SW7090101_CURRENT PERMIT_20120518

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

. r
WCD�ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, PE Dee Freeman
Governor Director Secretary
May 18, 2012
Ms. Virginia Eitner, Member/Manger
L. Washington Enterprises, LLC
PC) Box 3320
New Bern, NC 28560
Subject: State Stormwater Permit No. SW7090107 Modification
Dunkin Donuts —Washington, North Carolina
High Density Commercial Bio-Retention Project
Beaufort County
DE!ar Ms. Eitner:
The Washington Regional Office received a complete Stormwater Management Permit Application for
the permit modification of Dunkin Donuts, located at 1689 West 5th Street, Washington, North
Carolina on April 2, 2012. Staff review of the plans and specifications has determined that the
project, as proposed, will comply with the Stormwater Regulations set forth in Session Law 2008-211
and Title 15A NCAC 2H.1000. We are forwarding Permit No. SW7090101 MOD dated May 18, 2012,
for the construction of the subject project.
This permit shall'be effective from the date of issuance until December 30, 2021, 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 adtudicatory hearing upon written request within thirth (30) days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150E 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.
If you have any questions, or need additional information concerning this matter, please contact Scott
Vinson, or me at [phone]. A
AAId e�I --
Regional Supervisor
Surface Water Protection Section
AH/sv: S:\WQS\STORMWATER\PERMIT\SW7Q90101M
cc: Kevin Avolis, Avolis Engineering (erru} r
City of Washington Building Inspections/ tanning Dept
L,,-Washington Regional Office
North Carolina Division of Water Quality Internet: www.ncwaterqualitvore
943 `Nashington Square Mall Phone: [phone] One
Washington, NC 27889 FAX [phone] NorthCarolina
An Equal Opportunily/Aff rmative Action Employer— 50% Recycled110 % Post Consumer Paper naturally

State Stormwater Management Systems
Permit No. SW7090101 MOD
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
L. Washington Enterprises, LLC
Dunkin Donuts — 1689 West a Street, Washington, North Carolina
Beaufort County
FOR THE
construction, operation and maintenance of one bioretention basin(s) in compliance
with the provisions of Session Law 2008-211 and 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.
This permit shall be effective from the date of issuance until December 30, 2021, 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.
This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.7 on page 3 of this permit. The stormwater
control has been designed to handle the runoff from 26,424 square feet of
impervious area.
The tract will be limited to the amount of built -upon area as indicated in Section
1.7 of this permit, and per the application documents and as shown on the
approved plans.
4. 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.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The built -upon areas associated with this project shall be located at least 50 feet
landward of all perennial and intermittent surface waters.
Page 2 of 7

State Stormwater Management Systems
Permit No. SW7090101 MOD
The following design criteria have been provided in the bioretention basin and
must be maintained at design condition:
a. Drainage Area, ft2:
b. Total Impervious Surfaces, ft2:
C. Design Storm, inches:
d. Max. Ponded Depth, inches:
e. Seasonal High Water Table, fmsl:
f. Planting Media Depth, feet:
g. Basin Dimensions, feet:
h. Bottom Elevation, fmsl:
i. Bottom Surface Area, ft2:
j. Permitted Storage Volume, ft3:
k. Bypass / Storage Elevation, fmsl:
I. Drawdown Time, hours:
M. Underdrain Diameter, inches:
n. Type of In -situ Soils:
o. Expected Infiltration Rate, in/hr:
P. Total number of plants provided:
q. Receiving Stream/River Basin:
r. Stream Index Number:
S. Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
52,324
26,424
1.50 required
9.00
8.33
3.25
—69'x80'
11.5
5,833
4,344 provided — 3,300 required
12.40
12.0
n/a, no underdrains
Tarboro sands
10.30
60
Kennedy Creek / Tar -Pamlico
28 — 104
"C; NSW"
1. 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 surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all time provide the operation and maintenance necessary
to assure the permitted stormwater system 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).
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 basin and outlet structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and
what actions were taken.
5. The permittee shall submit to the Division of Water Quality an annual summary
report of the maintenance and inspection records for each BMP. The report
shall summarize the inspection dates, results of the inspections, and the
maintenance work performed at each inspection.
6. The facilities shall be constructed as shown on the approved plans. This permit
shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other
supporting data.
Page 3 of 7

