SW7070409_CURRENT PERMIT_20070629

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

9
OG
7
3�
Michael F. Easley, Governor
William G. Ross Jr., Secrctary
North Carolina Department of Environment and Natural Resources
DIVISION OF WATER QUALITY
June 29, 2007
Mr. Gordon B. Jones
4108 Ivy Lane
Kitty Hawk, NC 27949
Subject:
Dear Mr. Jones:
Coleen H. Sullins Director
Division of Water Quality
Stormwater Permit No. SW7070409
Moyock Town Shops
High Density Stormwater Project
Currituck County
The Washington Regional Office received your Stormwater
Application for the subject project on April 12, 2007. 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 NCAC 2H.1000. We are forwarding Permit No.
SW7070409 dated June 29, 2007 to Gordon B. Jones.
This permit shall be effective from the date of issuance
until June 29, 2017 and shall be subject to the conditions and
limitations as specified therein. Please pay special attention to
the Operation and Maintenance requirements in this permit.
Failure to establish an adequate system for operation and
maintenance of the stormwater management system will result in
future compliance problems.
If any parts, requirements, or limitations contained in this
permit are unacceptable, you have the right to request an
adjudicatory hearing upon written request within thirty (30) days
following receipt of this permit. This request must be in the
form of a written petition, conforming to Chapter 150B of the
North Carolina General Statutes, and filed with the Office of
Administrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-
7447. Unless such demands are made this permit shall be final and
binding.
North Carolina Division of Water Quality Internet h2o.enr.state.nc.us
943 Washington Square Mall Phone: [phone]
Washington, NC 27889 FAX [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled110% Post Consumer Paper
olle
NorthCarolina
Natura!!r,

Mr. Gordon B. Jones
June 29, 2007
Page Two
If you have any questions, or need 'additional information
concerning this matter, please contact Mr. Bill Moore at (252)9.48-
3919.
Ain cerely,
Al Hodge, Regional,Supervisor
Surface Water._ Protection Section
Washington Regional Office,
cc: Performance Engineering
C} rrituck County Planning/Inspections
✓WARD Stormwater Files'
Central Files

r
State Stormwater Management Systems
Permit No. SW7070409
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
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. Gordon B. Jones
Currituck County
FOR THE
construction, operation and maintenance of stormwater management
systems 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
Division of Water Quality and considered a part of this permit for
(2) infiltration basins to serve Moyock Town Shops located at 522
Caratoke Highway in Moyock, NC.
This permit shall be effective from the date of issuance until
June 29, 2017, and shall be subject to the following specified
conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and
volume of stormwater described in the application and other
supporting data.
2. This stormwater system has been approved for the management
of stormwater runoff as described on page 4 of this permit,
the Project Data Sheet.
3. Approved plans and specifications for this project are
incorporated by reference and are enforceable parts of the
permit.
91

DIVISION OF WATER QUALITY
PROJECT DATA
Project Name: Moyock Town Shops
Permit Number: SW7070409
Location: Currituck County
Applicant: Mr. Gordon B. Jones
Mailing Address: 4108 Ivy Lane
Kitty Hawk, NC 27949
Application Date: 04/12/2007
Water Body Receiving Stormwater:-
Runoff: UT-Moyock Run
Classification of Water Body: C
Total Site Area: 1.50 acres
Total Impervious
Surfaces Allowed: 36,261 sf
Basin Depths:
1.0
- Basin A
1.3
- Basin B
Required Storage Volume:
211
cf -
Basin
A
2782
cf -
Basin
B
Provided Storage Volume:
657
of -
Basin
A
9045
cf -
Basin
B
Provided Surface Area:
900
sf
- Basin
A
(Top of Basins)
7620
sf
- Basin
B
Top of Storage Elevation:
4.0
ft
- Basin
A
5.4
ft
- Basin
B
n

