SW7110902_CURRENT PERMIT_20111006

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

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North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
October 6, 2011
Mr. Arthur Ravenel, III, Managing Partner
ARTTSCOTWO, LLC
105 Wappoo Creek Drive, Suite 4-A
Charleston, SC 29412
Subject: Stormwater Permit No. SW7110902
Tractor, Supply
High Density Project
Craven County
Dear Mr. Ravenel:
The Washington Regional Office received a complete Stormwater Management Permit Application for
Tractor Supply on September 20, 2011. 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. SW7110902 dated October
6, 2011, for the construction of the subject project.
This permit shall be effective from the date of issuance until October 6, 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 adfudicatory 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 150E of the
North Carolina General Statutes, and filed with the Office of Administrative Hearings, 6714 Mail
Service Center, Raleigh, NC 27699-6714. Unless such demands are made this permit shall be final
and binding.
If you have any questions, or need additional
Vinson, or me at [phone].
Su
concerning this matter, please contact Scott
Protection Section
AH/sv: S:\WQS\STORMWATE R\PERM IT\SW7110902
cc: Kevin Avolis, PE
City of New Bern Planning/Building Inspections
Washington Regional Office
North Carolina Division of Water Quality Internet: v .ncvvateiqualny org One
943 Washington Square Mall Phone: [phone] FAX: [phone] NorthCarolina.
Washington, NC 27689 FAX: [phone] Naturally
An Equal Opportunity 1 Affirmative Action Employer

State Stormwater Management Systems
Permit No. SW7110902
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
ARTTSCOTWO, LLC
Tractor Supply
At the intersection of ML King, Jr. Blvd. and Academic Drive, New Bern, Craven County
FOR THE
construction, operation and maintenance of one infiltration basin and one curb outlet swale 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 October 6, 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.
2. This stormwater system has been approved for the management of stormwater runoff
as described in Section 1.8 on page 3 of this permit. The stormwater infiltration basin
has been designed to handle the runoff from 110,114 square feet of impervious area.
The stormwater curb outlet swale has been designed to handle the runoff from 13,641
square feet of impervious area.
3. This project proposes a curb outlet system. The curb outlet swale shown on the
approved plan must be maintained at a minimum of 100' long, maintain 5:1 (H:V) side
slopes or flatter, have a longitudinal slope no steeper than 5%, carry the flow from a
10 year storm in a non -erosive manner, maintain a dense vegetated cover, and be
located in either a dedicated common area or a recorded drainage easement.
4. The tract will be limited to the amount of built -upon area indicated in Section 1.2 and 1.8
on page 3 of this permit, and as shown on the approved plans.
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.
Page 2 of 7

State Stormwater Management Systems
Permit No. SW7110902
6. The runoff from all built -upon area within the permitted drainage area of this project
must be directed into the permitted stormwater control systems).
7. The built -upon areas associated with this project shall be located at least 50 feet
landward of all surface waters.
8. The following design criteria have been permitted for the infiltration basin and must be
provided and maintained at design condition:
a. Drainage Area, acres:
3.82
b. Total Impervious Surfaces, ft2:
110,114
C. Design Storm, inches:
1.50 / (10yr.=7.Oin.)
d. Basin Depth, feet:
5.20
e. Bottom Elevation, FMS
16.00
f. Bottom Surface Area, ft :
7,584
g. Bypass Weir Elevation, FMSy
21.20
h. Permitted Storage Volume, ft :
62,705
i. Predevelopment 1 year 24 hour:
0.09
j. Post -development 1 year 24 hour:
0.00
k. Type of Soil:
Autryville
I. Expected Infiltration Rate, in/hr:
8.30
m. Seasonal High Water Table, FMSL:
13.00
n. Time to Draw Down, hours:
14.00
o. Receiving Stream/River Basin:
Wilson Creek / Neuse
p. Stream Index Number:
27 — 101 — 37
q. Classification of Water Body:
"C; Sw, NSW"
II. SCHEDULE OF COMPLIANCE
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 times 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 revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of bypass structure, infiltration media, flow
spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all times.
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 facilities shall be constructed as shown on the approved plans. 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.
Page 3 of 7