State Stormwater Management Systems
Permit No. SW7090101 MOD
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 system installed certifying that the permitted
facility 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.
8. 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.
9. Access to the stormwater facilities shall be maintained via appropriate recorded
easements at all times.
10. 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 or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. A copy of the approved plans and specifications shall be maintained on file by
the Permittee at all times.
13. 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.
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
Division of Water Quality, accompanied by the supporting documentation as
listed on page 2 of the form. 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.
Page 4 of 7

State Stormwater Management Systems
Permit No. SW7090101 MOD
3. 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 143-215.6A 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.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. 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 2008-
211, Title 15A NCAC 21-1.1000, 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. This permit shall be effective from the date of issuance until December 30, 2021.
Application for permit renewal shall be submitted 180 days prior to the expiration
date of this permit and must be accompanied by the processing fee
Permit issued this the 18th day of May, 2012.
NOTH C R LINA ENVIRONMENTAL MANAGEMENT COMMISSION
/ I-- for
Charles Wakil , Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit No. SW7090101 Modification
Page 5 of 7

State Stormwater Management Systems
Permit No. SW7090101MOD
Dunkin Donuts
Stormwater Permit No. SW7090101 MOD
Beaufort County
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.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 6 of 7

State Stormwater Management Systems
Permit No. SW7090101MOD
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Trash rack is provided on the outlet/bypass structure.
8. All slopes are grassed with permanent vegetation, per the vegetation plan.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
15. The required system dimensions are provided per the approved plans.
cc: City of Washington Building Inspections/Planning Dept.
Page 7 of 7

DWQ USE ONLY
Date Received Fee Paid Permit Number
SW% g0101 Me 511'
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- I-IQW/ORW Waters ❑ Universal Stormwater Management PI, n
❑ Other WQ M gmt Plan: S WAc �t 3
State of North Carolina ,')P °
Department of Environment and Natural Resources APR - 2 2012
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATI�F�QAQ �` A , w �O
This forin may be photocopied for use as an original �� VVH
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.):
Dunkin Donuts - Washington, North Carolina
2. Location of Project (street address):
1689 West 5th Street
Ci ty: W ashington Co u n ty:l3eau fort Zip:27889
3. Directions to project (from nearest major intersection):
U.S.I-Iinhway 264 West to 200 feet before (east of) intersection of 264 and NCSR 1567 (Clarks Neck Road)
4. Latitude:35° 33.882' " N Longitude:77° 4.549' " 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 number SW 7090101 , its issue date (if known) May 13, 2009 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, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ®Sedimentation/Erosion Control: 1.2 ac of Disturbed Area
❑NPDES Industrial Stormwater 0404/401 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:
FormSWU-101 Version07Jun2010 Page I of

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lit: 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: L. Washington Enterprises, LLC
Signing Official &'Title: Virginia Eitner, Manager
b.Contact information for person listed in item la above:
Street Address:
City: State: Zip:
Mailing Address (if applicable): P.O. Box 3320
City: New Bern State:NC Zip:28563
Phone: (252 ) 671-1771 Fax: (252 ) 637-5576
Email:[e-mail]
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: L. Washington Enterprises, LLC
Signing Official & Title: Virginia Eitner, Manager
b.Contact information for person listed in item 2a above:
Street Address:
City: State: Zip:
Mailing Address (if applicable):P.O. Box 3320
City: New Bern State: NC Zip: 28563
Phone: (252 ) 671-1771 Fax: (252 ) 637-5576
Email:[e-mail]
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: L. Washington Enterprises, LLC
Signing Official & 1'itle:Virginia Eitner, Manager
b. Contact information for person listed in item 3a above:
Mailing Address: P.O. Box 3320
City: New Bern State:NC Zip:28563
Phone: (252 ) 671-1771 Fax: (252 ) 637-5576
Email:virginia.eitner@gmai].com
4. Local jurisdiction for building permits: City of Washington
Point of Contact: John Rodman Phone #: (252 ) 975-9334
Form SWU-101 Version 07Jun2010 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Stormwater runoff collected and treated in on -site bio-retention area.
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.lf 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 Tar -Pamlico River basin.
4. Total Property Area: 1.201 acres 5. Total Coastal Wetlands Area: 0 acres
6. "Total Surface Water Area: 0 acres
7. 'Total Property Area (4) -'rota) Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
AreW:1.201 acres
Total project area shall be calculated to exclude the followin the normal pool of impounded structures, the area
between tine banks of streans 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 MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal evetlannds laidroard of the NHW (or MHW) line any
be inL:uded in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 50.5 %
9. How many drainage areas does the project have?] (For high density, count 1 for each proposed engineered
stornavater BMP. For low density and other projects, use I 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
Draina e Area 1
Draina e Area _
Draina e Area _
Draina e Area
Receiving Stream Name
Kennedy Creek
_
Stream Class .
C, NSW
Stream Index Number *
28-104
Total Drainage Area (so
52,324
On -site Drainage Area (so
52,324
Off -site Drainage Area (so
0
Pro osed Impervious Area* (so
26,424
% Im ervious Area** total
50.5
Impervious** Surface Area
Drainage Area 1
Drainage Area _
Drainage Area —
Draina e Area
On -site Buildings/Lots (so
2,497
- —
On -site Streets (so
0
On -site Parking (so
22,302
On -site Sidewalks (so
1,625
Other on -site (so
0
Future (so
0
Off -site (sf)
1 0
Existing BUA*** (sf)
0
Total (so:
26,424
Stream Class and Index Number call be deternnined at: http.- portal.ncdmnr.org/iweb/toq/ps/csu/clnssi ications
hu ervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Report only that anount of existing BUA that will remain after development. Do not report ally existing BUA that
is to be removed and which will be replaced by new BUA.
FormSWU-101 Version 07Jun2010 Paae3of6

