SW8121103_CURRENT PERMIT_20130819

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 LZ 1
DOC TYPE
$1 CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
2olsos lc1
YYYYMMDD

NCDENR
North Carolina Department of Environment and Natural Resources
Tracy E. Davis, PE, CPM
Director
August 19, 2013
Division of Energy, Mineral, and Land Resources
Stormwater Section
Pat McCrory, Governor
John E. Skvada, III, Secretary
Mr. Thomas Nelson
3075 AB Carter Rd.
Fayetteville, NC 28312
Subject: State Stormwater Management Permit No. SW8 121103
IC Life
High Density Subdivision Wet Pond Project (Class SA waters)
Pander County
Dear Mr. Nelson
The Wilmington Regional Office received a complete State Stormwater Management Permit
Application for IC Life on August 16, 2013. Staff review of the plans and specifications has
determined that the project, as proposed, will comply with the Stormwater Regulations set forth
in Session Law 2008-211 and Title 15A NCAC 2H.1000. We are forwarding Permit No. SW8
121103 dated August 19, 2013, for the construction, operation and maintenance of the BMP's
and built -upon area associated with the subject project.
This permit shall be effective from the date of issuance until August 19, 2021, and shall be
subject to the conditions and limitations as specified therein. Please pay special attention to the
conditions listed in this permit regarding the Operation and Maintenance of the BMP(s),
recordation of deed restrictions, procedures for changes of ownership, transferring the permit,
and renewing the permit. Failure to establish an adequate system for operation and
maintenance of the stormwater management system, to record deed restrictions, to transfer the
permit, or to renew the permit, 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 by filing a written petition with the Office of
Administrative Hearings (OAH). The written petition must conform to Chapter 150B of the North
Carolina General Statutes, and must be filed with the OAH within thirty (30) days of receipt of
this permit. You should contact the OAH with all questions regarding the filing fee (if a filing fee
is required) and/or the details of the filing process at 6714 Mail Service Center, Raleigh, NC
27699-6714, or via telephone at 919-431-3000, or visit their website at www.NCOAH.com.
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
Christine Nelson, at [phone].
Sin rely,
7m Tracy Davis, P.E., Director
Division of Energy, Mineral and Land Resources
GDS/can: S:\WQS\Stormwater\Permits & Projects\2012\121103 HD\2103 08 permit 121103
cc: Michael Gallant, PE, PA
Pender County Inspections
Division of Coastal Management
Wilmington Regional Office Stormwater File
Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 Phone: [phone] Fax: [phone]

State Stormwater Management Systems
Permit No. SW8 121103
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
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 -
Thomas Nelson
IC Life
Little Kinston Rd., Surf City, Pender County
FOR THE
construction, operation and maintenance of one (1) wet detention pond discharging to
Class SA Waters in compliance with the provisions of Session Law 2008-211 and 15A
NCAC 2H .1000 (hereafter separately and collectively 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 and
considered a part of this permit.
This permit shall be effective from the date of issuance until August 19, 2013 and shall
be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. The subdivision is permitted for 10 lots, each allowed a maximum of 2,043
square feet of built -upon area.
3. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.6 of this permit. The runoff from all built -upon
area within the permitted drainage area of this project must be directed into the
permitted stormwater control system. The wet pond has been designed to treat
the runoff from 31,658 square feet of built -upon area.
4. The maximum built -upon area allowed for the entire subdivision is 31,658 square
feet.
5. The drainage area will be limited to the amount of built -upon area indicated in
Sections 1.3 and 1.8 of this permit, and per approved plans. Built -upon area for
the future development has not been allocated for this project
6. A 50' wide vegetative buffer must be provided adjacent all surface waters,
measured horizontally from and perpendicular to the normal pool of impounded
structures, the top of bank of both sides of streams and rivers and the mean high
water line of tidal waters.
Page 2 of 9

