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HomeMy WebLinkAboutSW5210701_Application Form_20210707DEMLR USE ONLY Date Received Fee Paid Permit Number Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction (select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan ❑ Other WQ Mgmt Plan: State of North Carolina Department of Environment and Natural Resources Division of Energy, Mineral and Land Resources STORMWATER MANAGEMENT PERMIT APPLICATION FORM This form may be photocopied for use as an original I. GENERAL INFORMATION 1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans, specifications, letters, operation and maintenance agreements, etc.): Beaver Creek Subdivision, Phase 2 & 3 2. Location of Project (street address): Claude Lewis Road City:Middlesex County:Nash Zip:27557 3. Directions to project (from nearest major intersection): Located at the intersection of Beaver Dam Road (NCSR 1111) and Claude Lewis Roas (NCSR 1101) 4. Latitude:350 46' 18.5592" N Longitude:-780 10' 56.1216" W of the main entrance to the project. II. PERMIT INFORMATION: 1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt tRenewals with modifications also requires SWU-102 - Renewal Application Form b.If this application is being submitted as the result of a modification to an existing permit, list the existing permit number , its issue date (if known) , and the status of construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification 2. Specify the type of project (check one): ®Low Density ❑High Density ❑Drains to an Offsite Stormwater System ❑Other 3. If this application is being submitted as the result of a previously returned application or a letter from DEMLR 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 Center at 1-877-623-6748): ❑CAMA Major ®Sedimentation/Erosion Control:11.0 ac of Disturbed Area ❑NPDES Industrial Stormwater 0404/401 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 permit: Is the project located within 5 miles of a public airport? ®No ❑Yes If yes, see S.L. 2012-200, Part VI: httl2://12ortal.ncdenr.org/web/lr/rules-and-regulations Form SWU-101 Version Oct. 31, 2013 Page 1 of 6 III. 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:Little Bear Creek Properties, LLC Signing Official & Title:David Geiger - Owner b. Contact information for person listed in item 1a above: Street Address:755 Ranch Road City:Cla State:NC Zip:27520 Mailing Address (if applicable):755 Ranch Road City:Clayton State:NC Zip:27520 Phone: (919 ) 612-5531 Fax: ( ) none Email:littlebear-creek.com Please check the appropriate box. The applicant listed above is: ® The property owner (Skip to Contact Information, item 3a) ❑ Lessee* (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) ❑ 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. (This is the person who owns the property that the project is located on): Property Owner/Organization: Signing Official & b. Contact information for person listed in item 2a above: Street Address: City: State: Zip: Mailing Address (if applicable): City: State: Zip: Phone: ( 1 Fax: ( 1 Email: 3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other person who can answer questions about the project: Other Contact Person/Organization:. Signing Official & Title: b. Contact information for person listed in item 3a above: Mailing Address: City: State: Zip: Phone: ( ) Fax: ( ) Email: 4. Local jurisdiction for building permits: Town of Middlesex Point of Contact:Luther Lewis -mayor Phone #: (252 ) 235-5761 Form SWU-101 Version Oct. 31, 2013 Page 2 of 6 IV. PROJECT INFORMATION 1. In the space provided below, briefly summarize how the stormwater runoff will be treated. not applicable 2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved: ❑ Approval of a Site Specific Development Plan or PUD Approval Date: ❑ Valid Building Permit Issued Date: ❑ Other: Date: b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with: ❑ Coastal SW -1995 ❑ Ph 11- Post Construction 3. Stormwater runoff from this project drains to the Neuse River basin. 