S 3 0 h -
Phone: 919=7.82-
Signature:
g
Date: ) a /S 1 ao o l
Note: The legal responsible party should not be a homeowners association unless more than 50% of the lots have been sold and a
resident oofpthels�jubdirvi�sion has been named the president. �l
1,� a Notary Public for the State of ! `� C- _..,,.. County of
�1r�L_Q do hereby certify that SOa1K577 SkILLk ^^ personally appeared before me this,!__11� I
day of t, and acknowledge he due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand add official seal, / I p
. '. 7 � . : 1 11 6*"
SEAL` My commission expires
Form SWU-103 Rcv 3.99 Page 3 of 3

Permit No. 5(,(Jd�G11 Z�S
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQStormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : CV5 Carolina RParh
Contact Person: An th nn y G i a caa Phone Number: (7 5 7) 54 8,—,7,3 0„Q_
This worksheet applies to: Basin No.. _ 2 in Drainage Area 2
(as identified on plans) (from Form SWU-101 )
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type sand
Infiltration Rate 2.0 in/hr or cf/hr/sf (circle appropriate runts)
SHWT Elevation 21 75 fmsl (Seasonal High Water Table elevation)
Basin Design Parameters
Design Storm 2 inch
Design Volume 1 839 c.f.
Drawdown Time 1 .48 days
Basin Dimensions
Basin Size TrrocinI aft. X
Basin Volume Provided 50610 c.f.
Basin Elevations
Bottom Elevation 24.00 fmsl
Storage Elevation 26 _1 h fmsl
Top Elevation 28.00 fmsl
(1.5 inch event for SA waters, 1 inch event for others)
16 YOE4Z 01&czs2blZ�,%3 a 0t7i�
Lta6A LEWu dpi-S. Irl✓
as 1). 14.161
ft. = 310 sq. ft. (bottom dimensions)
Form S WU-103 Rev 3.99 Page I of 3

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

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
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. 2.. ZS t ptr AA)-%rq 64LC0 ia,
When the design depth reads jjAM nt 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: Mr- Names T _ Street II
Address:
Phone: 919-782—
Signature:
Date: 1 r)/ Y /.) b o 1
Note: Tire legal0esponsible party should not be a homeowners association unless more than 50% of tire lots have been sold and a
r resident of the subdivision has been named the president.
1, LAW
�� wwt"., A ' /L- , a Notary Public for th State f � County of
EI�]L7J'�ia—n� , do hereby certify that L�Q/S � , personally appeared before me this 5-HA
day of J. k,lk1 VLIA�Y�— , Z�U� , and acknowled a the due execution of 1he forgoing infiltration basin maintenance requirements.
Witness trry,hand and official seal, 1 i�
SEAL,, My commission expires
Form SWU-iO3 Rev 3.99 Page 3 of 3