SW8931110_CURRENT PERMIT_20040920

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

�OF WA7' Michael F. Easley, Governor
O G William G. Ross, Jr., Secretary
Cl) Ei
North Carolina Department of Environment and Natural Resources
'r Alan W. Klimek, P.E. Director
Division of Water Quality
September 20, 2004
J. H. Lampe, Partner
Ample Storage 1, LTD
Post Office Box 150
Smithfield, NC 27577
Subject: Stormwater Permit No. SW8 931110 Modification
Guy C. Lee
High Density Project
Brunswick County
Dear Mr. Lampe:
The Wilmington Regional Office received a complete Stormwater Management Permit
Application for Guy,C. Lee on August 13, 2004. 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 931110 Modification ' ..
dated September 20, 2004, for the construction of the subject project.
This permit shall be effective from the date of issuance until September 20, 2014, 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 Rhonda Hill, or me at [phone].
it
Sincerely,
Rick Shiver 'A
Regional Supervisor
Surface Water Protection Section
RSSlrbh: S:1WQSISTORMWATIPERMIT1931110.sep04
cc: Elizabeth M. Nelson, El, East Coast Engineering Company, P.A.
Brunswick County Building Inspections
Rhonda Hall
L1Nilmington _Regional.cep Offi
Central Files
North Carolina Division of Water Q,bality 127 Cardinal Drive Extension Phone [phone] Customer Service 1 -877-623-6748 One
Wilmington Regional Office Wilmington, NC 28405-3845 FAX [phone] Intemet: h2o.enr.state.nc.us hlorthCarolina
�Vatrrrn!!y
An Equal OppWunity/Affirmative Action Employer — 50% Recycledl10% Post Consumer Paper

State Stormwater Management Systems
Permit No._SW8 permit#
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
JH Lampe, Ample Storage 9, LTD
Guy C. Lee
Brunswick County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with
the provisions of 15A NCAC 2H .1000 (hereafter referred to as the "storm water 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 September 20, 2014, and
shall be subject -to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.6 on page 3 of this permit. The stormwater
control has been designed to handle the runoff from 287,496 square feet of
impervious area.
3. The tract will be limited to the amount of built -upon area indicated on page 3 of
this permit, and per approved plans. The built -upon area for the future
development is limited to 42,131 square feet.
4. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
Page 2 of 5

State Stormwater Management Systems
Permit No. SW8 permit#
6. The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a. Drainage Area, acres: 11.76
Qnsite, ft : 512,464
Offsite, ft2: None
b. Total Impervious Surfaces, ft2: 287,496
C. Design Storm, inches: 1
d. Pond Depth, feet: 4
e. TSS removal efficiency. 90%
f. Permanent Pool Elevation, FMSL: 40.5
g. Permanent Pool Surface Area, ft2: 34,440
h. Permitted Storage Volume, ft3: 51,478
i. Temporary Storage Elevation, FMSL: 41.9
j. Controlling Orifice: 2.5"0 pipe
k. Permitted Forebay Volume, ft3: NA
I. Receiving Stream/River Basin: UT Mill Pond/Lumber River
M. Stream Index Number: 14-27-7
n. Classification of Water Body: "C-SW"
II. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The perri ittee 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. S6miannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device, flow
spreader, catch basins and piping.
g. Access to the outlet structure must be available at all times.
Page 3 of 5

State Stormwater Management Systems
Permit No. SW8 permit#
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 be allowed in the stormwater treatment system,
subject to the following criteria:
a. The fountain must draw its water from less than 2' below the permanent
pool surface.
b. Separated units, where the nozzle, pump and intake are connected by
tubing, may be used only if they draw water from the surface in the
deepest part of the pond.
c. The falling water from the fountain must be centered in the pond, away
from the shoreline.
d. The maximum horsepower for a fountain in this pond is 118 horsepower.
6. The facilities shall be constructed as shown on the approved plans. This permit
shall became 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. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
10. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
G. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project
area. The project area is defined as all property owned by the permittee,
fo.r which Sedimentation and Erosion Control Plan approval or a. CAMA
Major permit was sought.
f. Filling in, altering, or piping of any.vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. 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.
Page 4 of 5

State Stormwater Management Systems
Permit No. SW8 permit#
13. The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made.
III. GENERAL CONDITIONS
1. This permit is not transferable except after notice to and approval by the Director.
In the event of a change of ownership, or a name change, the permittee must
submit a formal permit transfer request to the Division of Water Quality,
accompanied by a completed name/ownership change form, 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. The permittee is responsible for compliance with all permit
conditions until such time as the Division approves the transfer 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) having 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.
1.
8. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
9. The permittee shall notify the Division any name, ownership or mailing address
changes within 30 days.
Permit issued this the 20t" day of September, 2004.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Aan VV. AlimeK, r.t., Director �
Division 'of Water Quality
By Authority of the Environmental Management Commission
Page 5 of 5

