SW7130504_CURRENT PERMIT_20130628

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW A�i
DOC TYPE
CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
❑ ,COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYM M D D

North Carolina
Pat McCrory
Governor
Mr. Barnes Boykin, Secretary
Eastern Pride, Inc.
2405 W. Nash Street, Suite F
Wilson. NC 27893
Dear Mr. Boykin:
r
NC®ENR
Department of Environment and
Division of Water Quality
Thomas A. Reeder
Acting Director
June 28, 2013
Natural Resources
John E. Skvarla, III
Secretary
Subject: Stormwater Permit No. SW7130504
Family Dollar Store # 100 — Elizabeth City Relocation
High Density Commercial Wet Pond Project
Pasquotank County
The Washington Regional Office received a complete Stormwater Management Permit Application for the
subject project on May 24, 2013. 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. SW7130504 dated June 28, 2013, for the
construction of the subject project. Please submit the required designer's certification upon completion of
construction.
This permit shall be effective from the date of issuance until June 28, 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 adjudicatory hearing upon written.request within thirty (30) days following receipt of this
permit. This request must be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings, 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 information concerning this matter, please contact Roger
Thorpe at [phone].
Sincerely,
ncel�
0 o ,n.c o
Thomas A. Reeder
cc: Hyman & Robey, PC
Elizabeth City Building Inspections
Elizabeth City - Pasquotank County Airport Authority
North Carolina Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
Phone: [phone] FAX: [phone]
Internet: www.nmatemuality.oro
One
NorthC..nrnlinn

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
Eastern Pride, Inc.
Family Dollar Store # 100 Relocation
Located at
709 W. Ehringhaus Street — Elizabeth City
Pasquotank County
FOR THE
construction, operation and maintenance of a wet detention pond 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 June 28, 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 1.6 of this permit. The stormwater control has been
designed to handle the runoff from 34,123 square feet of impervious area.
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.
The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.

5.
A
The built -upon areas associated with this proJ'ect shall be located at least 50 feet
landward of all perennial and intermittent surface waters.
The following design criteria have been provided in the wet detention pond and
must be maintained at design condition:
a.
b.
C.
d.
e.
f.
h.
i.
1•
k.
I.
M.
n.
o.
p-
Drainage Area,ft2
Total Impervious Surfaces, ftZ:
Design Storm, inches:
Average Pond Depth, feet:
TSS removal efficiency:
Permanent Pool Elevation, FMSI�:
Permanent Pool Surface Arei, ft:
Permitted Storage Volume, ft :
Temporary Storage Elevation, FMSL:
Predevelopment 1 year 24 hour:
Post development 1 year 24 hour:
Controlling Orifice:
Permitted Forebay Volume, ft3:
Receiving Stream/River Basin:
Stream Index Number:
Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
51,298
34,123
1.5
3.08
90%
3.5
4,358
4,912
4.40
1.23 cfs
4.00 cfs
7/8 " 0
2,113
Pasquotank River/ Pasquotank
30-3-(7)
"SC"
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. Mowin.9 and re -vegetation of slopes and the vegetated filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of outlet structure, orifice device, level
spreader, filter strip, catch basins and piping.
g. Access to the outlet structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
records will indicate the date, activity, name of person performing the work and
what actions were taken.
Access to the stormwater facilities shall be maintained via appropriate
easements at all times.

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.
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. 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. 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.
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.
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, to the Division of Water
Quality, signed by both parties, and accompanied by supporting documentation
as listed on page 2 of the form. The project must be in good standing with the
Division. 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.
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 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division 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 June 28, 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 28 th day of June 2013.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
C2
For Thomas A. eder, Acting Director
Division of Water Quality
By Authority of the Environmental Management Commission
Stormwater Permit No. SW7130504

Family Dollar Store # 100 Relocation — Elizabeth City, NC
Stormwater Permit No. SW7130504
Pasquotank 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:
SEAL
Signature
Registration Number
Date

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.
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.

