SW6201004_Application_20210427

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
Applicable Rules: 0 Coastal SW - 1995 E-1 Coastal SW - 2008 0 ph 11 - Post Construction
(select all that appll/) El Non -Coastal SW- IIQW/ORW Waters 0 Universal Stormwater Management plan
EJ Other WQ Mgrnt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may he photocopier) for use as an ffighlal,
I. GENERAL INFORMATION
1.. Project Name (subdivision, facility, or establishment name:. - Should be consistent with project name can plans,
specifications, letters, operation and maintenance agreements, etc.):
2. Location of Project (street address):
Rockfish Road
City:Raeford - ----------- ---l' COUnty:110ke .... . .. . ... ... ............ ....... . .... . .... ...... — --- ------ Zip:28376
3. Directions to project (from nearest major intersection):
The project is located 2,492 ft. from the intersection of Rockfish Road and Posey Farrn Road goingwest
towards Markus Place Drive,
4. LatitUde:34' 59' 30.30" N Longitude:79' 07'56.28" W of the main entrance to the project.
11. PERMIT' INFORMATION:
1. a. Specify whether project is (check one): ®New FlMod ification n Renewal w/ Modificationt
I Wwwals with modifit atimis also requires SWU-102 - Reaewal Application I -term
b. If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number I its issue date (if known) , and the status of
construction: ❑Not Started [:]Partially Completed* n Completed* 'provide a designer's certification
2. Specify the type of project (check one):
nLow Density ®High Density nDrains to an OffisiteStorniNvater System ElOther
3, If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, .. . ... ...... and the previous name of the project, if different than Currently
proposed, - — ---------
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Centel- at] -877-623-6748):
nCAMA Major N(-)c.diiiieiitatic)ii/l,.i-osioji Control: 23.43 ac of Disturbed Area
nNI'DF"S Industrial Storinwater n404/401 Permit: proposed Impacts —
b, If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each perrnit:
5. Is the project located within 5 miles of a public airport? ZNo H Yes
J.1"yes, sce S.L. 2012-200, Part VI: htth://poi-tal.iic(ietir.org/w(,b/lA,(i/WS/SLI/stLitesw/rLIles laws
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Ill. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the
project): Applicant/ Organization: f lendrix Brothers of I Poke LLC
Signing Official & Title: -D. Ralph I luff, 111, Mernber/Manager
b. Contact information for person listed in item I a above:
Street Address:2919 Breezewood Avenue, Suite'100
City:Fayetteville State:
Mailing Address (if applicable):
City:
State:
Phone: [phone] Fax: a] 0) 213-3012
U'linailDRI luff@)l luff'FarnilvOffice.corn
Zip:28303
Zip:
c. Please check the appropriate box. The applicant listed above is:
The property owner (Skip to Contact Information, item 3a)
❑ l,essee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
F-1 Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if YOU are the lessee, purchaser or developer. (']'his is the
person who owns the property that the project is located on):
Property Owner/Organization:
Signing Official &Title:
b.Contact information for person listed in item 2a above:
Street Address:
City: State: Zip:
Mailing Address (ift7J)J)1icnb1c):
City: State: zip:
Phone: Fax:
3. a. (Optional) Print the name and title of another contact such as the project's construction SUPCI-ViSOr or other
person who can answer questions about the project:
Other Contact Person/Organization:-
Signing Official &'Fitle:
b.Contact information for person listed in item 3a above:
Mailing Address:
City:
State:
Phone: ( 1 Fax:
H.rnail:
Zip:
4. Local jurisdiction for building permit,;: I ioke County Planning/Zoning
Point of Contact: Robert Farrell Phone #: [phone]
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IV. PROJECT INFORMATION
-1. In the space provided below, briefly summarize how the storrnwater runoff will be treated.
Storrnwater runoff from the developed areas of the site will be captured and treated in a stormwater wet
detention pond. Wet pond is overcompensating the off -site drainage area to balance out the impervious area
not directly draining to the wet pond (overdesigned)by Lots 38-42 & Lots 72-73.