State Stormwater Management Systems
Permit No. SW8 121103
7. The volume in excess of the design storm must flow overland through a level
spreader and 50 foot vegetative filter strip, designed
per NCAC 2H.1008 (f) to
pass the peak flow from the 10 year storm in a non -erosive
manner.
8. The following design elements have been permitted for this wet detention pond
stormwater facility, and must be provided in the system at all times.
a. Drainage Area, acres:
1.45
Onsite, ft2:
63,316
Offsite, ft2:
0
b. Total Impervious Surfaces, ft2:
31,658
Onsite, ft2:
31,658
Offsite, ft2:
0
c. Average Pond Design Depth, feet:
4.0
d. TSS removal efficiency:
90%
e. Design Storm, inches:
3.8
f. Permanent Pool Elevation, FMSL:
2.50
g. Permitted Surface Area @PP, ft2:
2,739
h. Permitted Temporary Storage Volume, ft3:
11,073
i. Temporary Storage Elevation, FMSL:
5.40
j. Predevelopment 1 yr-24 hr. discharge rate, cfs:
0.06
k. Controlling Orifice:
1.0" 0 pipe
I. Orifice Flowrate, cfs :
0.03
m. Permanent Pool Volume, ft3:
11,564
n. Forebay Volume, ft3:
2,539
o. Maximum Fountain Horsepower:
n/a (PP vol < 30000 ft)
p. Receiving Stream / River Basin:
Topsail Sound / Cape Fear
q. Stream Index Number:
18-87-10
r. Classification of Water Body:
"SA; HQW"
9. The discharge from all wet ponds must be directed to a secondary BMP. The
following design elements have been permitted for the
required secondary BMP,
a level spreader and vegetated filter strip, and must be provided in the system at
all times:
a. Peak Discharge
Design Storm, cfs: 0.03
10-yr Storm, cfs: 0.88
b. Length of Level Spreader, ft: 10
c. Width of Vegetated Filter Strip, ft: 50
d. Slope of Vegetated Filter Strip: 0.00%
II. SCHEDULE OF COMPLIANCE
No person or entity, including the permittee, shall alter any component of the
approved stormwater system shown on the approved plans unless and until the
Division has approved of the revised plan.
2. The permittee is responsible for the routine monitoring of the project for
compliance with the built -upon area limits, grading and storm drainage system
established by this permit, the permit documents, the approved plans and the
recorded deed restrictions.
Page 3 of 9

State Stormwater Management Systems
Permit No. SW8 121103
3. The permittee shall review all individual proposed and modified lot plans for
compliance with the conditions of this permit. The permittee shall not approve
any lot plans where the maximum allowed built -upon area has been exceeded,
where the revisions to the grading or to the storm drainage system are
proposed, unless and until a permit modification has been approved by the
Division.
4. The permittee shall notify any lot owner that is found to be in noncompliance with
the conditions of this permit, in writing and shall require remediation within a
reasonable time frame.
5. 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.
6. 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.
7. All stormwater collection and treatment systems must be located in either public
rights -of -way, dedicated common areas or recorded easements. The final plats
for the project will be recorded showing all such required rights -of -way, common
areas and easements, in accordance with the approved plans.
8. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
9. 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.
10. 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. Redesign or addition to the approved amount of built -upon area.
C. Further development, subdivision, acquisition, or sale of any, 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.
d. Alteration of any aspect of the approved stormwater drainage system
and/or the approved stormwater BMPs.
e. The construction of built -upon area within any permitted future
development areas shown on the approved plans.
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.
Page 4 of 9

State Stormwater Management Systems
Permit No. SW8 121103
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 design condition. The approved Operation and Maintenance
Agreement is incorporated by reference into this permit and must be followed in
its entirety and maintenance must occur at the scheduled intervals.
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 facilities shall be constructed in accordance with the conditions of this
permit, the approved plans and specifications, and other supporting data.
15. Prior to transfer of the permit, the stormwater facilities will be inspected by
Division personnel. The project and the stormwater facility must be in substantial
compliance with all permit conditions. Any items not in substantial compliance
must be repaired, replaced or restored to design condition prior to the transfer.
Records of maintenance activities performed to date will be required.
16. A decorative fountain will not be allowed in the pond as the permanent pool
volume is less than 30,000 ft3.
17. 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 SW8 121103, as issued
by the Division 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.
e. Alteration of the drainage as shown on the approved plans may not take
place without the concurrence of the Division:
f. The maximum built -upon area per lot is 2,043 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. For those lots within CAMA's Area of Environmental Concern, where DCM
calculates a different maximum lot built -upon area, the governing lot BUA
shall be the more restrictive of the two numbers.
h. All runoff from the built -upon areas on the lot must drain into the permitted
system. This may be accomplished through providing roof drain gutters,
which drain to the pond or to the street, grading the lot to drain toward the
pond or street, or grading perimeter swales and directing them into the
pond or street.
i. Built -upon area in excess of the permitted amount will require a permit
modification.
j. All affected lots shall maintain a 50' wide vegetative buffer adjacent to all
surface waters, measured horizontally from and perpendicular to the
normal pool of impounded structures, the top of bank of both sides of
streams and rivers and the mean high water line of tidal waters.
Page 5 of 9