March 28, 2014
Mr. Roger Thorpe, PE
Dept. of Environment and Natural Resources
Land Quality Section
943 Washington Square Mall
Washington, NC 27889
Subject: Engineer's Certification
Family Dollar Store #100 Relocation
Permit No. SW 7130504
HR Project. #130042
Dear Mr. Thorpe:
HYMAN 0
ROBEY
APR - 2 2014
Enclosed please find the Designer's Certification for the above referenced project. Please note
that, due to the time of year, grass vegetation on the slopes is not yet well established; however
the slopes have been seeded and mulched and vegetation is beginning to grow. Also, the
wetland plants on the vegetative shelf will be installed at the appropriate time of the year.
If you have any questions, please do not hesitate to contact this office at [phone].
Sincerely,
Hyman & Robey, PC
Kimberly D. Hamby
Engineering Project Manager
cc: file
Stocks & Taylor
P. 0. Box 339 Camden, North Carolina 27921
[phone] License C-0598
w .hymanrobey.com

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Family Dollar Store # 100 Relocation — Elizabeth City, INC
Stormwater Permit No. SW7130504 APR - 2
Pasquotank County 2014
Designer's Certification 3`�`��i'�..%4�sgARO
l+ L F' b 1 .. z
I, Sean C. Robey , as a duly registered Professional Engineer in the
State of North Carolina, having been authorized to observe (periodically/ weekly/ full
time) the construction of the project,
Family Dollar Store #100 Relocation
(Project)
for Eastern Pride, Inc. (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: CARo
��O oQSH l/*
a i QQ �•••.
SEAL
= 18550
i FNOINEERI i
_� SEALAN cl I poe
/o Sd-0
Date �8!f
7

Nos - - ,,,A

Certification Requirements:
X 1. The drainage area to the system contains approximately the permitted
acreage.
X 2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
X 3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
X 4. All roof drains are located such that the runoff is directed into the system.
X 5. The outlet/bypass structure elevations are per the approved plan.
X 6. The outlet structure is located per the approved plans.
X 7. Trash rack is provided on the outlet/bypass structure.
X 8. All slopes are grassed with permanent vegetation.
X 9. Vegetated slopes are no steeper than 3:1.
X 10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
X 11. The permitted amounts of surface area and/or volume have been
provided.
X 12. Required drawdown devices are correctly sized per the approved plans.
X 13. All required design depths are provided.
X" 14. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
X 15. The required system dimensions are provided per the approved plans.
"The wetland plants have not yet been installed on the vegetated shelf due to the time of
year. The landscaper for the site will return to install the wetland vegetation during the
recommended planting times.

DWQ USE'ONLY
Date Received
Fee Paid
Permit Number
.s-ay- _a
h
5W7136,541f
Applicable Rules: ❑ Coastal SW -1995 0 Coastal SW
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters
❑ Other WQ Mgmt Plan:
- 2008 ❑ Ph II - Post Construction
❑ Universal Stormwater Management Plan
6% 5
State of North Carolina
Department of Environment and Natural Resources w^^; ,;A, ("111 7—p V E D
Division of Water Quality �� e
STORMWATER MANAGEMENT PERMIT APPLICATION FORPg 21 2013
This form may be photocopied for use as an original AY
I. GENERAL INFORMATION � ��� r,� /r
1. Project Name (subdivision, facility, or establishment name -should be consistent withRpiojec0.Q ot�. ARO
specifications, letters, operation and maintenance agreements, etc.):
Family Dollar Store #100 - Relocation
2. Location of Project (street address):
709 W. Ehringhaus Street
City: Elizabeth City County: Pasquotank Zip: 27909
3. Directions to project (from nearest major intersection):
From the intersection of NC 344 and US 17 Business travel east on US 17 Business (Ehringhaus Street) for
approximately 0 9 miles Project is on the southwest comer of Ehringhaus Street and Westover Street.
4. Latitude: 36* 17' 44.34" N Longitude: 76' 13' 50.63" W of the main entrance to the project.
II. PERMIT INFORMATION:
a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
tRenewals with modifications also requires SWU-102 - Renewal Application Form
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) , and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from 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):
❑LAMA Major
®Sedimentation/Erosion Control: 1.5 ac of Disturbed Area
❑NPDES Industrial Stormwater 7404/401 Permit: Proposed Impacts
b.lf any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? ❑No ®Yes
If yes, see S.L. 2012-200, Part VI: httl?://12ortal.ncdenr.org/web/wq/ws/su/st-,itesW/rLileS laws
Form SWU-101 Version 06Aug2012 Page I of 6

