SW3210301_Application Form_20210309

DEMLR USE ONLY
Date Received Fee Paid Permit Numr
06-7 a- J 'b2-1 0 be--5 D t I
Applicable ules- 0 Coastal SW - 1995 F1 Coastal SW - 2008 P ';'- ost onstruc on
(.,;elect all that apply) 0 Non-CoastalSW- HQW/ORW Waters 0 Universal Stormwater Management PI
0 Other WQ Mernt Plan: i
State of North Carolina
MCI
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Cresswind Phase 2
2. Location of Project (street address):
Potter Road
City.Monroe County:Union Zip,.28110
3. Directions to project (from nearest major intersection):
1,8 MilM south from the intersection o(WeddipZton Road and Potter Road
4. Latitude:34' 59` 08" N Longitude.--80* 39'40" W . of the main entrance to the project.
H. PERMIT INFORMATTOiN:
1. a. Specify whether project is (cbeck- one): ZNew OModificatiosi El Renewal w/ Modifica kiont
tRenewals with raodifications also requires SWU-102 - Renewal Application Forin
b. If this application is being submitted as the result of a mocation to an existing permit, list the existing
permit number issue date (if known) . and the status of
construction: E]Not�tarted [:]P'artstially Completed* MCompletcd* *provide a designer's certification
2. Specify the type of project (check one):
E]Low Density ZHighDensity []Drains toanOffsiteSiormwaterSyslem []Other
3. If this application is being submitted as the result of a previously returned application or a letter from
DEMLR requesting a state stormwater ma-riagernent permit application, list the stormwater project number,
if assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks, information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748),
[ICAMA Major ZSedimentation/ Erosion Control: 37 acof Disturbed Area
MNPDES Industrial Stormwater E]404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each pe;mit:
Is the project located within 5 miles of a public airport? []No 5yyes
Ifyes, see S.L. 2012-200, Part VI: http�Hportalmcdenr-nr 1.'.tveb/,Ir/"ru -s-and-regul ns
g IL -acto S I
FormSWU-101 Version Oct. 31,2013 Page 1 of 6

I, a, Print Applicant/ Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project);
Signing M + #
c. appropriate applicantabove Please property Contactt }
agreementrl Lessee* (Attach a copy of the lease
Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 27a and
below)
Developer* (Complete Contact Information, item 2a and 2b below-)
Propertyand title below,f purchaser
person who owns the property that the project is located on):
♦ rOwner/Organization:KH Wesley Chapel, LLC
Signing Official e Title.Authorized
t} T) #- `. t
3, a. (Optional) Print the name and tide of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
• # # #. ' # f • f L f
Mailing Address.8413 Silver S rin s C,'ourt
City -Charlotte Statte:NC Zi :2 215
Phone: (704, 39OL6455 Fax: i
Pmaail.cZ1jm nerQkoller.co€x€
4. Local jurisdiction for building permits: Union Coun � ._.
Point of ContacULee Benson Phone (704, 1 283- 564
Forrn 8WU-101 Version Od. 31, 2013 Page 2 of i

.. l,..im
4. Total Property Area: 44.1 acres 5. TotalCoastal Wetlands Area:
7. Total Property Area (4) -Total Coastal Wetlands Total s = TotalProject
Total project be calculated to excluder E i •< s .rmal High ater (N Kq line or Mean High Water structures, the area
between the banks of streams and rivers, the area below the
(MHVO line, and coastal wetlands lan(hoardfrom the NHW (or MHM line. '17te resultant r s
calculateject area is used to
i i i"
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 67 %
9. How many drainage areas does the project have?l 1. '! for proposedengineered
f' t ff' A f..use for the wholepropertyarea)

