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Home My WebLink AboutWI0100469_DEEMED FILES_20170110I I Per,:nit Number Program Category Deemed Ground Water Permit Type WI0100469 Injection Deemed Stormwater Drainage Well Primary Reviewer shristi.shrestha Coastal SWRule Permitted Flow Facility Facility Name Schlichenmaier Residence Location Address 554 Covenant Ln Montreat Owner Owner Name NC 28757 Matthew Schlichenmaier Dates/Events Orig Issue 1/10/2017 App Received 1/5/2017 Reg ulated Activities State Stormwater -Infiltration System Outfall Waterbody Name Draft Initiated Scheduled ls~uance Public Notice Central Files: APS SWP 1/10/2017 Permit Tracking Slip Status Active Project Type New Project Version 1.00 Permit Classification Individual Permit Contact Affiliation Major/Minor Minor Facility Contact Affiliation Owner Type Individual Owner Affiliation Matthew Schlichenmaier 3951 Isle Vista Ave Orlando Region Asheville County Buncombe FL Issue 1/10/2017 Effective 1/10/2017 32812 Expiration Requested /Received Events Streamlndex Number Current Class Subbasin Water Resources ENVIRONMENTAL QUALITY January 10, 2017 Matthew & Kristy Schlichenmaier 3951 Isle Vista Avenue Belle Isle, FL 32812-2219 Subject: Notification for storm water drainage wells Permit No. W10100469 Buncombe County Dear Mr, & Mrs. Schlichenmaier: PAT MCCRORY Governor DONALD R. VAN DER VAART Secretary S. JAY ZIMMERMAN Drrecior Thank you for submitting the Notice of Intent to Construct or Operate Storm water drainage Wells (NOI) for Schlichenmaier Residence located at 554 Covenant Ln., Montreat NC 28757. The permit number assigned for the injection activity at the site is W10100469, Please include this number in all future correspondence_ If you have any questions, please contact me by phone at (919) 807-6406 or by email at shristi.shresthakiincdermllov. Thank you for your cooperation. Regards, ClOnatel Shristi Shrestha Hydrogeologist Division of Water Resources Water Quality Regional Operations Section Enclosures cc: Asheville- Regional Office — WQROS w/o enclosures Central Files - Permit No. WIOi 00469 w/o enclosures Slatc of North Carolina I Environmental Quality 1 Wa*Cr Rcawuccs 1611 Mail aarvico Center j Raleigh, North Carolina 276.99-1611 919 707 9000 NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES NOTIFICATION FOR STORMWATER DRAINAGE WELLS Stormwater drainage wells are Class 5 injection wells 'permitted by rule" and do not require an individual injection well permit when constructed in accordance with the rules of ' As described In _ this applies to rooftop runoff infiltration systems and certain other stormwater infiltration systems implemented as Best Management Practices designed in accordance with State stormwater regulations or an approved local government stormwater program. Additional guidance is available online at This notification form shall be submitted within 30 days of a change of status as described in Part D below, Print Clearly or Type Information. Illegible Submittals Will Re Returned As Incomplete: DATE: l� I" , 20 « PERMIT NO. 2'.f'-: L- t C' 4 + `r"' h 7 (to be completed by D WR) A. STATUS OF WELL OWNER (choose one (1) Single Family Residence (2) Business/Organization (3) Government: State Municipal County Federal B. WELL OWNER — For single family residences list the property owner(s)_ Fat all others, list name of the business, organization, or government agency and person delegated signature authority' h�a � Kris` cc -irk ictAerk lc j er Mailing Address: 3 i 51 15E V 5T11 A UE. City: sLE Ph#: EMAIL: C. WELL FACILITY Name of Facility: 5 c ' 6-6 11 « o &t �' wiLi Physical Address: 5 Slvi C.044 r r Ln (3) State: Zip Code:3.9 ' erne r l City: tun State: NC Zip Code: '111 S7 Facility Location Identified By (check one): Attached facility site map with property boundaries, or [ 1 Geographic Coordinates: Latitude: Longitude: Reference Datum: Position Accuracy: Method of Data Collection: D. WELL — Indicate the status of the well or well system (choose one): Proposed Active Inactive Temporarily Abandoned Permanently Abandoned UIC Stormwater Injection Notification Form (Revised 8/8/2013) Page I E. SIGNATURES — The following section is to be completed as required below or by that person's authorized agent. l 5A NCAC O2C .021 It e i requires signatures as follows: (a) for a corporation: by a responsible corporate officer; (b) for a partnership or sole proprietorship: by a general partner or the proprietor, respectively; (c) for a municipality or a state, federal, or other public agency: by either a principal executive officer or ranking publicly elected official; (d) for all others: by the well owner; (e) for any other person authorized to act on behalf of the applicant: documentation shall be submitted with the notification that clearly identifies the person, grants them signature authority, and is signed and dated by the applicant. "I hereby cert0i, under penalty of law, that I have personally examined and am familiar with the information submitted in this document and all attachments thereto and that, based on my inquiry of those individuals immediately responsible for obtaining said information. I believe that the information is true. accurate and complete, I am aware that there are significant penalties, including the possibility of fines and imprisonment, for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the injection well and all related appurtenances in accordance with the 5.4 Nrc •itr+2i_' i72 Rules. '• Signature of Property rlApplicant 5ch tick ki r Print nTypFull Name Signature f ; Print at ype 1 II Name k ri st1 5cAlic ,044 ter IVYCOMMISSiONkFF'f4Ti10 EXPt E3, SeiPem[xr Pe, 2018 M1,.'1• Lt 6UM:d T ru Ir lary aiAlir �Jmhrrnr.,ers Submi ne copy of the completed notification packageto: DWR — Aquifer Protection Section 1636 Mail Service Center Raleigh, NC 27699-1636 Telephone: 919-807-6464 Fax: 919-807-6496 UIC Slormwater Injection Notification Form (Revised 8/8/2013) Page 2 PERMANENT SEEDING SCFIEDLJE (GRASSED AREAS UP TO IT SLOPE; 5.rfanmM es.aAe we(SSaa. TO a.:.. sr.. I..d ..F1.-31 A Rdµ 7) 2A7Ss %.», •IWO S ARA7555t Ilfd, 1 -Pry 15 e5 6eporrer Mee ZSOl! Mesh 0 .1Sy 1p 6s1 AAR, fan a.d I.Ozv ®wq6 rAwe<, u.W AaOC.A.a. Vp.iu ytrtd.m.emne.re 120 P.. w-10-m . w1ee PP* SPX. .1:00 Ala• we. rt.. Q.Py y.LaeeAd anew Minrm151. Ab,Mm macs Er AA, Aft/RAPS raring tr•I.Ii C.bADIRE lAW..F.G -I hnrargm. neRE of C.B...uw regk:p E Am/AFAI . Isaw ue rwC Ir. 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