2. a. If claiming vested rights, identify the Supporting documents provided and the data they were approved:
F-1 Approval of a Site Specific Development Plan or PUT:) Approval Date:
F-1 Vatic] Building Permit Issued Date:
F-1 Other: Date:
b. If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
F-1 Coastal SW - 1995 F-1 Ph 11 -Post Construction
3. Stormwater runoff from this project drains to the
I' fiver basin.
4. Total Property Area: 40.8308 —acres 5. 'total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0.657 acres
7. Total Property Area (4) -Total Coastal Wetlands Area (5) -Total Surface Water Area (6) =Total Project
Area,: 40.1738 acres
. .. . ..... . - ----- -----
Total project area shall be calculated to exclude flit, lollo'coin : the iioniial jcool ofiiiipomided strut tares, the area
beftivell the blinks of streams and rivers, the area below the Lriiial High Water (NHW) line or Mcan High Water
(Ml-lW) line, and coastal wetlands IfflId-ClUrdfroiii flit, NHW (or M14W) line. '171c resultant project area is used to
calculate
overall percent built uponarea (BUA). Noii-coastal w0laWIS Ifflid-ccard of the N1 1W (or MHW) line iiiay
be included in the f0t(7l I)I'OjCCt area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 27.29 %
9. 1 low many drainage areas does the project have?'] (For high density, count 1.1or each proposal ciigbicercd
storinwatcr BMP. For loco density and other projects, use Ifior the whole property area)
'10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drainage Areal
Drainage Area 2
Drainage Area
Drainage Area
Rec-eiving Stream Name
Beaver Creek
Stream Class
C
Stream Index Number
18-31-19-5
'total Drainage Area (sf)
1,039,600
On -site Drainage Area (sf)
749,038
Off -site Drainage Area (so
290,562
Proposed Impervious Area** (sf)
723,758
% Impeu rvios Area" (total)
69.62
Impervious** Surface Area
Drainage Area I
DrainageArea 2
DrainageArea —
Drain geArea _
On -site Buildings/Lots (so
330,000
On -site Streets (so
84,842
On -site Parking (sf)
On -site Sidewalks (sl)
15,114
Other on -site (so
3,240
future (so
Off -site (so
290,562
11'xisting BUA*** (so
Total (so:
723,758
Stream Class and Index Number can be tictcriiiincd at: zoeh/ii�( / s
,V— 0)s c it/classificatiolls
I ly 11"crui ous area i . stletined as the built upon area including, but not limited to, buildings, rots, parking areas,
sit ezoalks, gravel areas, etc.
Form SWI1-101 Version 06ALI,,2012 Page 3 of'6

""Report only that aniount of existing BLIA that will remain after developnieW. Do not report any existing BLIA that
is to be removed and which -eoill be replaced by new BUA.
14. 1-low was the off -site impervious area listed above determined? Provide documentation. 100% Build -Out
Potential for residential areas and open space along Marcus Place Drive and Rockfish Road and apartments
along Rockfish Road. A I Joke County GIS map showing the the lot designation is included in the calculations.
Projects in U1Ii0 ii Comity: Conloct DWQ Central Q/ .1ice staff lo check if the project is located ii,ithin a Threatened ci
EwhingeredSpecies ii,alershed that niqy he sidyecl to nioresiringent slorniii)aler requirements os per 15A N(,,A( ' 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit Supplement and operation and maintenance (0&-M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from littp://L)ortal.iic(feiii-.oi,g/web/wc LwsZsujbmp-manual.
V1. 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. A detailed application instruction sheet and 13MP
checklists are available from httpjportal.ncdenr�.(, q s /statg, w/ )rms does. 'The complete
Lw su_f(
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST' be signed and initialed in blue ink. Download the latest versions
for each submitted application package from htt - . _gg/
p) L".porull.-n web/ J�
/ws jjsL4 _Ay ni / fors docs.
_t�Ls _
........... _
1. Original and one copy of the Storrnwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenant
Form. (if required as per Part V11 belo'co)
3. Original of the applicable Supplement Form(s) (scaled, signed and dated) and O&M
agreernent(s) for each 13MP.
4. Permit application processing fee of $505 pal/able to NCDFNR. (For an Express review, refe
h ttp: www.e.nvhelp.org/paw/onestopexprc.ss.html for information on the Express prc
and the associated fees. Contact the appropriate regional office Flxpress Permit Coordinat,
additional information and to schedule the 1-CCILlired application meeting.)