4. No homeowner/lot owner/developer shall be allowed to fill in,
alter, or pipe any vegetative practices (such as swales)
shown on the approved plans as part of the stormwater
management system without submitting a revision to the permit
and receiving approval from the Division.
5. The following items will require a modification to the
permit:
a. Any revision to the approved plans, regardless of size
b. Project name change
C. Transfer of ownership
d. Redesign or addition to the approved amount of built -
upon area
e. Further subdivision of the project area.
In addition, the Director may determine that other revisions
to the project should require a modification to the permit.
6. 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.
II. SCHEDULE OF COMPLIANCE
1. The permittee will comply with the following schedule for
construction and maintenance of the stormwater management
system.
a. The stormwater management system shall be constructed
in its entirety, vegetated and operational for its
intended use prior to the construction of any built -
upon surfaces except roads.
b. During construction, erosion shall be kept to a minimum
and any 'eroded areas of the system will be repaired
immediately.
2. The facilities must be properly maintained and operated at
all times. The approved Operation and Maintenance Plan must
be followed in its entirety and maintenance must occur at the
scheduled intervals.
3. The permittee shall at all times provide the operation and
maintenance necessary to assure the permitted stormwater
system functions at optimum efficiency including, but not
limited to:
5

0
a. Semi-annual scheduled inspections (every 6 months)
b. Sediment removal
C. Mowing and revegetation of side slopes
d. Immediate repair of eroded areas
e. Maintenance of side slopes in accordance with approved
plans and specifications
f. Debris removal and unclogging of outlet structure,
orifice device and catch basins and piping.
4. Records of maintenance activities must be kept and made
available upon request to authorized personnel of DWQ. The
records will indicate the date, activity, name of person
performing the work and what actions were taken.
5. This permit shall become voidable unless the facilities are
constructed in accordance with the conditions of this permit,
the approved plans and specifications, and other supporting
data.
6. Upon completion of construction and prior to operation of
this permitted facility, a certification must be received
from an appropriate designer for the system installed
certifying that the permitted facility has been installed in
accordance with this permit, the approved plans and
specifications, and other supporting documentation. Mail the
Certification to the Washington Regional Office, 943
Washington Square Mall, Washington, North Carolina, 27889,
attention Division of Water Quality.
7. A copy of the approved plans and specifications shall be
maintained on file by the Permittee for a minimum of five
years from the date of the completion of construction.
III. GENERAL CONDITIONS
1. This permit is not transferable. In the event there is a
desire for the facilities to change ownership, or there is a
name change of the Permittee, a formal permit request must be
submitted to the Division of Water Quality accompanied by an
application fee, documentation from the parties involved, and
other supporting materials as may be appropriate. The
approval of this request will be considered on its merits and
may or may not be approved.
2. Failure to abide by the conditions and limitations contained
in this permit may subject the Permittee to enforcement
action by the Division of Water Quality, in accordance with
North Carolina General Statute 143-215.6(a) to 143-215.6(c).
3. 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) which have jurisdiction.
6

4. 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.
5. The permit may be modified, revoked and reissued or
terminated for cause. The filing of a request for a permit
modification, revocation and reissuance or termination does
not stay any permit condition.
6. At least 6 months prior to the expiration date, the permittee
shall request that this permit be renewed.
Permit -issued this the 29 th-day of June, 2007.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
ICI �^
For Coleen H. Sullins, Director
Division of Water -Quality
By Authority of the Environmental
Permit Number SW7070409
7
Management Commission

