SW7070715_HISTORICAL FILE_20210225

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

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
BRIAN WRENN
Director
Pastor Steven Danser
Lighthouse Assembly
48060 NC Hwy 12
Buxton, NC 27920
Dear Pastor Danser:
NORTH CAROLINA
Environmental Quality
February 25, 2021
of God Church of Buxton
Subject: Stormwater Permit Renewal
Stormwater Management Permit SW7070715
Lighthouse Assembly of God Church of Buxton
Dare County
0 0"
A Division of Energy, Mineral, and Land Resources file review has determined that
Stormwater Permit SW7070715 for a stormwater treatment system consisting of four
interconnected infiltration basins serving the Lighthouse Assembly of God Family Life
Center located on NC Hwy 12 in Buxton, NC expires on August 3, 2021. This is a
reminder that permit renewal applications are due 180 days prior to expiration. We do
not have a record of receiving a renewal application.
Please submit a completed permit renewal application along with a $505.00 fee for
permit renewal. Also, it was noted in the file review that a designer's certification that the
project was constructed in accordance with the approved plans as required by the
permit has not been submitted. Please include this with your application. Permit
application forms for renewal can be found on our website at:
https•//dea nc gov/about/divisions/effigy-mineral-land-resources/energy-mineral-land-
rules/stormwater-program/post-construction. North Carolina General Statutes and the
Coastal Stormwater rules require that this property be covered under a stormwater
permit. Failure to maintain a permit subjects the owner to assessment of civil penalties.
If you have questions, please feel free to contact me at [phone]. 1 will be glad to
discuss this by phone or meet with you. If you would like, I can e-mail you a copy of the
application form. You can request a copy by e-mailing me at roger.thorpe(a)ncdenr.gov.
Sincerely,
t' Roger K. Thorpe
Environmental Engineer
North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
Washington Regional Office 1 943 Washington Square Mall I Washington, North Carolina 27889
252.946.6481
—
�o.w�r

North Carolina Secretary of State
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Perpetual
Stitt, Larry
48060 NC 12 Hwy
Buxton NC 27920
I of 2 ' 2/24/2009 3:58 PM

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2 of 2 2/24/2009 3:58 PM

1ER
Who
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Coleco H. Sullins, Director
Division of Water Quality
August 3, 2007
Mr. Stephen Jennette
Lighthouse Assembly of God, Church of Buxton
Light Assembly, Inc.
PO Box 459
Buxton, NC 27920
Subject: Stormwater Permit No. SW7070715
Lighthouse Assembly of God,
Church of Buxton
High Density Project
Dare County
Dear Mr. Jennette:
The Washington Regional Office received a complete Stormwater Management Permit
Application for Lighthouse Assembly of God, Church of Buxton on July 18, 2007. Staff review
of the plans and specifications has determined that the project, as proposed, will comply with
the Stormwater Regulations set forth in Title 15A NCAC 2H.1000. We are forwarding Permit
No. SW7070715 dated August 3, 2007, for the construction of the subject project.
This permit shall be effective from the date of issuance until August 3, 2017, and shall be
subject to the conditions and limitations as specified therein. Please pay special attention to
the Operation and Maintenance requirements In this permit. Failure to establish an adequate
system for operation and maintenance of the stormwater management system will result in
future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have
the right to request an adjudicatory hearing upon written request within thirty (30) days
following receipt of this permit. This request must be in the form of a written petition,
conforming to Chapter 150B of the North Carolina General Statutes, and filed with the Office
of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such
demands are made this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please
contact Scott Vinson, or me at [phone].
incerely,
Al Hodge
Regional Supervisor
Surface Water Protection Section
AH/sav: C:\STORMWAT\PERMIT\SW7070715
cc: Joseph Anlauf, PE — Quible& Associates, PC
Wre County Building Inspections
ashington Regional Office
Central Files
NortItCarolina
,Naturally
North Carolina Division of Water Quality Washington Regional Office Phone [phone] FAX [phone] Customer Service
Internet: www.ncwateraualitv.ore 943 Wazhington Square Mall, Washington, NC 27889 1-877-623-6748
An Equal OpportunirylA(frmadve Action Employer— 50% Recycled110% Post Consumer Paper

State Stormwater Management Systems
Permit No. SW7070715
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
Lighthouse Assembly of God, Churh of Buxton
Light Assembly, Inc.
Dare County
FOR THE
construction, operation and maintenance of four (4) infiltration basins, connected by a
level pipe system, in compliance with the provisions of 15A NCAC 2H .1000 (hereafter
referred to as the "stormwater rules') and the approved stormwater management plans
and specifications and other supporting data as attached and on file with and approved by
the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until August 3, 2017, 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 on page 3 of this permit. The stormwater control
has been designed to handle the runoff from 36,386 square feet of impervious
area.
3. The tract will be limited to the amount of built -upon area indicated on page 3 of this
permit, and per approved plans.
4. All stormwater collection and treatment systems must be located in either dedicated
common areas or recorded easements. The final plats for the project will be
recorded showing all such required easements, in accordance with the approved
plans.
5. The runoff from all built -upon area within the permitted drainage area of this project
must be directed into the permitted stormwater control system.
Page 2 of 7