State Stormwater Management Systems
Permit No. SW7110902
6. 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.
7. 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.
Access to the stormwater facilities shall be maintained via appropriate easements at all
times.
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.
10. Prior to transfer of ownership, the infiltration basin and/or swale(s) must be inspected
and determined to be in compliance with the permit. Any deficiencies will be repaired
or replaced prior to the transfer.
11. A copy of the approved plans and specifications shall be maintained on file by the
Permittee at all times.
12. 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 to any person .or entity 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 to the Division of
Water Quality, signed by both parties, and accompanied by the appropriate
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 the transfer request.
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.
Page 4 of 7

State Stormwater Management Systems
Permit No. SW7110902
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 reissuance or termination does not
stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
controls 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 2H.1000, and NCGS 143-215.1 et. al.
11. The permittee shall notify the Division in writing of any name, ownership or mailing
address changes at least 30 days prior to making such changes.
12. This permit shall be effective from the date of issuance until October 6, 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 6ch day of October, 2011.
LINA ENVIRONMENTAL MANAGEMENT COMMISSION
7z = for
oleen H. 6011ins: Direc or
Division of Water Quality
By Authority of the Environmental Management Commission
Permit No. SW7110902
Page 5 of 7

State Stormwater Management Systems
Permit No. SW7110902
Tractor Supply — New Bern
Stormwater Permit No. SW7110902
Craven 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)
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. SW7110902
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.
6. The bypass structure weir elevation is per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the bypass structure.
8. All slopes are grassed with permanent vegetation.
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. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
City of New Bern. Planning/Building Inspections
Page 7 of 7

tractor Supply — New Bern
Rormwater Permit No. SW7110902
yen Courrtv
)esigner's Certification
State Stormwater Management Systems
Permit No. §W7110902
RECEIVE®
MAR 2 8 2012
J. Kevin Avolis as a duty registered Professional Engineer intheState
;f North Carolina, having been authorized to observe (periodically/ weekly/ full time) the
instruction of the project,
Tractor Supply
(Project)
for ARTTSCOTWO , LLC I (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 bullt 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:
Page 6 of 1

't
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.:' �.
�' �V '

State Stormwater Management Systems
Permit No, SW7110902
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.
�ZI5. The bypass structure weir elevation is per the approved plan.
✓6. The bypass structure is located per the approved plans.
A Trash Rack is provided on the bypass structure.
All slopes are grassed with permanent vegetation.
✓9.
Vegetated slopes are no steeper than 3:1.
✓ 10 The inlets are located per the approved p tans and do not cause short-circuitin
I✓
11.
-712.
✓13.
—714.
of the system. 9
The permitted amounts of surface area and/or volume have been provided.
All required design depths are provided.
All required parts of the system are provided.
The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
City of New Bern Planning/Building Inspections
Page 7 of 7

AVOLIS ENGINEERING, P.A.
P.O. Box 15564 New Bern, North Carolina 28561 Office: 252.633.0068
RECEIVE®
March 22, 2012
MAR 2 8 2012
Mr. Al Hodge
Regional Supervisor
Surface Water Protection Section
Washington Regional Office
943 Washington Square Mall
Washington, NC 27889
RE: Engineer's Stormwater Certification — SW 7110902
"tractor Supply, New Bern, Craven County, North Carolina
AE Project No. 10051
Dear Al:
Enclosed please find the Engineer's Stormwater Certification for the above -referenced project.
Should you have any questions relating to this matter or need any additional information or
assistance, please do not hesitate to call.
Sincerely,
:vin Avolis, P.E.
ce-President

F� r
`DWQ USE ONLY . . ... -,..:
e s,
Fee Paid
Permit Number
Gr
e
094)
Applicabl 1 astal SW -1115 ❑ Coasta SW - 2008 ❑ Ph II - Post Construction
(select all t(g+td 1'���6❑ Non-CoastalSW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
�(r LJ�n�y�.�ther WQ M mtPlan:
State of North Carolina M �i E
Department of Environment and Natural Resources Q`1
Division of Water Quality �2 W py
tfij
STORMWATER MANAGEMENT PERMIT APPLICATION FO�CT `�n, Q (� 0
This form may be photocopied for use as an original D1J^u_ Y Y �1 �O
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.):
2. Location of Project (street address):
3821 Mi. King, In Boulevard
City:New Bern County:Craven Zip:28562
3. Directions to project (from nearest major intersection):
Project is located southeast of the intersection of ML King Jr. Boulevard (U517) and Academic Drive.
4. Latitude:35° 05' 41" N Longitude:77* 06' 43" W of the main entrance to the project.
IL 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 , its issue date (if known) and the status of
construction: []Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from 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
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 6.5 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:
Form SWU-101 Version 07Jun2010
Page 1 of 6

