SW7090701_CURRENT PERMIT_20090727

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW 7C_�u7D
DOC TYPE
CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Colleen H. Sullins I � Dee Freeman
Governor Director �5c1\f` Secretary
July 29, 2009
r
Mr. Benjamin Burford, CEO iy I"�,26 n 1
TGW1 North, LLC & Liberty Warehouse, LLC ���
1101 West Lake Road, Suite 600
Chicago, IL 60607
J�
Subject: Stormwater Permit No. SW7090701
Tanglewood Plaza
High Density Subdivision Wet Pond Project
Pasquotank County
Dear Mr. Burford:
The Washington Regional Office received a complete Stormwater Management Permit Application for
Tanglewood Plaza on July 24, 2009. 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. SW7090701, dated July 29, 2009,
for the construction of the project, Tanglewood Plaza, located on the northeast corner of Halstead
Boulevard Extension and Tanglwood Parkway, Elizabeth City, North Carolina.
This permit shall be effective from the date of issuance until July 29, 2019, 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 150E of the
North Carolina General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer
27447, Raleigh, NC 27611-7447. Unless such demands are made this permit shall be final and
binding.
If you have any questions, or need additional information concerning this matter, please contact Scott
Vinson, or me at [phone].
incerely
�I-
7�T odge
Regional Supervisor
Surface Water Protection Section
AH/sv: S:\WQS\STORMWATER\SW7090701
cc: Ken Sisk, PE, The Vision Group
gheryl Eggar, Elizabeth City Planning & Inspections
e/CNashington Regional Office
Central Files
North Carolina Division of Water Quality Internet: www rimaterquality.org One
943 Washington Square Mall Phone: [phone] FAX: [phone] North Carol I ❑ a
Washington, NC 27889 FAX: [phone]
An Equal Ppporlunily 1 Alfumarvc Action Employer ;Naturally

State Stormwater Management Systems
Permit No. SW7090701
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY SUBDIVISION 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
TGW1 North, LLC & Liberty Warehouse, LLC
Tanglewood Plaza
NE Corner of Halstead Blvd. & Tanglewood Pkwy, 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 July 29, 2019 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 subdivision is permitted for
10 lots, each allowed a maximum of "see Exhibit A" square feet of built -upon
area.
3. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
4. Each lot within the subdivision whose ownership is not retained by the permittee,
must submit a separate Offsite Stormwater Management Permit application
package to the Division of Water Quality and receive a permit prior to any
construction on the lot.
5. The built -upon areas associated with this project shall be located at least 50 feet
landward of all perennial and intermittent surface waters.
Page 2 of 9

State Stormwater Management Systems
Permit No. SW7090701
R
The following design elements have been permitted for this wet detention pond
stormwater facility, and must be provided in the system at all times.
C.
d.
e.
f.
I
m
n.
o.
p
q
r.
Drainage Area, acres:
Total Impervious Surfaces, ftz:
Average Pond Design Depth, feet:
TSS removal efficiency:
Design Storm:
Permanent Pool Elevation, FMSL:
Permitted Surface Area @PP ftz:
Permitted Storage Volume, ftJ:
Storage Elevation, FMSL:
Predevelopment 1 year 24 hour:
Post development 1 year 24 hour:
Controlling Orifice:
Permanent Pool Volume, ft3:
Forebay Volume, ft3:
Maximum Fountain Horsepower:
Receiving Stream / River Basin:
Stream Index Number:
Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
21.48
652,964
4.0 (6.50 total, including sediment cleanout)
90%
1.50
9.00
56,140
128,364 at temporary pool
10.95
13.43 cfs
0.18 cfs
3.00" 0 pipe
228,664
42,527
3/4hp or 0.75hp
Knobbs Creek / Pasquotank
30-3-8
"C; Sw"
No homeowner/lot owner/developer shall fill in, alter, or pipe any drainage feature
(such as swales) shown on the approved plans as part of the stormwater
management system without submitting a revision to the permit and receiving
approval from the Division.
2. The permittee is responsible for verifying that the proposed built -upon area for
the entire lot does not exceed the maximum allowed by this permit. Once the lot
transfer is complete, the built -upon area may not be revised without approval
from the Division of Water Quality, and responsibility for meeting the built -upon
area limit is transferred to the individual property owner.
3. If an Architectural Review Board or Committee is set up by the permittee to
review plans for compliance with the BUA limit, the plans reviewed must include
all proposed built -upon area. Any approvals given by the Board do not relieve the
homeowner of the responsibility to maintain compliance with the permitted BUA
limit.
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:
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.
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 the approved plans, regardless of size.
b. Project name change.
C. Transfer of ownership.
Page 3 of 9

