SW5161101_CURRENT PERMIT_20161110

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPE
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATEJ�Co1�10
YYYYMMDD

Energy. Mineral
and Land Resources
ENVIRONMENTAL OUALITY
November 10, 2016
Mr. Bill Bland -
Cade, Inc. '
120-F Weathers Street
Youngsville, North Carolina 27596
Subject: Stormwater Permit No. SW5161101
Envision, Franklin County
Dear Mr. Bland:
PAT MCCRORY
Go"'ou,
DONALD R. VAN DER VAART
see, ern, n
TRACY DAVIS
NC"M&Rate! R�tDRal
The Division of Energy, Mineral, and Land Resources (DELMR), received a complete Stormwater
Management Permit Application for the subject project on November 7, 2016. Staff review of the plans
and specifications has determined that the project, as proposed, will comply with the Stormwater
Regulations set forth in Title 15A Section NCAC 2H.1000. We are forwarding Permit No. SW5161101,
dated November 10, 2016, for the construction, operation and maintenance of the subject project and the
stormwater system. This permit shall be effective from the date of issuance until November 9, 2024, or
until rescinded and shall be subject to the conditions and limitations as specified therein, and does not
supersede any other agency permit that may be required.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing by filing a written petition with the Office of Administrative Hearings
(OAH). The written petition must conform to Chapter 150B of the North Carolina General Statutes. Per
NCGS 143-215(e) the petition must be filed with the OAH within thirty (30) days of receipt of this
permit. You should contact the OAH with all questions regarding the filing fee (if a filing fee is required)
and/or the details of the filing process at 6714 Mail Service Center, Raleigh, NC 27699-6714, or via
telephone at 919-431-3000, or visit their website at www.NCOAH.com. Unless such demands are made
this permit shall be final and binding.
This project will be kept on file at the Raleigh Regional Office. If you have any questions, or need
additional information concerning this matter, please contact Mike Randall at [phone]; or
[e-mail].
Sincerely,
for Tracy E. Davis, PE, CPM, Director
cc: SW5161101 File, Raleigh Regional Office
ec: Matt Lowder, PE, Triangle Site Design, PLLC
,,
Stale of North Carolina I Environmental Qua lily I Energy, Mineral and land Resources
1612 Mail Service Center I Raleigh. North Carolina 27699-1612
919-807-6375

State Stormwater Permit
Permit No. SW5161101
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT QUALITY
STATE STORMWATER MANAGEMENT PERMIT
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
Mr. Bill Bland
Cade, Inc.
for
Envision in Franklin County
FOR THE
construction, operation and maintenance of a bio retention cell 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 State and considered a part of this permit.
This permit shall be effective from the date of issuance until November 9, 2024, 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. The bio retention cell is approved for the management of stormwater runoff as
described in the application documents and as shown on the approved plans.
3. 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.
4. The runoff from all built -upon area within the permitted drainage area of this project
must be directed into the bio retention cell.
5. The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
It. SCHEDULE OF COMPLIANCE
During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
2. The permittee shall at all time provide the operation and maintenance necessary to
assure the bio retention cell functions 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).
Page 1 of 4
10

State Stormwater Permit
Permit No. SW5161101
b. Sediment removal.
C. Mowing and re -vegetation of slopes and the filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans.
f. Debris removal and unclogging of all drainage structures, level spreader, filter
media, planting media, underdrains, catch basins and piping.
g. Access to the cell and outlet structure must be available at all times.
3. Records of maintenance activities must be kept for the bio retention cell. The reports
will indicate the date, activity, name of person performing the work and what actions
were taken.
4. The permittee shall submit an annual summary report of the maintenance and
inspection records for each of the bio retention cell. The report shall summarize the
inspection dates, results of the inspections, and the maintenance work performed at
each inspection.
5. The bio retention cell shall be constructed in accordance with the approved plans
and specifications, the conditions of this permit, and with other supporting data.
6. 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 bio retention cell certifying that it 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. A modification may be required for
those deviations.
7. 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.
8. 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 any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease 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 was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
9. A copy of the approved plans and specifications shall be maintained on file by the
Permittee for a minimum of eight years from the date of the completion of
construction.
10. 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.
Page 2 of 4