floc E t 938
�
ti,

r Ill. CONTACT INFORMATION
I. 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:ARTTSCOTWO. LLC
Signing Official & Title:Arthur Ravenel, III - Managing Partner
b.Contact information for person listed in item I above:
Street Address:105 Wappoo Creek Drive, Suite 4-A
City:Charleston
Mailing Address (if
Phone: (843 ) 723-7840
Email:[e-mail]
Zip:29412
Fax: (843 ) 722-6647
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: Meadows Properties, LLC
Signing Official & Title:Heidi W. Ravenel, N en+er IAo. ag of
b. Contact information for person listed in item 2a above:
Street Address:120 Farmfield Avenue
City:Charleston State:SC Zip:29407
Mailing Address (if applicable):
Phone: ( ) 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/
Signing Official & Title
b.Contact information for person listed in item 3a above:
Mailing Address:
Phone: ( ) Fax:
4. Local jurisdiction for building permits: City of New Bern
Point of Contact:Mr. Johnny Clark Phone #: (252 ) 639-2941
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 from the high density portion of the site will be treated by an infiltration basin designed to
capture the 10-year, 24-hour storm. The low density driveway area runoff will be treated by a 5:1 swale.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Neuse River basin.
4. Total Property Area: 5.96 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*:5.96 acres
Total project area shall be calculated to exclude the following the nornnal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Nornal High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHA 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 = 47.64 %
9. How many drainage areas does the project have?2 (For high density, count 1 for each proposed engineered
stormrater 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. 'XPe;,t� ) pr( 1
P G J" "
Basin Information`
Drainage Area
Drainage Area
Drainage Area
Drainage Area "
Receiving Stream Name
Wilson Creek
Wilson Creek
Stream Class *
C; Sw, NSW
C; Sw, NSW
Stream Index Number *
27-101-37
27-101-37
Total Drainage Area (so
166,375
93,407
On -site Drainage Area (sf)
166,375
85,782
Off -site Drainage Area (sf)
1 0
7,625
Proposed Impervious Area** (so
1.10,114
13,641
% Im ervious Area** total
66.18
14.6
Impervious" Surface Area ''
'Draina e Areal_
Draina e Area2
Draina eArea
Draina e Area
On -site Buildings/Lots (so
19,050
0
On -site Streets (so
0
6,016
On -site Parking (so
84,126
0
On -site Sidewalks (so
6,938
0
Other on -site (so
0
0
Future (so
0
0
Off -site (sf)
1 0
7,625 (Driveway)
Existing BUA*** (sf)
1 0
0
Total (so:
1 110,114
13,641
* Stream Class and Index Number can be determined at: lltp:dportaLuedennr.or oeb/mq[ps/csn/elassifieatious
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
*** Report only that annount 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.
Form SWU-101 Version 07Jun2010 Page 3 of 6

11. How was the off -site impervious area listed above determined? Provide documentation.
Field visit and topographic survey.
Proiccts in Union County: Contact DWQ Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that inav 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 httt)://Dortal.ncdenr.ore/web/wo/ws/su/bmD-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 from http://portal. ncdennorg/web/wg/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://porta1.ncdennorg/web/wq/ws/so/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 ham://portal.ncclennorg/web/wq/ws/su/statesw/forms does.
II r
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
Porm. (if required as per Part VII beloL
oeo)
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.envhel]2.org/pages/onestopexpress.htmI for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 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.
I. 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 NI-IW 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.
I. 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 4 of 6