III. 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: Eastern Pride Inc.
Signing Official & Title: Barnes Boykin Secretary
b.Contact information for person listed in item la above:
Street Address: 2405 W. Nash Street, Suite F
City: Wilson State: NC Zip: 27893
Mailing Address (if applicable):
Phone: (252 ) 230-0632
Email: bamesboykinQyahoo.com
State:
Fax: (252 ) 237-0766
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: The Boys & Girls Club of Elizabeth CityInc.
Signing Official & Title: Mr. Tell Dixon President
b.Contact information for person listed in item 2a above:
Street Address: 524 S. Road Street
City: Elizabeth City State: NC Zip: 27909
Mailing Address
City:
Phone: (252 ) 330-5539
Email: [e-mail]
State: Zip:
Fax: (252 ) 330-4028
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:Contractor - Stocks & Taylor Construction
Signing Official & Title: B. Selden Taylor President
b.Contact information for person listed in item 3a above:
Mailing Address: P. O. Box 2147
City: Washington State: NC Zip: 27889
Phone: (252 ) 975-5855
Email: [e-mail]
Fax: (252 ) 975-5811
4. Local jurisdiction for building permits: City of Elizabeth City
Point of Contact: Stanley Ward, Chief Inspector Phone #: (252 ) 337-6868
Form SWU-101 Version 06Aug2012 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, bn'eFlv summarize how the stormwater runoff will be treated.
The stormwater runoff from the site will be collected in an underground piped drainage system and routed to
a wet detention basin designed to provide 90% TSS removal.
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
River basin.
4. Total Property Area: 1.35 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':0 acres
Total project area shall be calculated to exclude the folhnVinR the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NNW) 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 wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project.percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 63 %
9. Flow many drainage areas does the project have? 2 (For high density, count I for each proposed engineered
stormwater BMP. For Imo 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
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
Receiving Stream Name
Pasquotank Rvr
Pasquotank Rvr
Stream Class *
SC
SC
Stream Index Number *
30-3-(7)
30-3-(7)
Total Drainage Area (sf)
51,298
9,963
On -site Drainage Area (sf)
48,983
9,963
Off -site Drainage Area (sf)
2,315
0
Pro used Impervious Area** (so
34,123
2,945
% Impervious Area** (total)
66.5
29.6
Impervious*,* Surface Area'
Drainage Area 1
Drainage Area 2
Drainage Area
Drainage Area _
On -site Buildings/Lots (sf)
9,100
0
On -site Streets (so
0
0
On -site Parking (sf)
23,241
1,529
On -site Sidewalks (sf)
700
1,416
Other on -site (sf)
1,082
0
Future (sf)
0
0
Off -site (sf)
0
0
Existing BUA*** (sf)
0
0
Total (so:
34,123
2,945
Stream Class and Index Number can be determined at: http://portal.nedenr.org/zoeb/wq/ps/esu/classifications
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
*** Report only that amount of existing BUA 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 06Aug2012 Page 3 of 6

11. How was the off -site impervious area listed above determined? Provide documentation. N/A
Proiects in Union County: Contact DWQ Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15A 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 htto://portal.ncdenr.org/web/wq/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of 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.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 litti2://portai.iicdenr.org/web/wq/ws/su/m-,ii2s.)
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.ncdenr.org/web/wq/ws/su/statesw/forms dots.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. Wh
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants NIA
Form. (if required as per Part Vll below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
htto://www.envhelp.org/pages/onestopexpress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within'rz mile of the site boundary, include the'fi
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
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).
kAh
kah
P& I
Form SWU-101 Version 06Aug2012 Page 4 of 6

