SW7091002_HISTORICAL FILE_20210720

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

f
ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
BRIAN WRENN
Director
NORTH CAROLINA
Environmental Quality
July 20, 2021
Moyock Propco Holdings, LLC
Attention: Francisco T. Morales, General Council
P.O. Box 26255
Winston-Salem, iJC 27114
Subject: Stormwater Permit Renewal/Ownership Change
Stormwater Management Permit SV 7091002
Currituck Assisted Living Center
Currituck County
Dear Francisco Morales:
A Division of Energy, Mineral, and Land Resources file review has determined that
Stormwater Permit SV 7091002 for a stormwater treatment system consisting of a wet
detention pond serving Currituck Assisted Living located at 141 Moyock Landing Drive,
Moyock, NC expires on December 30, 2021. Renewal applications are due 180 days
prior to expiration. A review of the Currituck County tax records shows that the property
is currently owned by Moyock Propco Holdings, LLC.
The Coastal stormwater rules and the NC General Statutes require a stormwater permit
for this project. Stormwater permits are not automatically transferred when property is
sold. The stormwater permit is currently issued to Currituck Health Investors, LLC.
Please submit a completed permit renewal application and a stormwater ownership
transfer application along with a $505.00 processing fee. Permit application forms for
renewal and ownership transfer can be found on our website at:
https://deq.nc.,ov/about/divisions/energv-mineral-land-resources/energy-mineral-1 inci-
ruies/stormmvater-progi-am/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 permittee and landowner to
assessment of civil penalties.
If you have questions, please feel free to contact me at [phone]. 1 will be glad tc
discuss this by phone or meet with you. If you would like, I can e-mail you a copy of the
application forms. You can request a copy by e-mailing me at
roger.thorpe(cilncdenr.gov.
Sincerely,
Ro per K. Thorpe
Environmental Engineer
North Carolina Department of Environmental Quality I Division of Energy, Mineral urd Land Resources
Washington Regional Office, 1943 Washington Square Mail I Washington. North Carolina 27889
M ^^�^•^�252,94bh431

September 30, 2010
Mr. Scott Vinson
Dept. of Environment and Natural Resources
Water Quality Section
943 Washington Square Mall
Washington, NC 27889
OCT - 4 2010
Subject: Stormwater Management Permit
Currituck Assisted Living Center
Proj. #090222
Stormwater Permit No. SW7091002
Dear Mr. Vinson:
Enclosed please find the Designer's Certification for the above referenced project.
Please note that the pond was surveyed and inspected for dimensional and elevation accuracy
on April 2, 2010 and found to comply with the design. At that time, the banks were not
vegetated and the wetland plants had not been installed. Last week, a visual inspection was
performed to verify that permanent vegetation had been established on the side slopes and that
the wetland plants had been installed. During that inspection, sedimentation in the forebay rip
rap was observed. The pond has not been checked to see if sedimentation has reached the 1'
allowed depth.
If you have any questions or require additional information, please do not hesitate to call this
office at [phone].
Sincerely,
Kimberly D. Hamby C��r�
Sr. Project Manager
cc: file
Mr. Hunter Trefzger, Smith/Packett Med Com., LLC
Mrs. Donna Voliva, Currituck County Planning Dept.
P. O. Box 339 Camden, North Carolina 27921
[phone] License C-0598
w .hymanrobey.com

rliltmetm
October 28, 2009
Mr. Scott Vinson
Dept. of Environment and Natural Resources
Water Quality Section
943 Washington Square Mall 0 =a 'aV:
Washington, NC 27889
Subject: Stormwater Management Permit
Currituck Assisted Living Center
Proj. # 090222
i
NCDENR Stormwater Review SW7091002
Dear Mr. Vinson:
Enclosed per your request for additional information letter dated October 22, 2009, please find
the following items:
Two (2) copies of revised referenced plans. Note that the dumpster location has moved
and additional pavement added (some also removed). The previous Future Impervious
Surface Area of 5,000 sf has been adjusted down to 4,441 sf to account for additional
pavement wedge at dumpster and additional sidewalk at storage building. This
reduction keeps the overall total impervious on site unchanged. See Site Data, Sheet 2,
No. 3, for revised impervious data.
2. Two (2) copies of revised page 3 of 6 of the Stormwater Permit Application. The values
in the table reflect the same future impervious allotment reduction and overall impervious
as noted in 1. above.
3. Two (2) copies of the revised Project Description.
4. Two (2) copies of the support calculations for the Wet Detention Basin Supplement for
the 1-yr, 24-hr, Pre -development & Post -development values.
A copy of the USACE blueline determination (Action ID SAW-2009-01629) dated
10/13/2009. Per this document the blueline portion of the ditch passing along the west
boundary of the project site ends 45 feet south of the south end of the field culvert at the
south line of the 24 acres parcel on the south side of Moyock Landing Drive (which is
approx. 450 feet south of Moyock Landing Drive). The project site is on the north side of
Moyock Landing Drive.
P. O. Box 339 Camden, North Carolina 27921
[phone] License C-0598
w .hymanrobey.com

Mr. Scott Vinson
October 28, 2009
If you have any questions, please do not hesitate to call this office at [phone].
�
Sincerely,
fVyJ fU�7
Dougla A. Abbott, PE
Projec Engineer
cc: file
Troy Smith, Currituck Health Investors, LLC

PROJECT DESCRIPTION
Currituck Assisted Living Center
Currituck County - North Carolina
October 28, 2009
2:M6:4
RECEIVED
OCT 2 9 2009
DWQ
Currituck Health Investors, LLC is proposing to construct an assisted IivirfdiKt, _ ,�,:e Bite
in Moyock Township of Currituck County. The site is located on Moyock Landing Road. It is currently
vacant and is zoned GB (General Business).
Development will include the construction of one (1) building, (1) accessory building, required
parking, an underground piped drainage system in conjunction with grassed swales, required utilities,
sewer pump station, the installation of required landscaping, and a wet detention basin.
The proposed buildings will contribute 35,221 sf of impervious area. The parking and driveways
will contribute 49,107 sf, the dumpster pad 400 sf, and sidewalk and patios will contribute another 8,648
sf for a total of 93,376 sf of impervious coverage.
Drainage Area 1 encompasses 4.65 acres (202,485 sf) of the site including most proposed on -
site impervious areas. The only impervious areas not draining to the detention basin are a portion of the
entrance drive and a portion of the County required sidewalk along the front of this site. It is not practical
for all of these areas to drain to the detention basin. These small areas that are not directed to the basin
will be part of Drainage Area 2. Drainage will be collected in a combination of underground piping and
grass lined swales that will route all runoff to the proposed detention pond which is designed for 90% TSS
removal. The design impervious area is 45.34% of the drainage area. To have the flexibility to add future
building, pavement or sidewalk additions, the proposed wet detention basin has been sized to accept
runoff from approximately 4,441 sf of additional impervious area. The maximum onsite impervious area
will be 47.53% of the drainage area.
Drainage Area 2 contains the remainder of the 6 acre tract. Only the portion of the entrance drive
and portion of the required sidewalk mentioned above is on -site impervious and located in this drainage
area. Open space areas around the perimeter of the site will sheet flow into the perimeter swales.
The soil evaluation was performed on July 30, 2009 by Sean C. Robey, PE and Kimberly Hamby.
The soil boring was conducted with an AMS 2-3/4" diameter 6' long hand mud auger. The boring was
performed in the northwest corner of the property where the detention pond will be located. The USDA-
NRCS WEB Soil Survey indicates the site consists of Augusta and Roanoke soils. The elevation at the
boring location is approximately 6.5'. The sandy loam topsoil was 16-18" deep. From 18" to 36" was a
massive clay. At 36", we encountered a course sand. At 42" color of the sand changed to a chroma color
less than 2 according to the Munsell Soil Color Chart. The low chroma indicates the seasonal high water
table is located at a depth of approximately 42", or elevation 3.0'. The course sand continued to at least
48" but was too wet to continue removal with the auger.
The total disturbed area for this development will not exceed 6 acres. Limits of disturbance have
been shown on the plans.
GIAIR J(i ii
O y.
P. O. Box 339 Camden, North Carolina 27921
[phone] License C-0598
w .hymanrobey.com