State Stormwater Management Systems
Permit No. SW7090701
Redesign or addition to the approved amount of built -upon area.
Further subdivision, acquisition, 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. ,
Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
7. The permittee shall submit for approval, final site layout and grading plans for
any permitted future development areas shown on the approved plans, prior to
construction.
8. 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.
9. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
10. 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.
11. 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.
12. The permittee shall at all times provide the operation and maintenance
necessary to assure that all components of the permitted stormwater system
function at optimum efficiency. The approved Operation and Maintenance Plan
must be followed in its entirety and maintenance must occur at the scheduled
intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and re -vegetation of side slopes.
d. Immediate repair of eroded areas.
e. Maintenance of side slopes in accordance with approved plans.
f. Debris removal and unclogging of structures, orifice, catch basins and
piping.
g. Access to all components of the system must be available at all times.
13. Records of maintenance activities must be kept by the permittee. The records will
indicate the date, activity, name of person performing the work and what actions
were taken.
14. The permittee shall submit to the Division of Water Quality an annual summary
report of the maintenance and inspection records for each BMP. The report shall
summarize the inspection dates, results of the inspections, and the maintenance
work performed at each inspection.
15. This permit shall become void unless the facilities are constructed in accordance
with the conditions of this permit, the approved plans and specifications, and
other supporting data.
Page 4 of 9

State Stormwater Management Systems
Permit No. SW7090701
16. Prior to the sale of any lot, the following deed restrictions must be recorded:
a. The following covenants are intended to ensure ongoing compliance with
State Stormwater Management Permit Number SW7090701, as issued by
the Division of Water Quality under NCAC 2H.1000.
b. The State of North Carolina is made a beneficiary of these covenants to
the extent necessary to maintain compliance with the Stormwater
Management Permit.
C. These covenants are to run with the land and be binding on all persons
and parties claiming under them.
d. The covenants pertaining to stormwater may not be altered or rescinded
without the express written consent of the State of North Carolina, Division
of Water Quality.
e. Alteration of the drainage as shown on the approved plans may not take
place without the concurrence of the Division of Water Quality.
f. The maximum built -upon area per lot is (see Exhibit A) square feet. This
allotted amount includes any built -upon area constructed within the lot
property boundaries, and that portion of the right-of-way between the front
lot line and the edge of the pavement. Built upon area includes, but is not
limited to, structures, asphalt, concrete, gravel, brick, stone, slate, coquina
and parking areas, but does not include raised, open wood decking, or the
water surface of swimming pools.
g. All runoff on the lot must drain into the permitted system. This may be
accomplished through providing roof drain gutters, which drain to the
street, grading the lot to drain toward the street, or grading perimeter
swales and directing them into the pond or street. Lots that will naturally
drain into the system are not required to provide these measures.
h. Built -upon area in excess of the permitted amount will require a permit
modification.
i. Each lot within the subdivision whose ownership is not retained by
the permittee, must submit a separate Offsite Stormwater
Management. Permit application package to the Division of Water
Quality and receive a permit prior to any construction on the lot.
j. If permeable pavement credit is requested, the property owner must
submit a request, with supporting documentation, to the permittee and
receive approval prior to construction of BUA.
17. A copy of the recorded deed restrictions must be submitted to the Division within
30 days of the date of recording the plat, and prior to selling lots. The recorded
copy must contain all of the statements above, the signature of the Permittee, the
deed book number and page, and the stamp/signature of the Register of Deeds.
18, Prior to transfer of the permit, the stormwater facilities will be inspected by DWQ
personnel. The facility must be in compliance with all permit conditions. Any
items not in compliance must be repaired or replaced to design condition prior to
the transfer. Records of maintenance activities performed to date will be
required.
19. Decorative spray fountains will be allowed in the stormwater treatment system,
subject to the following criteria:
a. The fountain must draw its water from less than 2' below the permanent
pool surface.
b. Separated units, where the nozzle, pump and intake are connected by
tubing, may be used only if they draw water from the surface in the deepest
part of the pond.
c. The falling water from the fountain must be centered in the pond, away from
the shoreline.
Page 5 of 9