State Stormwater Permit
Permit No. SW5161101
III. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the Director. In
the event of a change of ownership, or a name change, the permittee must submit a
completed Name/Ownership Change form signed by both parties, to the State,
accompanied by the supporting documentation. 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 all permit conditions until such time
as the Division approves a request to transfer the permit.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the State, 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) having 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.
The permittee grants DEQ Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
The permit issued shall continue in force and effect until revoked or terminated. The
permit may be modified, revoked and reissued or terminated for cause. The filing of
a request for a permit modification, revocation and re -issuance or termination does
not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference and
are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit as
allowed by the laws, rules and regulations contained in Session Law 2006-246, Title
15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division in writing of any name, ownership or mailing
address changes at least 30 days prior to making such changes.
12. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the loth day of November, 2016.
Director Division of Energy, Mineral, and Land Resources
Page 3 of 4

State Stormwater Permit
Permit No. SW5161101
Envision
Franklin Countv
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 Name)
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.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
cc: NCDEQ-DEMLR Raleigh Regional Office
Page 1 of 1

..DEMI_R USE-0N1 Y ," ,-' ,
Date Received
Fee Paid
Permit Number _
�nn
'Applicable Rules: ❑ Coastal SW -1995 1 ❑ Coastal SW - 2008 ❑ Ph 11 - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Storm water Management Plan
❑ Other WQ M art Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources tarty
STORMWATER MANAGEMENT PERMIT APPLICATION FORM ;
This form may be photocopied for use as an original
I. GENERAL INFORMATION �c���
1. Project Name (subdivision, facility, or establishment name - should be consistent with project naps. on T
plans, specifications, letters, operation and maintenance agreements, etc.): 9 ` w
Envision `tom
2. Location of Project (street address): ,
City: You ngsville County:Franklin Zip:27596 �r1L
3. Directions to project (from nearest major intersection):
�^c
Q9Y cnulh n( Iho in I omoclion of Inffnry Wiv and NC Hwv Qh - YV w11I ' 1A0�
4. Latitude:36° 02' 05" N Longitude:78° 29' 33" W of the main entrance to the project p
�S\4Aj� t'
II. PERMIT INFORMATION:
1.a.Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificaliont
tRe iavals with aodl, fieations also requires SINU-102 - Reuea,al Applieatioa Font
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
certi fi cati oa
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 stale permits can be
obtained by contacting the Customer Service Center at 1-877-623,6748):
❑CAMA Major ®Sedimentation/Erosion Control: 4.97 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
b.lf any of these permits have already been acquired please provide the Project Name, Project/Permit
Number, issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? ®No ❑Yes
If yes, secS.L. 2012-200, Part Vl: h ai�rinl.ncdunr ory;(weti/h/rules-and-rce h I nc
Form SWU-101 Version Oct. 31„2013 Page I'of6

Applicant/Organization:Cade, Inc
Signing Official & Title:Bill Bland
b.Contact information for person listed in item 1a above:
Street Address: 1 20-F Weathers Street
City:Youngsville State:NC Zip:27596
Mailing Address (if applicable):
Phone: (919 ) 562-2115
Email: bbland(a)cadeinc.com
Fax: ( )
c. 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
Signing Official & Titt ,
b.Contact information for pe'fson listed in item 2a above:
Street Address:9000 Creedmoor Road
City:Raleigh State:NC Zip:27615
Mailing Address (if applicable):
City: _ State:
Phone: ( ) Fax: ( )
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:
Phone: ( )
4. Local jurisdiction for building permits: Youngsville^
Point of Contact:Bob Clark
IV. PROJECT INFORMATION
State:
Fax: ( )
a
Phone #: (919 ) 556-5073
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
A bio-retention basin will be used to capture storm water runoff from the impervious areas of the site.
Form SWU-101 Version Oct. 31, 2013 Page 2 of 6