H. How was the off -site impervious area listed above determined? Provide documentation.
Proieets in Union Countv: Contact DWQ CeniralOjTice siaffto check if the project is located within a Threatened &
Endangered Species watershed that may be subject to nwre 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 littp://Portal.nctlenr.orR/web/wo/ws/su/bap-manual.
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 fromlittL,://portal.ncdenr.org/web/wq/ws/su/statesw/forms dots. 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://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://Liortal.ncdenr.org/web/wq/"ws/su/statesw/forms does.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. 9-
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants 4'//t
Form. (if required as per Part V11 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.eiivhelp.org/pages/onestopexpress.htniI 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 G
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 E#
receiving stream drains to class SA waters within'/2 mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations. Tel
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 NCSIZ 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 MI-1W or NHW line of tidal
waters, and any coastal wetlands landward of the MFIW or NFIW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
Form SWU-101 Version 07Jun2010 Page of

9r Copy of any applicable soils report with the associated SHWT elevations (Please identify
e evations inaddition 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.
(Infiltra`.ion Devices submitted to WiRO: Schedule a site visit for DWQ to verifij the SHWT prior
to submittal, [phone].)
10. A copy of the most current property (iced. Deed book:1635 Page No: 0723
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 lnformation, item 'la, 2a, and/or 3a per NCAC 2I-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.
http://www.secretary.state.nc.us/Corporatiolis/­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
http://portal.ncdenr.org/web/wq/ws/su/statesw/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 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: Kevin Avolis, P.E.
Consulting Firm: Avolis Engineering, P.A.
Mailing Address: P.O. Box 15564
City: New BPrn
Phone: (252 ) 633-0068
Email:avol isengineering aOembargmail.com
State: NC Zip: 28561
Fax: (252 ) 633-6507
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 tins been filled out, complete this
section)
I, (print or hype name 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 type name of organization listed in
Contact Information, item la) 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.
ForaSWU-101 Vcrsion07Jun2010 Page 5of6

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 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.
a Notary Public for the State of
do hereby certify that
before me this _ day of
County of
personally appeared
and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission
X. APPLICANT'S CERTIFICATION
I, (print or type name ofperson listed in Contact Information, item la) Virginia Eitner
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 (iced restrictions
and protective covenants will her ied, and that the proposed project complies with the requirements of the
applicable storinw9ter rules nder 15 CAC 2I-I .1000, SL 2006-246 (Ph. II - Post Construction) or SL 2008-211.
Date:
4 I f'V�r'I'x2 3—I a Notary Public for the State of NQorA4. Q G(+"lk�r o-., Countyof
C,J 0.J¢r do hereby certify that J \ f (`ifs( C, Lt4/-,9./ personally appeared
before me this2:Y day of MO(r Cr 2Ct2 , and acdki wedge the due execution of the application for
a stormwater permit. Witness my hand and official seal, — �1r��_�
0,L ice.
NOTARY
PUBLIC
�*ilz�VfNIGO`��xxxx
SEAL
My commission expires t--�QC'% � 22. EON
Form SWU-101 Version 07Jun2010 Page 6 of 6