State Stormwater Management Systems
Permit No. SW7070715
4
6. The following design criteria have been provided in the infiltration basin and must
be maintained at design condition:
a.
Site Area, acres:
2.39
b.
Total Impervious Surfaces, ftZ:
36,386
C.
Design Storm, inches:
1.50
d.
Basins Depth, feet:
1.00
— e:
-- Bottom Elevaticn;_FhASL ..... _ _.... __
_. 3.50-_. _... _. .._......
f.
Bottom Surface Area, ftz:
4,293 (all 4 basins combined)
g.
Bypass Overflow Elevation, FMSL:
4.50
h.
Permitted Storage Volume, ft3:
5,392
i.
Type of Soil:
Fripp, Ousley & Currituck
j.
Expected Infiltration Rate, in/hr:
6.00
k.
Seasonal High Water Table, FMSL:
1.50
I.
Receiving Stream/River Basin:
Peters Ditch to Pamlico Sound /
Pasquotank
M.
Stream Index Number:
30 — 22 - 23
n.
Classification of Water Body:
"SA; HQW'
II. SCHEDULE OF COMPLIANCE
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 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.
Page 3 of 7

State Stormwater Management Systems
Permit No. SW7070715
4. Records of maintenance activities must be kept and made available upon request
to authorized Personnel of DWQ. The records will indicate the date, activity, name
of person performing the work and what actions were taken.
5. 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.
6. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received from
an appropriate designer for the system installed certifying that the permitted facility
.._.. _ .. _ J .-1 .. J..._..._...
has been in auea n accoraance with This permit, the app�oveu N a��� a --
specifications, and other supporting documentation. Any deviations from the
approved pIans and specifications must be noted on the Certification. A
modification maybe required for those deviations.
7. The stormwater systems shall not be used as Erosion Control devices. They must
be kept off line and free from sediment until the project is complete and the entire
site has been stabilized.
8. Access to the stormwater facilities shall be maintained via appropriate easements
at all times.
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 permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
11. A copy of the approved plans and specifications shall be maintained on file by the
Permittee for a minimum of ten years from the date of the completion of
construction.
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.
13. This permit shall be effective from the date of issuance until August 3, 2017.
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.
Page 4 of 7

State Stormwater Management Systems
Permit No. SW7070715
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 formal permit transfer request to the Division of Water Quality, accompanied by a
completed name/ownership change form, documentation from the parties involved,
and other supporting materials as may be appropriate. The approval of this request
will be considered on its merits and may or may not be approved. The permittee is
responsible for compliance with all permit conditions until such time as the Division
approves the transfer request.
O Failu. to abide tip. the nnnd Rinn S. and limi4n i— _containnd..in.this p '4_..+.+�._._._._
�. i auwe av auwc by u1c vvn auuvn 'anu unua uvnS uvi nauicu' ui uua 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.
3. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
4. In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or
replacement stormwater management systems.
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.
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.
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.
Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
9. The permittee shall notify the Division of any name, ownership or mailing address
changes within 30 days.
Permit issued this the 3rd day of August, 2007.
NA ENVIRONMENTAL MANAGEMENT COMMISSION
L' 1_._ for
Division of Water Quality
By Authority of the Environmental Management Commission
Permit No. SW7070715
Page 5 of 7

State Stormwater Management Systems
Permit No. SV 7070715
Lighthouse Assembly of God, Church of Buxton
Stormwater Permit No. SV 7070715
Dare County
Designer's Certification
I, , as a duly registered in
the State of North Carolina, having been authorized to observe (periodically/ weekly/ full
tine)'the-construition of'the"pr'oject, "-'
(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. SW7070715
l
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 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 Washington Regional Office
Dare Building Inspections
Page 7 of 7

i• ( c . .'. i . L� State of North Carolina
Department of Environment and Natural Resources
JUL 18 2007
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
=`e �` This form may be photocopied for use as an original
I. GENERAL INFORMATION
I. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
L 4kn L�s+ 1.1 ,.-f- f VA C1nVlrtk WE 181)t61A
2, Print Owner/Si nin Officand title (person legally responsible for facility and compliance):
a 1AApka AeMIAE11ial's name 6
3. Mailing Address for person listed in item 2 above:
City: BMX!61A State: NL Zip: Z74{20
Telephone Number: ( 257— ) 99S-5001
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
�-�A�il^o�s.t ,AtssevKbl., erF G►ed � UsVvaC. orr �.�x-4e..
a
5. Location of Project (street address):
48A31 t mr_ 4.1wtn. IL
City:_&�xf6" County: art
6. Directions to project (from nearest major intersection):
op NC IL
7. Latitude: hi ISO is 14-1„ Longitude: JAI -7 33' 1 Z. of project
8. Contact person who can answer questions about the project:
Name: Joseph , �tn�zu� i"2E. Telephone Number: ( 262) zG 1 — 3300
II. PERMIT INFORMATION:
1. Specify whether project is (check one): _X_New Renewal Modification
Form SWU-101 Version 3.99 Page I of

a
No, .�e• .. .'rt .wt. Y1: ^'_ �e^) 4q
I i-:
.. oi'•:.7.J.�..2 Iv ..:.ur>:: �) `a�!..i•a-•ft.1N $t•F:7' tt.`vt:1._..j t: r..S
,
.3•�-1•I�+n'1-P -:./ t.•:S7 .✓} .. AJc.�C 1•.: W.7 .rj`....� tp-;�:•n•1�711'.: •)OC: .I Ad.L l�j:
ii i?'. Yp tigl? n`t•vu �•' At. ).19'IAJ� l.`i4: l .%...•�.. I) �r+)f. •:•S • i>: rw'.. , .