State Stormwater Management Systems
Permit No. SW7090701
d. The maximum horsepower for the fountain's pump is based on the
permanent pool volume. The maximum pump power for a fountain in this
pond is 3/4hp or 0.75hp.
20. If permeable pavement credit is desired, the permittee must submit a request to
modify the permit to incorporate such language as required by the Division of
Water Quality. The request to modify must include a soils report identifying the
type of soil, the Seasonal High Water Table elevation and the infiltration rate.
Upon the successful completion of a permit modification, the individual lot owners
that request to utilize permeable pavements must submit the necessary forms
and documentation to the permittee and receive approval prior to construction of
the permeable pavement.
III. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the Director.
In the event of a change of ownership, or a name change, the permittee must
submit a completed Name/Ownership Change form signed by both parties, to the
Division of Water Quality, accompanied by the supporting documentation as
listed on page 2 of the form. The approval of this request will be considered on its
merits and may or may not be approved.
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves a request to transfer the permit.
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.
Page 6 of 9

State Stormwater Management Systems
Permit No. SW7090701
11. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
12. This permit shall be effective from the date of issuance until July 29, 2019.
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 29'h day of July, 2009.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
X LL.�
Division of Water Quality
By Authority of the Environmental Management Commission
Permit Number SW7090701
Page 7 of 9

State Stormwater Management Systems
Permit No. SW7090701
Tanglewood Plaza
Stormwater Permit No. SW7090701
Paspuotank County
Designer's Certification
Page 1 of 2
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 a part of this Certification.
Noted deviations from approved plans and specifications:
Signature
Registration Number
Date
SEAL
Page 8 of 9

State Stormwater Management'Systems
Permit No. SW7090701
Certification Requirements:
Page 2 of 2
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, a
forebay, and the vegetated filter.
15. The required dimensions of the system are provided, per the approved
plan.
cc: NCDENR-DWQ Regional Office
Elizabeth City Planning & Building Inspections
Page 9 of 9

"EXHIBIT A"
Tanglewood Plaza
Pond
1
Area
Area
(acres)
Impervious
%
Impervious
Area
(acres)
Lot 1
1.55
70%
1.09
Lot 2
1.52
70%
1.06
Lot 3
1.87
70%
1.31
Lot 4
1.98
70%
1.39
Lot 5
1.10
70%
0.77
Lot 6
1.44
70%
1.01
Lot 7
1.64
70%
1.15
Lot 8
1.70
70%
1.19
Lot 9
1.81
70%
1.27
Lot 10
2.13
70%
1.49
ROW
4.74
69%
3.27
Total 21.48 14.99
Percent Impervious 69.8%

DWQ USE ONLY
MEN P"ftbiN
Fee Paid
Permit Number
SWiOtI 0-IN
JUL --I tuuJ C,1444 1C14--'� .,Wc
State of North Carolina
NC ®ENR
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
TGW1 North LLC & Liberty Warehouse LLC
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
Beniamin Burford. CEO
3. Mailing Address for person listed in item 2 above:
1101 West Lake Road, Suite 600
Phone: ( 312 ) 558-1084
Email: [e-mail]
IL
Fax: (312 ) 291-4616
60607
^^ DNS
IJAJ41
C-qp�
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Tanalewood Plaza
5. Location of Project (street address):
Northeast corner of the intersection of Halstead Boulevard Extension and
City: Elizabeth Citv County: Pasauotank Zip: 27909
6. Directions to project (from nearest major intersection):
Head north from Hertford on route #17 toward Elizabeth Citv. Take route #17 BVoass north to Halstead Boulevard exit.
Head east on Halstead, at first traffic light turn left onto Tanglewood Pkwy. Site is on the right.
7. Latitude: 360 17 ' 40 " N Longitude: 76 ° 17' 34" W of project
8. Contact person who can answer questions about the project:
Name: Kenneth Sisk P.E. Telephone Number: ( 757 ) 410-5740
Email: [e-mail]
IL PERMIT INFORMATION:
1. Specify whether project is (check one):
X❑New
❑Renewal []Modification
FormSWU-101 Version09.25.08 Page Iof4