IV. , PROJECT INFORMATION
1. In the space provided below, brieflv summarize how the stormwater runoff will be treated.
A bio-retention basin will be used to capture storm water runoff from the impervious areas of the site.
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 II - Post Construction
3. Stormwater runoff from this project drains to the Neuse River basin.
4. Total Property Area: 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+:4.17 acres
Total project area shall be calculated to exclude thefollowing: the normal pool of impounded stnrctures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal zoetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Note -coastal zvetlamds landward of the NHW (orMHW) line tinny
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 56.1 % %
9. How many drainage areas does the project have?] (For high density, count 1 for each proposed engineered
stornnvater 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
Draiia °e Area -
.;Draina e Area_
-Draina e.Area,_.
Receiving Stream Name
Richland Creek
Stream Class *
SA;HQW
Stream Index Number*
20-36-7-2
Total Drainage Area (sf)
126,324
On -site Drainage Area (sf)
126,324
Off -site Drainage Area (so
0
Proposed Impervious Area*' (so
101,985
% Impervious Area** total
80.7%
Impervious- Surface Area"
Drainage Area 1
Drainage Area _.
Drainage Area
Drainage Area
On -site Buildings/Lots (so
50,000
On -site Streets (so
0
On -site Parking (so
50,575
On -site Sidewalks (so
1,410
Other on -site (so
0
Future (so
0
Off -site (so
0
Existing BUA*** (so
0
Total (so:
101,985
Stream Class and Index Number can be determined at: her.//Vortal.ncdenr.org oebfwq[ps/esu/classi 'cations
"* Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Report only that amount of existing BUA dint will remain after development. Do not report ally existing BUA that
is to be removed and which will be replaced by ❑ezo BUA.
Form SWU-101 Version Oct. 31, 2013 Page 3 of 6

11. How was the off -site impervious area listed above determined? Provide documentation.
Measured in design drawings.
Projects in Union County: Contact DEMLR Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringetvt stornnvater 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
Imttp://portal.ncdeiir.org/web/wq/-ws/su/statesw/forms does. 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 http://portal.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 http://12ortal.ncdenr.org/web/wq/ws/su/statesw/forms does.
In
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) O
1 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.orgLpages/onestopexpress.htmi 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/managementfor
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
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'/z mile of the site boundary, include the t/z
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.
c. Location map 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 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.
in. 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).
Y
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"xll" 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 SHVJF prior
to submittal, [phone].)
A copy of the most current property deed. Deed book: 1713 Page No: 70
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 la, 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.
littp://www.secret,iry.state.nc,us/Corporations/­CSearch.aspx
VIL 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 httl2://12ortal.ncdenr.org/web/Ir/state-stormwater-
forms 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
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.
Vltl. 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 P_ngineer:Matt Lowder, PE
Consulting Finn: Triangle Site Design, PLLC
Mailing Address:4004 Barrett Drive, Suite 101
City:Raleigh State:NC Zip:27609
Phone: (919 ) 553-6570 Fax:
Email:mlowder©trianglesitedesign.com
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, itent 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) BF Properties 1, LLC , certify that I
own the property identified in this permit application, and thus give permission to (print or hjpe name of person
listed in Contact Information, item la) Bill Bland with (print or type nante of organization listed in
Contact Information, itent la) Cade, Inc 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 1 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 ermit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement
action in uding e assessment of ivil p allies up to 5,000 per day, pursuant to NCGS 143-215.6.
Signatur Date:
a Notary Public for the State of /Uo 1i, C +,CCA a County of
�A/cL1e e do hereby certify that -,_Tnmes 14 \ r personally appeared
before me this-r d y of be, 2.014, and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission
X. APPLICANT'S CERTIFICATION
_as'-2.ai
I, (print or hype name of person listed in Contact Information, item la) Bill Bland
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 2H .1000 and any other applicable state stormwater requirements.
Date:
a Notary Public for the State of
do hereby certify that
County of
personally appeared
before me this _ day of and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
611F.1/
My commission expires
Form SWU-101 Version Oct. 31, 2013 1Page 6 of 6

a Notary Public for the State of ,
County of , do hereby certify that
personally appeared before me this day of , and acknowledge the
due execution of the application for a stormwater permit. Witness my hand and official seal,
SEAL
My commission
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 1a) Bill Bland
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 2H .1000 and any other applicable state stormwater requirements.
Signature: 14' ' Date: 1(21 &P 1(
I, C �LLB N"CxAt I {, po- a Notary Public for the State of _Norms C pYYi�t(�o
County of 5rox\ukN do hereby certify that 1W`i cLm N O.c-�d
personally appeared before me this ( 0 _ day of (')C , 7n110 , and acknowledge the
of the applicati"r a stormwater permit. Witness my hand and official seal,
,oOZpRY iN
M NexPtaEs
PU
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SEAL
Form SWU-101 Version Oct. 31, 2013 Page 6 ol'6