2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number and its issue date (if known)
3. Specify the type of project (check one):
_Low Density _High Density _Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
CAMA Major Sedimentation/Erosion Control _404/401 Permit _NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project .
"y""T w11 6 J `-r6 A: cF:ii�r.E e,. 6ser..s Z= (► ss4�1, 1\
loc. ..,,.li w'\l U3'Lrl7ta' t�a�e� ko �4Cwe S�kk.Tr Tir�wv.ek- w ll
occur i lvov_ rFtf. �\ ej4e/keti - s.�i�-14�r.v t. : FAwI
el��wa�o�l K- b:oloyme prete cSei.
2. Stormwater runoff from this project drains to the - A&AUVkdl&L River basin.
3. Total Project Area: s2. 3°l acres 4. Project Built Upon Area: !SZ . ti S %
103, `IS1 .7-7
5. How many drainage areas does the project have?�__
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
,(off-s pry,— --),3-zz-23
'Basin'Informaton' �''
`'-Drairage"Area1� '"'"'
.'Diamage'Area -2
Receiving Stream Name
Receiving Stream Class
Ps�++l: a SONNe(
Sk
DtziN: ilaec► v tl. C-3
Clstg
Drainage Area
10 3 981.77 -`-
Existing Impervious* Area
547 ,4, l c-
All -ovr. Gave
Proposed Impervious*Area
to 3SS. so A-Z-
bt A4_%1 Q!,%k4A swQ K
% Impervious* Area (total)
32 . y So/o '3
[mperJious* Surface Area
Drainage Area 1 ,' " "
-' Drainage Area 2
On -site Buildings
I I "0.00 ++&
On -site Streets
NIA
On -site Parking
e21 Sg3.36-i{z
On -site Sidewalks
83g i3 t
Other on -site
NIA
Off-site
,2, lOS 80 -ge
Total: 3�0 385 5
Total:
r,s etc the built upon area including, but not limited to, buildings, roads, parking areas,
Sidewalks, gravel area
s�' ft�w
Z~..4�
.6
o�vK.a C'W%twAt
Form SWU-101 Version 3.99 Page 2 of 4

I
M TIJ:1.

7. .How was the off -site impervious area listed above derived? llreuOJI�. 44-a_ SIV s�r 44a %vitr((►D
Y
w'tw 1 tel,oste(1
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
The following italicized deed restrictions and protective covenants are required to be recorded for all
subdivisions, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a table
listing each lot number, size and the allowable built -upon area for each lot must be provided as an attachment.
I. The following covenants are intended to ensure ongoing compliance with state stormwater management permit number
as issued by the Division of Water Quality. These covenants may not be
changed or deleted without the consent of the State.
2. No more than � square feet of any lot shall be covered by structures or impervious materials.
Impervious materia s include asphalt, gravel, concrete, brick, stone, slate or similar material but do not include wood
decking or the water surface of swimming pools.
3. Swales shall not be filled in, piped, or altered except as necessary to provide driveway crossings.
4. Built -upon area in excess of the permitted amount requires a state stormwater management permit modification prior to
construction.
5. All permitted runoff from outparcels or future development shall be directed into the permitted stormwater control
system. These connections to the stormwater control system shall be performed in a manner that maintains the integrity
and performance of the system as permitted.
By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, 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 State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each
BMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the status
and availability of these forms.
Form SWU-102
Wet Detention Basin Supplement
Form SWU-103
Infiltration Basin Supplement
Form SWU-104
Low Density Supplement
Form SWU-I05
Curb Outlet System Supplement
Form SWU106
Off -Site System Supplement
Form SWU-107
Underground Infiltration Trench Supplement
Form SWU-108
Neuse River Basin Supplement
Form SWU409
Innovative Best Management Practice Supplement
Form SWU-101 Version 3.99 Page 3 of 4

r r. ., I• n x• i_...

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. The complete application package should be
submitted to the appropriate DWQ Regional Office.
Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
Initials
• Original and one copy of the Stormwater Management Permit Application Form ni �al
• One copy of the applicable Supplement Form(s) for each BMP J 3 x
• Permit application processing fee of$62tJpayable to NCDENR) It L000 jJ 4-
• Detailed narrative description of stormwater treatment/management %1 p
• Two copies of plans and specifications, including: %30r
- Development/Project name
- Engineer and firm
-Legend
- North arrow
- Scale
- Revision number & date
- Mean high water line
- Dimensioned property/project boundary
- Location map with named streets or NCSR numbers
- Original contours, proposed contours, spot elevations, finished floor elevations
- Details of roads, drainage features, collection systems, and stormwater control measures
- Wetlands delineated, or a note on plans that none exist
- Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations
- Drainage areas delineated
- Vegetated buffers (where required)
VII. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section.
Designated agent (individual or firm): Qutole9Aeaoaskes Fe. Joiepk A,%Iv f •PE
Mailing Address: T-0. Drewtr 6-10
City: IKAl41&wk State: WC_ Zip: Z?'IJ 1
Phone: ( 2-92- ) 261 - %%oe Fax: ( ySZ. ) 2-61 - Ir-6o
VILL APPLICANT'S CERTIFICATION
I, (print or type name of person listed in General Information, item 2) f-A"hpM A NIpO•A.
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the eet-w.tll be constructed in conformance with the approved plans, that the required deed restrictions
and otective covenan dl be recorded, and that the proposed project complies with the requirements of 15A
NCA 2H .1000. \ 1
Date: ( - "► - el
Form SWU-101 Version 3.99 Page 4 of 4