'9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
ld' ' f 1
F111
11.
h h eevations m ad ition to depths) as well th as a map o e boring ocahons witte existing
efevations 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 verifij the SHWT prior
to submittal, [phone].) _
A copy of the most current property deed. Deed book: 1633 Page No: 242
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.
http://www.secretary.state.nc.us/Corl2orations/­CSearch.aVx
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://portalmcdennorg/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, PE
Consulting Firm: Avolis Engineering, PA
Mailing Address:P.O. Box 15564
City:New Bern
Phone: (252 ) 633-0068
Email:[e-mail]
State:NC Zip:28561
Fax: (252 ) 633-6507
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
1, (print or type naine of person listed in Contact Information, item 2a) Heidi Ravenel, Membei Moa ogef, certify that I
own the property identified in this permit application, and thus give permission to (print or type mmne of person
listed in Contact Information, item 1a) Arthur Ravenel with (print or type mmne of organization listed in
Contact Information, item la) ARTTSCOTWO, LLC 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 07Jun2010 Page 5 of 6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease'agreement, or pending sale, responsibility for compliance with the 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 iri appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature: �lfGQ�eT,foP i • G1-c 4, r C • Date: I^
1, �d N ✓��1 t9Iedd(1 ZT!! Z-Notary Public for the State of t � ounty of
C{ [/�2l �S�or✓ do hereby certify that t4�t D I �y��✓�L personally appeared
before me this I 17d4avof lJ L and acknowle$e the due ep9cution c1the application for
a stormwater permit. Witness my hand and official seal,
SEAL
L
&MWIM h, NdW cnanosimcountySt Ch dS`ti mnfVp
TIY11551plI Evp1165 NOv. 71, 101f (2/ I
My commission expires /_ 1 1 A
X. APPLICANT'S CERTIFICATION
1, (print or hjpe mmne of person listed in Contact Information, item ]a) Arthur Ravenel
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructeo in confor anc with the approved plans, that the required deed restrictions
and protective covenants wil Ue ecorded, nd the proposed project complies with the requirements of the
applicable stormwater rulesiin r 15A AC�1000, SL 2006-246 (Ph. II -Post Constructy6n) Pr SL 2008-217.
Signature: I N Dater
I, �C�hSlryv" a Notary Public for the State of N County of
C r0"x LPG do hereby certify that '1 0 J �"�1 -1-u- personally appeared
before me this Sf-day of �-Ati,S 2C,t\ and acynpwledge the due execution of the application for
a stormwater permit. Witness my hand and official seal"-
NOTARY
PUBLIC
�� I eNCO`�p�`•
SEAL
My commission expires \ 221 tow
Form SWU-101 Version 07Jun2010
Page 6 of 6

Permit
. (to be provided by DWD)
NCDEMRrXpRESS ���
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
.SEP 2 0 2011 401 CERTIFICATION APPLICATION FORM
p' pe
GRASSED SWALE SUPPLEMENT
NC ®ENR This form must be filled out, printed and submitted.
The Required Items Checklist (Part III) must also be filled out, printed and submitted along with all of the required information.
Project name
Contact name
Phone number
Date
Drainage area number
Site Characteristics
Drainage area
Impervious area
Percent impervious
Design rainfall depth
Peak Flow Calculations
10-yr storm runoff depth
10-yr storm intensity
Post -development 10-yr storm peak Flow
Velocity
Maximum non -erosive velocity (peak 10-year storm)
Soil characteristics (enter 'Y' below)
Sand/silt (easily erodible)
Clay mix (erosion resistant)
Grass Type (enter Y' below)
Bermuda
Tall fescue
Bahiagrass
Kentucky bluegrass
Grass -legume mixture
Swale type: Fill out one of the options below:
Option 1: Curb Outlet Swale:
Maximum velocity
Side slopes
Swale length
Option 2: Conveyance Swale, Seekina Pollutant Credit:
Maximum velocity for 10-yr storm
Side slopes
Swale length
F 93,407 00 f?
I 13,641.001fl2
14.6% %
I 1.50' inch
7.00 lin
I 8.38 l in/hr
( 5.20 Ife/sec
5.00 fYsec
C X
I I
X—�
I I
I I
I
I - I
(Y or N)
1.00 OK
5.00
1:1
OK
319.00
ift
OK
Y
I(YorN)
1.00
Ift/sec
OK
5.00
1:1
OK
319.00
Ift
OK
RECEIVE®
SEP 19 2011
DWQ-WARO
Form SW401-Grassed Swale-Rev.3 Parts I and II. Project Design Summary, Page 1 of 2