Stormwater Permit SW7070409
(2) Infiltration Basins
Moyock Town Shops
Moyock, NC
Designer's Certification
I.,
as a duly
registered Professional Engineer in the State of North Carolina,
having been authorized to observe (periodically/weekly/full time)
the construction of the project,
for
(Project)
(Project Owner)
hereby state that to the best of my abilities, due care and
diligence was used in the observation of the p.roject construction
such that the construction was observed to.be built within
substantial compliance and intent of the approved plans -and.
specifications.
Signature
Registration Number
Date
I

o/zl4/N PL
�q
DWQ USE ONLY
Date Received
Fee Paid
Permit Number
-01
s
Applicable Rules: ElCoastal 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 M mt Plan:
State of North Carolina
Department of Environment and Natural Resources p ,
Division of Water Quality SEP 2 4 2009
STORMWATER MANAGEMENT PERMIT APPLICATION FORM �p1�
This form may be photocopied for use as an original D i(F Q- p fl� A RO
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.):
Movock Town Shoos
2. Location of Project (street address)
City:Moyock County:Currituck Zip:27958
3. Directions to project (from nearest major intersection):
subject tract is located in the southwest quadrant of the intersection of Caratoke Highway (US H3yy.168) and
Camellia Drive (SR 1122), approximately two miles south of the NC/VA state line
4. Latitude:36° 31' 27" N Longitude:76° 10' 42" W of the main entrance to the project.
It. PERMIT INFORMATION
1. a. Specify whether project is (check one): ❑New ®Modification
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numberSW7070409 , its issue date (if known)lune 29, 2007 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 DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, n/a and the previous name of the project, if different than currently
proposed, n/a
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):
❑LAMA Major
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 1.5 ac of Disturbed Area
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:Erosion and Sedimentation Control Plan No. Curri-2007-031,
application for permit modification has been submitted
Form SWU-101 Version 07July2009
Page 2 of 6

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:Gordon B. Jones
Signing Official & Title:Owner
b.Contact information for person listed in item la above:
Street Address:4108 Ivy Lane
City:Kitty Hawk State:NC Zip:27949
Mailing Address (if applicable):same as above
City: State: Zip:
Phone: ( ) Fax: ( 1
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 Owner/Organization:
Signing Official &
b.Contact information for person listed in item 2a above:
Street Address:
Mailing Address (if
City:
Phone: ( 1
State: Zip:
State: Zip:
Fax: ( )
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: Per—Aryn c7 n 6e- En q 1 Yl e e Y 1 n G
Signing Official & Title: 4r,r(- S• Sfew a ✓ tf Q C•
b.Contact information for person listed in item 3a above:
Mailing Address:_ 50 Y c a ra ro Re Nla G w a y city: Pdwells AIht State: NC Zip: 7,196(,
Phone: (Z sZ, ) 491 Pj 354 Fax: (L5 Z ) 491 Slit
Email: 6 I n Q, 10 f) . co YY\
4. Local jurisdiction for building permits: Currituck County
Point of Contact:M r. Spence Castello, Chief Inspector Phone #: [phone]
Form SWU-101 Version 07July2009 Page 2 of

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
stormwater will be conveyed via sheet flow, gutters and flumes to the infiltration basin for retainage and
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.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 Pasquotank River basin.
4. Total Property Area:1.5 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`:1.5 acres
Total project area shall be calculated to exclude the followin the nonnal yool 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
(MHW) 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 MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 63 %
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
Moyock Run
Stream Class *
$� C
Stream Index NumberI-2-Z-
Total Drainage Area (sf)
59,559
On -site Drainage Area (so
59,559
Off -site Drainage Area (so
0
Pro osed Impervious Area** s
37,797
% Im ervious Area** total
63%
Impervious— Surface Area
Drainage Area _
Drainage Area _
Drainage Area _
Drainage Area _
On -site Buildings/Lots (so
8,500
On -site Streets (so
27,674
On -site Parking (sf)
incl. w/ streets
On -site Sidewalks (so
1,335
Other on -site (so
288
Future (so
0
Off -site (so
0
Existing BUA*"* (so
0
Total (so:
37,797
" Stream Class and Index Number can be determined at: http://h2o.enr.state.Pic. tis/biins/renorts/ ortsWB.html
Impervious 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 07July2009 Page 3 of