5. A detailed narrative (one to two pages) describing the storniwater treatment/ ilia nage men
6. A USES map identifying the site location. If the receiving stream is reported as class SA o
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the
mile radius on the map.
7. Scaled, signed and dated calculations (one copy).
S. 1 wo sets of plans folded to 6.5X 14 (sealed, signed, (,.,- clatc.ci), including:
a. Development/Project name.
b. E , ngineer and firm.
C. Location ruap with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the norrnal pool elevation of
impounded structures, the banks of strearns and rivers/ the MI IW or Nf IW line of tidal
waters, and any coastal wetlands landward of the MI 1W or NI IW lilies.
• Delineate the vegetated buffer landward frorn the normal pool elevation of il"11POUnded
structures, the banks of streams or rivers, and the MI iW (or NI iW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and storinwater control measures.
rn. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. FIxisting drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
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o. I)rainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated Sl IWTeleyations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xVI " copy of the MRCS County Soils map with the
project area clearly delineated. For projects with infiltration 13MPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to oerify the SHWI'prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 1126 Page No: 241
11. For corporations and limited liability corporations (LLC): Provide documentation frorn the NC.
Secretary of State or other official documentation, which Supports the titles and positions held
by the persons listed in Contact Information, iternla, 2a, and/or 3a per 15A N(.'.A(' 211.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
littp://www.seci-etary.state.ii(:.us/(.'01'12ol.atiolls/``CSea,i-cli.aspx
V11. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenant,., are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be
provided as an attachment to the completed and notarized deed restriction form. The appropriate deed
restrictions and protective covenants forms can be downloaded from
does. Download the latest versions for each
submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
tinder them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on Your behalf for this project (Such as
addressing requests for additional information).
Consulting FIngi neer: Matt Lowder, PE'
Consulting Firm: Triangle Site Design, PLLC
Mailing Address:4004 Barrett Drive, Suite 101
C.ity:Raleigh State:NC /ip:27609
Phone: (919 ) 553-6570
Eiiiail:mlowder((i,)triaiigiesitedesi�n.(:oiii
Fax: (
IX. PROPERTY OWNER AUTHORIZATION (ifContact 1111fi)1-P1(7ti011, item 2 has hues filled out, complete this
section)
1, (]mint or type name of person listed in Contact hifimnalion, item 2a) certify that I
own the property identified in this permit application, and thus give permission to (]mint or type 11(olle ofperson
listed in Contact Information, item la) with (print or tripe name of org(711iZ(7l-i011 listed in
Contact 11001,111ation, item 117) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the Submittal, which indicates the
party responsible for the operation and maintenance of the storillwater system.
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1

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (eritity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults Oil their
lease agreement, or pending sale, responsibility for compliance with the DWQ Storrnwater peril -lit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility Without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
perrnit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS'143-215.6.
Signature: Date:
a Notary public for the State of, County of
do hereby certify that . . .... . ...... , personally appeared
before me this — day of - , I 1 11 111, and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, ,............ . . . . .. . ..... ......... .......
SF" A 1,
My commission expires
X. APPLICANT'S CERTIFICATION
1, (prbit or tifpe iiai)ic oj'person listed in C"011hh't hlforiiiatioii, item ]a) Ralph Hut
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 iii this
with the approved plans, that the required deed restrictions
anal protective ts fl] be recorded, and that the proposed [)roj(-,,(-.t complies with the requirements of the
applicable s�ern,�w eirl 211 .1000 and any other applicable state storinwater reClUirerrictits.
Signature:
Date:
a Notary Public for the State of N C , , _ , (.,',OL]Ilty Of
LA �0,(-,d do hereby certify that i�a�f'h , AA personally appeared
before rile this c)l day ofc )0 and ac the due execution of the application for
a stormwater permit. Witness my hand and official seal, .. ... . . .... ...
XAOTARy
MY
COMMISSION EXPIRES
0 714MO23
,;t-
PUBUG
D
Sl �.A L
My commission expires —7/4�e3
I -
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