9. Copy of any applicable soils report with the associated SHWT elevations (Please identify kdh
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xll" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for D WQ to verify the SH WT prior
to submittal, [phone].)
A copy of the most current property deed. Deed book: 220 Page No: 343 J
For corporations and limited liability corporations (LLC): Provide documentation from the NC J
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
httl2://www.secreta!:y.state.nc.us/Corl2orations/CSearch.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
htto:/Ioortalmcdennore/web/wo/ws/su/statesw/forms dots. 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: Sean C. Robey, PE
Consulting Firm: Hyman & Robey. PC
Mailing Address: P. O. Box 339
City: Camden State: NC Zip: 27921
Phone: ( 252 ) 335-1888
Email:
Fax: ( 252 ) 331-2390
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) Jeff Dixon , certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item 1a) Barnes Boykin with (print or type name of organization listed in
Contact Information, item 1 a) Eastern Pride, Inc. to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 06Aug2012 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 in appropriate enforcement action including
the assessmentpf.Fivil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Date: `\ — - X-'s
a Notary Public for the State of IV x • , County of
7tS52 , do hereby certify that personally appeared
before me this 24day of 0.X7rI , blbl � and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seat, ��(Q�� ,� �• b ��eOl�a%X
SEAL
My commission
X. APPLICANT'S CERTIFICATION
My comn0sslon E.Vhu March 26, 2015
I, (print or type naive of person listed in Contact Information, item 1 a) Barnes Boykin
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded and that the proposed project complies with the requirements of the
applicable stormwater rules under N AC 2H .1000 and any other applicable state stormwater requirements.
Signature: -� Date:
�U
I, I It�Ii"SSC( 5 1aAQ S a Notary Public for the State of AA01 tGt \ G�W�h0- County of
WI spn do hereby certify that lCUroro personally appeared
before me this 3CPday of fl I 2013 , and acknowledge the duce execution of the application for
� a stormwater permit. Witness my hand and official seal, YeT� AN Y
J.
l
` 43
Uti
SEAL
My commission expires 10, 2013
Form SWU-101 Version 06Aug2012 Page 6 of 6

t'A counu nap frbp2 ;'jacp s8' 50

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
1 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.
The wet detention basin system is defined as the wet detention basin,
pretreatment including forebays and the vegetated filter if one is provided.
This system (check one):
❑ does ® does not incorporate a vegetated filter at the outlet.
This system (check one):
❑ does ® does not incorporate pretreatment other than a forebay.
Important maintenance procedures:
— Immediately after the wet detention basin is established, the plants on the
vegetated shelf and perimeter of the basin should be watered twice weekly if
needed, until the plants become established (commonly six weeks).
— No portion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
— Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— If the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
— Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected 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 should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash debris.
The perimeter of the wet
Areas of bare soil and/or
Regrade the soil if necessary to
detention 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.
Vegetation is too short or too
Maintain vegetation at a height of
long.
approximately six inches.
Form SW401-Wet Detention Basin O&M-Rev.4 Page 1 of 4

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
The pipe is clogged.
Unclog the pipe. Dispose of the
swale
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to
swale.
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible. Remove the sediment and
sediment storage.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
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. If pesticide is used, wipe it on
the plants rather than spraying.
The vegetated shelf
Best professional practices
Prune according to best professional
show that pruning is needed
practices
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design sediment
possible. Remove the sediment and
storage depth.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over
Consult a professional to remove
50% of the area.
and control the algal growth.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray).
the basin surface.
Form SW401-Wet Detention Basin O&M-Rev.4 Page 2 of 4