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Permit No.
I U� N VV"LuJ (to be provided by DWQ)
State of North Carolina
JUL 18 2007 Department of Environment and Natural Resources
Division of Water Quality
®RANAFSTORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name: I ;wG,Cr1�,,,u �rsrsevinbl ,,F oc{ Gkvreln e�x4e.t
Contact Person: SffoktK &wAf46 Phone Number: (ZFZ) QRS -Sod1
.T4-'HYA*'.
This worksheet applies to: Basin No. 1 in Drainage Area 1
(as identified on plans) (from Fonn SWU.101)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type
Infiltration Rate
SHWT Elevation
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
Erb
(o — Z.O in/hr or ef/hr/sf (circle appropriate units)
1.5 fmSI (Seasonal High Water Table elevation)
1 .S inch (1.5 inch event for SA waters, 1 inch event for others)
4 54e c.f.
1
L.BI I�gVJ y�OU►'S Ct71XpL ON INh� rTY�'���"� fiVl'G OT
"rcts ft. x
588.5 c.f.
fmsl
-4 fmsl
6. O , fmsl
Varies ft. = 352- sq. ft. (bottom dimensions)
Form SWU-103 Rev 3.99 Page 1 of 3

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
rJ A a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
JaA b. System is located at least 100 feet from water supply wells.
JJ A c. Bottom of system is at least 2 feet above the seasonal high water table.
11 Ff d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
JOA e. System is not sited on or in fill material or DWQ approval has been obtained.
_ f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easements to the pearest public right-of-way.
(J( �wr e%&JV s rrivat�e A4Wkl4IrW66&A suta ArOCA-6 4�rea. ..hf .`•.Yavc.s.l -60 ..A.-J)
�1 g. Drainage area for the device is less than 5 acres.
A1)A h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
JJA i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attac e .
JJA j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
AAA k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
iJI4 I.
A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
�Jit} m.
Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
JJtA n.
Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
Jh Ki o.
Flow distribution mechanism within the basin is provided.
33A p.
A benchmark is provided to determine the sediment accumulation in the pretreatment device.
J,%A q.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
3J10r - r.
System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
JrA s.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

M1.o•Jsi. e.•V o•.i�'1::�tt�M J: ���q�J .tea lYi♦'J"1'�v�•119'!l-'. ...!J-^.. }]F�.VA'j b�N:4YJ•�!'i .. �Y.. l.V:✓4+.: /.:;'�}�:.'. "'+. ♦
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ALG

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
l . After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate mariner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The treasuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads 3.75- feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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
Address
Note: The legally responsible party should not be a h
resident of the subdivision has been named the
Date: 1 - l - 0l
association unless
NU V-CL'L
been sold and a
5rh ;4h , a Notary Public for the State ofi 1 , County of tc
do hereby certify that `�E� R � n n to l Te— personally appeared before me this -_
day of �C i�_, �� and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my haqgh_aY1"jficlaLseal.
SEAL '
N O T A R My commission expiresil /� l— i 2na-
P U�a
Form SWl1-'.1 ev 3.9Page 3 of 3

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s•o�R: �: ly 'i .'/e/Ps .�l.� s f:I f•� Yon ..y^^,!. }s.i^ v'.: r.Y�f: '... ..fy(•�'!.

Permit No.
JUL 18 2007 State of North Carolina (to be provided by DWQ)
Department of Environment and Natural Resources
Dflt/OVAR0 Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may he photocopied for use as an original
DWO Stormwater Management Plan Review:
A complete Stormwater management plan submittal includes a Stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all Stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name : LPmtv41 au �suwvbl a o F �oc{ Clnurok o� S..x�e»
Contact Person: —Skfok uv JGNtA pit Phone Number: (252.) R`IS --Soo I
This worksheet applies to: Basin No. �L- in Drainage Area 1
(as identified on plans) (frmn Fonn SWUJ01)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (finsl).
Soils Report Summary
Soil Type
Infiltration Rate
SHWT Elevation
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
Erb
(o — Zo in/hr or cf/hr/sf (circle appropriate units)
.
1 . � fmSI (Seasonal High Water Table elevation)
1 . inch (1.5 inch event for SA waters, I inch event for others)
4Sh8 c.f.
2.fl1 / kv-S. ok
V3Y tt S ft. X Y s V % e.0 ft. = i W6 sq. ft. (bottom dimensions)
ISa 1 c.f.
3.� fmsl
�•5 fmsl
rJ.O fmsl
Form SWU-103 Rev 3.99 Page 1 of 3

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1 �
^f ci Y•/YO:T7v: ♦�'.?ti CN+iM11 :il iwa.,(frf: f. �. r�.-O.1 �-. �.'Y'. .r

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
13A a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
34A b. System is located at least 100 feet from water supply wells.
1%A c. Bottom of system is at least 2 feet above the seasonal high water table.
b3A d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
3JA e. System isperrsited on or in fill material or DWQ approval has been obtained.
IS) — f. System is located in a recorded drainage easement for the -purposes of operation and
maintenance and has recorded access ea ements to the near s
(S+evw.wvLe.- w.zHs.ya,...►�+6�y�.,� ctii.i.e�lt public right-ofway.
.....�.�... lob)
1.iA g. Drainage area for the device is less than 5 acres.
l J 14 h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
Jp j. System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
X) A k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
'44 I. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
�) A in. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
JJ14 n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
J1-4 o. Flow distribution mechanism within the basin is provided.
> >A p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
\a A q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
�a A r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
34A- s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