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERNUT APPLICATION FORM
This form may he photocopied for use as an original
I. GENERAL INFORMATION
1. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
J H_ L AmLr=,, PR@:vim -
3. Mailing Address for person listed in item z above:
Po o
City: F State: Zip:
Telephone Number: 21 J 1 _�13 i _(e L 95
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
5. Location of Project (street address):
_ .315 K �CKt,f11J�r�l1r Ko-�n
City:_ SmA" CME _ . County: `.32�Wst j_I Cf
6. Directions to project (from nearest major intersection): (3�
\\ q--2)o - b'A
7. Latitude: �� �15 Longitude: —�� - � b 1 of project � t,y
S. Contact person who can answer questions about the project:
Name:� J39`}A4i S-i�2IC'-LAMrD - TelephoneNumber: q10 5 S
II. PERMIT INFORMATION:
1. Specify whether project is (check one): New Renewal Modification

2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number 9.3 /un _ - and its issue date (if known)
3. Specify the type of project (check one):
Low Density High Density Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
�CAMA Major Sedimentation/Erosion Control �404/401 Permit _NFDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
III. PROJECT INFORMATION
I. 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.
N 5 ► - AlPONO
Z. Stormwater runoff from this project drains to the I t 0n A Urz_ River basin.
3. Total Project Area: _ I /. & acres
5. How many drainage areas does the project have? I
4. Project Built Upon Area: .Stu! I %
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:Infdrmauon. Drainagearea l.', Diairia e Area:Z
g
Receiving Stream Name
Receiving Stream Class C
Drainage Area o
Existing Impervious* Area I.Pq 3o-r o2. 4.3 /i
Proposed Impervious`Area oeZ-
% Impervious` Area (total) SRO . I
Iinpervious5urfaceArea'.
(,: :. l7rau�age urea 1 ::
„ ja Drainage Area;2
...
On -site Buildings
On -site Streets
On -site Parking
90 Sr oK AG
On -site Sidewalks
/ ObU SF , 0 RG
Other on -site j R
I /p �(p F op— y, a
Fcrrv,eE
LYa F 69- in, 97tic-
Total: ,9 F ,4
ar
Totai:
Impervious area is defined as the built upon area Including, butnot limited to, buiidings, roads, parking areas,
sidewalks, gravel areas, etc.

7. How was the off -site impervious area listed above derived?
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
The following italicized deed restrictions and protective covenants are required to be recorded for all
subdivisions, outparceis and future development prior to the sale of any lot. If lot sizes vay significantly, a table
listing each lot number, size and the allowable built -upon area for each lot must be provided as an attachment.
I. 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.
Z. 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-10� ,;•.,,. lnfiltration,Basin Supplement : M
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 Supplerrient , �� , ¢ i;� 77 �-•-_.

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.
1. 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 B1VIP
• Permit application processing fee of S420 (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
- Detaiis 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):
Mailing Address:
City:
Phone:
VIII. APPLICANT'S CERTIFICATION
State: Zip:
I. (print or type name of person listed in General Information, item Z) _ Aw/01 57/609 c ; i& X-N. %.o
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: OW -1A "r Date: ~ 3 - U
6"z
-' n

Permit No.
(to he provided by DTVQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWO Stormwater Management Plan Review:
A complete stormwater management plan submittal includes an application form, a wet detention basin
supplement for each basin, design calculations, and plans and specifications showing all basin and outlet
structure details.
I. PROJECT INFORMATION
Project Name:- 6[J Y G LoE
Contact Person: Phone Number: (910 ) 45 4 _ 5pp3c)
For projects with multiple basins, specify which basin this worksheet applies to: jltr�l4
elevations
Basin Bottom Elevation 3(a: S ft
Permanent Pool Elevation q0, 5 ft
Temporary Pool Elevation _ q/. 9 ft
areas
Permanent Pool Surface Area 3;q V46 sq. ft
Drainage Area ___ �js 76, ac.
Impervious Area 6,4Q ac.
volumes
Permanent Pool Volume
Temporary Pool Volume
Forebay Volume
Other parameters
SA/DA1
Diameter of Orifice
Design Rainfall
Design TSS Removal'-
Form SWU-102 Rev 3.99
(floor of'the basin)
(elevation of the orifice)
(elevation of the discharge structure overflow)
(water surface area at the orifice elevation)
(on -site and off -site drainage to the basin)
(on -site and off -site drainage to the basin)
"'-)GXiS-nA1 9 PoUOt PQcmrrr� PrLtc�2 +b
cu. ft. (combined volume of main basin and forebay)
51jqlD cu. ft. (volume detained above the permanent pool)
A cu. ft. (approximately 20% of'total volume)
e(15v NC, po a 0, P n117TG7? pe eg- 7a �D�t-'>gfl Y &ca,Cc�9Ew73
6, 0 �t 91 (satrface area to drainage area ratio from DWQ table)
in, (2 to 5 day teinporar v pool draw -down required)
in.
% (ininimum 85% required)
Page 1 of 4