'Report only that mnount 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 BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. areas were
calculated using Autocad commands and area calculation routines
Projects in Union County: Contact DWQ Central Office s1gffto check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per NCAC 02B .0600.
[rl�Yil�tiifRulB.Ylll.ilZ•7'_� �YiltilTi�9
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 hqp://h2o.enr.state.nc.us/su/bmp forms.htm.
VI. 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 BMP
checklists are available from http://h2o.enr.state.nc.us/su/bmp forms.htm. The complete 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 hHp://h2o.enr.state.nc.us/su/msi_maps.htm.)
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://h2o.enr.state.nc.us/su/bmp_forms.htm.
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 Vll 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/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 1/2 mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations.
B. 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.
Form SWU-101 Version 07July2009 Page 4 of 6

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).
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 DWQ to verify the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 928 Page No: 799
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 la, 2a, and/or 3a per NCAC 21-1.1003(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.
hqp:/ /www.secretary.state.nc.us/Corporations/CSearch.aWxx
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
V
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://h2o.enr.state.nc.us/su/bmp forms.htm#deed restrictions. 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 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 Engineer.Robert 1. Stewart, Jr., P.E.
Consulting Firm: Performance Engineering
Mailing Address:8604 Caratoke Highway
City:Powells Point State:NC Zip:27966
Phone: (252 ) 4918354
Email: bobpe93©yahoo.com
Fax: (252 ) 491-5112
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, items 2 has been filled out, complete this
section)
I, (print or hjpe natne of person listed in Contact Information, item 2a) , 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) with (print or hjpe name of organization listed in
Contact Infornmtion, item 1 b) 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 07July2009 Page 5 of

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 DWQ Stormwater permit 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
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:
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 h/pe nante of person listed in Contact Information, item 2) Gordon B. [ones
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 2I-I .1000, SL 2006-246 (Ph. II - Post Construction) or SL 2008-211.
Signatu
Date:
a Notary Public for the State of Y 761 l (yW-Y[,Klc-. County of
s t��2 do hereby certify that 1&11Apersonally appeared
before me this 17 day of rf o" 9 . and acknowledge ac��lethe due execution of the application for
a stormwater permit. Witness my hand and official seal, ( 4&e ty �j�tlez
SEAL
My commission expires 30 ;6/6
Form SWU-101 Version 07July2009 Page 6 of 6

DWQ 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 Storm water Management Plan
❑ Other WQ M mt Plan:
State of North Carolina RECEIVED
Department of Environment and Natural Resources SEP 2 4 2��9
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORNIWQ-WARM
This fornt nay be photocopied for use as an original
1. 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.):
2. Location of Project (street address):
522 Caratoke Highway
City:Movock County:Currituck Zip:27958
3. Directions to project (from nearest major intersection):
subject tract is located in the southwest quadrant of the intersection of Caratoke Highway (US Hwy. 168) and
Camellia Drive (SR 1122), approximately two miles south of the NC/VA state line
4. Latitude:36° 31' 27" N Longitude:76° 10' 42" W of the main entrance to the project.
if. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ❑New ®Modification
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numberSW7070409 , its issue date (if known)June 29, 2007 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 ®Fligh 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 DWQ
requesting a state stormwater management permit application, list the Stormwater project number, if
assigned, n/a and the previous name of the project, if different than currently
proposed,n/a
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: 1.5 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 permitErosion and Sedimentation Control Plan No. Curri-2007-031
application for permit modification has been submitted
Form SWU-101 Version 07JUN2009 Page 2 of