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 X❑High Density []Redevelop ❑General Permit ❑Universal SMP ❑Other
4. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major X❑Sedimentation/Erosion Control 0404/401 Permit ❑NPDES Industrial
Stormwater
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.
Stormwater for this project will be treated via one wet detention pond.
2. Stormwater runoff from this project drains to the Pasquotank River basin.
3. Total Property Area: 21.48 acres 4. Total Coastal Wetlands Area: 0.00 acres
5. Total Property Area (3) - Total Coastal Wetlands Area (4) = Total Project Area**: 21.48 acres
6. (Total Impervious Area / Total Project Area) X 100 = Project Built Upon Area (BUA): 69.8%
7. How many drainage areas does the project have? 1
8. 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.
For high density oroiects. comnlete the table with one drainage area for each engineered stormwater device.
Basin Information
Drainage Area 1
Drainage Area 2
Receiving Stream Name
Knobbs Creek
Stream Class & Index No.
C:Sw 30 -3 - Y
Total Drainage Area (so
21.48 Acres
On -site Drainage Area (so
21.48 Acres
Off -site Drainage Area (so
0.00 Acres
Existing Impervious* Area (so
0 Acres
Proposed Impervious*Area (so
14.99 Acres
% Impervious* Area (total)
69.8%
Impervious* Surface Area
Drainage Area 1
Drainage Area 2
On -site Buildings (so
N/A
ri -
On -site Streets (so
N/A
On -site Parking (so
N/A
On -site Sidewalks (so
N/A
Other on -site (so
See attached listing
, 7 S
Off -site (so
NIA
_41
Total (so:
14.99 Acres
Impervious area is defined as the built upon area inciriding, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 09.25.08 Page 2 of
S�

**Total project area shall be calculated to exclude Coastal Wetlands from use when calculating the built upon area
percentage calculation. This is the area used to calculate overall percent project built upon area (BUA).
9. How was the off -site impervious area listed above
Projects in Union County: Contact the DWQ Central Office staff to check to see ifyou project is located
wither a Threatened & Endangered Species watershed that may be subject to more stringent stormwaler
requirements.
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
One of the following property 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.
Forms can be downloaded from htto://h2o.enr.state.nc.us/su/bmp forms.htm - deed restrictions.
Form DRPC-1
High Density Commercial Subdivisions
Form DRPC-2
High Density Developments with Outparcels
Form DRPC-3
High Density Residential Subdivisions
Form DRPC-4
Low Density Commercial Subdivisions
Form DRPC-5
Low Density Residential Subdivisions
Form DRPC-6
Low Density Residential Subdivisions with Curb Outlets
By your signature below, you certify that the recorded property restrictions and protective covenants for this
project shall include all the applicable items required in the above form, 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.
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 Permitting Unit at [phone] for the status and
availability of these forms. Forms can be downloaded from ham://h2o.enr.state.nc.us/su/bml2 forms.htm.
Form SW401-Low Density
Form SW401-Curb Outlet System
Form SW401-Off-Site System
Form SW401-Wet Detention Basin
Form SW401-Infiltration Basin
Form SW401-Infiltration Trench
Form SW401-Bioretention Cell
Form SW401-Level Spreader
Form SW401-Wetland
Form SW401-Grassed Swale
Form SW401-Sand Filter
Form SW401-Permeable Pavement
Form SW401-Cistern
Low Density Supplement
Curb Outlet System Supplement
Off -Site System Supplement
Wet Detention Basin Supplement
Infiltration Basin Supplement
Underground Infiltration Trench Supplement
Bioretention Cell Supplement
Level Spreader/Filter Strip/Restored Riparian Buffer Supplement
Constructed Wetland Supplement
Grassed Swale Supplement
Sand Filter Supplement
Permeable Pavement Supplement
Cistern Supplement
Form SN'U-101 Version 09.25.08 Paee 3 of 4

