20121032 Ver 1_401 Application_20121112

M
2
032
Soil & Environmental Consultants, PA
11010 Raven Ridge Road • Raleigh, North Carolina 27614 • Phone: [phone] • Fax: [phone]
www.SandEC.com
To: US Army Corps of Engineers
Raleigh Regulatory Field Office
Attn: David Shaeffer
3331 Heritage Trade Drive, Ste. 105
Wake Forest, NC 27587
From: Nicole Thomson
Soil & Environmental Consultants, P.A.
11010 Raven Ridge Road
Raleigh, NC 27614
Re: Sanctuary Park, Raleigh, Wake County, NC
November 8, 2012
S &EC Project # 11974.P1
N.C. Division of Water Quality
WebSCaPe Unit
Attn: Karen Higgins
512 N. Salisbury Street -9`h floor
Raleigh, NC 27603
ZL 1=1 IDD
On behalf of the Owners, William Mills and Alease Mills Weatherspoon and Ricky & Denise Bennet, please find
attached a complete application and supplemental information requesting written concurrence from the US Army Corps
of Engineers (USACE) and the N.C. Division of Water Quality (DWQ) that the activities proposed below may proceed
under Nationwide Permit (NWP) 12 and General Water Quality Certification (GC) 3884. The applicants are also
requesting a Neuse River Riparian Buffer Authorization with this application package. Please contact me at (919) 846-
5900 if you have any questions or require additional information.
PROJECT Sl JMMARY
Project Name
Sanctuary Park
Project Type
Sanitary Sewer Line Installation
Owner / Applicant
William Mills and Alease Mills Weatherspoon and Ricky &
Denise Bennet
County
Wake
Nearest Town
Raleigh
Waterbody Name
UT to Hare Snipe Creek
Index Number
27-33-12-(])
Class
B, NSW
USGS Cataloging Unit
03020201
IMPACT SUMMARY
Stream Impact (acres):
0.004 Temp.
Wetland Impact (acres)
0
Open Water Impact (acres):
0
Total Impact to Waters of the U.S. (acres)
0.004 Temp.
Total Stream Impact (linear feet):
20 LF Temp.
Total Neuse River Riparian Buffer Impact (square feet)
1,752 (1,277 sq. ft Zone 1 & 475 sq. ft Zone 2)
Attachments
Pre - construction Notification (PCN) Application Forin
Agent Authorization Forms
USGS Topographic Site Vicinity Map
NRCS Soil Survey Site Vicinity Map
Recorded off -site sewer line easement
Impact Maps
Bioretention Cell & Level Spreadei Details /Worksheets
5240 Application Fee (DWQ Only)
WOM
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i3ENR - WATEH QUALITY

O�0F wA4F1 O
O Y
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre - Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ❑Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 12 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
® Yes
❑ No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ® Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
For the record only for Corps Permit:
❑ Yes ® No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes
® No
1g. Is the project located in any of NC's twenty coastal counties If yes, answer 1 h
below.
❑ Yes
® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2. Project Information
2a. Name of project:
Sanctuary Park
2b. County
Wake
2c. Nearest municipality / town:
Raleigh
2d. Subdivision name:
Sanctuary Park
2e. NCDOT only, T.I P. or state
project no:
N/A
3. Owner Information
3a. Name(s) on Recorded Deed:
William Mills & Alease Mills Weatherspoon /Ricky & Denise Bennet
3b. Deed Book and Page No.
08452/1539; 03075/0161
3c. Responsible Party (for LLC if
applicable):
N/A
3d. Street address.
8815 & 8816 Breeland Way
I t=
3e. City, state, zip:
Raleigh, NC 27613
3f. Telephone no.:
N/A
,� r
3g. Fax no
N/A
"-
3h. Email address:
N/A
"� iTy
Weganas �k ;S ,. �ro� •....
Page 1 of 12
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ® Other, specify: Applicants are Owner's as listed on the Agent
Authorizations; please copy agent (S &EC) on all correspondence
4b. Name:
William Mills & Alease Mills Weatherspoon /Ricky & Denise Bennet
4c. Business name
(if applicable):
N/A
4d. Street address:
8815 & 8816 Breeland Way
4e. City, state, zip:
Raleigh, NC 27613
4f. Telephone no.:
N/A
4g. Fax no.:
N/A
4h. Email address:
N/A
5. Agent/Consultant Information (if applicable)
5a. Name:
Nicole Thomson
5b. Business name
(if applicable):
Soil & Environmental Consultants, PA
5c. Street address:
11010 Raven Ridge Road
5d. City, state, zip:
Raleigh, NC 27614
5e. Telephone no.:
(919) 846 -5900
5f. Fax no.:
(919) 846 -9467
5g. Email address:
NThomson @sandec.com
Page 2 of 12

B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID):
0788630797;0788632952;0788642077;0788641047
1 b. Site coordinates (in decimal degrees):
Latitude: 35.9036 Longitude: - 78.7092
(DD.DDDDDD) (- DD.DDDDDD)
1 c. Property size:
+/- 7,29 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
UT to Hare Snipe Creek
proposed project:
2b. Water Quality Classification of nearest receiving water:
27- 33- 12 -(1); B; NSW
2c. River basin:
Neuse River (USGS Cataloging Unit 03020201)
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The majority of the subject site is forested and undeveloped. There are 3 existing homes on the property currently, which
will be removed prior to development of the site. The surrounding area consists of single family residential subdivisions.
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
0
3d. Explain the purpose of the proposed project:
The proposed project is to construct a single family subdivision consisting of approximately eighteen (18) lots. There will
also be areas of the site preserved as Open Space/Tree Conservation Area, as well as an area which will house the
stormwater BMP device (a bioretention cel). The impacts requested in this application are associated with a sewer line
connection which will result in temporary stream impact and associated riparian buffer impact (both for installation and the
permanent maintenance corridor). The sanitary sewer connection requires an offsite impact; attached is the
documentation of the deeded easement.
3e. Describe the overall project in detail, including the type of equipment to be used:
As described above, the proposed project is a sanitary sewer connection (off -site) which requires a stream crossing and
the associated temporary impacts necessary for its installation. Equipment typical to sanitary sewer installation will be
utilized including trackhoes, backhoes, dump trucks, etc.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
❑Yes ED No ❑Unknown
Comments:
4b. If the Corps made the jurisdictional determination, what type
❑ Preliminary ❑ Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency /Consultant Company:
Name (if known):
Other:
4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
The subject site does not contain any wetlands and /or streams on it. A UT to Hare Snipe Creek is located to the east of
the site; the applicant does not contest the relevancy of the Neuse River Riparian Buffer Rules.
S. Project History
5a. Have permits or certifications been requested or obtained for
❑ Yes ®No ❑Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Page 3 of 12
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
6. Future Project Plans
6a. Is this a phased project? ❑Yes No
6b. If yes, explain.
Page 4 of 12