®N'
NCD`ENR
Permit Number:
(to be provided by DWQ)
W
%AT
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information.
Project name
Contact name
Phone number
Date
Drainage area number
2016
II! DESIGN11NF0RMATIONr"tS' " ;, _ `, 'c >'
-
Site Characteristics
Drainage area 126,324 ft2
Impervious area 101,985 ft2
Percent impervious 80.7% %
Design rainfall depth 1.0 inch -
Peak Flow Calculations
Is pre/post control of the 1-yr, 24-hr peak flow required? Y (Y or N)
1-yr, 24-hr runoff depth - 2.87 in
1-yr, 24-hr intensity infhr
Pre -development 1-yr, 24-hr peak Flow 0.047 ft/sec
Post -development 1-yr, 24-hr peak flow 9.030 ft'/sec
Pre/Post 1-yr, 24-hr peak control 8,983 ft'/sec °o°ri..e u r nrgr
Storage Volume: Non-SAWaters
Minimum volume required, 8,171.0 ft
Volume provided 8,847.0 ft3 OK •°Q, f� °m
Storage Volume: SA Waters • Q $EAL 8
1.5' runoff volume ft,
Pre -development 1-yr, 24-hr runoff ff
Post -development 1-yr, 24-hr runoff
Minimum volume required 0 It b''�s�'7l�'(,t� c •�CLa,. Volume provided ft3"rrrr rrr i r�
Cell Dimensions
Ponding depth of water 12 inches OK
Ponding depth of water - 1.00 It
Surface area of the top of the bioretenlion cell 9,520.0 ft2 OK
Length: 190 ft OK -
Width: 60 ft OK
-or- Radius If
Media and Soils Summary
Drawdown time, ponded volume
6 hr
OK
Drawdown time, to 24 inches below surface
12 hr
OK
Drawdown time, total:
18 hr
In -situ soil.'
Soil permeability
0.50 in/hr
Insufficient. Increase infiltration rate or include underdrains.'
Planting media sok
Soil permeability
2.00 in/hr
OK
Soil composition
• Sand (by volume)
87%
OK
• Fines (by volume)
8%
OK
• Organic (by volume)
5%
OK
_
Total: 100%
Phosphorus Index (P-Index) of media
10 (unitless)
OK _
Form SW401-Bioretention-Rev.8
June 25, 2010
Parts I and II. Design summary, Page 1 of 2

Permit
(to be provided by DWQ)
Basin Elevations
Temporary pool elevation
Type of biorelention cell (answer "Y" to only one of the two
following questions):
Is this a grassed cell?
Is this a cell with frees/shrubs?
Planting elevation (top of the mulch or grass sod layer)
Depth of mulch
Bottom of the planting media soil
Planting media depth
Depth of washed sand below planting media soil
Are underdrains being installed?
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
Bottom of the cell required
SHWT elevation
Distance from bottom to SHWT
Internal Water Storage Zone (IWS)
Does the design include IWS .
Elevation of the top of the upturned elbow
Separation of IWS and Surface
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
Additional Information
Does volume in excess of the design volume bypass the
biorelention cell?
Does volume in excess of the design volume flow evenly distributed
through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute flow?
Is the BMP located at least 30 feet from surface waters (50 feet if
SA waters)? -
Is the BMP localed at least 100 feet from water supply wells?
Are the vegetated side slopes equal to or less than 3:1?
Is the BMP located in a proposed drainage easement with access
to a public Right of Way (ROW)?
Inlet velocity (from treatment system) -
Is the area surrounding the cell likely to undergo development in
the future?
Are the slopes draining to the bioretenlion cell greater than 20%?
Is the drainage area permanently stabilized?
Pretreatment Used
(Indicate Type Used with an "X" in the.shaded cell)
Gravel and grass
(8 inches gravel followed by 3-5 It of grass)
Grassed Swale
Forebay
Other
421.00 fmsl
Y (YorN) OK
N (Y or N)
420 fmsl
inches
417 fmsl
3 it
Oft
y
(Y or N)
10
OK
2
OK
1 it
416 fmsl
410 fund
6 it
OK
N
(YorN)
-
0 fmsl
420 it
OK
0
0
0
Recommend more species.
Y
(Y or N)
OK
Y
(Y or N)
OK
it
N
(Y or N)
Show how flow is evenly distributed.
Y
(Y or N)
OK
Y
(Y or N)
OK "
Y
(Y or N)
OK
Y
(Y or N)
OK
-
2 fUsec
Insufficient inlet velocity unless energy dissipating devices are
being used.
N
- (Y or N)
OK -
N (Y or N) OK
Y (Y or N) OK
X
OK
Form SW401-eioretenlion-Rev.8
June 25, 2010 -
Parts I and II. Design Summary, Page 2 of 2