Project Name: Currituck Assisted Living Center
Project Number: 090222
I. & It. Design Summary Variables
Calculation for Ration 'C' Post Development
As taken from 090222 SWApplication:
Building
Area (SF)
On -site Building
35221�
On -site Building (future)
4441
Total Building
39662
On -site Steets
r 0�
On -site Parking
48709
On -site Sidewalk
7486
Other on -site
400
Off -site
0
Existing BUA
0
Total Pavement et al. 56595
Total Impervious Area 96257
Green Area 106228
Total Drainage Area _ 202485 or 4.65 AC
Calculation for Ration 'C' Post Development
r ��
INS
OCR 29
DW Q
pg03 #
Rational C as calculated by the following equation:
(1.0 ` building area + 0.90 ' impervious (non -building) area + 0.20 ' green area) / total drainage area
Cw = 0.55
Rainfall intensity for 1-yr 24hr storm 3AA in/hr
Q=CIA
Q = 8.69 cfs for 1-yr/24hr storm event
Calculation for Ration 'C' Pre Development
For a section of undeveloped land with mixed grass and brush it is generally accepted to use
a weighted 'C' of 0.30 — 0.35
Cw = F 0.30
— --
Q=CIA
Q = 4.74 cfs for 1-yr/24hr storm event
FESS 6,'
=•Q Cr&I

1ji2nn1 11:,b 12524352533 Ktrwx AUHA KtALIY rraut o[
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID. aAW-2009-01629 County: Currituck y,
NO DEPARTMENT OF THE ARMY AUTHORIZATION Rl?���� 11�
Property Owner / Agent: CTX I Highland Properties. Inc. OCT 2 9 2009
Address: 378 Caratoke Highway DwQ
Mo oc North Carolina, 2795E
Telephone Number: Jerry Old 252-207-3002 mj # -----
Size and Location of Propertv
(waterbodv
road namelnumber,
town etc.): 24 acre
parcel located east of
NC 168just south of Moy"kLanding
Road near Mo
cock Currituck County,
Nortb Carolina.
Description of Activity: Proposed development.
Your work as proposed does not require Department of the Army authorization for the following
reason(s):
X There are no jurisdictional waters or wetlands within the boundaries of the property.
X The proposed project does not impact jurisdictional waters or wetlands.
_ The proposed project is exempt from Department of the Army regulation.
Specify: USACE iurisdiction beeini in the Irr of iRm..m. c
This Department of the Army determination does not relieve the permittee of the responsibility to obtain
any other required Federal, State, or local approvals/permits. The permittee may.need to contact
appropriatc State and local agencies beforc beginning work.
For any activity within the twenty coastal counties, before beginning work, you must contact the N.C.
required State authorization.
Division of Coastal Management in Elizabeth City, North Carolina, at [phone] to discuss any
Any changes in the above described work must be coordinated with the Corps of Engineers prior to
commenccmen.t. If you have any questions regarding the Corps of Engineers regulatory program, please
contact Tom SteffensAyle Barnes at telep46)te nt)mber [phone]
Regulatory Project Manager
Date: 10/13/2009
SURVEY PLATS, FIELD SKETCH, WETLANDDELINEATION FORM, ETC" MUST, 'BE
ATTACHED TO THE YELLOW (FILE) COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.

MC® MR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 22, 2009
Mr. Charles E. Trefzger, Jr., Member/Manger
Currituck Health Investors, LLC
PO Box 2568
Hickory, NC 28603
Subject: Stormwater Review SW7091002
Currituck Assisted Living Center
Currituck County
Dear Mr. Trefzger
Dee Freeman
Secretary
This office received a Coastal Stormwater permit application and plans for the subject project on October 8, 2009,
A preliminary review of the project indicates that before a State Stormwater permit can be issued the following additional
information is needed.
1. The impervious area sum on page 3of6 of die application is 96,194sf although 96,257sf is listed and neither match
the total impervious area given in the submitted narrative of 92,817sf even with the 5,000sf of proposed future.
Please correct form and/or narrative as needed so that they correspond.
2. Please provide the Pre -Post development 1-yr, 24-hr peak flow calculations, corresponding to the supplement
form, that help show the discharge volume from the pond is at a rate equal to or less than the predevelopment
discharge rate for the one year, 24-hour storm.
3. Regarding the energy dissipation / rock fill in the shown "blue line stream" in the northwest corner of the
property, please verify with the Army Corps of Engineers that the shown feature is or is not subject. If it is
subject and the ACOE requires a 404 permit & subsequent DWQ 401 certification in order to allow this fill, the
State Stormwater application may need to be placed on a short temporary hold until this matter can be cleared up.
The ACOE may very likely have already made a determination at this site when the Moyock Landing Drive
culvert was installed, however I could find no record of this in our DWQ files.
The above requested information must be received in this office prior to October 30, 2009 or your application will
be returned as incomplete. The return of this project will necessitate resubmittal of all required items including the
application fee. If you need additional time to submit the required information, please mail or fax your request for
time extension to this office at the Letterhead address.
You should also be aware that the Stormwater Rules require that the permit be issued prior to any development
activity. Construction without a permit is a violation of 15A NCAC 2H.1000 and North Carolina General Statute 143-
215.1 and may result in civil penalties of up to $10,000 per day.
Please reference the Stormwater Project Number above on all correspondence. if you have questions, please feel
free to contact me at [phone].
cc: Sean Robey, PE (by email)
Washington Regional Office
forth Carolina Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
An Eaual O000dunih, 1 Atfrmaliva Acuon Emob, er
Si ccrely
1557
Scott Vinson
Environmental Engineer
Internet, wmw.nmalerquality.oig
Phone: [phone] FAX: [phone]
FAX [phone]
One
NorthCarolina
Natunil y