Permit Number:
(to be provided by DWQ)
Swale Characteristics
Swale Shape: Enter an'Y in the appropriate cell below:
Trapezoidal
Parabolic
V-shaped
Width of the bottom of the Swale
Width of the top of the Swale
Additional Information
Is the Swale sized for all runoff from ultimate build -out?
Is the BMP located in a proposed drainage easement with a
recorded access easement to a public Right of Way (ROW)?
What is the distance from the bottom of the Swale to the SHWT?
What is the ground level elevation?
What is the elevation of the bottom of the swale?
What is the SHWT elevation?
What is the longitudinal slope of the Swale?
What is the depth of freeboard?
I I
x
I 0.00 lit
( lit
(YOrN) OK
I I
Yj (Y or N) OK
6.90 it OK
OK
OK
Form SW401-Grassed Swale-Rev.3 Parts I and II. Project Design Summary, Page 2 of 2

Permit No:
(to be assigned 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.
Initials Pagel Plan
Sheet No.
1. 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),
- Swale dimensions (width, length, depth),
- Maintenance access,
- Proposed drainage easement and public right of way (ROW),
- Grass species, and
- Boundaries of drainage easement.
c4— 2. Plan details (1" = 50' or larger) for the grassed swale showing:
- Swale dimensions (width, length, depth),
- Maintenance access,
- Proposed drainage easement and public right of way (ROW),
- Design at ultimate build -out,
- Grass species,
- Off -site drainage (if applicable),and
- Boundaries of drainage easement.
�V V — 3. Section view of the grassed swale (1" = 20' or larger) showing:
- Side slopes,
- Longitudinal slope,
- Freeboard
- Swale dimensions, and
- SHWT level(s)
A"n*HIV 4. Supporting calculations (including maximum velocity calculations for applicable storms)
=Y 5. A copy of the signed and notarized operation and maintenance (0&M) agreement.
AITACHO 6. A copy of the deed restrictions (if required).
SW401-Grassed Swale-Rev.3 Part III, Page 1 of 1

EXPRESS PermitName:
P Qi
to be ravided Y DW b
Drainage Area Number:
SEP 2 0 2011Grassed Swale Operation and Maintenance Agreement
NC ®ENR
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 maintenance procedures:
— The drainage area of the grassed swale will be carefully managed to reduce the
sediment load to the grassed swale.
— After the first-time fertilization to establish the grass in the swale, fertilizer will
not be applied to the grassed swale.
The grassed Swale will be inspected once a quarter. 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 length of the
Trash/debris is present.
Remove the trash/debris.
swale
Areas of bare soil and/or
Regrade the soil if necessary to
erosive gullies have formed.
remove the gully, and then re -sod
(or plant with other appropriate
species) and water until established.
Provide time and a one-time
fertilizer application.
Sediment covers the grass at
Remove sediment and dispose in an
the bottom of the Swale.
area that will not impact streams or
BMPs. Re -sod if necessary.
Vegetation is too short or too
Maintain vegetation at a height of
long.
approximately six inches.
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.
RECEIVED
SEP 19 2011
DWQ- V VAFrRO
Form SW401-Grassed Swale O&M-Rev.3 Page 1 of 2

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:Tractor Supply
BMP drainage area number:2
Print name:Arthur Ravenel, III
Title:Managing Partner - ARTTSCOTWO, LLC
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, � t �� rnm �t , a Notary Public for the State of
C , County of C t^0. rc do hereby certify that
0-f-A4- ' _lSL personally appeared before me this _
day of (� 2G\k , and acknowledge the due execution of the
forgoing grassed swale maintenance requirements. Witness my hand and official seal,
sl
NOTARY
rvCLl(;
09
eNICt0`\`
''
SEAL
My commission expires �fJ�t \ 22 2 3\-A
Form SW401-Grassed Swale O&M-Rev.3
Page 2 of 2