IR r
Envision
Jeffery Way
Youngsville
Franklin County, NC
Lat: 360 02'05"N
Long: 780 29'33"W
Bio-Retention System
Operation and Maintenance Agreement
NOV
a A116
R41el9h %lonal
onke •a
A maintenance record on this BMP will be maintained on the project site. This maintenance
record will be kept in a log in a known set location on the property. Any deficient BMP
elements noted in the inspection will be corrected, repaired or replaced immediately. These
deficiencies can affect the integrity of structures, safety of the public, and the removal efficiency
of the BMP.
Important operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered twice
weekly if needed until the plants become established (commonly six weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will be taken to prevent sediment from entering the bioretention cell.
- Once a year, a soil test of the soil media will be conducted.
- Maintenance records for this BMP are required to be maintained on the project site
After the bioretention cell is established, I will inspect it once a month and within 24 hours
after every storm event greater than 1.0 inches. Records of operation and maintenance will be
kept in a known set location and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be
repaired immediately. The Owner is responsible for performing the annual inspections and
reports, not the local Jurisdiction.
Annual Inspection reports are required as defined in the City of Creedmoor Ordinance. The
Owner shall keep records of inspections, maintenance and repairs for at least five years from
the date of the creation of the record and shall submit the same upon reasonable request to
the Stormwater Administrator. Annual Inspections are required on or before June 30th each
year.
BMP element:
Potentialproblems:
How I will remediate the problem
The entire BMP
Trash debris is present.
Remove the trash/debris.
The perimeter of the
bioretention cell
Areas of bare soil and/or
erosive gullies have formed.
Regrade the soil if necessary to
remove the gully, and then plant a

ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
BMP element:
Potentialproblems:
How I will remediate theproblem:
The pretreatment area
Flow is bypassing
Regrade if necessary to route all
pretreatment area and/or
flow to the pretreatment area.
gullies have formed.
Restabilize the area after grading.
Sediment has accumulated to
Search for the source of the
a depth greater than three
sediment and remedy the problem if
inches.
possible. Remove the sediment and
restabilize the pretreatment area.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand.
The bioretention cell:
Best professional practices
Prune according to best professional
vegetation
show that pruning is needed
practices.
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Tree stakes/wires are present
Remove tree stake/wires (which
six months after planting.
can kill the tree if not removed).
The bioretention cell:
Mulch is breaking down or
Spot mulch if there are only random
soils and mulch
has floated away.
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Soils and/or mulch are
Determine the extent of the clogging
clogged with sediment.
- remove and replace either just the

BMP element:
The underdrain system
The drop inlet
The receiving water
An annual soil test shows that
pH has dropped or heavy
metals have accumulated in
the soil media.
Potential problems:
Clogging has occurred
Clogging has occurred
The drop inlet is damaged
Erosion or other signs of
damage have occurred at the
outlet.
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
Dolomitic lime shall be applied as
recommended per the soil test and
toxic soils shall be removed,
disposed of properly and replaced
with new planting media.
How I will remediate the problen
Wash out the underdrain system.
Clean out the drop inlet. Dispose
the sediment off -site.
Repair or replace the drop inlet.
Contact the NC Division of Water
Quality 401 Oversight Unit at 919-
733-1786.

I acknowledge and agree by my signature below that l am responsible for the performance of the
maintenance procedures listed above. I agree to notify City of Youngsville of any problems with
the system or prior to any changes to the system or responsible party.
Project name: Envision- Youngsville
Bio-Retention Pond
Print n
Title:President
Address:120-F Weathers Street
Signature: ""L'-
Date- /0/(R/ /G
1, (`a�hlQ�1 N-lso(Q a Notary Public for the State of
JAc)t -h C-c mkk nr County of do hereby certify that
"N 1 11(� hC) �) I o r 6 personally appeared before me this —LL- day of
oc kotkr , Zo IC9 , and acknowledge the due execution of the forgoing dry
detention basin maintenance requirements. Witness my hand and official seal,
�40TARy. 7i
MY jf
COMMISSION EXPIRES
0ls-os-18
�/- "UBLIG
SEAL
My commission expires DU - OS- I

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