V

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
l . After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate mamier and shall not be handled in a matmer that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads 3.7 S feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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: 1'.01Aayu s , G j
Address: o C1 IU C S Zi 2-0
Phone: I 2_SZ1 492-4se r, . . ` 1 .
!Vote: The legally responsible party should not be a homeou nei
resident of the subdivision has been named the president.
IUVACA�
more than 50% of the lots haaN been sold and a
1I Cni e . !Sih;+ , a Notary Public for the State 04.h Q County of Q�
)OCt it IC 1�) , do hereby certify that n-fD hr n TP n nPN-P personally appeared before me this 1
day of �1 ) IT_, all, and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness my h 'hV.'&F' seal,
SEAL I N O T A R V r A My commission expires in ^ I( — C�.QI I
S
+;42� PUBLIC ci=
2
Form SWU IV^vN.`���`� Page 3 of 3

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Permit No.
�i�;�E'p��� (
State of North Carolina to be provided by DWQ)
JUL 1 8 2001 Department of Environment and Natural Resources
Division of Water Quality
DVU'Q-VYA STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
L PROJECT INFORMATION
Project Name:
Contact Person:
This worksheet applies to: Basin No.
(as identified on plans)
Phone Number: ( ?12) 945 - Soo I
in Drainage Area 4
(from Fonn SWU.101)
II. DESIGN INFORMATION - Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type
Infiltration Rate
SHWT Elevation
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
Fr D
[e — 2.0 in/hr or cf/hr/sf (circle appropriate units)
fmsl (Seasonal High Water Table elevation)
inch (1.5 inch event for SA waters, 1 inch event for others)
4548 c.f.
2.g1 d4I%". (F3are�
kt w t-r-c ft. x y/ZvNtA ft. _ (y G 0 sq. ft. (bottom dimensions)
8 to 7- c.f.
S-S' fmsl
=4•s' fmsl
5. 0' fmsl
Form SWU-103 Rev 3.99 Page I of 3

r,

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
,NSW a.
System is located 50 feet from class SA waters and 30 feet from other surface waters.
AM b.
System is located at least 100 feet from water supply wells.
_114 C.
Bottom of system is at least 2 feet above the seasonal high water table.
*i &%= d.
Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
—
.ij4 e.
System_s,pet sited on or in fill material or DWQ approval has been obtained.
_(/__ f.
_ System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easenwnts o the nearest public right-o -way.
C Sdevwwvia�- �`�akw.. ai.+F�C&+tA7 a.1j..� 1PwJ&dA- p�ree.(3
a g.
Drainage area for the device is less than 5 acres.
J 3Ik h.
Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
)V} i.
System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1_5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
J I A, j.
System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
S 114 k.
All side slopes stabilized with vegetated cover are no steeper than 3:1 (H:V).
1.
A pretreatment device such as a catch basin, grease trap, filter strip, grassed Swale or
sediment trap is provided.
JJ A m.
Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
JJk1 n.
Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for c ewers, 30 feet for other waters).
J3W o.
Flow distribution mechanism within the basin is provided.
p.
A benchmark is provided to determine the sediment accumulation in the pretreatment device.
1.1q q.
Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
.13A r.
System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
s.
Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Forth SWU-103 Rev 3.99 Page 2 of 3

_)ID
. O'.rrr.r„r.y;�.. .:v'7{�.i .:.w' :.y.. . rri. e7./ a .�:: Sr.t^.f V`' '•.j

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
I. After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas inunediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads ,7 feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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
Ir
Phone: l %-52_1l N 4
!Vote: The legally responsible party should not be A
resident of the subdivision has been named the
have been sold and a
I, k ,cote /—/ , a Notary Public for the State of � )OM Cn(VIjneQunty of
CuIrly; -ur «- , do hereby certify that 'S-�— p V& 1 _)C yn n & -1-I P personally appeared before me this 9
day of :S(r , and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
witness my}tiali0;£hdtfficial seal,
N 0 T A R y' I My commission expires I o- n- ao n
PUBLIC
Form -SYV Page 3 of 3

*j:'�:J::.9y •i.U.;•�, �'.::� ..r IVJ•1l_`r.c� �. � 4uJ y-:7 ,: ]..: V++;�."ry ...
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. _���! � f Ar%`+. �. �.

Permit No.
(to be provided by DWQ)
JUL 18 2007 State of North Carolina
Department of Environment and Natural Resources
D�Z Q-1yYAt�() Division of Water Quality
tl �[ STORMWATER MANAGEMENT PERMIT APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
infiltration basin supplement for each system, design calculations, soils report and plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name
Contact Person:
This worksheet applies to: Basin No.
(as identified on plans)
Phone Number: (45Z)gJ%—S00%
in Drainage Area
(from Fomn SWU 101)
II. DESIGN INFORMATION -Attach supporting calculations/documentation. The soils report must be
based upon an actual field investigation and soil borings. County soil maps are not an acceptable source
of soils information. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary
Soil Type
Infiltration Rate
SHWT Elevation
Basin Design Parameters
Design Storm
Design Volume
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Basin Elevations
Bottom Elevation
Storage Elevation
Top Elevation
Qu1&
�s — Z o in/hr or ef/hr/sf (circle appropriate units)
• S fmsl (Seasonal High Water Table elevation)
1 •S inch (1.5 inch eventfor SA waters, l inch eventfor others)
$8 c.f.
2.81 d sl+r•,. C3�-•e�w .`...�.'li+t`o{+a.. rytre wC Co /��,
VY�Iw.e ft. xyey-\tA ft. = MOSS sq. ft. (bottom dimensions)
Z$11 c.f.
3,
fmsl
• S
fmsl
5. O
fmsl
Form SWU-103 Rev 3.99 Page I of 3