Permit Number:
(to be provided by D WQ)
r, OF W Arpq
h r
NCDENR
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
,Dunkin Donuts
Contact name
:Virginia Eitner
Phone number
1252-671-177
Date
(March 21, 2012
Drainage area number
`i
II.'DESIGNIINF,ORMATION
Site Characteristics
Drainage area
__ __ _
I� 52,324•ft2
Impervious area
26,424!ft2
Percent impervious
50.5% %
Design rainfall depth
I 1.5inch
Peak Flow Calculations
Is pre/post control of the 1-yr, 24-hr peak flow required?
1-yr, 24-hr runoff depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
Pre/Post 1-yr, 24-hr peak control
SlorageVolume: Non-SAWaters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5' runoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
Cell Dimensions
Ponding depth of water
Fondling depth of water
Surface area of the top of the bioretention cell
Length:
Width:
-or- Radius
Media and Soils Summary
Drawdown time, ponded volume
Drawdown time, to 24 inches below surface
Drawdown time, total:
In -situ soil:
Soil permeability
Planting media soil:
Soil permeability
Soil composition
• Sand (by volume)
• Fines (by volume)
• Organic (by volume)
Phosphorus Index (P-Index) of media
Form SW401-Bioretention-Rev.8
June 25, 2010
Y #orN)
3.5`in
4.42� inlhr
1.910ift3lsec
0.000',ft3lsec
-1.910 ft3lsec
L_ " V~k''_�
C.N) a w6
jf
1 t Q10 - 00r(
4,344.0,ft3 OK
.ft3
' ft3
0 ft3
ft3
10.8'inches
0.90 It
6,691.oift2
Varies'ft
80;ft
Ift
42hr
54 hr
10.30i inlhr
1.Wj inlhr
86%
10%1
4%
Total: 100%
20i(unitless)
OK
OK
OK
OK
OK
Insufficient 24-inch drawdown time.
OK
OK
OK
OK
OK
OK
Parts I and II. Design Summary, Page 1 of 2

Basin Elevations
Permit Number:
(to be provided by DWQ)
Temporary pool elevation
Type of bioretention cell (answer 'Y' to only one of the two
following questions):
Is this a grassed cell?
Is this a cell with treeslshrubs?
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
12.40;fmsl
N (Y or N)
Y (Y or N)
11.5 fmsl
3, inches
8.25'.fmsl
3.25 it
0.33!ft
N (Y or N)
i
I
Ott
,7..-<fmsl
k;fmsl
Wft
Y j(Y or N)
fmsl
11.5 tt
OK media depth
OK
ren
�..__--—-2:
3
2
OK
Does volume in excess of the design volume bypass the
Y
'(Y or N)
bioretention cell?
Does volume in excess of the design volume flow evenly distributed':
N
(Y or N)
through a vegetated filter?
What is the length of the vegetated filter?
0'ft
Does the design use a level spreader to evenly distribute flow?
N
(Y or N)
Is the BMP located at least 30 feet from surface waters (50 feel if
Y
;(Y or N)
SA waters)?
Is the BMP Iocaled at least 100 feet from water supply wells?
Y
,(Y or N)
Are the vegetated side slopes equal to or less than 3:1?
Y
(Y or N)
Is the BMP located in a proposed drainage easement with access !
Y
(Y or N)
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 bioretention 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
OK
Excess volume must pass through filler.
Show how flow is evenly distributed.
OK
OK
OK
OK
112
or N) OK
or N) OK
or N) OK
OK
Form SW401-Bioretenlion-Rev.8
June 25, 2010 Parts I and II. Design Summary, Page 2 of 2

Permit No:
(to be assigned by DWO)
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.
_A—
1. Plans IV - 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),
- Cell dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement.
1 C/
2. Plan details (1' = 30' or larger) for the bioretention cell showing:
- Cell dimensions
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Design at ultimate build -out,
- Off -site drainage (if applicable),
.
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement,
- Indicate the P-Index between 10 and 30
3. Section view of the bioretention cell (1' = 20' or larger) showing:
- Side slopes, 3:1 or lower
- Underdrain system (if applicable), and
- Bioretention cell layers [ground level and slope, pre-treatment, ponding depth, mulch depth, fill media
depth, washed sand, filter fabric (or choking stone if applicable), #57 stone, underdrains (if applicable),
SHWT level(s), and overflow structure]
G%1.L
4. 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 DWO, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information. All
elevations shall be in feet mean sea level (fmsl). Results of soils tests of both the planting soil and the in
situ soil must include:
- Soil permeability,
//��
and
7r f
l..J
- index.
�1
d-Soilcomposition(%sand,%fines,%organic),
5. A detailed planting plan (1' = 20' or larger) prepared by a qualified individual showing:
- A variety of suitable species,
- Sizes, spacing and locations of plantings,
- Total quantity of each type of plant specified,
- A planting detail,
- The source nursery for the plants, and
- Fertilizer and watering requirements to establish vegetation.
6. A construction sequence that shows how the bioretention cell will be protected from sediment until the
entire drainage area is stabilized.
C k1�*
7. The supporting calculations (including underdrain calculations, if applicable).
8. A copy of the signed and notarized inspection and maintenance (I&M) agreement.
9. A copy of the deed restriction.
Fonn SW401'-Bioretention-Rev] Part III, Page 1 of 1