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair. if applicable)
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 local NC Division of
damage have occurred at the
Water Quality Regional Office, or
outlet.
the 401 Oversight Unit at 919-733-
1786.
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads 5;5 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 33:5 feet in the forebay, the sediment
shall be removed.
Sediment Removal
Bottom
0_0 1 1
-----------------
BASIN DIAGRAM
(fill in the blanks)
ft Min.
Sediment
Storage
Permanent Pool Elevation 3.5
Pool
\ Sediment Removal Elevation -2.0 Volur
--- ---- -------
Bottom Elevation -3.0 1 1-ft
Storage
FOREBAY
MAIN POND
Form SW401-Wet Detention Basin O&M-Rev.4 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: Family Dollar Store #100 - relocations
BMP drainage area number:
Print name: Bames Boykin
Title: Secretary, Eastern Pride, Inc.
Address: 2405 W. Nash St., Suite F, Wilson, NC 27893
vate: v
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, rY)P_VSSct S IOAeS , a Notary Public for the State of
N. kk CArot:na. County of WIbo , do hereby certify that
& MS &tAur% personally appeared before me this 304
day of �Jra , ar�, and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,
J
SEAL
My commission expires S)U_*_� 101 2013
14
Form SW40I-Wet Detention Basin O&M-Rev.4 Page 4 of 4

Permit No.
(to be provided by DWD)
AIK
o2ap W A Tg9O
y r
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORMo
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
Project name
Contact person
Phone number
Date
Drainage area number
17-May-13
1
II:�DESIGNINFORMATION.
Site Characteristics
Drainage area 51,298 ft2
Impervious area, post -development 34,123 ft2
%impervious 66.52 %
Design rainfall depth 1.5 in
Storage Volume: Non -SA Waters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5" mnoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
Peak Flow Calculations
Is the prelpost control of the lyr 24hr storm peak flow required?
1-yr, 24-hr rainfall depth
Rational C, pre -development
Rational C, post -development
Rainfall intensity: 1-yr, 24-hr storm
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
Pre/Post 1-yr, 24-hr peak flow control
Elevations
Temporary pool elevation
Permanent pool elevation
SHWi elevation (approx. at the perm pool elevation)
Top of 1Oft vegetated shelf elevation
Bottom of 1Oft vegetated shelf elevation
Sediment cleanout, top elevation (bottom of pond)
Sediment cleanout, bottom elevation
Sediment storage provided
Is there additional volume stored above the state -required temp. pool?
Elevation of the top of the additional volume
4,356 ft3
4,912 Ili
OK, volume provided is equal to or in excess of volume required.
ft3
ft2
ft2
ft3
0
N (Y or N)
3.1 in
0.20 (unitless)
0.70 (unitless)
5.21 in/hr OK
1.23 ft3lsec
4.00 ft3/sec
2.77 ft3/sec
4.40 fmsl
3.50 fmsl
3.50 fmsl
4.00 fmsl
3.00 fmsl
-2.00 foist
-3.00 foist
1.00 ft
y (Y or N)
4.4 fmsl OK
Fonn SW401-Wet Detention Basin-Rev.9-4/1 e/12 Pans 1. E 11. Design Summary, Page 1 of 2