ii
IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
All runoff from impervious surfaces will be collected in a combination of underground piping and grass lined
swales. The piping and swales will route runoff to a wet detention basin designed for 90% TSS removal.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUDApproval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.Identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph R - Post Construction
3. Stormwater runoff from this project drains to the Pasquotank River basin.
4. Total Property Area: 6 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project Area':
6 acres
Total project area shall be calculated to exclude the following the normal pool of imppounded structures, the area
between the area
of streams and rivers, the area below the Normal High Water (NM line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NW (or MHW) line may be
included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 37.43 %
9. How many drainage areas does the project have? 2 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
Receiving Stream Name
Moyock Run
Moyock Run
Stream Class *
C; Sw
C; Sw
Stream Index Number *
30-1-2-2-1
30-1-2-2-1
Total Drainage Area (sf)
202,485
58,875
On -site Drainage Area (sf)
202,485
58,875
Off -site Drainage Area (sf)
0
0
Proposed Impervious Area" (sf)
96,257
1,560
% Impervious Area** (total)
47.53%
2.65%
Impervious- Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
On -site Buildings/Lots (sf)
35,221
0
On -site Streets (sf)
0
0
On -site Parking (sf)
48,451
398
On -site Sidewalks (sf)
7,122
1,162
Other on -site (sf)
400
0
Future (sf)
5,000
0
Off -site (so
0
0
Existing BUA*** (sf)
0
0
Total (sf):
96,257
1,560
Stream Class and Index Number can be determined at: http://`h2o.enr.state.nc.uslbims/reportslreportsWB httnl
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that is
to be removed and which will be replaced by new BUA.
Form SWU-101 Version 07July2009 Page 3 of 6

POND CALCULATIONS
FOR EXPRESS
090222 POND VOLUME CALCULATIONS (1 basin 2 forebays).xls OCT 08 2009
POND CALCULATIONS FOR 1 BASIN AND 2 FOREBAYS NC DENR
AREA Fz
PERMANENT POOL SURFACE AREA 11,436.00
MAIN BASIN SURFACE AREA 7.780.00
FOREBAY SURFACE AREA (forebay A)
FOREBAY SURFACE AREA (forebay B)
AREA AT EDGE OF MAIN BASIN SHELF
AREA OF MAIN BASIN BOTTOM
AREA AT EDGE OF FOREBAY SHELF (forebay A)
AREA AT EDGE OF FOREBAY SHELF (forebay B)
AREA OF FOREBAY BOTTOM (forebay A)
AREA OF FOREBAY BOTTOM (forebay B)
SURFACE AREA AT 1.5" STORAGE
AREA AT TOP OF SHELF
AREA AT BOTTOM OF SHELF
ELEVATIONS
PP ELEVATION
ELEVATION AT EDGE OF MAIN BASIN SHELF
ELEVATION OF MAIN BASIN BOTTOM
ELEVATION AT EDGE OF FOREBAY SHELF
ELEVATION OF FOREBAY BOTTOM
ELEVATION OF TOP OF SHELF
ELEVATION OF 1.5" STORAGE
VOLUME CALCULATIONS
MAIN BASIN VOLUME BELOW SHELF
(A) FOREBAY VOLUME BELOW SHELF
(B) FOREBAY VOLUME BELOW SHELF
TOTAL VOLUME BELOW SHELF
AVERAGE POND DEPTH 3.277
MAIN BASIN VOLUME
TOTAL FOREBAY VOLUME
PERMANENT POOL VOLUME
FOREBAY PERCENTAGE OF TOTAL PERMANENT POOL VOLUME
VOLUME BELOW TOP OF SHELF
TEMP. STORAGE VOLUME (1.5" RUNOFF)
1,875.00
1,781.00
6,188.00
1,175.00
1,334.00
1,222.00
559.00
506.00
15,497.00
14,202.00
8,744.00
F
4.50
4.00
-1.00
4.00
1.00
5.00
5.75
F3
18,407.50
2,839.50
2,592.00
23,839.00
21,899.50
5,431.50
27,331.00
19.87%
33,740.50
17,546.63
FILELOCATION S:Wym8n6ROCny W090M CumtukAuislM Uvi,plEvcpMGp222 PoNO VOLUME CALCULATIONS(1 DeLn 21osUrydMIS
TAB 1 basin 21meMys
1 N5I2009 I109 AM Page 1 of 1

PERMANENT POOL DETENTION PONDS
DESIGN OF POND
090222 - Currituck Assisted Living Center
10 Yr, 24 Hr Storm
DETENTION POND
Hyman & Robey, PC
150-A Hwy 158 East
Camden, NC 27921
(252)-335-1888
10/05/09
SA/DA PERCENTAGES FOR 90% TSS REMOVAL WITHOUT VEGETATIVE FILTER
% IMPRV
3.0 FT
3.5 FT
4.0 FT
4.5 FT
5.0 FT
5.5 FT
6.0 FT
10%
1.3
1.0
0.8
0.7
0.6
0.5
0.4
20%
2.4
2.0
1.8
1.7
1.5
1.4
1.2
30%
3.5
3.0
2.7
2.5
2.2
1.9
1.6
40%
4.5
4.0
3.5
3.1
2.8
2.5
2.1
50%
5.6
5.0
4.3
3.9
3.5
3.1
2.7
60%
7.0
6.0
5.3
4.8
4.3
3.9
3.4
70%
8.1
7.0
6.0
5.5
5.0
4.5
3.9
80%
9.4
8.0
7.0
6.4
5.7
5.2
4.6
90%
10.7
9.0
7.9
7.2
6.5
5.9
5.2
100%
12.0
10.0
8.8
8.1
7.3
6.6
5.8
WATERSHED AREA:
4.65
ACRES
WATERSHED % IMPERVIOUS:
48"/R
PERMANENT POOL ELEVATION:
4J
FP
PERMANENT POOL AVG. DEPTH:
3
FT
SA/DA PERCENTAGE FACTOR:
5.38
%
POND SURFACE AREA REQ'D:
FOREBAY AREA:
AT WIDTH = 0.33 LENGTH,
WIDTH =
LENGTH =
Use these dimensions:
VOLUME OF 1.5" RAINFALL
10897 SF
3269 SF
6.5 FT
0.3
1.0
1.3
1.8
2.3
2.9
3.4
4.0
4.6
5.1
Page I
7.0 FT
0.2
0.9
1.4
1.9
2.4
2.9
3.4
3.9
4.3
(FROM ABOVE TABLE -TAKEN FROM DESIGN OF STORM WATER
CONTROL FACILITIES WORKSHOP MANUAL - PENC 1988)
60.27 LF (BASED UPON MINIMUM SURFACE AREA)
180.81 LF
WIDTH 61.74 LF
LENGTH 185.22 LF
AREA OF ROOFS:
0.81
AC
AREA OF PARKING/CONCRETE:
1.4
AC
AREA OF GREEN AREAS:
2.44
AC
VOLUME OF RUNOFF
14309.5
CF
STORAGE DEPTH FOR MINIMUM AREA =
ELEVATION OF 1.5" RAINFALL = 5.75
Nonnal Pool Elevation 4.5
VOL (CF)=([(ROOF• 1.0)+(PARKING'.95)+(GRASS'0.2)]'43,560/12)• 1.5
1.25 Fr
ACTUAL STORAGE VOLUME PROVIDED AS CALCULATED IN CAD:
17546.63 CF •:; . ✓ _-
/Jy��//� -
O "1 ' "W'VOi,