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 Office. (Appropriate office may be found by locating project on the
interactive online map at ht[n://h2o.enr.state.nc.us/su/nisi maos.htm)
1. Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
In tia
• Original and one copy of the Stormwater Management Permit Application Form
• Original and one copy of the Deed Restrictions &Protective Covenants Form (if
required as per Part IV above)
• Original of the applicable Supplement Form(s) and O&M agreement(s) for each BMP
• Permit application processing fee of $505 (Express: $4,000 for HD, $2,000 for LD)
payable to NCDENR
• Calculations & detailed narrative description of stormwater treatment/management
• Copy of any applicable soils report
• Two copies of plans and specifications (sealed, signed & dated), including:
- 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 (such as additional information requests), please complete this section. (ex. designing engineer or firm)
Designated agent (individual or
Mailing
NOW
City: C-t� P'O£AY_r_ State: VA Zip: 2-33Z7-
Phone: ( "7S'7 ) 'A1O -S'740 Fax: ( 79r7 ) 41n- 5-7q)
Email: KSISIC e 74FV15GRj>•COw1
VIII. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in General Information, item 2) ' HQJTAAIM 0V9 F0t? b
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 co enants w 1 recor e that the pro osed project complies with the requirements of 15A
NCAC 2H .1000. /
Signature: Date: I7
Form SWU-101 Version 09.25.08 V Page 4 of 4

High Density Commercial Subdivisions EMPRESS
ccD» Deed Restrictions & Protective Covenances
D JUL —7 zoos
In accordance with Title 15 NCAC 2H.1000, the Coastal Stormwater Management Regulations, deed
restrictions and protective covenants are required for High Density Commercial Subdivisl
lots will be subdivided and sold and runoff will be treated in an engineered stormwater contr i
Deed restrictions and protective covenants are necessary to ensure that the development maintains a
built -upon area consistent with the design crlteria used to size the stormwater control facility.
1, R fill j acknowledge, affirm and agree by my signature below, that
I will causaithe tollowingdeed- restrictions and covenants to be recorded prior to the sale of any lot
within the project known as Tanglewood Plaza
1, The following covenants are Intended to ensure ongoing compliance with State Stormwater
Management Permit Number as issued by the Division of Water Quality
under NCAC 2H.1000.
2. The State of North Carolina is made a beneficiary of these covenants to the extent necessary to
maintain compliance with the stormwater management permit.
3. These covenants are to run with the land and be binding on all persons and parties claiming
under them.
4.. The covenants pertaining to stormwater may not be altered or rescinded without the express
written consent of the State of North Carolina, Division of Water Quality.
5. Alteration of the drainage as shown on the approved plan may not take place without the
concurrence of the Division of Water Quality. (See attached
6. The maximum allowable built -upon area per lot is _Ex�h_ibit "A" square feet. (OR, If the
proposed built -upon area per lot will vary, please use th o owing format & language (in bold):
The maximum built -upon area per lot, In square feet, is as listed below:
Lot # BUA Lot # BUA Lot # BUA Lot # BUA
This allotted amount includes any built -upon area constructed within the lot property boundaries,
and that portion of the fight -of -way between the front lot line and the edge of the pavement. Built
upon area includes, but is not limited to, structures, asphalt, concrete, gravel, brick, stone, slate,
coquina and parking areas, but does not include raised, open wood decking, or the water
surface of swimming pools.
7. All runoff from the built -upon areas on the lot must drain Into the permitted system. This may be
accomplished through a variety of means including roof drain gutters which drain to the street,
grading the lot to drain toward the street, or grading perimeter swales to collect the fot runoff
and directing them into a component of the stormwater collection system. Lots that will naturally
drain Intoer the system are not re uired to provide these additional measures.
8. The ownof each 1 Qse o er�hip is not retained by the permfttee, is required to submit a
separate star er t a licatron to the Division of Water Quality and receive a permit
Sign
Z , a Notary Public in the
State of I L-L I I Ot S , County of Q_001_
do hereby certify that eiJ54A I I_i_T—) UR-FD RL personally appeared
before me this the day of aU 0 r✓ 20(2L, and acknowledge
the due execution of th foregoing instrument. Witness my hand and official seal,
j SEAL
My Commission expires
Page 1 of 1