i
,n
�P
i ml
fj

III. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. Attach justification if a requirement has not been met.
Applicants Initials
JJ>4 a. System is located 50 feet from class SA waters and 30 feet from other surface waters.
JJA b. System is located at least 100 feet from water supply wells.
JJ A C. Bottom of system is at least 2 feet above the seasonal high water table.
JJ 1i d. Bottom of the system is 3 feet above any bedrock or impervious soil horizon.
JJli e. System is not sited on or in fill material or DWQ approval has been obtained.
N�A f. System is located in a recorded drainage easement for the purposes of operation and
maintenance and has recorded access easemgnts tQ the nearest public right- way.
CS}vvww�fe.-S y}un►ee••ls:wi� -ili— pY-oferA-Vxvetlj
I �I4 g. Drainage area for the aevice is less than 5 acres.
3J1Q h. Soils have a minimum hydraulic conductivity of 0.52 inches per hour and soils report is
attached.
J a A- i. System captures and infiltrates the runoff from the first 1.0 inch of rainfall (1.5 inch event for
areas draining to SA waters ). Design volume and infiltration calculations attached.
System is sized to take into account the runoff at the ultimate built -out potential from all
surfaces draining to the system, including any off -site drainage. Calculations attached.
JJIt- k. All side slopes stabilized with vegetated cover are no steeper than 3:1 (H: V).
334 I. A pretreatment device such as a catch basin, grease trap, filter strip, grassed swale or
sediment trap is provided.
3J A m. Bottom of the device is covered with a layer of clean sand to an average depth of 4 inches or
dense vegetative cover is provided.
J314 n. Vegetated filter is provided for overflow and detail is shown on plans (Required minimum
length is 50 feet for SA waters, 30 feet for other waters).
o. Flow distribution mechanism within the basin is provided.
p. A benchmark is provided to determine the sediment accumulation in the pretreatment device.
3J A q. Runoff in excess of the design volume bypasses off-line systems (bypass detail provided).
1314 r. System is designed to draw down the design storage volume to the proposed bottom
elevation under seasonal high water conditions within five days. A soils report and all
pertinent draw -down calculations are attached.
J�tq s. Plans ensure that the installed system will meet design specifications (constructed or
restored) upon initial operation once the project is complete and the entire drainage area is
stabilized.
Form SWU-103 Rev 3.99 Page 2 of 3

IV. INFILTRATION BASIN OPERATION AND MAINTENANCE AGREEMENT
I . After every runoff producing rainfall event and at least monthly inspect the infiltration system for erosion,
trash accumulation, vegetative cover, and general condition.
2. Repair eroded areas immediately, re -seed as necessary to maintain adequate vegetative cover, mow
vegetated cover to maintain a maximum height of six inches, and remove trash as needed.
3. After every runoff producing rainfall event and at least monthly inspect the bypass, inflow and overflow
structures for blockage and deterioration. Remove any blockage and repair the structure to approved design
specifications.
4. Remove accumulated sediment from the pretreatment system and infiltration basin annually or when depth
in the pretreatment unit is reduced to 75% of the original design depth. The system shall be restored to the
original design depth without over -excavating. Over -excavating may cause the required water table
separation to be reduced and may compromise the ability of the system to perform as designed. Removed
sediment shall be disposed of in an appropriate manner and shall not be handled in a manner that will
adversely impact water quality (i.e. stockpiling near a stormwater treatment device or stream, etc.).
A benchmark shall be established in the pretreatment unit. The benchmark will document the original
design depth so that accurate sediment accumulation readings can be taken. The measuring device used to
determine the depth at the benchmark shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
When the design depth reads . 75'- feet in the pretreatment unit, the sediment shall be
removed from both the pretreatment unit and the infiltration basin.
5. If the Division determines that the system is failing, the system will immediately be repaired to original
design specifications. If the system cannot be repaired to perform its design function, other stormwater
control devices as allowed by NCAC 2H .1000 must be designed, approved and constructed.
I acknowledge and agree by my signature below that I am responsible for the performance of the five
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:_L,-42 i Q%r&.e 45n.y.61t 0.1r, (aoA��„r
Address: .. . o Y-4m.. wG z-z9 "io
Phone: s 9415 — soot Dater ^ l , D_1
Signature:
!Vote: The legally responsibl-par ouId not be a horn ners association unless in re t an 4' the lots have been sold and a
resident of P the /subdivisiion has
�been narn the presu ent.
�I, �� t Cn I H `di7 � ith r, a Notary Public for the State of ounty of
` .UCrl'FI)C �� , do hereby certify tha �, Y1 I'1 '�fl personally appeared before me this
day of \ r t'nant. r il, ryyD�-and acknowledge the due execution of the forgoing infiltration basin maintenance requirements.
Witness tn=u and of_ficKiai*bge�-ii��
3 N01ARY
SEAL c. My commission expires
Q. PUBS-`G ?e..
FormSWU-1Page 3of 3