4. Total Property Area: 36.324 acres 5. Total Coastal Wetlands Area: 0 acres 6. Total Surface Water Area: 0 acres 7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project Area+:36.324 acres + Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area between the banks of streams and rivers, the area below the Normal High Water (NHW) line or Mean High Water (MHVv) line, and coastal wetlands landward from the NHW (or MHM line. The resultant project area is used to calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHV0 line may be included in the total project area. 8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 23.90 9. How many drainage areas does the project have?1 (For high density, count 1 for each proposed engineered stormwater BMP. For low density and other projects, use 1 for 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 Area 1 Drainage Area _ Drainage Area _ Drainage Area _ Receiving Stream Name Beaverdam Creek Stream Class QNSW Stream Index Number * 24-86-3-8 Total Drainage Area (sf) 1,584,565 On -site Drainage Area (sf) 1,582,273 Off -site Drainage Area (sf) 2,292 Proposed Im ervious Area** (sf) 378,168 Impervious Area** (total) 23.90 Impervious- Surface Area Drainage Area 1 Drainage Area _ Drainage Area _ Drainage Area _ On -site Buildings/Lots (so 259,363 sf On -site Streets (sf) 67,362 sf On -site Parking (so 2,267 sf On -site Sidewalks (so 378 sf Other on -site (so 0 Future (so 46,506 sf Off -site (sf) 2,292 sf Existing BUA*** (so 0 Total (sf): 378,168 sf Stream Class and Index Number can be determined at: http.aortal.ncdenr.or web/wg&s/csu/classifications Im ervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas, sidewalks, gravel areas, etc. Form SWU-101 Version Oct. 31, 2013 Page 3 of 6 'Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that is to be removed and which will be replaced by new B UA. 11. How was the off -site impervious area listed above determined? Provide documentation. see attached Proiects in Union Countv: Contact DEMLR Central Office staff to check if the project is located within a Threatened & Endangered Species watershed that may be subject to more stringent stormwater requirements as per I5A NCAC 02B . 0600. V. SUPPLEMENT AND O&M FORMS The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded from http:/ /portal.ncdenr.org/web/wq/ws/su/bmp-manual. VI. SUBMITTAL REQUIREMENTS Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application instruction sheet and BMP checklists are available from http:/ /portal.ncdenr.org/web/wq/ws/su/statesw/forms_docs. The complete application package should be submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the interactive online map at htt2://j2ortal.ncdenr.org/web/wq/ws/su/maps.) 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 httj2://j2ortal.ncdenr.org/web/w!j/ws/su/statesw/forms docs. Initials 1. Original and one copy of the Stormwater Management Permit Application Form. 2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants Form. (if required as per Part VII below) 3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M agreement(s) for each BMP. 4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to http:/ /www.envhelp.org/pages/onestopexpress.html for information on the Express program and the associated fees. Contact the appropriate regional office Express Permit Coordinator for additional information and to schedule the required application meeting.) 5. A detailed narrative (one to two pages) describing the stormwater treatment/management for 6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the 1/2 mile radius on the map. 7. Sealed, signed and dated calculations (one copy). 8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including: a. Development/ Project name. b. Engineer and firm. The signed paper document was c. Location map with named streets and NCSR numbers. mailed to NCDEQ. Refer to the d. Legend. paper signed document, which you e. North arrow. received via mail. f. Scale. g. Revision number and dates. h. Identify all surface waters on the plans by delineating the normal pool elevation of impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal waters, and any coastal wetlands landward of the MHW or NHW lines. • Delineate the vegetated buffer landward from the normal pool elevation of impounded structures, the banks of streams or rivers, and the MHW (or NHW) 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 stormwater control measures. m. 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. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations. o. Drainage areas delineated (included in the main set of plans, not as a separate document). Form SWU-101 Version Oct. 31, 2013 Page 4 of 6 p. Vegetated buffers (where required). 9. Copy of any applicable soils report with the associated SHWT elevations (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"x11" copy of the NRCS County Soils map with the project area clearly delineated. For projects with infiltration BMPs, 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 DEMLR to verify the SHWT prior to submittal, (910) 796-7378.) 10. A copy of the most current property deed. Deed book: 3038 Page No: 548 11. For corporations and limited liability corporations (LLC): Provide documentation from the NC Secretary of State or other official documentation, which supports the titles and positions held by the persons listed in Contact Information, item 1a, 2a, and/or 3a per 15A NCAC 2H.