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HomeMy WebLinkAboutSWA000106_Application_20210621DEMLR USE ONLY Date Received Fee Paid Permit Number oh 21 Soil I A 505 * t %E—�)o5 SW A. c>�I E)6 SW Progra (s): : ❑ Coastal SA-HQW ❑ Coastal SA-ORW ❑ Coastal FW-ORW ❑ Coastal Other ❑ Non -coastal HQW ❑ Non -coastal ORW ❑ Urbanizing Areas ❑ USMP NC DEQ Division of Energy, Mineral and Land Resources STATE STORMWATER FAST TRACK PROCESS: "AUTHORIZATION TO CONSTRUCT" (ATC) PERMIT APPLICATIO MA IV Link to Application Instructions JUN 212021 DENR-LANE) QUALITY A. ELIGIBILITY FOR FAST -TRACK PERMITTING STORMWATER PERMITTING To be considered for a Fast Track ATC Permit, all of the items below must be checked. If any item cannot be checked, then the project must apply under the Standard Permitting Process. x❑ The project and all SCMs (including existing SCMs associated with the project) will meet all applicable requirements of 15A NCAC 02H .1000 - .1062, including the Minimum Design Criteria (MDC), upon project completion. ® The project is not proposing an alternative design. ® The project is not claiming an exemption from the MDC based on vested rights, a waiver or a Director's Certification. ® The project is not out of compliance with an existing stormwater permit or any other environmental permit. ® The project is not applying for an offsite permit, an exemption, or a minor modification (as defined in 15A NCAC 02H .1002(25)) to an existing state stormwater permit. ® The project application bears the signature and seal of a professional licensed pursuant to either Chapter 89A or 89C of the NC General Statutes. ® 1 understand that at project completion, an application with the as -built stormwater plans (as described in 15A NCAC 02H .1044 must be submitted, and DEQ will review the as -built stormwater plans to confirm compliance with the MDC. Approval of the as -built stormwater plans will be required before the Erosion and Sedimentation Control Plan for the project may be closed out. ® I understand that the Fast Track ATC Permit will expire five years after the date of issuance. B. GENERAL INFORMATION 1 Project Name: Pinewood Subdivision 2. Previous Project Name (if applicable): N/A 3. Location of Project (street address): Temporary Construction Address: 230 Pinewood Ln City:Concord County:Cabarrus Zip:28027 4. Directions to project (from nearest major intersection): Head West on NC-24/NC-27 W Toward US-601 S Left onto Old Camden Rd, Right onto Robinwood Dr, Right onto Woddbine Dr Left onto Robinwood Dr Right onto Pinewood Ln 5. Latitude:350 13' 54.17" N Longitude:801 34' 32.04" W of the main entrance to the project. C. PERMIT INFORMATION 1. Specify whether project is (check one): ® New, no previous application ❑ New, replacing a previous Fast Track ATC Permit -- provide previous permit number: SWA By choosing this option, you are also requesting that DEQ rescind the previous Fast Track ATC Permit upon issuance of the new Fast Track ATC Permit. Stormwater Fast Track ATC Application Form Page 1 of 9 Feb. 10.2018 ❑ Major Modification, replacing an existing stormwater permit — provide existing permit number: SW Status of construction? ❑ Not Started ❑ Partially Completed ❑ Completed Maio[ modifications must be submitted by the original permittee and are allowed only if the SW permit is not expired. Minor modifications must use Standard Permitting Process. By choosing this option, you are also requesting that DEQ rescind the previous SW Permit upon issuance of the new Fast Track ATC Permit. ❑ Transfer of existing Fast Track ATC Permit — provide existing ATC permit number: SW. Applicable state stormwater program(s) (check all that apply): ❑ Coastal SA-HQW ® Urbanizing Areas (Phase 2) ❑ Coastal SA-ORW ❑ Non -Coastal HQW Is any portion of the project within 575 feet of SA-ORW waters? ❑ Yes ❑ No ❑ Non -Coastal ORW ❑ Coastal Freshwater ORW ❑ USMP ❑ Coastal — Other 3. Other Permits (as applicable; write "NA" for those permit types that are not applicable): 4. Local jurisdiction for building permits: Cabarrus County _ Point of Contact:Todd Culp Phone #: (704 ) 920-2128 D. CONTACT INFORMATION 1. Applicant/Financially Responsible Party (maybe an Organization):Olde South Land Partners, Inc. Signing Official Name & Title:David E. Tibbals, President Street Address:11121 Carmel Commons Blvd City:Charlotte State:NC Zip:28226 Mailing Address (if different):PO Box 470643 City:Charlotte State:NC Zip:28247 Phone: (704) 955-2808 Fax: L ) Email:_david(a)-charlottecommercialpartners.com 2. If the Applicant is a Corporation or LLC (Address must match address on file with NC Dept of the Secretary of State): Name of Registered Agent:David E. Tibbals Mailing Address:PO Box 470643 City:Charlotte State:NC Zip:28247 Phone: (704) 955-2808 Fax: ( ) Email:david @..charlottecommercialpartners.com Stormwater Fast Track ATC Application Form Page 2 of 9 Feb. 10, 2018 The Applicant is the (check all that apply): ❑x Property Owner ❑ Lessee (Attach a copy of the lease agreement & complete Item 4.) ❑ Purchaser (Attach a copy of the pending sales agreement & complete Item 4.) ® Developer (Attach a copy of the development agreement & complete Item 4.) 