Footnotes:
' When using the Division SA/DA tables, the correct SA/DA ratio for permanent pool sizing should be computed based upon the
actual impervious % and permanent pool depth. Linear interpolation should be employed to determine the correct value for non-
standard table entries.
In the 20 coastal counties, the requirement for a vegetative filter may be waived if the wet detention basin is designed to provide
90% TSS removal. The NCDENR BMP manual provides design tables for both 85% TSS removal and 90% TSS removal.
II. 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 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. If a requirement has not been met, attach ,justification.
Applicants Initials
a.
N A b.
C.
d.
A R e.
The permanent pool depth is between 3 and 6 feet (required minimum of 3 feet).
The forebay volume is approximately equal to 20% of the basin volume.
The temporary pool controls runoff from the design storm event.
The temporary pool draws down in 2 to 5 days.
If required, a 30-foot vegetative filter is provided at the outlet (include non -erosive flow
calculations)
The basin length to width ratio is greater than 3:1.
The basin side slopes above the permanent pool are no steeper than 3:1.
A submerged and vegetated perimeter shelf with a slope of 6:1 or less (show detail).
Vegetative cover above the permanent pool elevation is specified.
A trash rack or similar device is provided for both the overflow and orifice.
A recorded drainage easement is provided for each basin including access to nearest right-
of-way,
1. If the basin is used for sediment and erosion control during construction, clean out of the
basin is specified prior to use as a wet detention basin.
m. A mechanism is specified which will drain the basin for maintenance or an emergency.
III. WET DETENTION BASIN OPERATION AND MAINTENANCE AGREEMENT
The wet detention basin system is defined as the wet detention basin, pretreatment including forebays and the
vegetated filter if one is provided.
This system (check one) 0 does does not
This system (check one) Q does 91does not
incorporate a vegetated filter at the outlet.
incorporate pretreatment other than a forebay.
Form SNV -102 Rev 3.99 Page 2 of 4

Maintenance activities shall be performed as follows:
After every significant runoff producing rainfall event and at least monthly;
a. Inspect the wet detention basin system for sediment accumulation, erosion, trash accumulation,
vegetated cover;��?rid'general dotidition` `� ` - ° °` • •`*
b. Check and clear the orifice of any, obstructions such that drawdown of the temporary pool occurs within
2 to 5 days as designed.
Repair eroded areas immediately, re -seed as necessary to maintain good v�.getative-cover"m w vegetative
cover to maintain a maximum height of six inches, and remove trash as neededf-
Inspect and repair the collection system (i.e. catch basins, piping, swales, riprap, etc.) quarterly to maintain
proper functioning.
4. Remove accumulated sediment from the wet detention basin system semi-annually or when depth is
reduced to 75% of the original design depth (see diagram below). Removed sediment shall be disposed of
in an appropriate manner and shall be handled in a manner that will not adversely impact water quality (i.e.
stockpiling near a wet detention basin or stream, etc.).
The measuring device used to determine the sediment elevation shall be such that it will give an accurate
depth reading and not readily penetrate into accumulated sediments.
When the permanent pool depth reads _3__ __� feet in the main pond, the sediment shall be removed.
When the permanent pool depth reads _ Ai�L} _ feet in the forebay, the sediment shall be removed.
BASIN DIAGRAM
(fill in the blanks)
Permanent Pool Elevation 5
Sediment Rey oval El. 75 0
_- Sediment Removal Elevation .3-7,5- 75%
Botiom Ele ation_ %---------------------------------- �5%--
Bottom Elevation ;�,� /
FOREBAY
NJA
MIN POND
5. Remove cattails and other indigenous wetland plants when they cover 50% of the basin surface. These
plants shall be encouraged to grow along the vegetated shelf and forebay berm.
6. If the basin must be drained for an emergency or to perform maintenance, the flushing of sediment through
the emergency drain shall be minimized to the maximum extent practical.
Form SWU-102 Rev 3.99 Page 3 of4