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. http:/ /www.secretary.state.nc.us/Corporations/CSearch.aspx VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective covenants 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 http://portal.ncdenr.org/web/lr/state- stormwater-forms docs. 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 under them, that they will run with the land, that the required covenants cannot be changed or deleted without concurrence from the NC DEMLR, 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 Engineer:Stephen 1. Ballentine Consulting Firm: Rivers & Associates, Inc. Mailing Address:353 E. Six Forks Road City:Raleigh State:NC Zip:27609 Phone: (919 ) 594-1626 Fax: ( ) N/A Email:sballentine@riversandassociates.com IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this section) I, (print or type name of person listed in Contact Information, item 2a) r , certify that I own the property identified in this permit application, and thus give permission to (print or type name of person listed in Contact Information, item 1a) with (print or type name of organization listed in Contact Information, item 1a) 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 stormwater system. Form SWU-101 Version Oct. 31, 2013 Page 5 of 6 As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back to me, the property owner. As the property owner, it is my responsibility to notify DEMLR 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 permit 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: I, a Notary Public for the State of do hereby certify that before me this _ day of County of personally appeared , and acknowledge the due execution of the application for a stormwater permit. Witness my hand and official seal, SEAL My commission expires The signed paper document was mailed to NCDEQ. Refer to the paper signed document, which you X. APPLICANT'S CERTIFICATION received via mail. I, (print or type name of person listed in Contact Information, item 1a) David Geiger 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 the applicable stormwater rules under 15A NCAC 21-1.1000 and any other applicable state stormwater requirements. Signature: Date: I, , a Notary Public for the State of County of do hereby certify that before me this _ day of personally appeared , and acknowledge the due execution of the application for a stormwater permit. Witness my hand and official seal, SEAL My commission expires Form SWU-101 Version Oct. 31, 2013 Page 6 of 6 Low Density Residential Subdivisions Deed Restrictions & Protective Covenances In accordance with Title 15 NCAC 21-1.1000 and S.L. 2006-246, the Stormwater Management Regulations, deed restrictions and protective covenants are required for Low Density Residential Subdivisions where lots will be subdivided and sold. Deed restrictions and protective covenants are necessary to ensure that the development maintains a "built -upon" area consistent with the applicable regulation governing the density level. I, David Geiger acknowledge and affirm by my signature below, that I will cause the following deed restrictions and protective covenants to be recorded for Beaver Creek Subdivision Phase 2 & 3 prior to the sale of any lot: 1. The following covenants are intended to ensure ongoing compliance with State Stormwater Management Permit Number , as issued by the Division of Energy, Mineral and Land Resources under the Stormwater Management Regulations. 2. The State of North Carolina is made a beneficiary of these covenants to the extent necessary to maintain compliance with the stormwater management permit. 3. These covenants are to run with the land and be binding on all persons and parties claiming under them. 4. The covenants pertaining to stormwater may not be altered or rescinded without the express written consent of the State of North Carolina, Division of Energy, Mineral and Land Resources. 5. Alteration of the drainage as shown on the approved plan may not take place without the concurrence of the Division of Energy, Mineral and Land Resources. 6. The maximum allowable built -upon area per lot is 8,000 square feet. 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, and coquina, but does not include raised, open wood decking, or the water surface of swimming pools. 7. In the case of a lot within CAMA's regulated AEC, where the Division of Coastal Management calculates a different maximum allowable built -upon area for that lot than is shown herein, the governing maximum built -upon area for that lot shall be the most restrictive of the two. 8. Filling in or piping of any vegetative conveyances (ditches, swales, etc.) associated with the development except for average driveway crossings is strictly prohibited by any persons. 