4. if the Applicant is NOT the Property Owner (skip to Item 5 if the Applicant IS the Property Owner): Property Owner Name/Organization: Signing Official & Title: Street Address:123 Hillside Ave SW City:Concord State:NC Zip:28025 Mailing Address (if applicable): City:_ Phone: Email: State: Zip: Fax: ( ) The licensed Design Professional that will be retained for the duration of the project, who may provide information on the Applicant's behalf, and who will prepare and certify the as -built package: Consulting Engineer/Landscape Architect: Catherine W. Underwood PE Consulting Firm: CESI, Inc. Mailing Address:PO Box 268 City:Concord State:NC Zip:28026-0268 Phone: (980 ) 234-7500 Fax: (704) 786-5404 Email: kateunderwoodaces icgs.com 6. [OPTIONAL] If you would like to designate another person to answer questions about the project: Name & Title: Organization: _ Mailing Address: City:_ Phone: Email: E. PROJECT INFORMATION State: Fax: i 1. Specify the type of project (check one): ® Low Density ❑ High Density 2. Briefly summarize how the Stormwater runoff will be treated/conveyed: Zip: The site includes the development of a shared access easement with a driveway with road -side ditches to convey water. The water is collected in the ditches, crosses the driveway via a culvert, and then continues off -site through an existing Swale. 3. Stormwater runoff from this project drains to the Yadkin Pee -Dee River basin(s). 4. Receiving water information (if more than 3 receivina waters. provide additional information on an attarhArr .QhAAA• Receiving Water 1 Receiving Water 2 Receiving Water 3 Receiving Stream Name Far Branch Stream Classification Cr Stream Index Number 13-17-17-2-1 Stormwater Fast Track ATC Application Form Page 3 of 9 Feb. 10, 2018 Project area and density information: Total Property Area 2,049,846 sf Total Surface Water Area 0 sf Considered to include: the normal pool of impounded structures; • the area between the banks of streams and rivers, and the area below the Normal High Water, (NHKO .line or Mean High Water (MHK9 line. Total Coastal Wetlands Area 0 sf Considered to include: coastal wetlands landward from the NHW (or MHM line. Total Project Area 2,049,846 sf .Excludes the surface water area and coastal wetland area identified above. . May or may not be the same as Property Area: . Built -Upon Area (BUA) associated with Existing Development 0 sf "Existing development" means those projects that are built or those projects that have established a vested right under North Carolina law as of the effective date of the state stormwater program or applicable local government ordinance to which the project is subject. Proposed New BUA 40,554 sf Includes proposed.new BOA that is.not associated with existing development. (18,054 in newshared access drive adn up to "BUA" is defined in N. C. G.S. 143-214.7(b2). It includes, but is not limited to: buildings, roads, parking 22.500 in future areas, sidewalks, and some gravel areas. The design volume of SCMs must take into account the runoff from build out from all surfaces draining to the SCM in accordance with 15A NCAC 02H .1050(1). homesntial Project Density w/ Existing Development. Project Density = (New BUA]/[Total Project Area — Existing BUA] x 100 or 1.98 w/o Existing Development: Project Density = [New BUA]/Total Project Area] x 100 6. Anticipated construction start date July 1, 2021 7. Is the project located within 5 miles of a public airport? ® No ❑ Yes /f `Yes/see S.L. 2012-200, Part VI: http://www.ncleg.net/Sessions/2011/Bills/Senate/PDF/S229v6.pdf and DEQ Stormwater Design Manual Chapter E-4 Airports. 8. For projects in Union County: Contact DEMLR Central Office Stormwater staff at 919-707-9200 to determine if the project is located within a Threatened & Endangered Species watershed that may be subject to more stringent stormwater requirements per 15A NCAC 02B .0600. Stormwater Fast Track ATC Application Form Page 4 of 9 Feb. 10, 2018 F. SUBMITTAL REQUIREMENTS Submit the application package to the appropriate DEMLR Regional Office (Coastal, SA Waters) or DEMLR Central Office (Urbanizing Areas Ph 2, USMP, Non -Coastal HQW/ORW). Only application. packages that include all required items listed below will be accepted and reviewed. Initial each item below to indicate that the required information is provided in the application package: Initials KWU 1. Two original signed hard copies and one electronic copy of this State Stormwater Fast Track Process "Authorization to Construct" (ATC) Permit Application Form. KWU 2. Permit application processing fee of $505 payable to NCDEQ. KWU 3. Two hard copies and one electronic copy of a USGS map identifying the project location and GPS coordinates for the project. If the receiving water is Class SA or the receiving water drains to Class SA waters within'/ mile of the project boundary, include the % mile radius on the map. If the project is within 575 feet of Class SA-ORW waters, include the 575-foot radius on the map. KWU 4. Two original signed hard copies and one electronic copy of a site plan depicting the boundary of the project or project phase currently being permitted, including the locations of SCMs, streams, wetlands, and buffers. KWU 5. Two hard copies and one electronic copy of a construction sequence that discusses how any future development on the project may be phased. KWU 6. A copy of the most current property deed. Deed book: 5627 Page No: 217 KWU 7. [IF