DRAWDOWN - WATER QUALITY
Q(2 DAYS)= 0.10154 CFS
Q(5 DAYS) = 0.04062 CFS
t" RUNOFF STAGE 1.25 FT
DEPTH OF DRAWDOWN DEVICE BELOW OUTLET 1.5 FT
V RUNOFF OUTLET DEVICE: 2.0477 INCH DIA HOLE
Page 2
A=[Q/(Cd*SQRT(2gh))]* 144
Rad =SQRT(A/PI)
Dia. =2*Rad.
DIAMETER OF HOLE TO USE: 2.25 INCH DIAMETER
DRAWDOWN RATE 0.08582 CFS
I" STORM RUNOFF DRAWDOWN TIME 2.36646 DAYS
INFLOW HYDROGRAPH
Return Year Storm 10 Yr
Qp = Peak Discharge = 18.56 cfs
Tc = Time of Concentration = 13.86 min
Calculation of Tp (Time to Peak)
From SCS NEH 4 , page 15-7 Eqn. 15.4
Lag Time (L)= (IA0.8*(S+l)A0.7)/(1900*YA0.5) for L in Hrs
where: I = hydraulic length of watershed (R)
S = (1000/CN)-10
CN = approximately same CN from TR-55
Y = avg. watershed land slope in %
S = (1000/CN)-10 = 1.76471
L= 0.25287 hrs
From SCS NEH 4 , page 16-7 Eqn. 16.7
Tp=D/2+L
where : D = unit of excess duration rainfall (hrs)
L = Lag Time (hrs)
From SCS NEH 4, page 16-8 Eqn. 16.12
D = 0.133 tc
where: Tc = Time orConcentration (hrs) - (See Tr-55 Printout)
THEREFORE: D= 0.03072 hrs
Tp = 0.26823 hrs = 16.0937 min
Volume under Hydrograph = 1.39 * Qp * Tp = 24911.5 Cubic Feet
699
1.76471
85
0.64

STAGE STORAGE FUNCTION OF POND
(FOR RECTANGULER DETENTION POND ONLY)
Minimum surface area taken at normal water level
BASIN AREA [NCR ACCUM
VOLUME VOLUME STAGE In s
S Z
sf cf cf ft
Page 4
Pond Side Slope (M) = 3
In Z Z est Elevation
11435
0
0
0
Surface area at normal pool
4.5
12185
5905
5905
0.5
8.68
-0.69
0.56
5
12953
6285
12190
1
9.41
0.00
1.04
5.5
13739
6673
18863
1.5
9.84
0.41
1.52
6
14543
7071
25933
2
10.16
0.69
2.01
6.5
15365
7477
33410
2.5
10.42
0.92
2.50
7
16205
7892
41303
3
10.63
1.10
3.01
7.5
17063
8317
49620
3.5
10.81
1.25
3.52
8
17939
8750
58370
4
10.97
1.39
4.06
8.5
18832
9193
67563
4.5
11.12
1.50
4.61
9
19744
9644
77207
5
11.25
1.61
5.17
9.5
Regression
Output:
Constant
9.34346
Ks
= S/Z^b
= 11625.09
Sid Er of Y Est
0.00969
R Squared
0.99962
No. of Observations
7
Degrees of Freedom
5
X Coefficient(s) 1.15215 = b
Sid Er of Coef. 0.01009
FOR VERTICAL SIDED DETENTION POND SET b=0, AND Ks = SURFACE AREA (SF)
STAGE DISCHARGE
(FOR RISER/BARRELL SPILLWAY
W EMERGENCY WEIR)
RISER
Dr =
24
Riser Dia. (in)
Etop =
50.00
Elev. Top Riser (ft) 6.68
Cwr =
3.33
Riser weir coeff
Cdr =
0.60
Riser orifice coeff
Hln =
0
Number of Holes
H 1 d =
2
Hole Dia. (in)
EHI =
50.00
Elev. Holes (1)
H2n =
0
Number of Holes
H2d =
2
Hole Dia. (in)
EH2 =
50.00
Elev. Holes (2)
H3n =
0
Number of Holes
H3d =
2
Hole Dia. (in)
EH3 =
50.00
Elev. Holes (3)
BARREL:
Db =
15
Barrel Dia. (in)
Einv =
50.00
Elev Invert Barrel (ft) Barrel[ Adjustment Factor
Cdb =
0.60
Barrel orifice coeff

EMERGENCY WEIR
Page 5
Elevation
Cw,
Ecr
Lw
Riser
Hole
(1)
Riser
Hole
(2)
3 Weir coeff
5.75 Elev weir coeff (ft)
5 Weir Length (ft)
Riser
Hole Riser
(3) (weir)
4.50
0.0
0.0
0.0
0.0
4.50
0.0
0.0
0.0
0.0
4.51
0.0
0.0
0.0
0.0
4.53
0.0
0.0
0.0
0.0
4.57
0.0
0.0
0.0
0.0
4.63
0.0
0.0
0.0
0.0
4.71
0.0
0.0
0.0
0.0
4.82
0.0
0.0
0.0
0.0
4.95
0.0
0.0
0.0
0.0
5.09
0.0
0.0
0.0
0.0
5.23
0.0
0.0
0.0
0.0
5.37
0.0
0.0
0.0
0.0
5.50
0.0
0.0
0.0
0.0
5.62
0.0
0.0
0.0
0.0
5.74
0.0
0.0
0.0
0.0
5.84
0.0
0.0
0.0
0.0
5.92
0.0
0.0
0.0
0.0
5.98
0.0
0.0
0.0
0.0
6.03
0.0
0.0
0.0
0.0
6.06
0.0
0.0
0.0
0.0
6.09
0.0
0.0
0.0
0.0
6.12
0.0
0.0
0.0
0.0
6.12
0.0
0.0
0.0
0.0
6.12
0.0
0.0
0.0
0.0
6.10
0.0
0.0
0.0
0.0
6.08
0.0
0.0
0.0
0.0
6.05
0.0
0.0
0.0
0.0
6.03
0.0
0.0
0.0
0.0
6.01
0.0
0.0
0.0
0.0
5.98
0.0
0.0
0.0
0.0
5.97
0.0
0.0
0.0
0.0
5.92
0.0
0.0
0.0
0.0
5.89
0.0
0.0
0.0
0.0
Riser
Barrel
Principal
Emergcy
(orifice)
Spillway
Weir
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.0
0.0
0.0
0.00
0.4
0.0
0.0
0.00
1.1
0.0
0.0
0.00
1.7
0.0
0.0
0.00
2.2
0.0
0.0
0.00
2.6
0.0
0.0
0.00
2.9
0.0
0.0
0.00
3.3
0.0
0.0
0.00
3.4
0.0
0.0
0.00
3.3
0.0
0.0
0.00
3.1
0.0
0.0
0.00
2.8
0.0
0.0
0.00
2.5
0.0
0.0
0.00
2.2
0.0
0.0
0.00
1.9
0.0
0.0
0.00
1.7
0.0
0.0
0.00
1.5
0.0
0.0
0.00
1.1
0.0
0.0
0.00
0.8