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"EXHIBIT A"
Tanglewood Plaza
Pond
1
Area
Area
(acres)
Impervious
%
Impervious
Area
(acres)
Lot 1
1.55
70%
1.09
Lot 2
1.52
70%
1.06
Lot 3
1.87
70%
1.31
Lot 4
1.98
70%
1.39
Lot 5
1.10
70%
0.77
Lot 6
1.44
70%
1.01
Lot 7
1.64
70%
1.15
Lot 8
1.70
70%
1.19
Lot 9
1.81
70%
1.27
Lot 10
2.13
70%
1.49
ROW
4.74
69%
3.27
Total 21.48 14.99
Percent Impervious 69.8%

Permit No. 57W 701L77 r)l
(lobe provided by DWo)
EXPRESS
ilwA
A��.i
NCDENR
Project name
Contact person
Phone number
Date
Drainage area number
JUL -7 2009
SIC DENR
O�O�- W A Pf9O
h
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Pad 111) must be printed, filled out and submitted along with all of the required information.
II. DESIGN INFORMATION
Site Characteristics
Drainage area
Impervious area, post -development
% impervious
Design rainfall depth
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 mnoH
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 intensity1-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
SHWT 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
[phone]
19,Jun-09
1
935,669 ft'
652,964 ft2
69.79 %
1.5 in
79,532 fit' OK
128,364 ft'
OK, volume provided is equal to or in excess of volume required.
it
ft'
0 ft3
N (Y or N)
in
(unifless)
(unidess)
Whir
13.43 ft'Isec
ft'Isec
ft'Isec
10.95 fmsl
9.00 first
fmsl
9.50 fmsl
8.50 fmsl
Data not needed for calculation option #1, but OK if provided.
3.50 fmsl
2.50 fmsl
Data not needed for calculation option #1, but OK if provided.
1.00 1t
Y (Y or N)
10.95 fmsl
OK
Form SW401-Wet Detention Basin-Rev.6-2I20109 Parts I. & II. Design Summa, Page 1 of 2