III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specificall), the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organiza
Signing Official & Ti
b.Contact information for person listed in item la above:
Street Address:4108 Ivv Lane
City:Kitty Hawk State:NC Zip:27949
Mailing Address (if applicable):same as above
City: State: Zip:
Phone: ( ) 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 Owner/i
Signing Official &
b.Contact information for person listed in item 2a above:
Street Address:
Mailing Address (if
City:
Phone: 1 1
State:
State:
Fax:
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/
a rice. -
Signing Official & Title: /?o6c rf J • few <, Y, I fY-, "JP f • p /uPJ ff,
b.Contact information for person listed in item 3a above:
Mailing
IYA
City: i'dW t 11S Pc I P1 f V State: N Zip: 2• i��
Phone: (7�7 ) �Ngf pi54 Fax: 1 5��2
Email: 6 � „c.�( Si k o n , CnIn
4. Local jurisdiction for building permits: Currituck County
Point of Contact:Mr. Spence Castello, Chief Inspector Phone #: [phone]
Form SWU-101 Version 07July2009 Page 2 of6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
stormwater will be conveyed via sheet flow, gutters and flumes to the infiltration basin for retainage and
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.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 Pasquotank River basin.
4. Total Property Area: 1.5 acres
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
Total Property Area (4) - Total Coastal Wetlands Area (5) -Total Surface Water Area (6) = Total Project
Area- 1.5 acres
Total project area shall be calculated to exclude thefollowing: the nornml 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
(MHI,V) line, and coastal Wetlands landeoard from the NHIN (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal enetlmids Imidu'ard of the NHW (or MHW) lure pray
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 63
9. I -low 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
Moyock Run
_
Stream Class *
,SF
Stream Index Number *
Total Drainage Area (so
59,559
On -site Drainage Area (so
59,559
Off -site Drainage Area (so
0
Proposed Impervious Area** (so
37,797
% Impervious Area*' total
63%
Impervious- Surface Area
Draina e Area _
Draina e Area _
Draina e Area _
Draina e Area
On -site Buildings/Lots (so
8,500
_
On -site Streets (so
27,674
On -site Parking (so
incl. w/ streets
On -site Sidewalks (so
1,335
Other on -site (so
288
Future (so
0
Off -site (so
0
Existing BUA*** (so
0
Total (so:
37,797
Stream Class and Index Number cam be determined at: http://li2o.enr.state.uc.us/bims/reports/reportsWB htnd
Impervious area is dafiined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 07Ju1y2009 Pace 3 of 6

Report only that amount of existing BUA that will retnain after development. Do not report any existing BUA that
is to be removed and which will be replaced bil new BUA.
11. Flow was the off-site'inipervious area listed above determined? Provide documentation. areas were
calculated using Autocad commands and area calculation routines
Projects in Union County: Contact DIVQ Central Office stcf 'to check ifthe project is located within a Threatened &
Enticagered Species tratershed that mat+ be subject to more stringent stormwater requirements as per 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://h2o.ear.state.nc.tis/su/bntp_fonns.htm.
VI. 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 BMP
checklists are available from http://h2o.ear.state.nc.us/su/bmp_forms.htnr. The complete 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 http://h2o.eiir.stite.ilc.us/sti/­nisi niaps.htni.)
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://li2o.enr.state,tic.tis/su/bmp forms.htm.
1. Original aid 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 Forni(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDE NR. (For an Express review, refer to
http://www.enviielp.org/_pages/onestopexpress.litml 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 1/2 mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations.
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 MFIW or NHW line of tidal
waters, and any coastal wetlands landward of the MI-IW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MFIW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with hearings & 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.
Initials
u/
FonnSWU-101 Version07July2009 Page 4of6

m. kVetlands 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).
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"xl I" 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 DWQ to verifi/ the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 928 Page No: 799
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 Informations, item ] a, 2a, and/or 3a per NCAC 21-I.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://wwiN,.secretarv.st,ite.nc.Lis/Corporatioiis/CSearcli.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
13UA 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://112o.enr.state.ncus/su/bnlp forms.htm"deed restrictions. 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 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 Engineer:Robert 1. Stewart, Jr., P.E.
Consulting Firm: Performance Engineering
Mailing Address:8604 Caratoke Highway
City:Powells Point State:NC Zip:27966
Phone: (252 ) 4918354
Email:bobpe93©yahoo.com
Fax: (252 ) 491-5112
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type none of person listed in Contact Information, item 2a) , 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 la) with (print or hype name of organization listed in
Contact Information, item lb) 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 07July2009 Page 5 of6