EXPRESS Permit No.
(to be provided by DWQ)
,SEP d 0 i1111
I'`
State of North Carolina
Department of Environment and Natural Resources
����'��®
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
SEP 19 2011
LOW DENSITY SUPPLEMENT
This form may be photocopied far use as an original n w .o_, n IARO
A low density project is one that meets the appropriate criteria for built upon area and transports stormwater
runoff primarily through vegetated conveyances. Low density projects should not have a discrete stormwater
collection system as defined by 15A NCAC 2H .1002(18). Low density requirements and density factors can be
found in Session Law 2008-211, 15A NCAC 2H .1000, Session Law 2006-246, and the DWQ BMP Manual.
Curb and gutter systems are allowed provided they meet the requirements in 15A NCAC 2H .1008(g).
1. PROJECT INFORMATION
Project Name : Tractor Supply
Contact Person: Kevin Avolis, PE Phone Number: ( 252 )633-0068
Number of Lots:I Allowable Built Upon Area (BUA) Per Lot*:N/A
Number of Dwelling Units Per Acre**:N/A
Low Density Development (check one): ❑ without curb & gutter ® with curb & gutter, outlets to (check one):
® Swales ❑ Vegetated Area
*If lot sizes are not uniform, attach a table indicating the number of lots, lot sizes and allowable built upon area for each lot.
The attachment must include the project name, phase, page numbers and provide area subtotals and totals. BUA shall be
shown in units of square feet.
**(Phase 11 Post -Construction (non -SA) only)
II. BUILT UPON AREA
Refer to DWQ's forms and applications website for specific language that must be recorded in the deed
restrictions for all subdivided projects.(http://h2o.enr.state.nc.us/su/bmp_fonns.htm)
Complete the following calculation in the space provided below where:
• SA Site Area - the total project area above Mean High Water.
• DF Density Factor - the appropriate percent built upon area divided by 100.
• RA Road Area - the total impervious surface occupied by roadways.
• OA Other Area - the total area of impervious surfaces such as clubhouses, tennis courts, sidewalks, etc.
• No. of Lots - the total number of lots in the subdivision.
• BUA per Lot - the computed allowable built upon area for each lot including driveways and impervious
surfaces located between the front lot line and the edge of pavement.
• Total allowable lot BUA - the computed allowable built upon area for all lots combined.
• Total BUA from lot listing - the sum of built upon area allocated for each lot on the list of non -uniform lots.
Form SW401-Low Density-Rev.3-2/10/09 Page 1 of 4

ME e f 93Z
� ��

Calculation:
For uniform lot sizes:
(SA: ft2 x DF: ) — (RA: ft2) — (OA: ft2) = BUA per Lot = ftZ
(No of Lots:
For non -uniform lot sizes:
a. (SA: ft2 x DF: ) — (RA: ft2) — (OA: ft2) = Total allowable lot BUA = ft2
b. Total BUA from lot listing: sf. b must be < a
III. DESIGN INFORMATION
Complete the following table. If additional space is needed the information should be provided in the same
format as Table 1 and attached to this form. Rainfall intensity data can be found in Appendix 8.03 of the State
of North Carolina Erosion and Sediment Control Planning and Design Manual or at
http://hdsc.nws.noaa.gov/hdsc/pfds/
Table 1. Swale design information based on the 10-vear storm.
Swale No.
Drainage
Area (ac)'
Impervious
Area (ac)'
Grassed
Area (ae)
C
Q
(cfs)
Slope
(%)
V.11'.
(fps)
Vactual
(fps)
Flow
Depth ft
l
2.14
0.31
1.06
0.45
5.2
0.10
4.5
1.0
1.0
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Form SW401-Low Density-Rev.3-2/10/09 Page 2 of 4

IV. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the North Carolina Administrative Code Section 15A
NCAC 2H .1000, NCDENR BMP Manual (2007), Session Law 2006-246, and Session Law 2008-211.
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 that the following requirements
have been met and supporting documentation is provided as necessary. If the applicant has designated an agent
on the Stormwater Management Permit Application Form, the agent may initial below. If any item is not met,
then iustification must be attached. Only complete items n through p for projects with curb outlets.
Page/Plan
Initials Sheet No.
VtA- a. t For projects in the 20 coastal counties: Per NCAC 2H.1005, a 50 foot wide vegetative buffer
is provided adjacent to surface waters. For Redevelopment projects, a 30' wide vegetative
buffer adjacent surface waters is provided.
hA b. t For HQW or ORW projects outside the 20 coastal counties: A 30 foot wide vegetative buffer
is provided adjacent to surface waters.
14A c. t
For Phase II Post -Construction projects: All built upon area is located at least 30 feet
landward of all perennial and intermittent surface waters.
4
d.
Deed restriction language as required on form SWU-101 shall be recorded as a restrictive
covenant. A copy of the recorded document shall be provided to DWQ within 30 days of
platting and prior to the sale of any lots.
q-rjt� Of e.
Built upon area calculations are provided for the overall project and all lots.
f.
Project conforms to low density requirements within the ORW AEC. (if applicable per
15A NCAC 2H .1007)
C 9 g.
Side slopes of swales are no steeper than 3:1; or no steeper than 5:1 for curb outlet swales.
V 4 It.
Longitudinal slope of swales is no greater than 5%; for non -curb outlet projects, calculations
for shear stress and velocity are provided if slope is greater than 5%.
lk C8LCL i.
At a minimum, swales are designed to carry the 10 year storm velocity at a non -erosive rate.
NtA j.
Swales discharging to wetlands are designed to flow into and through the wetlands at a non -
erosive velocity (for this flow requirement into wetlands, non -erosive is velocity < 2 ft/s).
B' C` k.
Swale detail and permanent vegetation is specified on the plans.
I.
Swale detail provided on plans; includes grass type(s) for permanent vegetative cover.
-ram m.
Swales are located in recorded drainage easements.
C-+ n.tt
Length of swale or vegetated area is at least 100 feet for each curb outlet.
4- o."
The system takes into account the run-off at ultimate built -out potential from all surfaces
draining to the system (delineate drainage area for each swale).
C4- p.tt
Curb outlets direct flow to a swale or vegetated area.
t Projects in the Neuse,
Tar -Pamlico, Catawba River basins, and Randleman Lake may require additional buffers.
tt Only complete these items for projects with curb outlets.
Forth SW401-Low Density-Rev.3-2/10/09 Page 3 of 4