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ® Streams - tributaries ® Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e.
2f.
Wetland impact
Type of jurisdiction
number -
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ - non -404, other)
(acres)
Temporary T
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
2h. Comments: There are no wetland impacts proposed.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
3b.
3c.
3d.
3e.
3f.
3g.
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ - non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ PEI T
Sewer Line
UT to Hare Snipe
® PER
® Corps
+/- 9
20
Installation
Creek
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
20
3i. Comments: The proposed impact to the stream is temporary for the sanitary sewer line connection. Disturbance to the
stream will be for the minimum amount of time necessary to install said sewer.
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then indiv dually list all open water impacts below.
4a.
4b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number -
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P ❑T
4f. Total open water impacts
4g. Comments: There are no open water impacts proposed.
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
Page 5 of 12
PCN Form - Version 1.3 December 10, 2008 Version

5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments: The project is for a sanitary sewer line installation; therefore, no ponds or lakes
are proposed.
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
® Neuse ❑ Tar - Pamlico ❑ Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number —
Reason for impact
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
Stream name
mitigation
(square feet)
(square feet)
Temporary T
required?
Sanitary Sewer
61 ® P ❑ T
Installation /Perms
UT to Hare Snipe
❑ Yes
1,277
475
nent Maintenance
Creek
® No
corridor
6h. Total buffer impacts
1,277
475
6i. Comments: The buffer impacts are necessary for the sewer line installation and are "allowable" per the Neuse Buffer
Rules. The permanent maintenance corridor will be revegetated with herbaceous species.
Page 6 of 12

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The applicant recognizes that the proposed temporary impacts for the sewer line installation will be for the minimum
period of time required to complete the activity and that the stream area must be returned to pre- impact conditions.
Directional drilling and /or boring is not feasible at the proposed stream crossing due to topography (i.e. shallow depth of
the sewer line) and the sewer line corridor easement width (i.e. the pits required to directionally drill /bore would exceed
the allotted easement width). The proposed sewer line construction corridor as well as the proposed permanent
easement corridor is only 20 feet wide (i.e. does not exceed 40 feet in width). The proposed sewer line is not anticipated
to interfere with navigation nor is it proposed to be aerial in nature. The proposed sewer line corridor does not incur any
wetland impacts. No rip -rap is proposed at the stream crossing for the proposed sewer line installation.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Orange protective silt fencing will be placed outside of the impacted sewer line corridor to ensure protection of the non -
impacted riparian areas. It is the intent of this plan for construction impact to take place during the dryer months of the
year and the proposed temporary impacts for the sewer line installation will be for the minimum period of time required to
complete the activity.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
❑ Yes ® No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this
El Payment to in -lieu fee program
project?
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non - riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested.
acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
Page 7 of 12
PCN Form — Version 1.3 December 10, 2008 Version

5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments: The proposed buffer impacts associated with the sewer line installation are "allowable" per the Neuse River
Buffer Rules "Table of Uses."
Page 8 of 12

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
® Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: Per previous discussions with the Project Engineer:
The proposed site drains to a bioretention area for nitrogen reduction and
stormwater runoff peak reduction, in compliance with the City of Raleigh's
stormwater requirements. The bioretention would outlet onto an existing slope
outside of the Neuse Riparian Buffer and contains no existing draws thus
® Yes ❑ No
the proposed outlet enters a level spreader and engineered vegetative filter strip.
Since the 10yr storm outflow from the Bioretention area into the engineered
vegetative filter strip is less than 10 cfs (3.7 cfs) a bypass is not required /provided.
While bioretention cels are permitted to discharge directly through a buffer to the
stream, the stream is off property and the applicant was unable to secure a
drainage easement from the neighboring property owner. Therefore, the outlet from
the bioretention cel was routed to a level spreader.
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
N/A %
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: The proposed project is for temporary
impacts associated with a sewer line installation. General Certification No. 3884 does not have a stormwater
management requirement.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
Even though this project does not require an SMP through DWQ, the City of Raleigh still has stormwater requirements in
place. Therefore, the applicant is proposing a bioretention cel to treat the stormwater runoff generated by the completed
subdivision. Additionally, the BMP device outlets to a level spreader and engineered filter strip prior to entering the
protected Neuse River Riparian Buffer. The City of Raleigh will be the reviewing agency of the SMP.
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
❑ Phase II
3b. Which of the following locally - implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4. DWQ Stormwater Program Review
4a. Which of the following state - implemented stormwater management programs apply
El Coastal counties
El HQW
(check all that apply):
❑ ORW
Page 9 of 12
PCN Form — Version 1.3 December 10, 2008 Version

C. Stormwater Management and Diffuse Flow Plan (required by DWQ), continued
Page 10 of 12
❑ Session Law 2006 -246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 10 of 12

F.
Supplementary Information
I.
Environmental Documentation (DWQ Requirement)
1a.
Does the project involve an expenditure of public (federal /state /local) funds or the
❑ Yes ® No
use of public (federal /state) land?
1 b.
If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.)
❑ Yes ❑ No
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after - the -fact permit application?
❑ Yes ® No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s),
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
El Ye s ®No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
We have reviewed the "DRAFT Internal Policy, Cumulative impacts and the 401 Water Quality Certification and Isolated
Wetland Programs" document prepared by the NC Division of Water Quality on April 10, 2004, version 2.1. The proposed
sewer line installation does not meet any of the "growth stimulating" criteria Additionally, the proposed sewer line is
connecting to an existing sanitary sewer easement within a developed landscape.
4.
Sewage Disposal (DWQ Requirement)
4a.
Clearly detail the ultimate treatment methods and disposition (non- discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
It is not anticipated that this project will generate any waste water. Further, the City of Raleigh will insure that the capacity
of the subject facility for this sewer line connection will not be exceeded.
Page 11 of 12
PCN Form — Version 1.3 December 10, 2008 Version

S. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Raleigh
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
The NC- Natural Heritage Programs Virtual Workroom was used to search for elemental occurrences of state and
federally protected species in the vicinity of the project. There were no elemental occurrences of federally threatened or
endangered species on the subject property. There was one obscure reference for a State species of "special concern"
(Hemidactylium scutatum ) and one historical occurrence of a State Endangered species (Solidago radula) within 2 miles
of the center of the project area.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
The proposed project is in Wake County which is not near any coastal or tidal habitat that would support EFH (i.e. salt
marshes, oyster reefs, etc.)
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
* Records checks at the State Historic Preservation Office or the Office of State Archeology were not performed.
Utilizing Google Earth and NC National Register Points, there are no historic sites immediately adjacent to the proposed
project. This project is consistent with adjacent land uses.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? http: / /www.ncfloodmaps.com
Nicole J. Thomson
11/8/12
Applicant/Agent's Printed Name
Date
Appli �gens at ure
(Agent's signature is valid on n letter from the applicant
is provided
Page 12 of 12

Environmental Consultants, PA
Road - Raleigh, North Carolina 27614 • Phone: [phone] - Fax: [phone]
www.SandEC.com
AGENT AUTHORIZATION FORM
All Blanks To Be Filled In By The Current Landowner or Municipal Official
Name:—,&///- C //lam 4 %�LL-'�'�SG '-wi aS G�/L-�d r1oe-WPoe"11
Address: 98/
rU G 2710 / 3'
Project Name/ Description: - "C S&EC Project # q
Date: Z
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
P.O. Box 1890
Wilmington, NC 28402
Attu: DAY 11Z 5A A EFF EX-
Re: Wetlands Related Consulting and Permitting
Field Office: R A Lt l fr R
To Whom It May Concern:
1, the current landowner or municipal official, hereby designate and authorize Soil &
Environmental Consultants, PA to act in my behalf as my agent in the processing of permit
applications, to furnish upon request supplemental information in support of applications, etc.
from this day forward. The ✓r day of it666,/.
This notification supersedes any previous correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only for
government officials to enter the property when accompanied by S &EC staff. You should call
S &EC to arrange a site meeting prior to visiting the site.
Print Property Owne s or Municipal Official's Name
Arty , Owner's or Municipal Offuw's Signature
cc Ms Karen Higguu cc Mrs Nicole Thomson
NCDENR - DWQ WeBSCAPe Sod & Environmental Consultants, PA
Archdale Building
512 N Salcsbury St., qm Floor
Raleigh, NC 27604

Environmental Consultants, PA
Road • Raleigh, North Carolina 27614 • Pbone: (919) 846 -5900 + Fax: [phone]
www.SandE.C.com
AGENT AUTHORIZATION FORM
All Blanks To Be Filled In By The Current Landowner or Municipal Official
Name: ,Ol CLC C- 77
Address: BBL'Zi�-Z' -qw1)
u L Z Ile /13
Project Name/ Description: S&EC Project #I I q714
Date:
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
P.O. Box 1890
Wilmington, NC 28402
Re: Wetlands Related Consulting and Permitting
Field Office: RI Lrc (Lr I+
To Whom It May Concern:
1, the current landowner or municipal official, hereby designate and authorize Soil &
Environmental Consultants, PA to act in my behalf as my agent in the processing of permit
applications, to furnish upon request supplemental information in support of applications, etc.
from this day forward. The -5 day of /Ul l/.
This notification supersedes any previous correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only for
government officials to enter the property when accompanied by S &EC staff. You should call
S &EC to arrange a site meeting prior to visiting the site.
rent Property Owner's or Murucipal Official's Name Pro a uni 1 Officuil's Signature
cc Ms Karen Higgins cc Mrs Nicole Thomson
NCDENR - DWQ WeBSCAPe Soil & Environmental Consultants, PA
Archdale Buildmg
512 N Salisbury St, 9h Floor
Raleigh, NC 27604

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11

BKO1485OPGO2022
WAKE COUNTY. MC 347
LAURA M RIDDICK
REGISTER Of DEEDS
PRESENTED 8 RECORDED ON
07/20/2812 AT 14:13:45
BOOK:014850 PAGE:82822 - 02026
Instrument Prt parod By: Ragsdale Liggett (Bolton)
Brief Description for Index: Breeland Paris Homeowners Association Inc.
Parcel Identifier: Pin # 0788634850
Mail After Recording to: City Real Estate
Office P.O. Box 590
Raleigh, N.C.27602
STATE OF NORTH CAROLINA
GENERAL WARRANTY DEED
EASEMENT FOR SANITARY SEWER PURPOSES
COUNTY OF WAKE
THIS DEED OF EASEMENT, made and executed this 1gi`day of July 2012, by Breeland
Park Homeowners Association, Inc. , with a mailing address of P.U. Box 20969, Raleigh, NC
27619-0969., hereinafter referred to as the "Grantors ", to the City of Raleigh. a municipal corporation
of the State of North Carolina, with a mailing address of P.O. Box 590, Raleigh, NC 27602,
hereinafter referred to as the "City ";
WITNESSETH:

8KC1485OPGO2023
appurtenant facilities and equipment necessary or convenient thereto, in, upon, and across the property
of the Grantors, which easement is more particularly located and described as follows:
That area in, upon, and across the property of the Grantors lying within the sanitary sewer
easement lines, and, ifapplicable, that area designated as temporary construction easement, all as
shown on a map prepared by John A Edwards & Company - —
entitled, `Breeland Park Homeowners Association. Inc. "dated May 11, 2012 and attached hereto as
"Exhibit A ".
T14F PROPER'T'Y HEREIN DESCRIBED AND CONVEYED:
Does not include a primary residence.
TO HAVE AND TO HOLD the aforesaid easement interest and all privileges and rights
thereunto belonging to the City of Raleigh, its successors and assigns forever.
THE FURTHER TERMS AND CONDITIONS of the easement interest herein conveyed are as
follows:
I. The City is authorized hereunder to remove and keep removed from the easement all trees,
vegetation, and other obstructions as necessary to maintain, repair or protect said sanitary sewer line or
lines and appurtenances. The Grantors will, however, be allowed to plant and maintain shallow - rooted
ground cover within the easement area, provided all risk of damage to such material cause by maintenance or
repair of the sewer line and appurtenant facilities shall be with the Grantors.
2. Nothing herein shall be construed to grant to the City any right of access through or over
any other property of the Grantors except that lying within the easement herein described and
conveyed.
3. The Grantors shall retain fee simple ownership of the property through and over which this
easement passes; provided no use may be made of the properly which interferes with the full,
reasonable use of the easement by the City for sanitary sewer purposes.
4. Following the installation of a sanitary sewer main and appurtenant facilities within the
permanent easement herein described, any temporary construction easement interest herein oonve ed to
the City shall terminate; and furdrer, the area within the permanent and temporary easements shall be re- graded,
mulched, and re- seeded or otherwise restored in accordance with P-meralIv accer�cd landscanirm and enaineenne

BKO1485OPGO2024
IN WITNESS WHERL-OF, the the Grantor has caused this instrument to be singed in its
corporate name by its duly authorized 1rcs%",A and its seal to be hereunto affixed
by authority of its members, as of the day and year first above written.
PROPERTY DESCRIPTION APPROVED:
(Assistant) Public Utilities
Director
STATE OF NORTH CAROLINA
COUNTY OF Wpm,('_
BREELAND PARK HOMEOWNERS ASSOCIATION, INC.
a North Carolina nonprofit corporation
By: (SEAL)
Name: `4 0 " r6/ L3 o r i
Title: P r e--f ; d @ vt. j'
APPROVED AS TO FORM:
1, a Notary Public of the County and State aforesaid, certify that
ck , k" of Breeland Park Homeowners
Association, Inc, a No arolina nonprofit corporation, personally appeared before me this day and
either (i) being personally known to me; or (ii) having provided satisfactory evidence in the form of a:
cle one)
(a state issued driver's license;
state issued identification card; or
(c) United States Passport
acknowledged to me that he voluntarily signed the foregoing instrument for the purpose stated therein as

BKO1485OPGO2025
EXHIBIT A
,�- REELAND PARK HOMEOWNERS ASSOCIATION INC.
NEW SANITARY SEWER EASEMENT
MAY 11, 2012
8REELAND PARK 1+ ,
HOMEOWNERS ASSOG, INa +
D.B. 6405, PG 441 ► ,
PIRJ 078E 15 -64 -535? /' i / + LOT 48
MMLAND PARK
SUMMON
•'�rj. A. SR 3 /' i &M. 1998. PG 1045
DENISE S BENNETT /
O.B. 845,2 P8 1539
PIN/ 078815 -63 -2952 '
+ i
+ + LOT 47
BREELMD PARK i BREELAND PARK
j HOMEOWNERS ASsOC., INC: ' 1
SUBDIVISION
D.B. 7664. PG.495 + + B.M. 1996. PC a
1045
PINJ 078815 -63 -4850
t i
+
LOT 46
'► + BREELAND PARK
SUBDI N90N
I B.M. 199& PG. 1045
?6`E 113.78' ' w �1
20,01' % b /.'� J I'
LOT 45
N 85. BRfEYM►D PARK
J 11.97' �I 1 SUBDIVISION
N/F i B.M. 1996. PG 1045
RICKY A. SR. Ir +
DENISE S BENNETT PROPOSED EI
D.B. 8452, PG 1539 CITY OF RALEIGH + (—�- ---
PIN/ 078B.1S -63 -0797 SANITARY SEWER + � LOT 44
EASEMENT +
.W i J f 8REDAVD PARK
1 , susaasrow
+ B.M. 1996. PG 1045
+ � 1
t +
EX 20' cITY OF---;
RALEIGH SANITARY i
SEWER EASEMENT +
B.M. 1996, PG 1045 + LOT 43
+ BREELAND PARK
eti ieruuernu

BKO1485OPGO2026
BOOK:814858 PAGE:82822 - 82026
Yellow probate sheet is a vital part of your recorded document.
Please retain with original document and submit for rerecording.
Wake County Register of Deeds
PW A 7WV
Laura M. Riddick

VICINITY MAP
NTT
SANCTUARY PARK
RALEIGH, N.C.
SINGLE FAMILY SUBDIVISION
OWNER:
SP PARTNERS, LLC.
4441 SIX FORKS ROAD, SUITE 106
Raleigh, N.C. 27609
(919) 422 -9384
CIVILENGINEER:
JOHN A. EDWARDS
Consulting Engineers
333 Wade Ave
Raleigh, N.C. 27605
Phone [phone]
FAX [phone]
P
I
ATTENTION CONTRACTORS:
�n. ear �� am..rcrmrm
.....avn�s. eswc..embw pr. smwrrema
o�Np+mic now�e DEFAmmirrmr.weem.
mq pm m1BUG ur411pe oFPNnYFM r maw'i+..o rbM
y�[mmPdm o.d..hV mn mmrammum.n
cAUlmem mm/ mn Cy o.prmiro m.e�e rC�yNV
+.ur.rm r ry.rr v br mrnnw ar asvnd �. n.�
rmrmerrmnb�.a
FA►L11Ebdbm.p.emn Y.trf. Dp..r.r s
F.,.,m Prr oe tlr ke.b. r rN a1r vmmm r dCPY on aF
xnaon srao�vms.r m.r b.
ew...nbomcm acwim�a
& COMPANY
ALL CONSTRUCTION SHALL BE IN
ACCORDANCE WITH CITY OF RALEIGH
STANDARDS AND SPECIFICA710NS.
SHEET INDEX
I STORMWATER MANAGEMENT PLAN
2 IMPACT MAP

O
6
PLAN VIEW OF LEVEL SPREADER WITH ENGINEERED FILTER
STRIP ADJACENT TO NEUSE RIPARIAN BUFFER
NOT TO SCALE
-- -- MaStrp Z-22Ms 70418;; - -- i�
uwnw
PROFILE NEW OF LEVEL SPREADER WITH ENGINEERED FILTER STRIP
(NOT TO SCALE)
64 1ff3A 30 ft
R[fNP10 �- -- - -•- -:
w�
L-W Spmedor
�� Swole I OISiMI f»,...._VppOOtlm Rha S1AP
.� 15,51ar
r
+'
YARRI 60i
1•
FABRIC
BIORETENTION - LEVEL SPREADER - FILTER STRIP DETAIL
(1' -20')
GRADING & STORM DRAINAGE NOTES.
1 STREET & STORM DRAINAGE CONSTRUCTION
SMALL BE IN ACCORDANCE WITH THE
STANDARDS AND SPECIFICATIONS OF NCDOT
�,a CRY9TAL CLAY
(46, PUBLIC RM
� ! ,- `� .(�•L� 1�i \ �' I / " \/ \ B Mt 1994. 0 PG
1
BM 2004. PC 2363
8 Mp 2004. PC 1383 lIIj•O 6 I
•' `` \ / 1 7+ mi(�, O Y 199, PG )948 111
f I \ B M.'1994, PG 1948 I I� B M 1994, PC lb 16 I
11' ,9 w T99 P(i 1444'
N/F
JAMES L. JR & /
CAROL B OBENSCHAIN
D.8 2523, PC. 103
PIN# 0788 15 -54 -5161
N/F
CARRIE LEVOW GUERRA \
D B 12497, PC 1014 \
PIN# 078815 -53 -6976
1
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,
IOPEN 9 ACE' f ® Sa S-14 f
PRIVATE (VAIOABLE)
4432 SF
BIOREIFNTKAI AREA
MICHAEL S
BECKY D CAMPBELL -
D B 12448. PG 1127 -� N/F ( \ _ /, �%%' - r - / •\''pQ }1��'� I
PIN# 078815 -53 -6569 BETHANY EDWARD STEMPIEN 1 \ \ / 1 ues sF / / ® 1 j I I I / p f _ • 1'
D B 8152, PG 2324 R S. ERR d % OP SP
SANDRA 8 IT •JONE
PIN# 0768 15-53 -8578 D 8 3008, PG. 608
PIN# 078815 -63 -0585 r� 1
- - - 1174 Y
IF
N,*
I \\ I I II 11
NOTE- BIORETENTION AREA AND LEVEL SPREADER SMALL NOT STEVEN J HARRIS
BE CONSTRUCTED UNUL ENURE STE HAS BEEN STABILIZED- D 13 14'105, PC 054 1
r Tj/ 7 1
PIN# 078815 -fr3 -3428
I '
LEGEND
l= EXISTING CATCH BASIN
� PROPOSED CATCH BASIN GRAPHIC
HIC SCALE
E3 EXISTING DROP INLET
PROPOSED DROP INLET \\
w a �^^ ALL CONSTRUCTION SHALL BE
Q
OUSTING FLARED ENO SECTION ACCORDANCE WITH CITY OF RALEIGH m
STANDARDS AND SPECIFICATIONS
..4 PROPOSED FLARED END SECTION
PROPOSED STRRM PIPE ( OT I= I
I m0L - 40 R
8
mill
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1991 PG 1948
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,
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PRIVATE (VAIOABLE)
4432 SF
BIOREIFNTKAI AREA
MICHAEL S
BECKY D CAMPBELL -
D B 12448. PG 1127 -� N/F ( \ _ /, �%%' - r - / •\''pQ }1��'� I
PIN# 078815 -53 -6569 BETHANY EDWARD STEMPIEN 1 \ \ / 1 ues sF / / ® 1 j I I I / p f _ • 1'
D B 8152, PG 2324 R S. ERR d % OP SP
SANDRA 8 IT •JONE
PIN# 0768 15-53 -8578 D 8 3008, PG. 608
PIN# 078815 -63 -0585 r� 1
- - - 1174 Y
IF
N,*
I \\ I I II 11
NOTE- BIORETENTION AREA AND LEVEL SPREADER SMALL NOT STEVEN J HARRIS
BE CONSTRUCTED UNUL ENURE STE HAS BEEN STABILIZED- D 13 14'105, PC 054 1
r Tj/ 7 1
PIN# 078815 -fr3 -3428
I '
LEGEND
l= EXISTING CATCH BASIN
� PROPOSED CATCH BASIN GRAPHIC
HIC SCALE
E3 EXISTING DROP INLET
PROPOSED DROP INLET \\
w a �^^ ALL CONSTRUCTION SHALL BE
Q
OUSTING FLARED ENO SECTION ACCORDANCE WITH CITY OF RALEIGH m
STANDARDS AND SPECIFICATIONS
..4 PROPOSED FLARED END SECTION
PROPOSED STRRM PIPE ( OT I= I
I m0L - 40 R
8
mill
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BECKY D CAMPBELL -
D B 12448. PG 1127 -� N/F ( \ _ /, �%%' - r - / •\''pQ }1��'� I
PIN# 078815 -53 -6569 BETHANY EDWARD STEMPIEN 1 \ \ / 1 ues sF / / ® 1 j I I I / p f _ • 1'
D B 8152, PG 2324 R S. ERR d % OP SP
SANDRA 8 IT •JONE
PIN# 0768 15-53 -8578 D 8 3008, PG. 608
PIN# 078815 -63 -0585 r� 1
- - - 1174 Y
IF
N,*
I \\ I I II 11
NOTE- BIORETENTION AREA AND LEVEL SPREADER SMALL NOT STEVEN J HARRIS
BE CONSTRUCTED UNUL ENURE STE HAS BEEN STABILIZED- D 13 14'105, PC 054 1
r Tj/ 7 1
PIN# 078815 -fr3 -3428
I '
LEGEND
l= EXISTING CATCH BASIN
� PROPOSED CATCH BASIN GRAPHIC
HIC SCALE
E3 EXISTING DROP INLET
PROPOSED DROP INLET \\
w a �^^ ALL CONSTRUCTION SHALL BE
Q
OUSTING FLARED ENO SECTION ACCORDANCE WITH CITY OF RALEIGH m
STANDARDS AND SPECIFICATIONS
..4 PROPOSED FLARED END SECTION
PROPOSED STRRM PIPE ( OT I= I
I m0L - 40 R
8
mill
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r \ X S M. 2004, PG 2363 // _ J !, Q' 1�1,� I I \<
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ELM 11994. PG 1948 s 111 11 "J I BM 1994, PG 19481 BM 19940,' PG 7948 i',
N 14YY32' E
NIF 69• S 837726' E _ - 10 70' (TOTAL)
JAMES CAROL 8 L JR. HAIN 50,01 240,0' To,, S 858772•E J,, 380, 48.' OTAL 1 �•� /A ea.
D B 2523, PG 103 r _ '
PIN/ 078815 -54 -5161 9f .3v 19ws /
4yy a 1© I
� v I
i C9- s O '' 3901 Sf o N/F
c
d ® 8 -I R
1 BREEIAND PARK
_ HOMEOWNERS ASSOC. INC.
'CS-8 CB-e .- - - - - - - - J3 M 199 }, PG 1948
$ PIN/ 0788.15 -64 -5352
s 1 I
CARRIE LEVOW GUERRA W
D B. 12497, PG 1014
PIN/ 078815 -53 -6978 Y y "3
I ® APPROXIMATE LOCATION OF
FLOOD HAZARD SOILS
Y ��� ! J ,/; PER WAKE COUNTY GIS
'a 4.-
1, NIP
/
\ 8 1 I I j /,f 1 (HOMEOWNERS ASSOC, INC
®, -3 RCP. Cho O I (/ ' ! 1 % B M 1998, PG 1045
✓a , / PIN/ 0788 15-63 -4850
10 is
P M _ M • Z SANITARY OF R 7148
SMDIT 4g/ G'
0.a ,EA4550. PO. 2022 SANITARY g R
1 1� 6 PROPOSED ZO' CITY _ IMP T SF I I, I EASEMENT
oaJSr \\ _ s6s 14420• rAL ®- re
OF RALEIGH ER EASEMErNT PROP SS-MN � � ' IMPACT QSSF t ,sea vo ,a4s
1111`- -
- - - - --
w-72
— _ _ b r\
8 -'j - - -- - - --- - -_ - -- - — ^�i— , ~ P �/ I Ex SANITARY SEWER
s 362 sF I I OPEN SPACE - 113 11� — p4= - +'- .� I MANHOLE
Ss; MH yl
PRIVATE DRAIN a�
\ i 4 232 SF
EASEMENT � % O .
225E MORETENTION AREA IV / ph• J/ /f f�'¢
N/F N es•4,TXO• w - 703.80' . X30• (' _ ' • • 1 // ,(O`er ?�0 1,�,
MICHAEL S g I- - - 3,3.46'
BECKY 0. CAMPBELL _
D B 12448, PC 1727 - N/F 7 'X T t _ / `� T' -- X - - / �� I? . /
PIN/ 078875 -SJ -8589 EDWARD J. TII 8e J 1965 SF ® 1 M,6 / ry ry
BETHANY A. STEMPIEN / - / / I / / 0 1 17 N/F
D B 8152, PG. 2324 N/F N / 2 sot sc / OPEN SPACE I / / / �2�1 / 1 BREELAND PARK
PIN# 0788 15-53 -8578 SANDRA BRITT JONES i �,3• / l / / �v 1 f • 1 HOMEOWNERS ASSOC • INC.
D.8 3006, PG. 608 IF /� _ ` _ 1 /, / 1 �, I 8 M 1996• PG 1045
PIN/ 0788.15 -63 -0585 / 1 5321 S' \ / 1 /\ 1 111 PIN/ 078815 -63 -4850
NOTE BIORETENT10N AREA AND LEVEL SPREADER SHALL NOT % T� 668? 1 \\ •� / 11 ) 11
BE CONSTRUCTED UNTIL ENTIRE SITE HAS BEEN STABILIZED.
I ' r
I EX sM TFALL Di
LEGEND GRAPHIC SCALE STEVEN NIP HARMS ` ,)
[�
D B. 14
B ASIN a o m 105, PG. 1054
E7051DIC CATCH
PROPOSED CATCH BASIN PIN/ 078815 -63 -3428
C3 EXISTING DROP INLET e
■ PROPOSED DROP [MET ( DE M? )
d EXISTING FEARED END SECTION 1 inch - 40 0. {
PROPOSED FLARED END SECTION EsrT-A-No,"AiRD'S RUC710N SMALL BE IN
PROPOSED SiROM PIPE E WITH CITY OF RALEIGH
AND SPECIFICATION S
Z
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IMPACT MAP
I a, �44e1
o ,in
In
20' CITY OF RALEIGH y/
SANITARY EASEMENT R z/ STREAI
1 D.B. 14850, PG. 2'22 01 / ZOLF(1
co
ZONE 2
PROP. SS –MH ° IMPACT:475SF
_- PROPpSEp 8„ PVC, SS O 1 0 • i
BIORETENTIO4
AREA f l
4CE 11
• I
I F TCA
I 5,320 SF
/l
� I
ZONE 1
: -s
1277SF
ZONE 1
1
IMPACT: 1277SF
r
J
• 4.
i r �� •
IMPACT:
• Fti.
�OSF)
r ( 20" CITY CITY OF RALEIGH
Feld Book
• t •
J
LEVEL SPREADER
I F TCA
I 5,320 SF
/l
� I
PROP. SSA MH � A- y I
�V— /2
„
TOTAL
ZONE 1
IMPACT:
1277SF
ZONE 1
1
IMPACT: 1277SF
r
TOTAL
r I
IMPACT:
? I
�OSF)
r ( 20" CITY CITY OF RALEIGH
Feld Book
I I SANITARY SEWER
EASEMENT
r / B.M. 1996. PG. 1045
r
`� EX. SANITARY EWER
Ir
MANHOLE
PROP. SSA MH � A- y I
�V— /2
„
TOTAL
ZONE 1
IMPACT:
1277SF
TOTAL
ZONE 2
IMPACT:
475SF
TOTAL
STREAM
IMPACT:
20LF (190SF)
SANCTUARY PARK
WAKE COUNTY NORTH CAROLINA
JOHN A. EDWARDS & COMPANY
NC License F -0289
333 Wade Ave., Raleigh, NC 27605
Phone (M) 828 -4428
PROPERTY OF
t L �.
• =
27 51
RALEIGH
Scale
le zz •.• �� ��.
f`¢ \�
Date
Ck IC p�
1 -31 -2011
Feld Book
N/A
SANCTUARY PARK
WAKE COUNTY NORTH CAROLINA
JOHN A. EDWARDS & COMPANY
NC License F -0289
333 Wade Ave., Raleigh, NC 27605
Phone (M) 828 -4428

PROFILE OF NEW SANITARY SEWER LINE
4
41
SCALE
l " =G0'
°o
n
=
rn
pq
co
�WM
"i ce
+ 0)
II 3
Q p II
�2
ti4C
EXISTING
GROUND----
/
r
r -
I�
II
78 LF 8' PVC
SANITARY SEWER
® 1.00R
0+00
I
'4
;O
/
/
x
an
v�a�Z
10
1+001+23
45 LF -8' PVC
SANITARY SEWER
?
® 10.0ox
W
' o
Q.
390
1+001+23

Permit Number
(to be provided by DINO)
PTOp WATFgO
H=HR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must be W out, primed and submitted.
nxi Required Hems Checklist (Part ill) must be printed, tilted out and submitted along with all of the required informahon.
-
s
Project name Sanctuary Park
Contact name Patrick Perez
Phone number 919-8284428
Date
Drainage area number
10.18.2012
111AWKWO
Site Characteristics
Drainage area 168,577 ftr
Impervious area 55,630 ftt
Percent impervious 33.0% %
Design rainfall depth 10 inch
Peak Flow Calculations
Is prelpost control of the 1 -yr, 24-hr peak flow requmV
n (Y or N)
OK
1 -yr, 24-hr runoff depth
in
1 -yr. 24-hr intensity
inmr
OK
Pre-development 1 -yr, 24-hr peak flow
ll&ec
Post - development 1 -yr, 24-hr peak flow
ft3/sec
OK
Pre/Post 1 -yr, 24-hr peak control
rye /sec
OK
Storage Volume: Non-SA Waters
5%
OK
Minimum volume required
4,874.0 ft3
Volume provided
5,510.0 ft3
OK
Storage Volume: SA Waters
15' runoff volume
ft3
Pre - development 1 -yr, 24-hr runoff
ft3
Post - development 1 -yr, 24 -hr runoff
rya
Minimum volume required
0 ft3
Volume provided
rya
Cell Dimensions
Ponding depth of water
12 inches
OK
Ponding depth of water
100 It
Surface area of the top of the bioretentlon cell
5,510 0 ft2
OK
Length-
133 ft
OK
Width:
55 ft
OK
-or- Radius
ry
Media and Soils Summary
Drawdown time, ponded volume
6 hr
OK
Drawdown time, to 24 inches below surface
15 hr
OK
Drawdown time, total
21 hr
In -situ sod-
Sal permeability
4 00 In/hr
OK
Planting media sal.
Sod permeability
2 00 in/hr
OK
Sod composition
% Sand (by volume)
85%
OK
%Fines (by volume)
10%
OK
% Organic (by volume)
5%
OK
Fo SW 01 -Bic t6n RBv a
Phg�s�ac �-In eX Oi media
Total 100%
20 (unitless)
OK Parts 1 and 11 Design Summary, Page t or 2

Permit Number
(to be provded by DIA QJ
Bas!n Elevations
Temporary pool elevation
425.00 fmsl
Type of bioretention cell (answer 'r to only one of the two
What factor of safety is used for sizing the underdrains? (See
following questions):
Is this a grassed cell?
y (Y or N) OK
Is this a cell with MxWshrubs?
n (Y or N)
Planting elevation (top of the mulch or grass sod layer)
424 fmsl
Depth of mulch
0 inches Insufficient mulch depth, unless installing grassed cell.
Bottom of the planting media sal
421.25 fmsl
Planting media doh
2.75 It
Depth of washed sand below planting media sal
0.75 ft
Are underdrains being installed?
y (Y or N)
How many dean out pipes are being installed?
6
OK
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12 3.6)
2
OK
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
1 It
Bottom of the cell required
419.5 fmsl
SHWT elevation
417.5 fmsl
Distance from bottom to SHWT
2 ft
OK
Internal Water Storage Zone (MIS)
Does the design inciude IWS
Y (Y or N)
Elevation of the top of the upturned elbow
6nsf
Separation of IWS and Surface
424 ft
Planting Plan
Number of tree species
0
Number of shrub species
Number of herbaceous groundcover species
Additional Information
Does volume in excess of the design volume bypass the
bioretention cell?
y (Y or N)
OK
Does volume in excess of the design volume flow evenly distributed
through a vegetated fitter?
y (Y or N)
OK
What is the length of the vegetated fifter7
37 ft
Does the design use a level spreader to evenly distribute flow?
y (Y or N)
Submit a level spreader supplement.
Is the BMP located at least 30 feet from surface waters (50 feet if
SA waters)?
y (Y or N)
OK
Is the BMP localed at least 100 feet from water supply wells?
y (Y or N)
OK
Are the vegetated side slopes equal to or less than 3.1?
y (Y or N)
OK
Is the BMP located in a proposed drainage easement with access
to a public Right of Way (ROW)?
y (Y or N)
OK
Inlet velocity (from treatment system)
1 ft /sec
OK
Is the area surrounding the cell likely to undergo development in
the future?
n (Y or N)
OK
Are the slopes draining to the bioretention cell greater than 20° %?
n (Y or N)
OK
Is the drainage area permanently stabilized?
y (Y or N)
OK
Pretreatment Used
(Indicate Type Used with an 'X' in the shaded cell)
Gravel and grass
(8-inches gravel followed by 3-5 ft of grass)
Grassed swale
OK
Forebay
x
Other
Forth SW401- Bioetenbon -Rev e
June 25, 2010 Parts I and If Design Summary, Page 2 of 2

PenrM NO
(to be essrgned by DWQJ
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
Indicate the following design requirements have been met If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Pagel Plan
I ' a Sheet No.
1
M11-11
Plans (1' - 50' or larger) of the entire site showing,
- Design at ultimate build -out,
- Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Cell dimensions,
Pretreatment system,
-
High flow bypass system,
- Maintenance access,
Recorded drainage easement and public right of way (ROW),
Clean out pipe locations,
- Overflow device, and
Boundaries of drainage easement
2. Plan details (1' = 30' or larger) for the bioretention cell showing
- Cell dimensions
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
Design at ultimate bulk! -out,
Off -sde drainage (if applicable),
Clean out pipe locations,
Overflow device, and
Boundaries of drainage easement
Indicate the P -Index between 10 and 30
Section view of the bioretention cell (1' = 2(Y or larger) slowing:
- Side slopes, 3:1 or lower
Underdrain system (if applicable), and
Baretention cell layers (ground level and slope, pre - treatment, pondhng depth, mulch depth, fill media
depth, washed sand, fitter fabric (or choking stone if applicable), #57 stone, underdrams (d applicable),
SHINT level(s), and overflow structure)
A soils report that Is based upon an actual field investigation, soil borings, and infiltration tests The
results of the sods report must be verified in the field by DWQ, by completing & submitting the sods
Investigation request form County sod maps are not an acceptable source of soils Information, All
elevations shall be In feet mean sea level (fmsl) Results of soils tests of both the planting soil and the In
sdu soil must include
- Sod permeability,
Soil composition (% sand, % fines, % organic), and
Pandex
5 A detailed planting plan (1' = 20' or larger) prepared by a qualified individual showing
A variety of suitable species,
Sizes, spacing and locations of plantings,
Total quantity of each type of plant specified,
A planting detail,
- The source nursery for the plants, and
- Fertilizer and watering requirements to establish vegetation.
6 A construction sequence that shows how the bioretention cell will be protected from sediment until the
entire drainage area is stabilized.
*D 7 The supporting calculations (Including underdrahn calculations, if applicable)
AEI -410 8 A copy of the signed and notarized inspection and maintenance (I &M) agreement
9 A copy of the deed restriction
Form SW401- Broretenbon -Rev 7 Part III, Page 1 of 1

810- RETENTION AREA DETAIL
(NOT TO SCALE)
RIP RAP DISSAPATOR AND BERM
ELEV 425.75'
BIORETENTION MINIMUM CRASS SURFACE
AREA - 5.510 SF
MINIMUM STORAGE 5.510 CF GRASSED SURFACE MUST BE SOD
•!� HYBRID BERMUDA OR CENTIPEDE ELEV m
FES -13
424.0'
ELEV- 425.00'
01 -14
ELEV 425.00'
TOP RETAINING WALL- 426.5'
INLET PIPE
♦
• • • • s • • • Z = % ♦ • • • • . • • CHOKING STONE ELEV - 421.25'
•• +♦ ♦• ♦•••• ♦.•• null • ♦ • • FES -15
• • • ♦ • • . 05 ♦ • •, ,• ELEV-414.40'
• a • • •
TIE TO FOREBAY/LEVEL SPREADER
/57 STONE 18 PI
6' PERFORATED PIPE NS GRAVEL 70LF O O 5X
JACKET INV ELEV-420.50'
INV ELEV - 414.75'
810RETENIION SOIL SPECIFICATION:
SANDY LOAM (85 -88X SAND. 8 -12X FINES. 3 -5X ORGANIC)
6

�Qi WAI�
M K ? G
HWENR °
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
LEVEL SPREADER - VEGETATED FILTER STRIP (LS -VFS) SUPPLEMENT
This form must be completely filled out, printed, InNahrd, and submitted.
Project name
Contact name
Phone number
Date
Drainage area number
The purpose of the LS-VFS
Stormwater enters LS-VFS from
Type of VFS
Explanation of any 'Other' responses above
N Stornwater Enters the LS-VFS from the Drainage Area
Drainage area
Impervious surface area
Percent impervious
Rational C coefficient
Peak flow from the 1 kOr storm
Tune of conoerntration
Rainfall mtansity, 10-yr storm
Peak flow from the 10-yr storm
Design storm
Maximum amount of flow directed to the LS-VFS
Is a flow bypass system going to be used?
Explanation of any 'Other' responses above
If Stormwater Enters the LS-VFS from a BMP
Type of BMP
Peak discharge from the BMP during the design storm
Peak discharge from the BMP during the 10 -year stone
Maximum capacity of a 100 -foot long LS-VFS
Peak flow directed to the LS -VFS
Is a flow bypass system going to be used?
Explanation of any 'Other, responses above
.''
Form SW401 - LS-VFS - 29June2012 - Rev 10
page 1 of 3
fly
Do not complete this section of the torn.
fill
Do not complete this section of the form.
%
Do not complete this section of the form.
Do not complete this section of the form.
cis
Do not complete this section of the form.
mm
Do not complete this section of the forth.
inlhr
Do not complete this section of the form.
cis
Do not complete this section of the form.
Picts one:
cfs
Do not complete this section of the fort.
(Y or N)
Do not complete this section of the forth.
Infiltration basin
0
cis
37
cis
10
cis
37
cis
N
(Y or N)
Form SW401 - LS-VFS - 29June2012 - Rev 10
page 1 of 3

,LS-VFS Design
Forebay, suAaoe area
20
sq It No brebay is required
Depth of forebay at stormwater entry point
18
in
Depth of forebay at stomnwater exit point
6
in Depth is appropnate.
Feet of level tip needed per ds
10
fNds
Computed mvhhmum length of the level lip needed
37
It
Length of level lip provided
37
It
Width of VFS
30
It
Elevation at downslope base of level tip
414.40
kd
Elevation at the end of the VFS that is farthest from the LS
412.00
(rest
Slope (from level lip to the end of the VFS)
8.00
%
Are any draws present in the VFS?
In
(Y or N) OK
Is there a Collector Swale at the end of the VFS?
n
(Y or N)
BypaSS System Design (if applicable)
Is a bypass system provided.
Is there an engineered flow splitting device?
Dimensions of the channel (see diagram below).
M
W
y (flow depth for 10-year stomp)
freeboard (dunng the 10-yearstwm)
Peak velocity in the channel during the 10-yr storm
Channel fining material
Does the bypass discharge through a wetland?
Does the channel enter the stream at an angle?
Explanation of any 'OW Apo nses above
n (Y or N)
n (Y or N)
It
It
It
it
ft
UK
Pick one:
W
(Y or N)
(Y or N)
13
Form SW401 - LS-VFS - Mune2012 - Rev 10
page 2 of 3

cal.: REQV�O' � -C ECKUST.
_ ,}t+w ="� %Li rx'. �.:�` r; t�: r,%• YC' �: 2c ,h�'��,K"4�r'i °o�' :f-�vn.,,;�� :rent �Y�'c. :iii : :.�`'i..�`�12=i'�,'�i� =4 �"'
EDIT Please indicate the page or plan sheet numbers where the supporting documentation can be found. M incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project Initial In the space provided to indicate the
following design requirements have been met K the applicant has designated an agent, the agent may initial below. I a requirement has not been
met, attach justification.
Requried Item:
1. Plans (1'- 50' or larger) of the entire site showing-
- Design at ultimate build-out
Off-site drainage (if applicable),
-
Delineated drainage basins (include Rational C coefficient per basin),
Forebay (d applicable),
High flow bypass system,
Maintenance aaxss,
Proposed drainage easement and public right of way (ROW), and
Boundaries of drainage easement
2. Plan details (1' = 30' or larger) for the level spreader showing:
- Forebay (if applicable),
High flow bypass system,
One foot topo lines between the level lip and top of stream bank,
Proposed drainage easement and
Design at ultimate build -out
3 Section view of the level spreader (1' = 2(Y or larger) shaving:
- Underdrain system (it applicable),
Level lip,
Upslope channel, and
Downslope filter fabric.
4 Plan details of the flow splitting device and supporting calculations (it applicable),
5. A construction Lion sequence that shows taw the level spreader will be protected from
sediment until the entire drainage area is stabilized.
6. If a non-engineered VFS is being used, then provide a photograph of the VFS showing
that no draws are present
7 The supporting cakvlabons.
8. A copy of the signed and notarized operation and maintenance (0 &M) agreement
In' ' Is Page or plan sheet number and any notes:
2
i
7
2
1, 2
(YF5 M
/;lr,4C11OP
AyjA6rD
Form SW401 - LS-VFS - 29June2012 - Rev 10 page 3 of 3