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 DWQ Stormwater permit 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
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.
Date:
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 2) Gordon B. Iones
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, SL 2006-246 (Ph. II - Post Construction) or SL 2008-211.
Date: 7/-"
a Notary Public for the State of 7LttUi'l l.auiku'c County of
do hereby certify that �..oQyY� personally appeared
before me this / %day of 2 ge09 • and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, �� Z�
SEAT.
My commission expires 30 ;0 i O
Donn SWU-101 Version 07Ju1y2009 Page 6 of

ElCEI VEUd Permit No
(to be Provided by DWQ)
®�F � SEP 2 4 2009 WATF
STORMWATER MANAGEMENT PERMIT APPLICATION FORM o�C €
WDENR D k p Q-WARO 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part /it) must be printed, filled out and submitted along with all of the required information.
Project Name Moyock Town Shops
Contact Person Robert J. Stewart, Jr., P.E.
Phone Number 252.491.8354
Date 25-Aug-09
Drainage Area Number one
II. DESIGN INFORMATION
Site Characteristics
Drainage area 59,559.00 f?
Imperviousarea 37,797.00 (tz ��QCAR �iO
Prcent impervious 0.63 % �,� , ��
Design rainfall depth 1.(12 in ✓ C) Q�F SS1p 2
Peak Flow Calculations Z 4 S�,�%� 1/-�y�,,
1-yr, 24-hr rainfall depth 3.13 in /f iD(iy[yy - '' ` J yJr
1 -yr, 24-hr intensity 0.13 inlhr /I//�'-,e U
Pre -development l-yr,24-hrdischarge 0.05 ft3/sec '�� �;N( le'.�•,�` p
PrelPost 1 yr, 24-hr peak flow control 0.11 ft3/sec """to
"" o J11S 1►&P ,,`' q13 / r0 l
Storage Volume: Non -SA Waters
Minimum design volume required 3,139.00 ft3 l/ PERFORMANCE ENGINEERING
Design volume provided 10,760.00 fl3 t/ OK for non -SA Water6664 CARATOKE HIGHWAY 4—.
Storage Volume: SAWaters POWELLS POINT, NG 27968, 'a
1.5" runoff volume n/a -ft3
Pre -development 1-yr, 24-hr runoff volume n/a ft3
Post -development 1-yr, 24-hr runoff volume ft3
Minimum required volume # ALUE! ft3
Volume provided 71
Ala ft3 #VALUE!
Soils Report Summary
Soil type ivista fine sandy loam
Infiltration rate 0.6-2.0 inlhr ✓
SHWT elevation 2.57 fmsl ✓
Basin Design Parameters
Drawdown time
0.73
days OK
Basin side slopes
2 3.00
:1 OK
5 42F,
Basin bottom elevation
1 3.60
fmsl Raise basin bottom, Must beat least 2-ft above SHWf
dl/3KK/�'T/�Gr
Storage elevation
5.50
fmsl
Storage Surface Area
6,681.00
e
Top elevation
5.60
fmsl
Basin Bottom Dimensions
Basin length
irregular
ft
Basin width
irregular
ft
Bottom Surface Area
4,645.00
ftz
Forth SW401-Infkration Basin -Rev 4 Parts I. a H. Design Summary, Page 1 of 2

Permit
(to be provided by DWQ)
Additional Information
Maximum runoff to each inlet to the basin?
Length of vegetative filter for overflow
Distance to structure
Distance from surface waters
Distance from water supply well(s)
Separation from impervious soil layer
Naturally occuring soil above shwa
Bottom covered with 4-in of clean sand?
Proposed drainage easement provided?
Capures all runoff at ultimate build -out?
Bypass provided for larger storms?
Pretreatment device provided
0.43
ac-in
30.00
ft
45.00
it
300.00
it
100 min.
it
it
5' min.
i
V
4.43
ft
y
(Y or N)
n
(Y or N)
�✓
y
(Y or N)
It
(Y or N)
n
OK
OK
OK
OK
OK
OK
OK
OK
Need a recorded drainage easement --�CCAJ#KkA77VE
OK
Must provide bypass for larger flows
Form SW401-Infiltration Basin-Rev.4 Parts 1.811. Design Summary, Page 2 of 2