Permit No.
(to be provided by DWO)
II. DESIGN'. INFORMATION. (m Ft .t i, 1 i,•p Atl tf,�^�+'., i tlrn': V'tti. iavK13o-nl 1INt,.1s,.1;.,? IFS
Surface Areas
Area, temporary pool
6,131 f12
Area REQUIRED, permanent pool
3,986 1112
SAIDA ratio
7.77 limitless)
Area PROVIDED, permanent pool, APo,,,.
4,358 tl`
OK
Area, bottom of 1 Oft vegetated shelf, A._.
2,279 ft`
Area, sediment cleanout, top elevation (bottom of pond), A,.
293 ft`
Volumes
Volume, temporary pool
4,912 ft'
OK
Volume, permanent pool, V,, .,
9,889 ft'
Volume, forebay (sum of forebays if more than one forebay)
2,113 tt'
Forebay %of permanent pool volume
21.4% %
OK
SAIDA Table Data
Design TSS removal
90
Coastal SAIDA Table Used?
Y (Y or N)
Mountain/Piedmont SAIDA Table Used?
N (Y or N)
SAIDA ratio
7.77 limitless)
Average depth (used in SAIDA table):
Calculation option 1 used? (See Figure 10-2b)
N (Y or N)
Volume, permanent pool, Vr or -ow
9,889 W
Area provided, permanent pool, A,_,,
4,1i58 ft`
Average depth calculated
3.08 ft
OK
Average depth used in SAIDA, d„, (Round to nearest 0.5ft)
3.0 It
OK
Calculation option 2 used? (See Figure 10-2b)
Y (Y or N)
• Area provided, permanent pool, A..,
4,358 ft`
Area, bottom of 1011 vegetated shelf, Ab "
2,279 1t`
Area, sediment cleanout, lop elevation (bottom of pond), Awl. d
293 fe
'Depth' (distance b/w bottom of 1Oft shelf and top of sediment)
5.00 It
Average depth calculated
3.08 It
OK
Average depth used in SAIDA, d„., (Round to down to nearest 0.511) c
'3.0'ft
OK
Drawdown Calculations
Drawdown through orifice?
Diameter of office (if circular)
Area of office (if -non -circular)
Coefficient of discharge (Co)
Driving head (Ha)
Drawdown through weir?
Weir type
Coefficient of discharge (C„)
Length of weir (L)
Driving head (H)
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
Storage volume discharge rate (through discharge orifice or weir)
Storage volume drawdown time
Additional Information
Vegetated side slopes
Vegetated shelf slope
Vegetated shelf width
Length of flowpath to width ratio
Length to width ratio
Trash rack for overflow & office?
Freeboard provided
Vegetated filter provided?
Recorded drainage easement provided?
Capures all runoff at ultimate build -out?
Drain mechanism for maintenance or emergencies is:
Y (Y or N)
0.88 in
in
0.60 limitless)
0.90 ft
N (Y or N)
limitless)
limitless)
ft
fit
1.23 ft'/sec
4.00 ft'/sec
0.03 ft'/sec
2.30 days
3 :1
10 :1
10.0 1t
OK, draws down in 2-5 days.
OK
OK
OK
3:1 OK
2.0 :1 OK
Y (Y or N) OK
25fl OK
N (Y or N) OK
N (Y or N) Insufficient. Recorded drainage easement required.
Y (Y or N) OK
pump
Form SW401-Wet Detention Basin-Rev.94118112 Pans I. & II. Design Summary, Page 2 of 2

Permit No
(to be provided by DWQ)
IICI,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.
Odh C300
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),
- Basin dimensions,
- Pretreatment system,
- High Flow bypass system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROW),
- Overflow device, and
- Boundaries of drainage easement.
�' °
�v{'C903-C904
2. Partial plan (1" = 30' or larger) and details for the wet detention basin showing:
- Outlet structure with trash rack or similar,
Maintenance access,
Permanent pool dimensions,
Forebay and main pond with hardened emergency spillway,
Basin cross-section,
Vegetation specification for planting shelf, and
Filter strip.
_l�&
C903-C904
3. Section view of the wet detention basin (1" = 20' or larger) showing:
- Side slopes, 3:1 or lower,
- Pretreatment and treatment areas, and
- Inlet and outlet structures.
1A L
C902
4. If the basin is used for sediment and erosion control during construction, clean out of the basin is specified
on the plans prior to use as a wet detention basin.
I&L
narrative
5. A table of elevations, areas, incremental volumes & accumulated volumes for overall pond and for forebay,
to verify volume provided.
C902
6. A construction sequence that shows how the wet detention basin will be protected from sediment until the
entire drainage area is stabilized.
narrative
7. The supporting calculations.
attached
8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
f
NIA
9. A copy of the deed restrictions (if required). 5erve5 5 iv15I e 51 It
narrative 10. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. County
soil maps are not an acceptable source of soils information.
Form SW401-Wet Detention Basin-Rev.9-4/18/12 Part III. Required Items Checklist, Page 1 of 1