V. SWALE SYSTEM MAINTENANCE REQUIREMENTS
Mowing will be accomplished as needed according to the season. Grass height will not exceed six inches
at any time; and grass will not be mowed too close to the ground or "scalped".
2. Swales will be inspected monthly or after every runoff producing rainfall event for sediment build-up,
erosion, and trash accumulation.
3. Accumulated sediment and trash will be removed as necessary. Swales will be reseeded or sodded
following sediment removal.
4. Eroded areas of the swales will be repaired and reseeded. Swales will be revegetated as needed and in a
timely manner based on the monthly inspections. Side slopes must be maintained at the permitted slope.
Catch basins, curb cuts, velocity reduction devices, and piping will be inspected monthly or after every
significant runoff producing rainfall event. Trash and debris will be cleared away from grates, curb cuts,
velocity reduction devices and piping.
6. Swales will not be altered, piped, or filled in without approval from NCDENR Division of Water Quality.
acknowledge and agree by my signature below that I am responsible for the performance of the six
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.
Print Name and Title:Arthur Ravenel, III - Managing Partner - ARTTSCOTWO, LLC
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.
I, I��.f\L(-� o�lrvs✓v� or, V , a Notary Public for the State of N �- , County of
J�.
Cr Q.V Cl^ , do hereby certify that personally appeared before me this _
day of ��.,.�.� 'Zps s , and acknowledge the due execution of the forgoing swale maintenance requirements.
Witness my hand and official seal,
Notary signature
NOTARY
seA�UBLIC
Q Z.
My commission expires Dl�)f t � 22,'2-
porm SW401-Low Density-Rev.3-2/10/09 Page 4 of 4

• �,,.r �
�r !�P�
LMi �
� Yw �'�
•' �•i� .
{*'�'; �.
.,,, �.

EV"'RESS
Permit
(to be provided by DWQ)
Ill. REQUIRED,IT,EM$jCHECKLIST
u v.pi r •YYY
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.
Page/ Plan
RECEIVED
Initials
Sheet No.
G4
1. Plans (1" - 50' or larger) of the entire site showing: SEP , 9 ZO,�
- Design at ultimate build -out,
- Off -site drainage (if applicable),
- Delineated drainage basins (include Rational C coefficient per basin),®, w ,�_, A I �®
-Basindimensions, VV VVH
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROW),
- Overflow device, and
- Boundaries of drainage easement.
GS
2. Partial plan (1" = 30' or larger) and details for the infiltration basin showing:
- Bypass structure,
- Maintenance access,
- Basin bottom dimensions,
- Basin cross-section with benchmark for sediment cleanoul,
- Flow distribution detail for inflow,
- Vegetated filter, and
- Pretreatment device.
GS
3. Section view of the infiltration basin (1" = 20' or larger) showing:
- Pretreatment and treatment areas, and
- Inlet and outlet structures.
GS
4. A table of elevations, areas, incremental volumes & accumulated volumes to verity the volume provided.
A WK9 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 DWO, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information.
�_ 6. A construction sequence that shows how the infiltration basin will be protected from sediment until the
entire drainage area is stabilized.
AIM2W 7. The supporting calculations.
8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
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