Page 6
ROUTING OF INFLOW HYDROGRAPH THROUGH POND AND OUTFLOW DEVICE
Total
Riser
Riser
Riser
Barrel
Emerg
Time
Inflow
Storage
Stage
Outflow
Holes
(weir)
(orifice)
Spillway
t (hr)
cfs
cf
Elevation
cfs
(1+2+3)
efs
cfs
cfs
cfs
cfs
0.000
0
0
4.50
0.00
0.00
0.00
0.00
0.00
0.00
0.027
1
0
4.50
0.00
0.00
0.00
0.00
0.00
0.0c
0.054
2
53.7659
4.51
0.00
0.00
0.00
0.00
0.00
0.0c
0.080
4
232.986
4.53
0.00
0.00
0.00
0.00
0.00
0.00
0.107
6
573.503
4.57
0.00
0.00
0.00
0.00
0.00
0.0c
0.134
9
1129.08
4.63
0.00
0.00
0.00
0.00
0.00
0.00
0.161
12
1971.42
4.71
0.00
0.00
0.00
0.00
0.00
0.0c
0.188
15
3154.27
4.82
0.00
0.00
0.00
0.00
0.00
0.00
0.215
17
4623.87
4.95
0.00
0.00
0.00
0.00
0.00
0.0c
0.241
18
6290.61
5.09
0.00
0.00
0.00
0.00
0.00
0.0c
0.268
19
8064.88
5.23
0.00
0.00
0.00
0.00
0.00
0.00
0.295
18
9857.08
5.37
0.00
0.00
0.00
0.00
0.00
0.00
0.322
17
11631.4
5.50
0.00
0.00
0.00
0.00
0.00
0.00
0.349
16
13298.1
5.62
0.00
0.00
0.00
0.00
0.00
0.00
0.376
14
14839.4
5.74
0.00
0.00
0.00
0.00
0.00
0.00
0.402
13
16237.3
5.84
0.38
0.00
0.00
0.00
0.00
0.38
0.429
10
17419.2
5.92
1.06
0.00
0.00
0.00
0.00
1.0E
0.456
9
18320.8
5.98
1.70
0.00
0.00
0.00
0.00
1.70
0.483
7
18981.2
6.03
2.23
0.00
0.00
0.00
0.00
2.23
0.510
6
19465.1
6.06
2.64
0.00
0.00
0.00
0.00
2.64
0.536
5
19801.4
6.09
2.94
0.00
0.00
0.00
0.00
2.94
0.590
4
20236.6
6.12
3.35
0.00
0.00
0.00
0.00
3.35
0.644
3
20332.2
6.12
3.44
0.00
0.00
0.00
0.00
3.44
0.697
2
20195.1
6.12
3.31
0.00
0.00
0.00
0.00
3.31
0.751
1
19939.8
6.10
3.07
0.00
0.00
0.00
0.00
3.07
0.805
1
19623
6.08
2.78
0.00
0.00
0.00
0.00
2.78
0.858
1
19282.8
6.05
2.48
0.00
0.00
0.00
0.00
2.48
0.912
1
18946.6
6.03
2.20
0.00
0.00
0.00
0.00
2.20
0.966
0
18626
6.01
1.94
0.00
0.00
0.00
0.00
1.94
1.019
0
18327.1
5.98
1.70
0.00
0.00
0.00
0.00
1.70
1.073
0
18051.8
5.97
1.50
0.00
0.00
0.00
0.00
1.50
1.207
0
17427.6
5.92
1.06
0.00
0.00
0.00
0.00
1.06
1.341
0
16959.9
5.89
0.77
0.00
0.00
0.00
0.00
0.77
6.12452 = maximum stage elevation
3.43804 = maximum discharge

E)(PRESS PROJECT DESCRIPTION
OCT 08 2553 Currituck Assisted Living Center
Currituck County - North Carolina
NC ®ENR September 25, 2009
Currituck Health Investors, LLC is proposing to construct an assisted living facility on a 6 acre site
in Moyock Township of Currituck County. The site is located on Moyock Landing Road. It is currently
vacant and is zoned GB (General Business).
Development will include the construction of one (1) building, (1) accessory building, required
parking, an underground piped drainage system in conjunction with grassed swales, required utilities,
sewer pump station, the installation of required landscaping, and a wet detention basin.
The proposed buildings will contribute 35,221 sf of impervious area. The parking and driveways
will contribute 48,912 sf, the dumpster pad 400 sf, and sidewalk and patios will contribute another 8,284
sf for a total ofW,8.1.71sf of impervious coverage.
Drainage Area 1 encompasses 4.65 acres (202,485 sf) of the site including most proposed on -
site impervious areas. The only impervious areas not draining to the detention basin are a portion of the
entrance drive and a portion of the County required sidewalk along the front of this site. It is not practical
for all of these areas to drain to the detention basin. These small areas that are not directed to the basin
will be part of Drainage Area 2. Drainage will be collected in a combination of underground piping and
grass lined swales that will route all runoff to the proposed detention pond which is designed for 90% TSS
removal. The design impervious area isr45 07% of the drainage area. To have the flexibility to add future
building, pavement or sidewalk additions, the proposed wet detention basin has been sized to accept
runoff from approximately 5;000=sf-of-additional°impervious=areas The mazimunfonsite-impervious•area
will=be:47'53%_of,the:dra i nage=a rea,
Drainage Area 2 contains the remainder of the 6 acre tract. Only the portion of the entrance drive
and portion of the required sidewalk mentioned above is on -site impervious and located in this drainage
area. Open space areas around the perimeter of the site will sheet flow into the perimeter swales.
The soil evaluation was performed on July 30, 2009 by Sean C. Robey, PE and Kimberly Hamby.
The soil boring was conducted with an AMS 2-3/4" diameter 6' long hand mud auger. The boring was
performed in the northwest corner of the property where the detention pond will be located. The USDA-
NRCS WEB Soil Survey indicates the site consists of Augusta and Roanoke soils. The elevation at the
boring location is approximately 6.5'. The sandy loam topsoil was 16-18" deep. From 18" to 36" was a
massive clay. At 36", we encountered a course sand. At 42" color of the sand changed to a chroma color
less than 2 according to the Munsell Soil Color Chart. The low chroma indicates the seasonal high water
table is located at a depth of approximately 42", or elevation 3.0'. The course sand continued to at least
48" but was too wet to continue removal with the auger.
The total disturbed area for this development will not exceed 6 acres. Limits of disturbance have
been shown on the plans. ���ttlltUgpyb
� 0 • �454%/\ r � i
F—
� O • L• ' ` tb.l��
P O. Box 339 Camden, Norlh Carolina 27921
[phone] License C-0598
www,hymanrobeyxom