9. Each lot will maintain a 30* foot wide vegetated buffer between all impervious areas and surface waters. 10. All roof drains shall terminate at least 30* foot from the mean high water mark of surface waters. The signed paper document was mailed to NCDEQ. Refer *50 foot for projects located in the 20 coastal counties, to the paper signed document, which you received via mail. Signature: Date: State of , County of do hereby certify that before me this the day of a Notary Public in the rsonally appeared 20 , and acknowledge the due execution of the foregoing instrument. Witness my hand and official seal, SEAL Signature My Commission expires Form DRPC-5 Rev.2 05Nov2009 Page 1 of 1 Lot Number Allowable Built -Upon Area 24 8,000 sf 25 8,000 sf 26 8,000 sf 27 8,000 sf 28 8,000 sf 29 8,000 sf 30 8,000 sf 31 8,000 sf 32 8,000 sf 33 8,000 sf 34 8,000 sf 35 8,000 sf 36 8,000 sf 37 8,000 sf 38 8,000 sf 39 8,000 sf 40 8,000 sf 41 8,000 sf 42 8,000 sf 43 8,000 sf 44 8,000 sf 45 8,000 sf 46 8,000 sf 47 8,000 sf 48 8,000 sf 49 8,000 sf 50 8,000 sf 51 8,000 sf 52 8,000 sf 53 8,000 sf 54 8,000 sf 55 8,000 sf Mail Kiosk Lot 8,000 sf i� ivers & ASSOCIATES, INC. SInw 1918 ENGINEERS, PLANNERS, SURVEYORS & LANDSCAPE ARCHITECTS NARRATIVE BEAVER CREEK SUBDIVISION PHASE 2 AND 3 NASH COUNTY, NORTH CAROLINA 107 East 2-1 Street 6/17/2021 oz 14, e � ■ � 5FJ1l. ■ 26493 iuu ` F-0334 Greenville NC 27858 Cell:252-714-3002 Office:252-752-4135 sjanowski@riversandassocia tes.com 1 i Y�rs ATES. INC, SIRm 191E ENGINEERS,PLANNERS, SURVEYORS& LANDSCAPE ARCHITECTS Narrative: This is a prosed 32-lot single-family residential subdivision with 40,000 sf minimum lot sizes, and includes a mail kiosk, parking lot, and NCDOT roads. The roads will have vegetated ditches. The roads will not have curb and gutter. Storm pipe conveyances are limited to culvert road and driveway crossings. This project is located in the Town of Middlesex zoning jurisdiction and is in Nash County. Deed restrictions and protective covenants are attached, which will limit the impervious allocation for each lot, so that the project is less than 24% impervious and qualifies for Low Density. tormwater Management Reutdrements: This project is located in the Neuse River Basin and is applying to NCDEQ for a Low Density Stormwater Permit, which requires that the project not exceed a 24% impervious limit. Any proposed storm pipe conveyances are to be limited to culverts under roads and driveways. NCDEQ has confirmed that there are no nitrogen nor phosphorus limits for this project, which is located within the Town of Middlesex jurisdiction. Since this is a Low Density project, there are no requirements for this project to construct a stormwater SCM. There are no known stormwater detention requirements for this project. There is a jurisdictional stream and Neuse Riparian Stream Buffer running along the west perimeter of Phase 3. Wetlands were mapped by Dan Bliley, and are located along the west portion of Phase 3. This project drains to Beaverdam Creek, which is classified as QNSW waters. The completed project will consist of one 36.324 acre project. IMPERVIOUS AREA CALCULATIONS Roadway Allocation per lot Mail Kiosk Lot Impervious Contingency Total Impervious area % Impervious Area 107 East 2iic7 Street 69,354 sf 8,000 sf x 32 lots = 256,000 sf 8,000 sf 44,814 sf 378,168 sf = 8.6815 ac 23.90% F-0334 Greenville NC 27858 Cell:252-714-3002 Office:252-752-4135 sjanowski@riversandassociates.com t 0 lVe-S 8 ASSOCIATES, INC Since 1919 ENGINEERS,PLANNERS, SURVEYORS S LANDSCAPEARCHrrECTS APPENDIX 107 East 2nd Street F-0334 Greenville NC 27858 Cell:252-714-3002 Office:252-752-4135 sjanowski@riversandassociates.com North Carolina Secretary of State Search Results • 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 Little Bear Creek Properties , LLC Information Sosld: 1745953 Status: Current -Active O Date Formed: 8/31 /2018 Citizenship: Domestic Annual Report Due Date: April 15th CurrentAnnuaL Report Status: Registered Agent: Kristoff, Lawrence E, II Addresses Reg Office 444 East Main Street Clayton, NC 27520 Reg Mailing 444 East Main Street Clayton, NC 27520 Company Officials Mailing 755 Ranch Road Clayton, NC 27520 All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20. Member/Manager Member/Manager David Geiger Karen Geiger 755 Ranch Road 755 Ranch Road Clayton NC 27520 Clayton NC 27520 Principal Office 755 Ranch Road Clayton, NC 27520 https://www.sosnc.gov/online_services/search/Business_Registration_ResuIts 1 /1