a soil

s� Permit No.
11 (to be provided by D WD)
°F WATeq`
STORMW
°
N ATER MANAGEMENT PERMIT APPLICATION FORM
NCDENR t4, ^ YF•'ft 401 CERTIFICATION APPLICATION FORM o Y
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, rifled out and submitted along with all of the required information.
I.11P,RWECT I N F,ORMATION
Project Name iTractor Supply
Contact Person !Kevin Avolis, PE
Phone Number 1252-633-0068 i
Date ;8,lul-1 l
Drainage Area Number 11 !
Site Characteristics
Drainage area
Impervious area
Percent impervious
Design rainfall depth
Peak Flow Calculations
1-yr, 24-hr rainfall depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr discharge
Post -development 1-yr, 24-hr discharge
Pre/Post 1-yr, 24-hr peak flow control
Storage Volume: Non -SA Waters
Minimum design volume required
Design volume provided
Storage Volume: SA Waters
1.5" runoff volume
Pre -development 1-yr, 24-hr runoff volume
Post -development 1-yr, 24-hr runoff volume
Minimum required volume
Volume provided
Soils Report Summary
Soil type
Infiltration rate
SHWT elevation
Basin Design Parameters
Drawdown time
Basin side slopes
Basin bottom elevation
Storage elevation
Storage Surface Area
Top elevation
Basin Bottom Dimensions
Basin length
Basin width
Bottom Surface Area
1 166,375TO 1ft2
110,114.00 Ift'
66.18 % tr
7.00 n ISD
1 3.70
lin
1 0.15
;in/hr
1 0.09
Ift'/sec
1 0.00
I ft'/sec
-0.09
ft'/sec
RECEIVE®
SEP 19 2011
DWQ-WARD
F 13,437.00 It,
1 62,705.00 {ft' OK for non -SA waters
Autryville ���
i 8.90 lin/hr
1 13.00 Ifmsl
0.10 days OK
3.00
C1
OK
16.00
fmsl
OK
1 21.20
jfmsl
1 17,003.00
Ift2
/6t Ss`t
1 22.00
Ifmsl
it 237.00 _ If
32.40 Ift
7,626.00 'fta
-71s $4
Form SW401-Infiltration Basin-Rev.5 11Ap2011 Parts I. & 11. Design Summary, Page 1 of 2

Permit No.
(to be provided by DWQ)
Additional Information
Maximum runoff to each inlet to the basin? 1
— 12.:
__' ac-in
Maximum of 2 acre -inches allowed
Length of vegetative filter for overflow
0.00
)fl
Filter is too short, must be > 30-ft
Distance to structure
50.00
It
OK
Distance from surface waters
150.00
ift
OK
Distance from water supply well(s) i
150.00.
;It
OK
Separation from impervious soil layer i
4.00
ift
OK
Naturally occuring soil above shwt i
4.00
ff
OK
Bottom covered with 4-in of clean sand? 1
Y
J(Y or N)
OK
Proposed drainage easement provided?
Y
I (Y or N)
OK
Capures all runoff at ultimate build -out? t
Y
i (Y or N)
OK
Bypass provided for larger storms? i.
N
(Y or N)
Must provide bypass for larger flows
Pretreatment device provided !
None
Fonn SW401-Infttmtlon Basin -Revs 11Ap2011 Parts I. & 11. Design Summary, Page 2 of 2

.EXPRESS
SEP 2 0 2011
NC ®ENR
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 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 maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the
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 1 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.
RECEIVES
SEP 19 2011
Form SW401-Infiltration Basin O&M-Rev.3D' A Q_, w , w RO Page I 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
spraying.
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:
(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
BMP drainage area number: I
Print name:Arthur Ravenel, III
Title:Managing Partner - ARTTSCOTWO,LLC
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.
I, (' & n--'m o-y , a Notary Public for the State of
L County of , do hereby certify that
fur w�
personally appeared before me this
day of�� 20and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
SIM
NOTARY(
PUBLIC
,a
9�EN10P\0�`
SEAL
My commission expires 22 12
Form SW401-Infiltration Basin O&M-Rev.3
Page 3 of 3