•"�':/: ra.•t7. .�l._. c�rr:a:.' :.i r-J`-t '�r.�.c.. /CS�•rti a- 61.;cliltC

17W: Lighthouse Assembly of God
Subject: FW: Lighthouse Assembly of God
From: "Joseph Anlauf' <[e-mail]>
Date: Toe, 17 Jul 2007 08:51:09 -0400
To: "Scott Vinson" <[e-mail]>
CC: "Lyn Hardison" <[e-mail]>
Scott,
This time I will actually send the email with the attachment attached.
From: Joseph Anlauf
Sent: 'Tuesday, July 17, 2007 8:50 AM
To: Scott Vinson
Subject: Lighthouse Assembly of God
Scott,
JUL 18 2007
Lei`! YVARQ
Attached is the .pdf file illustrating the soil boring locations. There are four (4) soil borings total, SB#I is located in
the parking area near proposed infiltration basin 41, SB#2 is located within the perimeter of IB#2, SB#3 is located
within the perimeter if IB43 and SB#4 is located along the interface between the 50' vegetated filter and IB#4.
A bypass for stormwater volume over the calculated storage volume has been eliminated for the following reasons:
I. The soils present in the areas of the proposed infiltration basins have very high infiltration rates typically within
the range of 6-20 inches per hour.
2. The calculated drawdown period for the basin system is in the range of hours verses days. The calculated
drawdown period for this basin network is 2.81 hours at the infiltration rate of 6 inches per hour.
3. Stonmvater generated in excess of the system capacity will overflow a level spreader to a 50' vegetative filter
and proceed on to Section 404 wetlands for additional treatment. The treated runoff must transverse over 250 feet of
wetlands and low uplands before reaching the nearest surface water "Peter's Ditch"
4. The calculations performed to calculate the surface water runoff are based on the very conservative
mathematical approach by which all impervious surfaces will shed 100% of the precipitation to the proposed
storage, treatment & disposal system.
Let me know when or if you will be in Dare County on Wednesday, July 18, and I will arrange to meet you at this
site in Buxton.
Thanks,
Joe Anlauf, P.E.
1303077-base.dwg GRADING & DRAINAGE PLAN
1103077-base.dwg
Content -Description: GRADING &
DRAINAGE PLAN (I.pdf
Content -Type: application/octet-stream
Content -Encoding: base64
I off 7/17/2007 9:13 AM

WE
(2) 45 FT., 12" DIAMETER,
CONTECH SLOTTED DRAINPIPE
O O.00R SLOPE
PROPOSED 24' EASEMENT FOR SHARED DRIVE WITH VFD
FrD
BEGIN RETAINING
WALL
(2) 9 FT. SECTIONS OF
12"0 CMP
(2) 15 FT., 18- RCP PIPE
O 0.00% SLOPE
RETAINING WALL
TOP O 5.50'
EXISTING WETLANDS
20 FT. WADE LEVEL SPREADER
JUNCTION BOX /2 TO BE CONSTRUCTED IN THE
5'x5' PRECAST CONCRETE BOX TOP OF THE RETAINING WALL.
RIM O 6.3' LEVEL SPREADER TO BE
VERT IN O 3.5' INSTALLED WITH SPILLWAY
IN T OUT O 3.5' ELEVATION OF 4 50
(1) 15 FT., 18 RCP PIPES Q1� END RETAINING_
O 0.00% SLOPE ALL`
FILTRATION =�
k
Be70' NNW
-
{ i
6' RDL F.6: E. 10.1'
•t
6NMI—
L
,
_. "(NGVD 88')
6" C.O. (TYP)
'
PHASE 2 ��t
1
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d' sa
{ �,) 96'- FTS 18 E' A4 PIP ,
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Dbbz sI cfE 6aR i
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.
GHT ASSEM LY OF GOD
''
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.�
J
GH EL 110 SEATS ( GPD/SEAT)
.
SANC ARY
70'
,� I50.Qd'
N Il• 27�'Yl
4" C.O. WITH
(2) 94 FT., 18" RCP PIPE �"—* _x
EXISTIN5 51N 6LE
_s
(2) 9 FT. SEMWWOF
O 0.00% SLOPE I
FAMILY DWELLING
CONTR
t2.0 CMp RATED COVER
JUNCTION BOX !1
PANEL
5'x5' PRECAST CONCRETE BOX CLASS "A" EROSION CONTROL
RIM O 6.3. STONE RIPRAP APRON (TYP) SEE
2" SPEARS
NORTH AND SOUTH
PARCEL TO BE
INVERT IN O 3.5' DETAIL THIS SHEET
HEAVY BODIED
RECOMBINED
INVERT OUT O 3.5'
GATE VALVE
AND VALVE BOX
MANIFOLD
;.0.
N j
..� IN LTRAAON.
125- ,
LIGHT IASSf_MBLY OF/GOD CHURCH
/i22 SLAT(5(5 GPD/ AT)—WSH ,�dt1B
_/
f�-
;6- aboF/DRA,N,F ,C GVD 88')14
CO TAH (RDL) _._ RETAINING WALL_..
125' _ TOP ._O 8.fi0'..'\,
WOOD FEE /
6"
FrD
SEED IN FILTRATION BASIN
-AS PER THE GENERAL
SEEDING SPECIFICATION
PROPOSED CONTOURS
231 X 4'W X 1'D CLASS
'A" EROSION CONTROL
STONE RIPRAP APRON
__RETAINING WALL 50 FT. VEGETATIVE FILTER
TOP O 6.50' O ELEVATION 4.0 FT.
REGK
FZF
TVNI
FrD
CuA
Sc;f r-