Permit
(to be provided by DWQ)
III. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Pagel Plan
Initials Sheet No.
I� <, Z
WA
$r'a NR2Cli'P'15
sEiC N ft PRP_ -Tfvts
` z k1t11Lt fNhlS
Sep NA2R:ATIut;
Sec &JA(Ltt-n4t
Plans (1" - 50' or larger) of the entire site showing:
Design at ultimate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Basin dimensions,
Pretreatment system,
High flow bypass system,
Maintenance access,
Proposed drainage easement and public right of way (ROW),
Overflow device, and
Boundaries of drainage easement.
Z 2. Partial plan (1" = 30' or larger) and details for the infiltration basin showing:
SI`C A ULI f X - Bypass structure,
S" h)K L"t L - Maintenance access,
- Basin bottom dimensions,
- Basin cross-section with benchmark for sediment cleanout,
S$r& NA- Ill - Flow distribution detail for inflow,
- Vegetated filter, and
�%
Nba�P�'JIM- Pretreatmentdevice.
kq(�� J 7- 3. Section view of the infiltration basin (1" = 20' or larger) showing:
ll No p Pretreatment and treatment areas, and
EEInlet and outlet structures.
S
LAICJl 4. A table of elevations, areas, incremental volumes &accumulated volumes to verify the volume provided.
� 1`1_11�XIAKD 5. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWQ, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information.
3 6. A construction sequence that shows how the infitlration basin will be protected from sediment until the
entire drainage area is stabilized.
1 7. The supporting calculations.
I0 8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
/ WA_ 9. A copy of the deed restrictions (if required).
Form SW401-Infiltration Basin-Rev.4 Page 1 of 1 Part III. Required Items Checklist, Page 1 of 1

Permit Number:
(to be provided by DWQ
Drainage Area Number:
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will -
corrected, repaired or replaced immediately. These deficiencies can affect the integrit CEIVED
of structures, safety of the public, and the removal efficiency of the BMP.
SEP 2 4 2009
Important maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to tTeWQ-WAR
infiltration basin.
— Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
— No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
— The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basin is established, it will be inspected once a quarter and within
24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). 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.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin
erosive gullies have formed.
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 or
The pipe is clogged (if
Unclog the pipe. Dispose of the
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.
Form SW401-Infiltration Basin O&M-Rev.3
Page 1 of 3

BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred or
Provide additional erosion
riprap is displaced.
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticides are used, wipe
them on the plants rather than
Brain.
The main treatment area
A visible layer of sediment
Search for the source of the
has accumulated.
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP. Replace any media that
was removed in the process.
Revegetate disturbed areas
immediately.
Water is standing more than
Replace the top few inches of filter
5 days after a storm event.
media and see if this corrects the
standing water problem. If so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Weeds and noxious plants are
Remove the plants by hand or by
growing in the main
wiping them with pesticide (do not
treatment area.
spray).
The embankment
Shrubs or trees have started
Remove shrubs or trees
to grow on the embankment.
immediately.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-Infiltration Basin O&M-Rev.3 Page 2 of 3

Permit Number:
(io be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:Movock Town Shops
BMP drainage area
Print name:Gordon B. Jones
Title:owner
Address:4108 Ivy Lane, Kitty Hawk, NC 27949
Phone:[phone]
Signature: A44
Date: _ `7/1 ,/-i
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
1, �Uj a Notary Public for the State of
`%trrj L), County of 04� do hereby certify that
n personally appeared before me this /7
day of 9 ,and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires JLO/ d
Form SW401-Infiltration Basin O&M-Rev.3 Page 3 of 3