Receiving Stream Name
EastFork
,I+ Ie; Creek
_ ■ _: ■
+
11����11 ������
IIIIIIIIIIIIII�
y!
■
-...
s- i•
on
N I i y
I
_-s lIna ' l is (total)
. ; -
I
...
_.
O ,....
Stream Clra.&,s and Index Dumber can be determined at: ittt�r �i�rErrd.7tc�i� �=,vr�hveh ngtp7:1C-,,ulclraSsi Rion
'ratgg us areaa is defined as the built upon area including, but not limited to, buildings, roads, par)dng areas,
sialealks, gratvel aareras, etc,
'Report only that amount of existing BUA that aarill remaain ewer development. Igo not report any existing BUA that
is to be remaoed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. ALA,,,
•� 1 x s i' " /' s f s r i 1 s s- • �;
Fit
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
trust be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
frcrrra c wvslq�a bm -ma nt aal.
. -1, i :♦ �� 1 '. i! �1, f-� •i •,• • '"1: 1. '. iR';%i i 1 F '1 �.,.
instruction sheet and BMP checklists are available from
ahm
PA L
InitiaTs
1. is F x •Management Application jl
Original
2. ! M py of the ...E •:''dnotarized`- •Restrictionse. Protective Covenants
Form. • requiredp.. Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and datedl and O&M &K
aqfor `:
Form SWU-ltil Version Oct, 31, 2013 Page 4 of 7

pages)4. Permit application processing fee of $505 payable to NCOENR. (For an Express review, refer to Asl<
httl2:/Zwww.envheln.orgIL!aE_e,;/"onesiol2exl!re.-;s.httnI for information on the Express program
and the associated fees. Contact the appropriate reRional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the A.�.'K
receivin
stream drains to class SA waters within V2 mile of the site boundary, include the Y2
mile rr� on :;f
8. Two sets of plans folded to .5" x 1 #" (sealed, signed, & deed), including:
a. Development/Project name,
. Engineer and firma.
c. Location :nap with .named streets and NCSR numbers.
d. Legend.
e, North yarrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the non-nalpool
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal [ landward
of the MHW or NHW lines.
Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensionedproperty/project boundary bearings C:
- distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours,proposedcontours,#elevations,! flooris •
drainage1. Details of roads,
Wetlandsm. de! or anoteon plansbe
qualified person. Provide documentation of qualifications and identify the person who
made determination on
drainagen. Existing • ! drainagepipe runoffcalculations.
i
iareasdelineated(includedin the main set ofplans, ♦separatea
Vegetatedp. buffers
f
! Ypy any applicablesoilsi the asscKiated(Please & `
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xll" copy of the NRCS County Soils map with the
ct area clearly delineated. For projects with infiltration BMPs, the report �hould also
de the soiltype,i •..infiltrationrate,♦ 1infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visitfor DEMLR to verq� the SHVff p;ior
to submittal, [phone])
0. #w<. of the most property deed. Deed book:attached Page of
11. For corporations and limited liability corporations (LLQProvide documentation from
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 2H.1003(e).
'Me corporation or LLC must be listed as an active corpora Lion in good standing with the NC
Secretary ofState,otherwise! 7. #returned.

k
11�i:11111 11111 1;,,, 1 111 Jill a
that the deed restrictions arrecorded.
li
By the notarized signature(s) below, the pern-dt holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include aH the itetris required in the permit and listed
o-.
. 4;WIL
1' :� 1 ' !.:• i R ' i:. R f
I '
Applicant. Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer anal/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer.Matthew S. Kiker, PE
Consulting Firm: Thomas & Hutton
Mailing Address. R,Q , cj Awnue ...............................
City.Charlotte tate:NC Zip.28203
Phone: 980 521- +999 Fax. f )
Email.kiker.rem@ta n d h.com
Dc. pRopERT-Y OWNER AUTHORIZATION (if Contact lnjbrmation, item 2 has been filled out, complete this
1, (print or type name of p t Inprm . ation, item 2a) V.L",6-4. certify that I
erson listed in Contac
own the property identified in this pennit ap ion, and thus give permission to (print or type name ofter-rion
listed in Contact Injbrmatiov, i I tem' (printAU type name oforganization
Contact Information, item I a, o develop the project as currently proposed. A copy of
dnrkam� k,
party responsible for the operation and maintenance of the storinwater system.
10.. 31, 2013 Page 6

Mill
riTars
N All
ITUINvIal
� � I
a stormwater permit. Witness my hared and official
El
12ersonally
and now dge e e ex mution of the application for
seal,
iy commission expires
a stormwater permit. Witness my hared and official seal,
Icy commission expires
— 00 16�
Form SWU-101 Version Oct. 31,2013 •: