SW8970241_CURRENT PERMIT_20040506

STaRMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPE
� CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

WAT
Michael F. Easley, Governor
O�
r pG
William G. Ross Jr., Secretary
0�1
North Carolina Department of Environment and Natural Resources
>
Alan W. Klimek, P.E.,Director
O C
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
May 6, 2004
Mr, John McLean
Cape Emerald Properties, LLC
Brother and Sisters, LLC
403 Sound View Court
Cape Carteret, NC 28584
Subject: Permit No. SW8 970241Moditica6on
The Boardwalk RV Park
High Density SubdiNision Stormwater Project
Carteret County
Dear Mr. McLean:
The Wilmington Regional Office received a complete Stormwater Management Permit
Application for The Boardwalk RV Park on May 5, 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
13A NCAC 2H.1000. We are forwarding Permit No. SW8 970241 Modification, dated May 6, 2004, for
the construction of the project, The Boardwalk RV Park.
This permit shall be effective from the date of issuance until May 6, 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 follo%%ing 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
Laurie Munn, or me at [phone].
Sincerely,
Rick Shiver
Water Quality Regional Supervisor
RSS/:Ism SAWQSISTORttiIWAT\PERMM97024Lmay04
cc: Carteret County Inspections
Division of Coastal Management
Laurie Munn
Wilmington Regional Off -ice
Central Files
N. C. Division of Water Quality 127 Cardinal Drive Extension [phone]
Wilmington Regional Office Wilmington, NC 28405 [phone] Fax
Customer Service
1 800 623-7748
AWNW
n+s..'I}ERK

State Stormwater Management Systems
Permit No. SW8 970241 Modification
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STOILhIWATER 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
Cape Emerald Properties, LLC and Brother and Sisters, LLC
The Boardwalk RV Park
Carteret County
FOR THE
construction, operation and maintenance of 1 infiltration basin and 3 infiltration trenches in
compliance with the provisions of 15A NCAC 2H .1000 (hereafter referred to as the "stormwater
rules") and the approved stormwater management plans and specifications and other supporting
data as attached and on file with and approved by the Division of Water Quality and considered a
part of this permit.
This permit shall be effective from the date of issuance until May 6, 2014 and shall be subject to
the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater runoff as
described on page 3 of this permit, the Project Data Sheet. The subdivision is permitted
for 199 lots with Lots 1-184 allowed 500 square feet of built -upon area and Lots 185-199
allowed 728 square feet of built -upon area.
Approved plans and specifications for this project are incorporated by reference and are
enforceable parts of the permit.
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.

State Stormwater Management Systems
Permit No. SW8 970241 Modification
DIVISION OF WATER QUALITY
PROJECT DATA SHEET
Project Name:
The Boardwalk RV Park
Permit Number:
SW8 970241 Modification
Location:
Carteret County
Applicant:
yir. John McLean
Mailing Address:
Cape Emerald Properties, LLC
Brother and Sisters, LLC
403 Sound View Court
Cape Carteret, NC 28584
Application Date:
May 5, 2004
Receiving Stream / River Basin:
Atlantic Ocean (Trenches) I Bogue Sound (Basin)
Stream Index Number:
20-36-(0.5) 99-4
BASIN TRENCH #1
Classification of Water Body:
"SA ORW" "SB"
Design Storm:
1.5 1.5
Drainage Area, acres:
5.82 0.75
Onsite:
253,519 32,725
Offsite:
none none
Total Impervious Surfaces, ft2:
157,284 21,655
Trench Dimensions, LxWxH/Pipe Dia.:
100' x 8' x CAT'
Required Storage Volume, ft3:
*43,493 1,805
Provided Storage Volume, f13:
47,844 2,674
Bottom Elevation, FMSL:
10.5 12
Temporary Storage EIevation, FMSL:
13.5 18
Type of Soil:
Sand
Time to Drawdown, hours:
19 22
Seasonal High Water Table, FMSL:
8.33 8.33
*The system is sized to contain and infiltrate the 25 year, 24 hour storm. Therefore, no vegetative filter is required.
1
J

State Stormwater Management Systems
Permit No. SW8 970241 Modification
Project Name:
Permit Number:
Location:
Applicant:
Mailing Address:
DIVISION OF WATER QUALITY
PROJECT DATA SHEET '
The Boardwalk RV Park
SW8 970241 Modification
Carteret County
Application Date:
Receiving Stream / River Basin
Stream Index Number:
Classification of Water Body:
Design Storm:
Drainage Area, acres:
Onsite:
Offsite:
Total Impervious Surfaces, ftz:
Trench Dimensions, LxWxH/Pipe Dia.:
Required Storage Volume, ft3:
Provided Storage Volume, ft3:
Bottom Elevation, FMSL:
Temporary Storage Elevation, FMSL:
Type of Soil:
Time to Drawdown, hours:
Seasonal High Water Table, FMSL:
Mr. John McLean
Cape Emerald Properties, LLC
Brother and Sisters, LLC
403 Sound View Court
Cape Carteret, NC 28584
May 5, 2004
Atlantic Ocean (Trenches) / Bogue Sound (Basin)
99-4
99-4
TRENCH 92
TRENCH #3
"SB"
"SB"
1.5"
2"
0.65
0.64
28,154
28,000
13,730
13,139
65' x 8' x 6'/48"
60' x 10' x 6'/48"
1,144
2,189
1,738
2,345
12
11.5
19 18.7
Sand
22 24.3
8.33 8.33
4

State Stormwater Mana¢ement Systems
Permit No. SW8 970241 Modification
II. SCHEDULE OF COMPLIANCE
I . No homeowner/lot owner/developer shall fill in, alter, or pipe any drainage feature (such
as swales) shown on the approved plans as part of the stormwater management system
without submitting a revision to the permit and receiving approval from the Division.
2. The permittee is responsible for verifying that the proposed built -upon area for the entire
lot, including driveways and sidewalks, does not exceed the allowable built -upon area.
Once the lot transfer is complete, the built -upon area may not be revised without approval
from the Division of Water Quality, and responsibility for meeting the built -upon area
limit is transferred to the individual property owner.
3. If an Architectural Review Committee (ARC) is required to review plans for compliance
with the BUA limit, the plans reviewed must include all proposed built -upon area. Any
approvals given by the ARC do not relieve the homeowner of the responsibility to
maintain compliance with the permitted BUA limit.
4. 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 the approved plans, regardless of size.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area.
e. Further subdivision, acquisition, or sale of all or part of the project area. The
project area is defined as all property owned by the permittee, for which
Sedimentation and Erosion Control Plan approval or a CAMA Major permit was
sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the approved
plan.
5. The Director may determine that other revisions to the project should require a
modification to the permit.
6. 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.
The stormwater management system shall be constructed in its entirey, vegetated and
operational for its intended use prior to the construction of any built -upon surface.
S. During construction, erosion shall be kept to a minimum and any eroded areas of the
system will be repaired immediately.
9. 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.
10. 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.

State Stormwater Management Systems
Permit No. SW8 970241 Modification
11. Permanent seeding requirements for the stormwater control must follow the guidelines
established in the North Carolina Erosion and Sediment Control Planning and Design
Manual.
12. The permittee shall at all times provide the operation and maintenance necessary to assure
that all components of the permitted stormwater system function at optimum efficiency.
The approved Operation and Maintenance Plan must be followed in its entirety and
maintenance must occur at the scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
c. Mowing and revegetation of side slopes.
d. Immediate repair of eroded areas.
e. Maintenance of side slopes in accordance with approved plans and specifications.
f. Debris removal and unclogging of structures, orifice, catch basins and piping.
g. Access to all components of the system must be available at all times.
13. 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.
14. Prior to the sale of any lot, deed restrictions must be recorded which limit the built -upon
area per lot to the amount as shown on the Project Data Sheet, per Section I, Part 2. The
recorded statements must follow the form:
a. The following covenants are intended to ensure ongoing compliance with State
Stormwater Management Permit Number SW8 970241 Modification, as issued by
the Division of Water Quality under NCAC 2H.1000.
b. The State of North Carolina is made a beneficiary of these covenants to the extent
necessary to maintain compliance with the Stormwater Management Permit.
These covenants are to run with the land and be binding on all persons and parties
claiming under them.
d. The covenants pertaining to stormwater may not be altered or rescinded without
the express written consent of the State of North Carolina, Division of Water
Quality.
e. Alteration of the drainage as shown on the approved plans may not take place
without the concurrence of the Division of Water Quality.
f. The maximum built -upon area per lot is 500 square feet for Lots 1 — 184 and 728
square feet for Lots 185 - 199. This allotted amount includes any built -upon area
constructed within the lot property boundaries, and that portion of the
right -of --way between the front lot line and the edge of the pavement. Built upon
area includes, but is not limited to, structures, asphalt, concrete, gravel, brick,
stone, slate, coquina and parking areas, but does not include raised, open wood
decking, or the water surface of swimming pools.
g. Lots within CAMA's Area of Environmental Concern may be subject to a
reduction in their allowable built -upon area due to CAMA regulations.
h. All runoff on the lot must drain into the permitted system. This may be
accomplished through providing roof drain gutters which drain to the street,
grading the lot to drain toward the street, or grading perimeter swales and
directing them into the pond or street. Lots that naturally drain into the system are
not required to provide these measures.
R

State Stormwater Management Systems
Permit No. SW8 970241 Modification
15. Prior to transfer of the permit, the stormwater facilities must be inspected by DWQ
personnel, and determined to be in compliance with all permit conditions. Any items not
in compliance must be repaired or replaced to design condition prior to the transfer.
Records of maintenance activities performed to date will be required.
16. A copy of the recorded deed restrictions must be submitted to the Division within 30 days
of the date of recording the plat, and prior to selling lots. The recorded copy must bear the
signature of the Permittee, the deed book number and page, and stamp/signature of the
Register of Deeds.
17. This permit shall become voidable unless the facilities are constructed in accordance with
the conditions of this permit, the approved plans and specifications, and other supporting
data.
18. Built upon area includes, but is not limited to, structures, asphalt, concrete, gravel, brick,.
stone, slate, coquina and parking areas, but does not include raised, open wood decking,
or the water surface of swimming pools.
III. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the Director. In the
event there is a desire for the facilities to change ownership, or there is a name change of
the Permittee, a "Name/Ownership Change Form" must be submitted to the Division of
Water Quality accompanied by appropriate documentation from the parties involved,
including as may be required, but not limited to, a deed of trust, recorded deed
restrictions, Designer's Certification and a signed Operation and Maintenance plan. The
project must be in good standing with DWQ. The approval of this request will be
considered on its merits and may or may not be approved.
2. The permittee is responsible for compliance with the terms and conditions of this permit
until such time as the Director approves the transfer request.
3. 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.
4. The issuance of this permit does not preclude the Permittee from complying with any and
all statutes, rules, regulations, or ordinances which may be imposed by other government
agencies (local, state, and federal) which have jurisdiction.
5. 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.
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. Permittee grants permission to staff of the DWQ to access the property for the purposes
of inspecting the stormwater facilities during normal business hours.
S. The permittee shall notify the Division of any name, ownership or mailing address
changes within 30 days.

State Stormwater Management Systems
Permit No. SW$ 970241 Modification
1
9. A copy of the approved plans and specifications shall be maintained on file by the
Permittee for a minimum of ten years from the date of the completion of construction.
Permit issued this the 6th day of May 2004.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Alan W. Klimek, P.E., irector
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number SW8 970241 Modification

State Stormwater Management Systems
Permit No. SW8 970241 Modification
The Boardwalk RV Park Page 1 of 2
Stormwater Permit No. SW8 970241 Modification
Carteret County
Designer's Certification
I, , as a duly registered in
the State of North Carolina, having been authorized to observe (periodically/weekly/full time) the
construction of the project,
(Project)
for (Project Owner) hereby state that, to the best of
my abilities, due care and diligence was used in the observation of the project construction such
that the construction was observed to be built within substantial compliance and intent of the
approved plans and specifications.
The checklist of items on page 2 of this form are a part of this Certification.
Noted deviations from approved plans and specifications:
Signature
Registration Number
Date
SEAL
9

State Stormwater Management Systems
Permit No. SW8 970241 Modification
Certification Requirements: Page 2 of 2
1. The drainage area to the system contains approximately the permitted acreage.
2. The drainage area to the system contains no more than the permitted amount of
built -upon area.
3. All the built -upon area associated with the project is graded such that the runoff
drains to the system.
4. The outletibypass structure elevations are per the approved plan.
S. The outlet structure is located per the approved plans.
6. Trash rack is provided on the outletibypass structure.
7. All slopes are grassed with permanent vegetation.
8. Vegetated slopes are no steeper than 3:1.
_9. The inlets are located per the approved plans and do not cause short-circuiting of
the system.
_10. The permitted amounts of surface area and/or volume have been provided.
_11. Required drawdown devices are correctly sized per the approved plans.
12. All required design depths are provided.
13. All required parts of the system are provided, such as a vegetated shelf, a forebay,
and the vegetated filter.
14. The dimensions of the system, as shown on the approved plan, are provided.
cc: NCDENR-DWQ Regional Office
Carteret County Building Inspections
a

OFFICE USE ONLY
Date Received Fee Paid Permit Number
3 o tl L{ 14, I oa t 5w 7oa N!
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This fom) may be photocopied for use as an original
I. GENERAL INFORMATION
I. Applicants name (specify the name of the corporation, individual, etc. who owns the project.):
65K4T0E7r_ AA(0 LLCM "
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
JN44 MCI F6,Q _ MAfJW--F_V_ r'AP- EMEZALn AMPEKTIES. L
A6r=NT tbi- e?=T4er_ .r mb S 5TepS , LC.
3. Mailing Address for person listed in item 2 above:
403 SouwD 111.-vv CAURT
City: eAFE: CARTE EX State:M r- Zip: Z gjSa4
Telephone Number: ( 2CO Z ) 39 3 - ZZ ( q--
4. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
PLpPOsED "PS - TR � 60d.�ZDA&A V fin
5. Location of Project (street address):
(o 1 IS LA N DEP-- DRIVE
City:F_KF,,.9&Lr.) 151 . F;' _ County: c4n,, &T
6. Directions to project (from nearest major intersection): Mnm M C Z 4 / N [ S 8 W TEes i___CTZat i
PROCEED 60UTA oN MG SS, DRkyr= 2. Z MiLhs , rulzn! sauT�
oN ISLANMR DRIVE _- _ RZWEC-T tS M3 mILS_- OCEAN .
7. Latitude:_ 3_�_ STi S, _ Longitude:_ • 0537 ,_ of project
8. Contact person who can answer questions about the project:
Name:' r, OtJ C Telephone Number: cf5z393-*ZZ19
II. PERMIT INFORMATION:
1. Specify whether project is (check one): New Renewal Modification
Form SWU-l01 Version 3.99 Page l of

2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the.
existing permit number 5 �7 4 and its issue date (if known)j! A 4. 1 q9 8
3. Specify the type of project (check one):
Low Density t/ High Density Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
_CAMA Major Sedimentation/Erosion Control _404/401 Permit �NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project .
E XTIA.69ED eASGE�
2. Stormwater runoff from this project drains to the Y- 91TE: OAK River basin.
3. Total Project Area: 0.7*3 acres 4. Project Built Upon Area: 4.9
5. How many drainage areas does the project have?_�� +- 3 Arr� V— D W8 97a4l
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.
� P06 CC)�c s-r,rr�
Basin Information
Receiving Stream Name
Receiving Stream Class
Drainage Area
3 z z
Existing Impervious* Area
5
Z i 5
Proposed Impervious*Area
15, q40S
% Impervious` Area (total)
c o
G t °
Impervious' Surface Area
-�
On -site Buildings
_ 0
IG(4
On -site Streets
(4
7 Q S
On -site Parking
4- -SE
ZOO 5
On -site Sidewalks
Other on -site
& Z S
S
Off -site
}
Total: 13,139 S
Total: 9 0 S
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
i
Form SWU-101 Version 3.99 Page 2 of
5� lb 4-

}L1L
1

05/05/2004 15:04 252-393-2463
W.B. MC LEAN
PAGE 02/02
5W6 970 z41 -E 6TING,
C--pSTING
W R LTF,&T.O �3
BA51 h
E Y_-)
Basin Inlormadon
T ENG
vF C� AO
Receiving Stream Name
Receiving Stream Class
Drainage Area
�$ C,a�L 5
' .$Z .AC
Existing Impervious' Area
�j, (p7 Atc@ras
Proposed Impervious�Area
S
• �D'I AC>2E
% Impervious- Area (total)
Impervious- Surface Area
'{� DEf`AOLI
On -site BuildingsOn-si(e
Streets
S
Z 7
On site Parking
On -size Sidewalks
Z� d}DO S
o
,o
ether on•site
Off -site
Total' 3 3 %3 5
Total: 5q 045 •�
• Impervious area is defined as the bLdlc upon area including. bur nor lirnfred to, buildi; p. roads. parkln� areas.
sidewalks, gravel areas, etc.
ED)
L oTs Nc1MOEIZ! a f 'v' gbd6d /8 4- AR F
4a'% ' 500
La-rs AVt1Mf -9&D /85 �a cicu 1 q 9
tN Fl066--6960 Fog 7Z8 sFIz-or:
�cv • Sf5�4

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, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a table
listing each lot number, size and the allowable built -upon area for each lot must be provided as an attachment.
1. The following covenants are intended to ensure ongoing compliance with state stormwater management permit number
as issued by the Division of Water Quality. These covenants may not be
changed or deleted without the consent of the State,
2. No more than --- square feet of any lot shall be covered by structures or impervious materials.
Impervious materials include asphalt, gravel, concrete, brick, stone, slate or similar material but do not include wood
decking or the water surface of swimming pools.
IVIA - PRO PECT� is Alan SE (Mdi 40 "E CO
3. Swa es shall not be filled in, piped, altered except as necessary to provide driveway crossings.
4. Built -upon area in excess of the permitted amount requires a state stormwater management permit modification prior to
construction.
5. All permitted runoff from outparcels or future development shall be directed into the permitted stormwater control
system. These connections to the stormwater control system shall be performed in a manner that maintains the integrity
and performance of the system as permitted.
By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, that the covenants will be binding on all parties and persons
claiming under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each
BMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the status
and availability of these forms.
Form SWU-102
Wet Detention Basin Supplement
Form SWU-103
Infiltration Basin Supplement
Form SWU-104
Low Density Supplement
Form SWU-105
Curb Outlet System Supplement
Form SWU-106
Off -Site System Supplement
Form SWU-107
Underground Infiltration Trench Supplement
Form SWU-108
Neuse River Basin Supplement
Form SWU-109
Innovative Best Management Practice Supplement
Form SWU-101 Version 3.99
Page 3 of 4

.Vl. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. The complete application package should be
submitted to the appropriate DWQ Regional Office.
Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
Initials
• Original and one copy of the Stormwater Management Permit Application Form J PM
• One copy of the applicable Supplement Form(s) for each BMP J PM
• Permit application processing fee of �42C(payable to NCDENR} Zlo 60 JPM
• Detailed narrative description of stormwater treatment/management J PM
• Two copies of plans and specifications, including:
- Development/Project name
-Engineer and firm
r
-Legend
- North arrow r
- Scale
- Revision number & date
- Mean high water line W f A
- Dimensioned property/project boundary
- Location map with named streets or NCSR numbers
- Original contours, proposed contours, spot elevations, finished floor elevations
- Details of roads, drainage features, collection systems, and stormwater control measures
- Wetlands delineated, or a note on plans that none exist `�
- Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations r
- Drainage areas delineated ✓
- Vegetated buffers (where required) A//A
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): JoA6_MC LEAtJ ._
Mailing Address: "3. �OUt.3p V tP—W C4ur'f
City: i�Q e Cq,CState: AfC zip: Zg S$¢
Phone: { Z 22 19 tax:( Z Z ) 3 �13 - 7-4 / 3
VIII. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in General Information, item 2) �0 N Ai
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,
r�
Form SWU-101 Version 3.99 Page 4 of 4
Date: 5 —4 5 - Z4a 4

Permit No. 5W6 } G Z 4 ( AltW
(to he provide d by D IVO
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form t)ay be photocopied for use as an original
DWO Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : 170E ftAK DINALK RV PARY EM7AQs1oN
Contact Person: c„)n"N_ MG L—EQN. Phone Number;
EXISTING ln4V71LT1ZA-UC) J
This workshect applies to: Basin No. in Drainage Area
(as idenfilied on plans) (from Form SIVU-101)
II. DESIGN INFORMATION -Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type
Infiltration Rate
SHWT Elevation
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
N EW 1- Ate
1 .db -� �n/hrr of/hr/sf (circle appropriale units)
46, 3 fmSI (Seasonal High Wafer Table elevation)
8 inch (1.5 inch event for SA raters, I inch even! for others)
7 z c.f.
.7 days
100 ft. x 17O
7 c.f.
c). J fmsl
4— fllsl
furs I
Form S WU- l 03 Rev 3.99 Pace l of 3
ft. = _ 17, 000 sq. ft. (bottom dimensions)
EXISTING, gASf�( 5w8 970241

11f. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stortnwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stoumwater Management Pcnnit
Application Form, the agent may initial below. Attach justification if a requirement has not been inet.
Applicants Initials
a. Systern is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
--� c. Bottom of system is at least 2 feet above the seasonal high water table.
J PM d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
c. System is not sited on or in fill material or DWQ approval has been obtained.
J r M f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the nearest public right-of-way.
-J PM g. Drainage area for the device is less than 5 acres. lla
RM h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
0-1
attached. NQT OTrl1C{-�(]
F>t I i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached. N O
JPM j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached. YE—s
J P k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
P 1. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided. NO
JPM m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided. �f'-5
n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
r length is 50 feet for SA waters, 30 feet for other waters).
�1 o. Flow distribution mechanism within the basin is provided. Y-E-5
P,, p. A benchmark is provided to determine the sediment accumulation in the pretreatment evice.
-.i P AA q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
.� e V t r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. nd a
ea Z d,a
s. Plans ensure that the installed system will meet design specific tions (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SwU-l03 Rev 3.99 Page 2 of 3

n y
41
' 7•
I

I\'.' INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
ve-etated cover to maintain a maximum height of six Inches, and remove trash as needed.
zn
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4_ Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate Manner and shall not be handled in a manner that will
adversely impact water quality (i.e, stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can betaken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads+ I I -0 feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible parry.
Print Nai
Address:
Phone:
Signature:
2 F Z- 5CB - 2 Z 19-- Date: 5— a S- Z.GIo 4
W- ZZ 58
Note: The le all erpnnsihle pnrly should not he a homeowners association unless more than 50% of the lots have been sold and a
rresid nr 0j re suhdrvisrn/++hers been ncrnred 11+e president.
a Notary Public for the State of / Qf C A County of
,061.4 .�_ do hereby certif -_'T42 . 'v/ �G� � _ personally appeared before me this S�
day of zoo , and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my hand and official seal,
SEAL My commission expires A/6t 4101 1
Fonri. SWU-103 kev 3.99 Page 3 of 3

mL

Permit No.
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
UNDERGROUND INFILTRATION TRENCH SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater_Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
underground infiltration trench supplement for each system, design calculations, and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : `I V 5
Contact Person: IJ6 QN LEAN Phone Number: (?qZ) '59 3 - ZZ_ 19
For projects with multiple infiltration systems, a supplement form must be completed for each system. This worksheetappliesto: Trench in Drainage Area k?CISTfI�1G► # S�jg g70�4r!
(from plans) (from Form SWU-101)
H. DESIGN INFORMATION (attach supporting calculations/documentation):
Soils Report Summary (based upon an actual field investigation and soil borings)
Soil Type N
Infiltration Rate • $ n/hr r cf/hrlsf (circle appropriate units)
SHWT Elevation '� g .?J�J fmsl (Seasonal High Water Table elevation)
Trench Design Parameters
Design Volume 2301 c.f.
Design Storm inch event (1.5 inch eventfor SA waters, 1 inch eventfor others)
Drawdown Time • % days
Perforated Pipe Size inch diameter
Perforated Pipe Length
No. Observation Wells (may be required on a case -by -case basis)
Stone Type (if used) 57 fj �j'� jiv P12aJ6r-T'
Stone Void Ratio 4"0 ✓
Trench Elevations (in feet mean sea level)
� fa
Bottom Elevation fmsl
Storage/Overflow Elevation '� _� g fmsl
Form S WU- l07 Rev 3.99 Page I of 4
N5rNG TKNC� :" 1

Y

Trench Dimensions
Height
Width
tO a
8 ft.
II1. REQUIRED ITEMS CHECKLIST
Length 100 ft.
Volume Provided 2 ,?d 1 _ cu.ft.
The following checklist outlines design requirements per the Stormwater Best Management Practices manual (N.C.
Department of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met .and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
J F M
System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. Off-line system, runoff in excess of the design volume bypasses the system (bypass detail
provided). r[lo yPASS
Jf. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon infiltration
through the bottom only (a hydrogeologic evaluation may be required).
g. Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
h. System is not sited on or in fill material or DWQ approval has been obtained.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage.
Jk. System is located in a recorded drainage easement for the purposes of operation and A�Q
maintenance and has recorded access easements to the nearest public right-of-way. r`l
PSI
System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event
for areas draining to SA waters ).
m. Drainage area for the device is less than 5 acres.
A pretreatment device ( filter strip, grassed swale, sediment trap, etc.) is provided.
o. Trench bottom is covered with a layer of clean sand to an average depth of 4 inches.
p. Sides of the infiltration trench are lined with geotextile fabric.
q. Rock used is free of fines (washed stone) and has a large void ratio.
Side to bottom area ratio is less than 4:1.
Form S WU- l07 Rev 3.99 Page 2 of 4

GPM
s. Observation well(s) are provided (case -by -case basis).
t. Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters)
and detail is shown on plans.
u. A benchmark for checking sediment accumulation is provided.
c 14 KrK 5Emi1A4eAJT -ki'y WSPCcn0N1 of -PIPE,
IV. UNDERGROUND IN!'FILTRATION TRENCH OPERATION AND MAINTENANCE AGREEMENT
After every runoff producing rainfall event and at least monthly inspect the bypass/overflow structure for
blockage and deterioration and the- infiltration system for erosion, trash accumulation,. grass cover, and general
condition.
2. Repair eroded areas immediately, re -seed as -necessary to maintain adequate vegetative, cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumulated sediment annually or when depth is reduced to 75% of the original design depth. Restore
depth to original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed.
4. The water level in any monitoring wells will be recorded after a 1 inch rainfall event and at least once a month.
Chronic high water table elevations (within 1 foot of the bottom of the system for a period of three months)
shall be reported to DWQ immediately.
5. If DWQ determines that the system is failing, the system will immediately be repaired or replaced to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater control
devices as allowed by NCAC 2H J000 must be designed, approved and constructed.
Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced to
75% of the original design depth. The system shall be restored to the original design depth without over -
excavating. Over -excavating may cause the required water table separation to be reduced and may
compromise the ability of the system to perform as designed. Removed sediment shall be disposed of in an
appropriate manner and shall not be handled in a manner that will adversely impact water quality (i.e..
stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the infiltration system. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the depth at the benchmark reads YIA , the accumulated sediment shall be removed
from the system.
Form S WU- l07 Rev 3.99 Page 3 of 4

' I acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. I agree to notify DWQ
of any problems with the system or prior to any changes to the system or responsible party.
Print Name and Title:_ Jbg m Ac LEAM , t"!,M kc EO.
Address: 402" SOuoo VtEVJ 6AUP-1- CAPE. CoR15--RE-r ZSS5�
Phone: Z C/ Z - 3 �13 - Z Z I ci Date:_ sit _ &404 ► zoo 4-
Signature:
Note: The legally +p4sible party should not be a homeowners association unless more than 50% of the lots have been sold and a
resident of th ubdi vision has been nanted the president.
1, i w... ► a Notary Public four the State of - "" &JAJIL,, County of
A 9%) do hereby certify at 0 /• 4440personally appeared before me this
day of, and acknowledge the due execution of the forgoing infiltration basin maintenance
requirements. W mess my hand and fficial seal, .
SEAL My commission expires l a "VI
OF
Form S WU-107 Rev 3.99 Page 4 of 4

§.r
.�'
;..
. , t
.r

Permit No. � p PJQ�,q'(MUO
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
UNDERGROUND INFILTRATION TRENCH SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
underground infiltration trench supplement for each system, design calculations, and plans and specifications
showing all stormwater conveyances and system details.
1. PROJECT INFORMATION
Project Name: AQV3ALY, V PARK, E x PA Qs l o NS
Contact Person: 1:�CLEA N Phone Number: (254) _ 3!9 3 - 7- z 9
For projects with multiple infiltration systems, a supplement form must be completed for each system. This
worksheet applies to: Trench �W- 2 in Drainage Area _-A Z E +iS-riN(; 5UJ a 970Z4j
(from plans) (from Form SWU--1 p1)
II. DESIGN INFORMATION (attach supporting calculations/documentation):
Soils Report Summary (based upon an actualfield investigation and soil borings)
Soil Type NgW14AN
Infiltration Rate 1 • (or cf/hr/sf (circle appropriate units)
SHWT Elevation + 9- 3 3 fmsl (Seasonal High Water Table elevation)
Trench Design Parameters
Design Volume 11-717 cs.
Design Storm I t12 inch event (1.5 inch event for SA waters, 1 inch event for others)
Drawdown Time 0,9 days
Perforated Pipe Size it inch diameter
Perforated Pipe Length r ft.
No. Observation Wells (may be required on a case -by -case basis)
Stone Type (if used) f 5 -7 `-^ 3 for, 1�mTk R E M0 J EZ-T
Stone Void Ratio
Trench Elevations (in feet mean sea level)
Bottom Elevation + I Z fmsl
Storage/Overflow Elevation t 19 fmsl
Form SWl1-107 Rev 3.99 Page 1 of 4
EXi s-nNG

Trench Dimensions II� //
Height (D fl. Length i0 S ft.
Width U _ ft. Volume Provided �i'7 cu.ft.
III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices manual (N.C.
Department of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
.. FM
J
JPM
PM
a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
c. Bottom of system is at least 2 feet above the seasonal high water table.
d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
e. Off-line system, runoff in excess of the design volume bypasses the system (bypass detail
provided). tS(} 13`rPpSS
JPM f. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon infiltration
through the bottom only (a hydrogeologic evaluation may be required).
g. Soils have a minimum hydraulic conductivity of 0.52 inches per hour.
h. System is not sited on or in fill material or DWQ approval has been obtained.
Plans ensure that the installed system wilt meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
JPMj. System is sized to take into account the runoff at the ultimate built -out potential from all
y An surfaces draining to the system, including any off -site drainage.
1�1Y l k. System is located in a recorded drainage easement for the purposes of operation and A � O
maintenance and has recorded access easem nts to the nearest public right-of-way. IV
OWgER OPG-RATES fZPNRK 4 O4 M
1. System captures and infiltrates the runoff from the first 1.0 inch of rainfall 1.5 i ch event
. for areas draining to SA waters ). I III
Jm. Drainage area for the device is less than 5 acres. J n. A pretreatment device ( filter strip, grassed Swale, sediment trap, etc.) is provided. NZ
J P6 o. Trench bottom is covered with a layer of clean sand to an average depth of 4 inches.
p. Sides of the infiltration trench are lined with geotextile fabric. YE-5
J PAA q. Rock used is free of fines (washed stone) and has a large void ratio.
�� r. Side to bottom area ratio is less than 4:1.
Form SWU-lo7 Rev 3.99 Page 2 of 4

' ' .i Q M s. Observation well(s) are provided (case -by -case basis). 3 a Q N20i oc-Q`
�1 Q t. Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters)
p and detail is shown on plans.
r M u. A benchmark for checking sediment accumulation is provided. M 6
C�EzK SMrMa-mi Z� ExAWNW6 Pf PE-
N. UNDERGROUND INFILTRATION TRENCH OPERATION AND MAINTENANCE AGREEMENT
I. After every runoff producing rainfall event and at least monthly inspect the bypass/overfloiv structure for
blockage and deterioration and the infiltration system for erosion, trash accumulation, grass cover, and general
condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumulated sediment annually or when depth is reduced to 75% of the original design depth. Restore
depth to original design depth without over -excavating. Over excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed.
4. The water level in any monitoring wells will be recorded after a 1 inch rainfall event and at least once a month.
Chronic high water table elevations (within I foot of the bottom of the -system for a period of three months)
shall be reported to DWQ immediately.
5. if DWQ determines that the system is failing, the system will immediately be repaired or replaced to original
design specifications. if the system cannot be repaired to perform its design function, other stormwater control
devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced to
75% of the original design depth. The system shall be restored to the original design depth without over -
excavating. Over -excavating may cause the required water table separation to be reduced and may
compromise the ability of the system to perform as designed. Removed sediment shall be disposed of in an
appropriate manner and shall not be handled in a manner that will adversely impact water quality (i.e.
stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the infiltration system. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the depth at the benchmark reads , the accumulated sediment shall be removed
from the system.
Form SWU-107 Rev 3.99 Page 3 of 4

` 'I acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. I agree to notify DWQ
of any problems with the system or prior to any changes to the system or responsible party.
Print Name and Title: Joj,4Q Mc Le0.n
Address: kO25 S8Q136y IEAi IfOU A
Phone:
Signature:
4ckrr
Date: 5 AA Zoo 4-
Note: The 1�gully responsible party should not be a homeowners association unless more than 50% of the lots have been sold and a
resident of the subdivision has been named the president,
I, ►� ! 4.w - a Notary Public for the State of AW /ft1��, County of
/rf•.f /a rJ , do hereby certi that �D% 1' G4ae.._� personally appeared before me thisS
day of ZM and acknowledge the due execution of the forgoing infiltration basin maintenance
requirements. Vitness my hand and official seal,
,tSF.AL My commission expires
Form SWU-107 Rev 3.99 Page 4 of 4

Permit No. '50 0 gg0xi bm
(to be provided ht, DWQ)
State of Norte Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORuIWATER MANAGEMENT PERMIT APPLICATION FORM
UNDERGROUND INFILTRATION TRENCH SUPPLEMENT
This form may be photocopied for use as an original
DWO Storrnwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
underground infiltration trench supplement for each system, design calculations, and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : TAF, &4fMWALK RV &9K _ E)�PANs1a N
Contact Person: 'Aogi C-�-E&N _ Phone Number: 25 Z 3 3 - Z Z
For projects with multiple infiltration systems, a supplement form must be completed for each system. This
worksheet applies to: Trench in Drainage Area :�- 3 mo PO ✓&l] -T, ENC44
(from plans) (from Form SWU--101)
H. DESIGN INFORMATION (attach supporting calculations/documentation):
Soils Report Summary (based upon an actual field investigation and soil borings)
Soil Type VFW944
Infiltration Rate F1UW15EO u I inJhr or cf/hr/sf (circle appropriate units)
SHWT Elevation + $•�J�1 fnsi (Seasonal High Water Table elevation) (&4ei\J Lee,t,itS,LJS)
Trench Design Parameters
Design Volume
2 a c.f.
Design Storm
2 inch event (1, S in nt for SA waters, I inc or others) E,=,
Drawdown Time
0. 3 days
Perforated Pipe Size
45 inch diameter
Perforated Pipe Length
ft.
No. Observation Wells
(mav be required on a case -by -case basis)
Stone Type (if used)
57
Stone Void Ratio
0.55
Trench Elevations (in feet mean sea level)
Bottom Elevation -F 11.5 fmsl
Storage/Overflow Elevation 1$ fmsl
Form SWU-l07 Rev 3.99 Page 1 of 4
i R�cN A- 3 Poseo

f 4A
1
�rl

0
0
Trench Dimensions
Height tD ft.
Width _ 0 ft.
III. REQUIRED ITEMS CHECKLIST
Length
Volume Provided
2^, 19 0 cu.ft.
The following checklist outlines design requirements per the Stormwater Best Management Practices manual (N.C.
Department of Environment, Health and Natural Resources, November 1995) and Administrative Code Section: 15
A NCAC 2H ,1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
_1 F V"-4 a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
b. System is located at least 100 feet from water supply wells.
J c. Bottom of system is at least 2 feet above the seasonal high water table. ✓
�) 6A d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon. MIA
-J PM e. Off-line system, runoff in excess of the design volume bypasses the system (bypass detail N/p
provided). ► o (3TR 5
JI?1"i f. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days based upon infiltration
through the bottom only (a hydrogeologic evaluation may be required). �e-5
P g. Soils have a minimum hydraulic conductivity of 0.52 inches per hour. (`re,)
-J P M h. System is not sited on or in fill material or DWQ approval has been obtained.
-� p
[ �A i. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized. ✓
J PM j. System is sized to take into account the runoff at the ultimate built-out�otential from all
surfaces draining to the system, including any off -site drainage. ✓
-.1 P&A k. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded acces a silents to the nearest public ht- IF -way
bWNEV b RDT�S t':4R C A%t LO 8 6C IN R 1- s` sm--M
M 1. System captures and infiltrates the runoff from the first L0 inch of rainfall (1.5 inch event
for areas draining to SA waters ). 7— `t
�j P M m. Drainage area for the device is less than 5 acres. Less +ka ^ f acxLf
JPNL n. A pretreatment device ( filter strip, grassed swale, sediment trap, etc.) is provided. NO
J P M o. Trench bottom is covered with a layer of clean sand to an average depth of 4 inches. Y-S
12 to p.
3 P M q.
J PN1 r.
Form SWU-107 Rev 3.99
Sides of the infiltration trench are lined with geotextile fabric. �e—s
Rock used is free of fines (washed stone) and has a large void ratio. lqr�
Side to bottom area ratio is less than 4:1
Page 2 of 4
No — 5E;E- DET'A L-

ots 5rr-E: A�Rp7
PMs. Observation wells) are provided (case -by -case basis). 6 C—
\f-_ t. Vegetated filter is provided for overflow (50 feet for SA waters, 30 feet for other waters)
and detail is shown on plans. -- At,. 51TES ARE \IV M_0
. j Pu. A benchmark for checking sediment accumulation is provided. N A
VI'-wQ a I /w, f Ti O r\
0
IN'. UNDERGROUND INFILTRATION TRENCH OPERATION AND MAINTENANCE AGREEMENT
After every runoff producing rainfall event and at least monthly inspect the bypass/overflow structure for
blockage and deterioration and the infiltration system for erosion, trash accumulation, grass cover, and general .
condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash and blockages as needed to maintain
system performance.
3. Remove accumulated sediment annually or when depth is reduced to 75% of the original design. depth. Restore
depth to original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed.
4. The water level in any monitoring wells will be recorded after a 1 inch rainfall event and at least once a month.
Chronic high water table elevations (within 1 foot of the bottom of the system for a period of three months)
shall be reported to DWQ immediately.
5. If DWQ determines that the system is failing, the system will immediately be repaired or replaced to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater control
devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
6. Remove accumulated sediment from the infiltration system annually or when depth in the unit is reduced to
75% of the original design depth. The system shall be restored to the original design depth without over -
excavating. Over -excavating may cause the required water table separation to be reduced and may
compromise the ability of the system to perform as designed. Removed sediment shall be disposed of in an
appropriate manner and shall not be handled in a manner that will adversely impact water quality (i.e..
stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the infiltration system. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
r
When the depth at the benchmark reads the accumulated sediment shall be removed
� � ,
from the system.
Form SWU-107 Rev 3.99
Page 3 of 4
_10yo f -1

' I acknowledge and agree by my signature below that 1 am responsible for maintaining the stormwater
collection system in accordance with the six maintenance procedures listed above. I agree to notify DWQ
of any problems with the system or prior to any changes to the system or responsible party.
Print Name and Title:
Address:
J. VP i" Leo— r% , l Y L Cc. rL"
Phone: 2 _Cl Z — 30 -3L_ ZZ i
Signature:
e-�- & Pa!+
� L .__ O , t.- L LG
Date:_ . wo4-
j
Note: The legaify�6&5ible 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.
t, Aj < ( k , a- � • rc" + r+ 4 a Notary Public for the State of _d`� o �� Au.. county of
flwS �L.) , do hereby certify that s O nn r`t y fy � �!'� T� lN� � L e4r� � - personally appeared before me this
day of D and acknowledge the due execution of the forgoing infiltration basin maintenance
requirements. Witness my hand and official seal,
i
My commission expires r".
Cpu1ttt�,,
Form SWU-107 Rev 3.99 Page 4 of 4
5�3/a