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Bioretention 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 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 betaken to prevent sediment from entering the bioretention cell.
— Once a year, a soil test of the soil media will be conducted.
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 (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:
Potentialproblems:
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
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide time 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).
Form SW401-BioretentionO&M-Rev.3 Page I of

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 necessar .
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
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
possible.
An annual soil test shows that
Dolomitic lime shall be applied as
pH has dropped or heavy
recommended per the soil test and
metals have accumulated in
toxic soils shall be removed,
the soil media.
disposed of properly and replaced
with new planting media.
Fomt SW401-Bioretention O&M-Rev.3 Page 2 of 4

BMP element:
Potentialproblems:
How I will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
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-Bioretention O&M-Rev.3 Page 3 of 4

Permit Number:
(to 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: Dunkin Donuts - Washington
BMP drainage area number:
Print name: L. Washington Enterprises, LLC
Title:Virginia Eitner, 'Manager
Address:P.O. Box 3320, New Bern, NC 28563
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.
& a Notary Public for the State of
moo— , County of Q.(-OLO � do hereby certify that
�f QAf�� a personally appeared before me thisL
day of ��O / Ch 2012 , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
NOTARY
PUBLIC ZF
��'NICtO`\\sP�
SEAL
My commission expires PQC 1 22. 20%"
Form SW401-Bioretention 1&M-Rev. 2 Page 4 of 4

STORMWATER NARRATIVE — MODIFIED SITE
Proposed Dunkin Donuts
1689 U.S. Highway 264 West (West 51h Street)
Washington, Beaufort County, North Carolina
This project consists of the development of a new Dunkin Donut facility on a parcel of land
covering a total of 52,324 square feet, 1.201 acres. The subject property is presently developed
with three residential dwellings which will be demolished. A new Dunkin Donuts facility and
parking facilities will be constructed on the site which will cover a total area of 26,424 square feet.
The project built -upon percentage of 50.5% results.
The proposed project is classified as a high density project as it relates to stormwater collection
and treatment. Additionally, the project is located within the City of Washington which has a
Stormwater Management Ordinance and Program for Nutrient Control. The City of Washington
Stormwater Program requires that the post -development runoff level be attenuated, through
stormwater control, to pre -development levels, as a minimum. This Stormwater Program sets
threshold for nitrogen and phosphorus export from the site.
The new Coastal Stormwater Regulations which are effective October 1, 2008 are triggered by this
project since in excess of 10,000 square feet of impermeable surfaces is proposed.
In order to attenuate post -development runoff levels to pre -development runoff levels, a
bio-retention area will be installed on the site. The bio-retention area is sized to contain the full
difference between pre and post development runoff levels for the one-year, 24-hour storm. The
proposed storage volume in the bio-retention basin is 4,344 cubic feet.
The proposed bio-retention area provides nutrient removal efficiencies of 35% reduction for
nitrogen and 45% for phosphorus. The removal of the nitrogen and phosphorus in the
bio-retention area results in export levels near 'lie prescribed minimums. A buydown feature is
provided for in the City of Washington Stormwater Management Ordinance and will be utilized to
further offset nitrogen and phosphorus exports for the project. Payment to the Ecosystem
Enhancement Program is proposed for the additional nutrient control measures.
The soils on the subject property consist of Tarboro sand. The permeability rates for these soils is
reported to be 6 to 20 inches per hour. The season high water table on the subject property was
revealed at a depth of 50 below the surface, at an elevation of 8.33. The bottom of the
bio-retention basin is set to an elevation of 11.2 feet or approximately 2.87 feet above the seasonal
high water table.
As designed, the project complies with Coastal Stormwater Regulations effective October I, 2008
and the City of Washington Stormwater Management Ordinance and Program for Nutrient Control
last revised February 6, 2008.