Permit No.
(to be provided by DWD)
II. DESIGN INFORMATION '
Surface Areas
Area, temporary pool
69,832 If
Area REQUIRED, permanent pool
56,140 ftz
SAIDA ratio
6.00 (unitless)
Area PROVIDED, permanent pool, A...
56,140 112
OK
Area, bottom of 1 Oft vegetated shelf, A, u,dl
49,500 f 2
Area, sediment cleanout, top elevation (bottom of pond), A�t ooe
31,981 t
Volumes
Volume, temporary pool
128,364 ft'
OK
Volume, permanent pool, Vp,, -.
228,664 ft'
Volume, forebay (sum of forebays if more than one forebay)
42,527 ff3
Forebay %of permanent pool volume
18.6% %
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
6.00 (unifless)
Average depth (used in SAIDA table):
Calculation option 1 used? (See Figure 10-2b)
Y (Y or N)
Volume, permanent pool, Vp,,,,ym
228,664 ft'
OK
Area provided, permanent pool, Ap,,,,,.
56,140 tz
OK
Average depth calculated
4.07 ft
OK
Average depth used in SAIDA, d.., (Round to nearest 0.511)
4.0 ft
OK
Calculation option 2 used? (See Figure 10-2b)
N (Y or N)
Area provided, permanent pool, Aa,,,,_�y
ttz
Area, bottom of 10ft vegetated shelf, A, ,�
ftz
Area, sediment cleanout, top elevation (bottom of pond), A„.,
ttz
'Depth' (distance blw bottom of 10ft shelf and top of sediment)
It
Average depth calculated
It
Average depth used in SAIDA, d., (Round to nearest 0.511)
it
Drawdown Calculations
Drawdown through office?
Y
(Y or N)
Diameter of office (if circular)
3.00 in
Area of office (tt-noncircular)
inz
Coefficient of discharge (Co)
0.60 (unidess)
Driving head (Ho)
0.65 ft
Drawdown through weir?
N
(Y or N)
Weir type
(unittess)
Coefficient of discharge (C,)
(untless)
Length of weir (L)
ft
Driving head (H)
If
Pre -development 1-yr, 24-hr peak flow
13.43 113lsec
OK
Post -development 1-yr, 24-hr peak flow
ft3lsec
Storage volume discharge rate (through discharge office or weir)
0.18 113lsec
Storage volume drawdown time
4.83 days
OK, draws down in 2-5 days.
OK, drawdown time is correct.
Addttional Information
Vegetated side slopes
3 :1
OK
Vegetated shelf slope
10 :1
OK
Vegetated shelf width
10.0 It
OK
Length of towpath to width ratio
3 :1
OK
Length to width ratio
3.0 :1
OK
Trash rack for overtow, 8 office?
N
(Y or N)
Trash rack or similar device recommended.
Freeboard provided
2.0 It
OK
Vegetated filter provided?
N
(Y or N)
OK
Recorded drainage easement provided?
Y
(Y or N)
OK
Capures all runoff at ultimate buildcut?
Y
(Y or N)
OK
Drain mechanism for maintenance or emergencies
Pump Out
Form SW401-Wet Detention Basin-Rev.6-220109 Pans L 811. Design Summary, Page 2 of 2

Permit No.
(to be provided by DWQ)
III. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Page/ Plan
Sheet No.
e.-4
111
.A
DUG"
nlUf,
p_1SL
� 'IiED
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.
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.
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.
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.
5. A table of elevations, areas, incremental volumes 8 accumulated volumes for overall pond and for Forebay,
to verify volume provided.
6. A construction sequence that shows how the wet detention basin will be protected from sediment until the
entire drainage area is stabilized.
7. The supporting calculations.
8. A copy of the signed and notarized operation and maintenance (08M) agreement.
9. A copy of the deed restrictions (if required).
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.6-2/20/09 Part III. Required Items Checklist, Page 1 of 1

EXPRESS
JUL - 7 2009
Permit Number:
(to be provided by D N7Q)
Drainage Area Number:
Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of, the public, and the removal efficiency of the BMP.
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.
Fonn 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.
Ponn SW401-Wet Detention Basin O&M-Rev.4 Page 2 of 4

Permit N
(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 55 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 5.5 feet in the forebay, the sediment
shall be removed.
BASIN DIAGRAM
ill in the blanks)
Sediment Removal . 3_5 Pe nanen Pool
Elevatio
Form SW401-Wet Detention Basin O&M-Rev.4
----------------- Volume
Bott
om
Permanent Pool Elevation 9.0
Sediment Removal Elevation 3.5 Volume
�.5 -ft Min.
Sediment Bottom Elevation 2.5 1-fr r
Storage Sedimei
Storage
FOREBAY MAIN POND
Page 3 of 4

Permit Number:
(to be provided by DWQ)
acknowledge and agree by my signature below that 1 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:TAeJGtS t,JCOlb F-' A I= A
BMP drainage area number: ° I
Print name: &(N�te (3V hs!'d
Title: 6&-�>
Address: lfol I). L ke Sf-iref 6t- 9,r r' ��>o -rL 606O7
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, , a Notary Public for the State of
1 LLl QQ (-'A County of l_paL , do hereby certify that
_Be03A t-A t YJ BQPL170( l] personally appeared before me this
day of _tU oe 170O01 , and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,
RUTH HERNANDEZ
m°SEAL. MY COMMISSION EVIRES
+�.....•�e APRIL 13, 2013
OF 14
SEAL
My commission expires `�-13 U)dDS
Form SW401-Wet Detention Basin O&M-Rev.4 Page 4 of 4