All components of the wet detention basin system shall be maintained in good working. order.
I acknowledge and agree by my signature below that I am responsible for the performance of the seven
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 parry.
Print name:
Title:
x / AAi/c
1., ; 3: N.
Address:_S �;^/G �� cS�.'�•� r�' �CaC �C 7S 7
Phone:
Signa
Date:
Note: The legally responsible party should not be a homeowners association unless more than 50% of the lots have been sold and a
resident of the subdivision has been named the president.
a Notary Public for the State of 27 ),,? � � —•
County of °�i-r�-� , do hereby certify that
personally appeared before me this r� day of ?7CtA °6 and acknowledge the due
execution of the forgoing wet detention basin maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires
7
Form SWU-102 Rev 3.99 Page 4 of 4

F w' A' fir. „5 Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
> Alan W. Klimek, P.E.,Director
Division of Water Quality
C6een H. Sullins, Deputy Director
Division of Water Quality
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
WATER QUALITY SECTION
COASTAL STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
1. CURRENT PERM IT I1NFORMATION:
Stormwater Management Permit Number: _93 l 1 10
2. Permit Holder's Name: Lampe Company Building__
3. Signing Official's Name: _floss W. Lampe Title: _General Mangier
(person legally responsible for permit)
4. Mailing Address: — P.O. Box 150 City: Smithfield
State: NC_ Zip Code: _27577 Phone: [phone]_ Fax:
[1. NEW OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
Xa, Change in ownership of the property/company (Please complete Items #2,
#3, and #4 below)
X_b. Name Change of project (Please complete Item 45 below)
C. Mailing address change (Please complete Item 94 below)
d. Other (Please explain):
2. New owner's name to be put on permit: Ample Storage 1, LTD
i
3. New owner's signing official's name and title: J.H. Lame Partner
(person legally responsible for permit)
4. New Mailing Address: P.O. Box 150 City: —Smithfield
State: _NC_ Zip Code: _27577 Phone: [phone] l 95_ Fax-.
New Project Name to be placed on permit: Guy C. Lee
W, r;X�'�y
N. C. Division of Water Quality 127 Cardinal Drive Extension [phone] Customer Service
Wilmington Regional Office Wilmington, NC 28405 [phone] Fax [phone]^

PERMIT NAME/OWNERSHIP CHANGE FORM
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION OF
WATER QUALITY UNLESS ALL OF THE APPLICABLE ITEMS LISTED BELOW
ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed form.
2. Legal documentation of the transfer of ownership.
3. A copy of the recorded deed restrictions, if required by the permit.
4. The engineer's certification, if required by the permit.
A signed Operation and Maintenance plan, if a system that requires maintenance will
change ownership.
6. Maintenance records.
CERTIFICATION MUST BE COMPLETED AND SIGNED BY BOTH THE CURRENT
PERMIT HOLDER AND THE NEW APPLICANT IN THE CASE OF A CHANGE OF
OWNERSHIP.
FOR NAME CHANGES, COMPLETE
PERMITTEE'S CERTIFICATION.
Current Permittee's Certification:
AND SIGN ONLY THE CURRENT
L�"r'IP �_ attest that this' application for a name/ownership
change has been reviewed and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this applicatnon are not completed and that if all required
supporting information and attachments are not included, this application package will be
returned as incor p te.
Si 7natw _. Date: ¢ z�
I
New Applicant's Certification: (Must be completed for all transfers of ownership)
/7 rr. �4'
J `�'� attest that this application for an ownership change
has been reviewed and is accurate and corplete to the best of my knowledge. I understand that if
all required parts of this application are not completed .and that if all required supporting
information a7_)V'�7
tachments are not included, this application package will be returned as
incomplete.
Signature:
Date. I?- y"
THVCOWLETEIYAPPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INF ATION XND MATERIALS, SHOULD BE SENT TO THE FOLLOWING
ADDRESS:
North Carolina- Department of Environment and Natural Resources
Division of Water Quality
127 Cardinal Drive Extension
Wilmington, NC 28405
ATTN: Laurie Munn

Lampe Company Build ing-Shallotte
Stonnwater Project No. 931110
&o4 s w r-Ic Cd.
Engineer's Certification
1 O�J�'1 ��!'i /yUl as a dul istered Professional Engineer in the State
�' �� g
of North Carolina, having been authorized to obsery eriodical /vueel1%,"! Fa ) the construction (if
the project,
(Project)
for (Project Owner) hereby state that, to the best of my abilities,
due care and diligence was u ed 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 specification,-,.
Sig
u
Date
0
Number &/ &P&
p EC V1
D
4 AY 0 2 1995
D E M
PROJ
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11966
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