Ilk

Hydrologic Soil Group-Conduck County, North Carolina
(CURBock Assisled Living Center)
MAP LEGEND
MAP INFORMATION
Am of Inl.rax (AOI)
Map Scale, 1 1,280 d dumbed on A size (8.5' - 11') sosel.
Area of IMareH (Aab
The soul su"ys that compose your A01 Were mapped at 1.20.000.
toile
Please rely on the her Scale On each map street far accurate mace
Soil Map Units
rr'RBSUI2n1en15.
Soil RMInN
Source of Map. Natural Resources Conservatbn Service
A
Web Soil Survey URL'. hap.Morebsoilsurvey.b..u.da gov
❑
Ayp
Coordinate System: UTM Zone 18N NA083
a
This prow uct ¢ ganende,1 from the USDA-NRCS cedir data as of
Me version dale(.) listed below.
❑
Rm
Sod Surrey Aree: Cuniluck County, North Carolina
❑
C
Survey Area Data. Version 11, Sep 26. 2008
ID
Dates) edel images ware proftc9 aphod 511512008
❑
o
The odhopholo or other base map on which the sal fares were
Nm sled or nor. YfibN
compiled and digitized grab" differs from Ita; background
displayed on Thesere maps. As a sull, some mirror shilling
Pollak.] Fed.
of
of map unit boundaries may he eviderd.
pero,
W.Mr F....
or.os
Streams end Canals
T,.nwribi
Ralk
.M*
Inredur, Hpb,,t,
,.
ITS Rome,
M.ia Roads
N Lu eu ROad.
INOA Natural R........
r� C...arveto. S.M.
Web Soil Survey
National Cooperative Soil Survey
81512009
Page 2 of 4

xr—EXPRESS
�.e
77
1
= 4i
0
YNE 111tlq
m'(al� J � •ra" a ��macw.�cuw d ® u .,
•�••••• v ••••• • •:� we avE N ui amorac wr.r�ma.+wrn �
r wm •"s�iYr�ra�•r rmv.rWa °�"M�Rm11K4l IXVmltnNu£'•n°�4p�
OCT 08 2000
i!I! III. 4u" wiu
�I
..;, 1 r.Cr
_J US Ht % _
) Box 3
lmden NC 27',21
:i2) 338 29 3
52) 338
..vw.hymanr� I,ey.com
SECTION OF QUAD MAP
SHOWING AREA OF
CURRITUCK
ASSISTED LIVING
MOYOCK TOWNSHIP
CURRITUCK COUNTY
NORTH CAROLINA
Drawing M 090222 TopoMap
Drawn: JLW
Date: 08-11-09
Sheet* 1 OF 1
Scale: 1"=0.5 Mi.
0o z z�aD�EE 3o
ROAD CLASSIFICATION
-
""-dWy_ LightE �r
Nedmu uly��� Unimpl di" .......
U 5. Route SaPo Rein¢ v �
�c
MOYOCK, VA.—N.C.
WEORMGIE tAG1T,On
36076-E2-TF4)24
complial -� on wun onweaun lqs!
of V E n a ag¢ oes 1 0. aer41 n 11y n 1-k ] 48 a +we, FHOTOHEViSED 19M . f s.w e 0 tpis mforms(un not iot0 cna Med M-0 ld'W 1986 DW S9SP 11 SW—SBRIES V ti
E

Hydrologic Soil Group—Currtuck County, North Carolina
Hydrologic Soil Group
Currituck Assisted Living Center
Hydrolog yc Sod Gro vp Summary by Map Umt Curntudk Coun North Carobna+4'> a" R�
��.�.. -. .rye: w. ' . ,r , u.�, w;
Map unit symbol
_ .;.
i<' , Mapunit names !
;9 Ra_luig # t
t.Acres in AOI ,jj
sP,ercent of'AO_Iz
At
Augusta f ne sandy loam
C
3.5
48.0
Ro
Roanoke fine sandy loam
D
3.8
52.0%
Totals for Area of Interest
7.3
100.0 %
Description
Hydrologic soil groups are based on estimates of runoff potential. Soils are
assigned to one of four groups according to the rate of water infiltration when the
soils are not protected by vegetation, are thoroughly wet, and receive precipitation
from long -duration storms.
The soils in the United States are assigned to four groups (A, B, C, and D) and
three dual classes (A/D. B/D, and C/D). The groups are defined as follows:
Group A. Soils having a high infiltration rate (low runoff potential) when thoroughly
wet. These consist mainly of deep, well drained to excessively drained sands or
gravelly sands. These soils have a high rate of water transmission.
Group B. Soils having a moderate infiltration rate when thoroughly wet. These
consist chiefly of moderately deep or deep, moderately well drained or well drained
soils that have moderately fine texture to moderately coarse texture. These soils
have a moderate rate of water transmission.
Group C. Soils having a slow infiltration rate when thoroughly wet. These consist
chiefly of soils having a layer that impedes the downward movement of water or
soils of moderately fine texture or fine texture. These soils have a slow rate of water
transmission.
Group D. Soils having a very slow infiltration rate (high runoff potential) when
thoroughly wet. These consist chiefly of clays that have a high shrink -swell
potential, soils that have a high water table, soils that have a claypan or clay layer
at or near the surface, and soils that are shallow over nearly impervious material.
These soils have a very slow rate of water transmission.
If a soil is assigned to a dual hydrologic group (A/D, B/D, or C/D), the first letter is
for drained areas and the second is for undrained areas. Only the soils that in their
natural condition are in group D are assigned to dual classes.
Rating Options
Aggregation Method: Dominant Condition
Component Percent Cutoff.' None Specified
U`�T Natural Resources Web Soil Survey 8/512009
Conservation Service National Cooperative Soil Survey Page 3 of 4

North Carolina Secretary of State
Page I of 2
CORPORATIONS
North Carolina
ElNJOIEMrshall DEPARTMENT OF THE
Secretary SECRETARY OF STATE
PO Box 29622 Rale4jh, NC 2762"622 (9191807.2000
EXPRESS
OCT 08 2009
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Corporation Names
Name Name Type
NC Currituck Health Legal
Investors, LLC
Limited Liability Company Information
SOSID:
Status:
Date Formed
Citizenship:
State of Inc.:
Duration:
Registered Agent
Agent Name:
Registered Office
Address:
Registered Mailing
Address:
Principal Office
Address:
Principal Mailing
Address:
1024615
Current -Active
1 /30/2008
Domestic
NC
Perpetual
Bell, Davis & Pitt, P.A.
100 North Cherry Street, Suite 600
Winston Salem NC 27101
Attention: Jac
PO Box 21029
Winston Salem NC 27120-1029
1978 Eighth Avenue, NW
Hickory INC 28601
1978 Eighth Avenue, NW
Hickory NC 28601
http://www.secretary.state.nc.us/corporations/Corp.aspx?Pitemld=8732923 7/27/2009

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Corporations Division
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http://www.secretary.state.ne.us/corporations/Corp.aspx?Pitemld=8732923 7/27/2009

r00802900370
State of North Carolina
Department of the Secretary of State
Limited Liability Company
ARTICLES OF ORGANIZATION
Date Filed: 1/30/2008 10:41:00 AM
Elaine F. Marshall
North Carolina Secretary of State
C200802900370
Pursuant to §57C-2-20 of the General Statutes of North Carolina, the undersigned does hereby submit
these Articles of Organization for the purpose of forming a limited liability company.
The name of the limited liability company is: Currituck Health Investors, LLC
2. If the limited liability company is to dissolve by a specific date, the latest date on which the
limited liability company is to dissolve: (Ifno date for dissolution is specified, there shall be no
limit on the duration of the limited liability company.)
The name and address of each person executing these articles of organization is as follows:
(State whether each person is executing these articles of organization in the capacity of a
member, organizer or both).
Bell, Davis & Pitt, P.A., Organizer
PO Box 21029
Winston-Salem, NC 27120-1029
4. The street address and county of the initial registered office of the limited liability company is:
100 North Cherry Street
Suite 600
Winston-Salem, NC 27101
Forsyth County
The mailing address, if different from the street address, of the initial registered office is:
Bell, Davis & Pitt, P.A.
Attention: JAC
PO Box 21029
Winston-Salem, NC 27120-1029
6. The name of the initial registered agent is: Bell, Davis & Pitt, P.A.
Principal office information: (Select either a or b.)
a. ® The limited liability company has a principal office.
The street address and county of the principal office of the limited liability company is:
1978 Eighth Avenue, NW
Hickory, NC 28601
Catawba County
The mailing address, if different front the street address, of the principal office of the corporation is:

C:00802900370
b. ❑ The limited liability company does not have a principal office.
8. Check one of the following:
(i) Member -managed LLC: all members by virtue of their status as members shall be
managers of this limited liability company.
_X_(ii) Manager -managed LLC: except as provided by N.C.G.S. Section 57C-3-20(a), the
members of this limited liability company shall not be managers by virtue of their status as
members.
9. Any other provisions which the limited liability company elects to include are attached.
10. These articles will be effective upon filing, unless a date and/or time is specified:
This is the 28th day of January, 2008.
Bell, Dams_& Pitt, P.A.,
0
Vice President
NOTES:
1. Filing fee is $125. This document must be riled with the Secretary of State.
CORPORATIONS DIVISION P.O. Box 29622 RALEIGH, NC 27626-0622
(Revised January 2002) (Form L-01)

C200810901633
SOSID: 1024615
Date Filed: 4/18/2008 4:54:00 PM
LIMITED LIABILITY COMPANY (LLC) Elaine F. Marshall
r4 North Carolina Secretary of State
' ANNUAL REPORT C200810901633
NAME OF LIMITED LIABILITY COMPANY: CURRITUCK HEALTH EMSTORS, LLC
STATE OF FORMATION: NC
SECRETARY OF STATE L.L.C. ID NUMBER: 1024615
YEAR DUE: 2008
11, MPLETE
RM. IF
LLLC SSIS THE INITIAL INFORMAT ON HAS
OT CHANGEDINCE THEREVI UUAL REPORT FILING, YOU MUST 3 REPORTHE
PLEASEI ENTIRE
CCK THE BOX
AND COMPLETE LINE 8. ❑
I. REGISTERED AGENT & REGISTERED OFFICE MAILING ADDRESS: BAeDavis & Pitt, P.A.
P.O. Box 21029
Winston-Salem, NC 27120-1029
2. STREET ADDRESS AND COUNTY OF REGISTERED OFFICE: WINoCherry StreetNC,Slit 600
Forsyth Couufy�
3. IF THE REGISTERED AGENT CHANGED, SIGNATURE OF THE NEW AGENT: S CONSTITUCES C NSENT TO THE APPO TMEP
4. ENTER PRINCIPAL OFFICE ADDRESS HERE: ADDRESS-1978 Eighth Avenue,
CITY -Hickory ST. KC ZIP- 28601
5. ENTER PRINCIPAL OFFICE TELEPHONE NUMBER HERE: 82& PLEASE INCLUDE AREA CODE
6. ENTER NAME, TITLE, AND BUSINESS ADDRESS OF MANAGER(S) OR IF THE LLC HAS NEVER HAD MEMBERS, ITS ORGANIZERS:
NAME- Charles E. Trefzger, Jr. ADDRESS- 1978 Eighth Avenue, NW
TITLE- Manager
CITY- Hickory ST- NC ZIP- 28601
NAME- David S. Jones ADDRESS- 1978 Eighth Avenue, NW
TITLE- Manager
CITY Hickory ST-NC ZIP-28601
NAME ADDRESS-
TY- ST- ZIP-
TITLE -
CI
7. BRIEFLY DESCRIBE THE NATURE OF BUSINESS: Healthcare
8. CERTIFIC ON 0 0RT MUST BE COMPLETED BY ALL LIMITED LIABILITY COMPANIES.
dG tlb�
FORM MUST BE SIG D BY A ANAGER OF THE LLC.
DATE
Charles E. Trefzger, Jr.
Member/Ivfanager
TYPO OR PRINT NAME
TYPE OR PRINT TITLE
ANNUAL REPORT FEE: $200.00 MAIL TO: Secretary of State • Corporations Division • Post Office Box 29525 • Raleigh, NC 27626.0525

BOON 1102PAGE 0031p*
I'RANSFERTAX AM�UNT 3
UATEtcOLLECCOR - 9Rl�ffiC,r
Tax Callwor Certification That No Delinquent Taxes
rc ADue. Date ./N • By$&_: Ce,fiention
expires fan. Ne of the year following certification date.
Prepared by: William Brumsey, IV
File No. 091141129
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ex 1102 PD36-37 EXPRESS
OCT 08 2009
Return to: Leigh C. Bagley NORTH CAROUNA EXCISE STAMPS ICIYY''GG
�� ®IG�Itl lm
Bell Davis & Pitt, P.A.
PO Do. 21029 ATTACHED AND CANCELLED WQ.00
Winston-Salem,NC 27101
PARCEL NUMBER: out nf0009-000-029N-0000
NORTH CAROLINA GENERAL WARRANTY DEED
CURRITUCK COUNTY
THIS DEED made this the 91h day of September, 2009, by and between CTX,
Inc., a North Carolina corporation, Grantor, to Currituck Health Investors, LLC, a
North Carolina limited liability company, Grantee, whose address is 4423 Pleasant
Ridge Rd., Suite 301, Roanoke, VA 24014.
The designation of Grantor and Grantee as used herein shall include said parties,
their heirs, and successors and assigns, and shall include singular, plural, masculine,
feminine or neuter as required by context.
WITNESSETH:
THAT the Grantor, for a valuable consideration paid by the Grantee, the receipt
of which is hereby acknowledged, have and by these presents do grant, bargain, sell and
convey, unto the Grantee a fee simple interest, in and to all that certain lot or parcel of
land, and any improvements located thereon, situated in Moyock Township, Currituck
County, North Carolina, and more particularly described as follows:
All that certain lot and parcel and land shown as "Area After
Recombination- 6.00 AC" on that certain plat entitled in part
"Recombination Survey for CTX, INC." prepared by Hyman & Robe ,
dated September 1, 2009 and recorded in Plat Cabinet L- , Slide
of the Currituck County Registry.