Quible
Quible & Associates, P.C.
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING
SINCE 1959
July 10, 2007
Mr. Scott Vinson
NCDE&NR, Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
Re: Express Permit Application Package
Lighthouse Assembly of God, Church of Buxton
Buxton, Dare County, North Carolina
Dear Scott;
Ll r-1-1 CET \'/ ED
JUL 18 2CV'7
DWQ-V ARO
P.O. Drawer B70
Kitty Howk. NC 27949
Phone: [phone]
Fox: 252-261-1260
PRINCIPALS
Sean C. Boyle, P.E.
Joseph S. Lasdter. C.E.P.
Eduardo J. ValdMeso. PE.
ASSOCIATES
Joseph J. Anlaut PE.
Kcthenne C. MorchelIo, RL.S.
On behalf of the Lighthouse Assembly of God Church, Quible & Associates, P.C., hereby submit
for your review and approval an Express Permit Application package for the Lighthouse Assembly
of God, Church of Buxton.
The project site is located in Buxton, Dare County, North Carolina. The site is located
approximately 920 feet west of the intersection of NC Hwy. 12 and Buxton Back Road (S.R. 1232).
The latitude and longitude for the approximate center of this site are 35o15'47"N and 75o33'12"W.
The subject property is located across from the Cape Hatteras High School property on the south side
of NC 12.
The proposed development will be comprised of a Fellowship Hall and a Sanctuary. A high density
stormwater management plan permit is being sought. Please see the attached plans.
The following items have been included in this package:
One (1) check in the amount of $4000.00 (Express Permit Review Fee) made payable to the
NCDE&NR
2. Two (2) copies of the NCDE&NR, DWQ, Stormwater Management Permit Application
Form
3. Two (2) copies of the Infiltration Basin Supplement Form SWU-103 Rev. 3.99 (4 total
supplement forms)
4. Two (2) copies of the letter authorizing Stephen Jennette to act as an agent for the Church.
5. Two (2) copies of the Plan Set including the following Sheets:
Sheet Title Sheet Number
Site Plan 1
Grading & Drainage Plan 2
Utility Plan 3
Soil Erosion & Sedimentation Control Plan 4
Grading & Drainage Plan Details 5

Soil Erosion & Sedimentation Control Plan Details
6. Two (2) copies of the project narrative.
Please review and approve the attached. Please call with any questions at [phone], ext. 236.
Sincerely,
Quible & Associates,, PP..C.
Joseph J. Anlauf, P.E.
cc: Pastor David Waterfield
Steve Jennette

1Lig4thouse Assembly of God
PO Box 459
Buxton, NC 27920
[phone]
July 9, 2007
To Whom It May Concern:
JUL 18 2007
®WQ-WARO
Rev. David Waterfield and the official church board give Mr. Steve Jennette
the authority to act as an agent for the church.
The church has always be known as Lighthouse Assembly of God, but on
our corporate papers it is Light Assembly, Inc.
Sincerely,
Rev. David Waterfield
...1 have set thee to be a light..." Acts 13:47

Lighthouse Assembly of God
PO Box 459
Buxton, NC 27920
[phone]
July 9, 2007
To Whom It May Concern:
Rev. David Waterfield and the official church board give Mr. Steve Jennette
the authority to act as an agent for the church.
The church has always be known as Lighthouse Assembly of God, but on
our corporate papers it is Light Assembly, Inc.
Sincerely,
Rev. David Waterfield
".J have set thee to be a light..." Acts 13:47

Quible
Quible & Associates, P.C.
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING
SINCE 1959
July 10, 2007
Mr: Rid chard -Peed
NCDE&NR, Land Quality Section
943 Washington Square Mall
Washington, NC 27889
Re: Express Permit Application Package
Lighthouse Assembly of God, Church of Buxton
Buxton, Dare County, North Carolina
Dear Richard;
PO. Drawer 870
Kitty Hawk. NC 27949
Phone: [phone]
Fax: [phone]
PRINCIPALS
Sean C. Boyle, P.E.
Joseph S. Lassiter C.E.P.
Bauaroo J. VoldiAl P.E.
ASSOCIATES
Joseph J. AnIl P.E.
Katherine C, Morahello, PLS.
JUL 7 8 2007
,1,AVQ WARE
On behalf of the Lighthouse Assembly of God Church, Quible & Associates, P.C., hereby submit
for your review and approval an Express Permit Application package for the Lighthouse Assembly
of God, Church of Buxton.
The project site is located in Buxton, Dare County, North Carolina. The site is located
approximately 920 feet west of the intersection of NC Hwy. 12 and Buxton Back Road (S.R. 1232).
The latitude and longitude for the approximate center of this site are 35o 15'47"N and 75o33'12"W.
The subject property is located across from the Cape Hatteras High School property on the south side
of NC 12.
The proposed development will be comprised of a Fellowship Hall and a Sanctuary. The total
proposed area of disturbance is 1.52 acres. Please see the attached plans.
The following items have been included in this package:
1. One (1) check in the amount of $100.00 ($50 per acre) made payable to the NCDE&NR.
2. One (1) check in the amount of $4000.00 (Express Permit Review Fee) made payable to the
NCDE&NR
3. One (1) originally signed and notarized Financial Responsibility/Ownership Form
Sedimentation Pollution Control Act Express Permitting Option.
4. Two (2) copies of the letter authorizing Stephen Jennette to act as an agent for the Church.
5. Two (2) copies of the Plan Set including the following Sheets:
Sheet Title Sheet Number
Site Plan 1
Grading & Drainage Plan 2
Utility Plan 3
Soil Erosion & Sedimentation Control Plan 4

Grading & Drainage Plan Details
Soil Erosion & Sedimentation Control Plan Details
6. Two (2) copies of the property deeds.
7. Two (2) copies of the project narrative.
Please review and approve the attached. Please call with any questions at [phone], ext. 236.
Sincerely,
Quible & Associates, P.C.
Joseph J. Anlauf, P.E.
cc: Pastor David Waterfield
Steve Jennette