APPLICABLE] When the applicant is a corporation or a limited liability corporation (LLC): Provide two hard copies and one electronic copy of documentation from the NC Secretary of State, or other official documentation, which supports the titles and positions held by the persons listed in Section C.2 per 15A NCAC 2H. 1043(3)(b). The corporation or LLC must be listed as an active corporation in good standing with the NC Department of the Secretary of State; otherwise, the application will be returned. https://www.sosnc..qov/search/index/corl) N/A 8. [IF APPLICABLE] When the applicant is a Partnership or other person engaging in business under an assumed name, attach a copy of the Certificate of Assumed Name. N/A 9. [IF APPLICABLE] When the applicant is not the property owner: Provide two hard copies and one electronic copy of lease agreements, affidavits, pending sales agreement, development agreement, or other documents showing that the applicant has obtained legal rights to submit a stormwater permit application within the proposed project area. N/A 10. [IF APPLICABLE] If modifying an existing permit for completed or partially completed projects, a copy of the designer's certification. Stormwater Fast Track ATC Application Form Page 5 of 9 Feb. 10, 2018 G. CERTIFICATION OF APPLICANT/ FINANCIALLY RESPONSIBLE PARTY The Applicant, who is also the Financially Responsible Party, identified in Section D of this form must sign and have notarized the following guaranty: I, (print or type name of Applicant/Financially Responsible Party) David E. Tibbals, , certify that the information included on this permit application form is, to the best of my knowledge, correct and that: 1. the design has been or will be completed in accordance with the MDC as set forth in Rules 15A NCAC 02H .1050 through .1062, to the best of my knowledge; 2. the completed design meets or will meet the MDC and that the percentage BUA that is the basis for the design shall not be exceeded, to the best of my knowledge; and 3. As the applicant, I shall maintain a licensed professional of record for the duration of the project who will prepare and certify the as -built package. If I retain another licensed professional before the project is complete, then I shall provide an updated guaranty with the current licensed professional's seal. A licensed professional shall inform the Division if he is no longer associated with this project. The above information is true and correct to the best of my knowledge and belief and was provided by me under oath I agree to provide corrected information should there be any change in the information provided herein. Signature Title or Authority Date I, -Had t so n W ou) a Notary Public for the State of K)Q('� (�q rn t i t'iot County of W w ry u.S do hereby certify that personally appeared before me this , '1 day of 7� t) rj_Q� Z0 2A and acknowledge the due execution of the application for a stor ter permit. Witness my hand and official seal, ,%SON IWFq���i •l' O A < T R pUBL�G v SEAL My commission expiresCp oa-e ;�UA r - '7,F") 'Zo Stormwater Fast Track ATC Application Form Page 6 of 9 Feb. 10, 2018 H. DESIGN PROFESSIONAL'S CERTIFICATION To be completed by the Design Professional identified in Section D.5. I, Catherine Wolf Underwood attest to the following: 1. This application has been reviewed by me and is accurate and complete, to the best of my knowledge; 2. The design has been completed in accordance with the MDC as set forth in Rules 15A NCAC 02H .1050 through .1062, as applicable; 3. The percentage built -upon area that is the basis for the design will not be exceeded; and 4. 1 have the expertise, education, and experience required to design the SCMs proposed in this application in accordance with the MDC asset forth in Rules 15A NCAC 02H .1050 through .1062. 5. 1 will provide all documents and certified as -built plans in hard copy and electronic format related to this permit to a new Applicant/Property Owner and to DEMLR upon transfer of this permit to a new Applicant/Property Owner. Note: In accordance with N.C.G.S. 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation. In addition, any person who knowingly makes any false statement, representation, or certification in any application may be reported to the appropriate NC professional licg4ng board. Signature: /� Date: 06/17/2021 SEAL Stormwater Fast Track ATC Application Form Page 7 of 9 Feb. 10, 2018 • File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online • Add Entity to My Email Notification List • View Filings Print a Pre -Populated Annual Report form • Print an Amended a Annual Report form Limited Liability Company Legal Name South Oak Partners, LLC Prev Legal Name Olde South Land Partners LLC Information Sosld: 1786026 Status: Current -Active O Date Formed: 12/28/2018 Citizenship: Domestic Annual Report Due Date: April 15th CUrrentAnnual Report Status: Registered Agent: Tibbals, David E. Addresses Principal Office Reg Office Mailing Reg Mailing 8111 Sealey Ct 8111 Sealey Ct P O Box 470643 P O Box 470643 Charlotte, NC 28277 Charlotte, NC 282// Charlotte, NC 28241 Charlotte, NC 28241 Company Officials All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20. Member Member Teddy Hicks , Jr David Tibbals 217 Glenmoor Drive 8111 Sealey Ct Waxhaw NC 28173 Charlotte NC 28277