BOOK 110 2 PAGE Q 0 3 i
The above -described property was acquired by the Grantor by deed recorded in
Deed Book 629, Page 84 of the Currituck County Registry.
TO I LAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges
and appurtenances thereto belonging to the Grantee and his heirs and assigns forever.
And 1he said Grantor covenants with the Grantee, that Grantor is seized of the
premises in fee simple and has the right to convey the same in fee simple; that title is
marketable and free and clear from all encumbrances, and that Grantor will warrant and
defend the title against the lawful claims of all persons whatsoever except for the
exceptions herein stated.
Title to the property hereinabove described is subject to the following exceptions:
Easements, reservations and restrictions of record
IN TESTIMONY WHEREOF, the said Grantor has hereunto set their hand and
official seal, or if Corporate, have caused this instrument to be signed in its corporate
name by its duty authorized officers and its seal to be hereunto affixed by authority of its
Board of Directors, the day and year first above written.
Grantor: CTX, Inc.
By: `l)� lr_(SEAL)
resse PrestdiOld
�rt
STATE OF NORTH CAROLINA
COUNTY OF CURRITUCK
I, a Notary Public of the County and State aforesaid, certify that Jerry L. Old
personally appeared before me this day and acknowledged that he is President of CTX,
Inc., a North Carolina corporation and that said writing was signed by him in behalf of
said corporation by its authority duly given. And the said Jerry L. Old acknowledged the
said writing to be the act and deed of said corporation.
Witness my hand and official stamp or seal, this tot'"day of September, 2009.
Printed Name: Tracy Jo Jones`', G
,'
My Commission expires: 10/29/2012 Noton Puo°`
camaon County
SEAL: .2¢.

October 6, 2009
Mr. Scott Vinson
Dept. of Environment and Natural Resources
Water Quality Section
943 Washington Square Mall
Washington, NC 27889
Subject: Stormwater Management Permit
Currituck Assisted Living Center
Proj. # 090222
Dear Mr. Vinson:
II.
HYMAN
ROBEY-1
EXPRESS
OCT 08 2009
NC DENR
Enclosed for your review and approval, please find the following items:
1. Two (2) copies of the above referenced plans.
2. The original and one (1) copy of the Stormwater Permit Application, Wet Detention Basin
Supplement, and Wet Detention Basin Operation and Maintenance Agreement.
3. Two (2) copies of the project description and calculations.
4. A portion of the USGS quad map showing project location.
5. A portion of the NCSS/NRCS soils maps showing project location. (3 pages)
6. One (1) copy of the deed for the property. (2 pages)
7. A copy of the Limited Liability Company (LLC) Annual Report for Currituck Health
Investors, LLC, obtained from the NC Department of Secretary of State.
8. A check in the amount of $4000.00 for the Express Permitting Option fee.
9. A letter signed by Mr. Jerry Old, President of CTX, adjacent property owner to
the east of the project, giving permission for construction activities to be
performed on CTX property as shown in the plans.
If you have any questions, please do not hesitate to call this office at [phone].
Sincerely,
Dougl A. Abbott, PE
Project Engineer
cc: file
Clayton Perry, Currituck Health Investors, LLC
P. O. Box 339 Camden, North Carolina 27921
[phone] License C-0598
w .hymanrobey.com

For DENR Use ONLY
North Carolina Department of Environment and Reviewer: iz CC— "rC—'
ATA
Natural Resources Submit: 510 V\
NC®� Request for Express Permit Review Time:
confirm:
FILL-IN all the information below and CHECK the Permit(s) you are requesting for express review. FAX or Email the completed form to Express
Coordinator along with a completed DETAILED narrative, site plan (PDF file) and vicinity map (same items expected in the application package
of the project location. Please include this form in the application package.
• Asheville Region -Alison Davidson 828.296.4698,alison.davidson(7pncmail.net
• Fayetteville or Raleigh Region -David Lee 919-791-4203; daviddee(dncmail.net
• Mooresville & -Patrick Grogan 704-663-3772 orpatrick.grogana(� cmail.net
• Washington Region -Lyn Hardison 252-946.9215 orlvn.hardisononcmail.net
• Wilmington Region -Janet Russell910-350-2004 orianet.russell(a2ncmaii.net
NOTE: Project application received after 12 noon will he stamped in the following work day. �������
Project Name: CURRITUCK ASSISTED LIVING CENTER County: CURRITUCK 0CT 08 2009
Applicant: CHARLES E. TREFZGER, JR. Company: CURRITUCK HEALTH INVESTORS, LLC
Address:1270 25TH STREET PLACE,SE City: HICKORY, State: NC Zip: 28603-2568 NC DENR
Phone: [phone] Fax::[phone] Email: _@_
Physical Location:141 MOYOCK LANDING DRIVE, MOYOCK, INC
Project Drains into MOYOCK RUN waters — Water classification C SW (for classification see-
http://h2o.enr.state.nc.us/bims/repods/repodsWB,htmi)
Project Located in NORTHWEST River Basin. Is project draining to class ORIN waters? N , within 'h mile and draining to class SA waters N
or within 1 mile and draining to class HOW waters? N
Engineer/Consultant: DOUG ABBOTT OR KIM HAMBY Company: HYMAN & ROBEY
Address: 150 US HWY 158 E. City: CAMDEN, State: NC Zip: 27921-_
Phone: [phone] Fax::[phone] Email: [e-mail]
(Check all that apply)
❑ Scoping Meeting ONLY ❑ DWQ, ❑ DCM, ❑ DLR, ❑ OTHER:
❑ Stream Origin Determination: # of stream calls — Please attach TOPO map marking the areas in questions
® State Stormwater ❑ General ❑ SFR, ❑Bkhd & Bt Rmp, ❑ Clear & Grub, ❑ Utility
❑ Low Density ❑ Low Density -Curb & Gutter _ # Curb Outlet Swales ❑ Off -site [SW _ (Provide permit #)]
® High Density -Detention Pond 1 # Treatment Systems ❑ High Density -Infiltration _ #Treatment Systems
❑ High Density -Bio-Retention _ # Treatment Systems ElHigh Density—Stormwater Wetlands _ # Treatment Systems
❑ High Density -Other _ # Treatment Systems /❑ MODIFICATION: E] Major E] Minor E] Revision SW
❑ Coastal Management ❑ Excavation & Fill ❑ Bridges & Culverts ❑ Structures Information
❑ Upland Development ❑ Marina Development ❑ Urban Waterfront
® Land Quality ® Erosion and Sedimentation Control Plan with 6 acres to be disturbed.(CK # (for DENR use))
WETLANDS QUESTIONS MUST BE ADDRESSED BELOW
❑ Wetlands (401): Check all that apply Isolated wetland on Property ❑ Yes ❑ No
Wetlands on Site ❑ Yes ® No Buffer Impacts: ❑ No ❑ YES: _acre(s)
Wetlands Delineation has been completed: ❑ Yes ❑ No Minor Variance : ❑ No ❑ YES
US ACOE Approval of Delineation completed: ❑ Yes ❑ No Major General Variance ❑ No ❑ YES
404 Application in Process w/ US ACOE: ❑ Yes ❑ No 401 Application required: []Yes ❑ No If YES, ❑ Regular
Permit Received from US ACOE ❑ Yes ❑ No Perennial, Blue line stream, etc on site ❑ yes ❑ No
For DENR use only
Fees lit for multiplepermits: Check# Total Fee Amount $ 39�-7
SUBMITTAL DATES
Fee
I
SUBMITTAL DATES
Fee
CAMA
$
I Variance ❑ Ma'; ❑ Min
$
SW ❑ HD, ❑ LID, ❑ Gen
$ A56)0
401:
$
LQS
I
$ ,,'90 1
Stream Deter,_
$
NCDENR EXPRESS July 2008