State Stormwater Management Systems
Permit No. SW8 121103
k. Any individual or entity found to be in noncompliance with the provisions of
the stormwater management permit or the requirements of the Stormwater
Rules is subject to enforcement procedures as set forth in G.S. 143,
Article 21.
18. 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.
19. If permeable pavement BUA credit is desired, the permittee must submit a
request to modify the permit to incorporate such language as required by the
Division. 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 shall submit the necessary forms and
documentation to the permittee, or a designated agent, 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.
At least 30 days prior to the sale of the property, or a change of ownership, or a
name change of the permittee or of the project, or a mailing address change, the
permittee must submit a completed and signed Name/Ownership Change form to
the Division, accompanied by the supporting documentation as listed on the
form. The approval of this request will be considered on its merits and may or
may not be approved.
The permittee is responsible for compliance with all permit conditions until such
time as the Division approves a request to transfer the permit. Neither the sale of
the project, in whole or in part, nor the conveyance of common area to a third
party constitutes an approved transfer of the permit.
Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Energy, Mineral
and Land Resources, 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.
Page 6 of 9

State Stormwater Management Systems
Permit No. SW8 121103
Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit. The permittee shall maintain a copy of
the permit, O&M agreements, and the approved plans at all times.
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 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall submit a permit renewal application at least 180 days prior to
the expiration date of this permit. The renewal request must include the
appropriate documentation and the processing fee.
Permit issued this the 19t" day of August 2013.
CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
57� racy vis, P.E., Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW8 121103
Page 7 of 9

State Stormwater Management Systems
Permit No. SW8 121103
IC Life Page 1 of 2
Stormwater Permit No. SW8 121103
Pender County
Designer's Certification
I, , as a duly registered in
the State of North Carolina, having been authorized to observe (periodically/weekly/full
time) the construction of the project,
(Project)
for (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is 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. SW8 121103
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-DEMLR Regional Office
Pender County Building Inspections
Page 9 of 9

i
Permit Number: - _5�er/Z//0--3
(to be provided by DWQ)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
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 grotmdcover 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 m;n;m;zed to the
maximum extent practical.
— Once a year, a dam safety expert should inspect the embankmen#'6'
C* E AVE
After the wet detention pond is established, it should be inspected onceoJ(%4d1 2013
within 24 hours after every storm event greater than 1.0 inches (or 1.5 es if in a
Coastal County). Records of operation and maintenance should be kept Wh 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:
Potential roblem:
How I will remediate the roblem:
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
I
long.
approximately six inches.
Form SW401-Wet Detention Basin O&M-Rev.4
Page 1 of 4

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Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element
Potentialproblem:
How I will remediate the roblem:
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.
JUN 1 1 2013
6
Form SW401-Wet Detention Basin O&M-Rev.4 BY:-- of 4

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Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element•.
Potentialproblem:
How I will remediate theproblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair. if applicable)
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Division of
damage have occurred at the
Water Quality Regional Office, or
outlet.
the 401 Oversight Unit at 919-733-
1786.
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads 66:5 feet in the main pond, the sediment
shall be removed.
When the permanent pool depth reads 6.5 feet in the forebay, the sediment
shall be removed.
Sediment Removal
I: 6 W=6
-4.0
--------------
FOREBAY
BASIN DIAGRAM
(fill in the blanks)
Fft Min.
Sediment
Storage
Form SW401-Wet Detention Basin O&M-Rev.4
Permanent Pool Elevation 2.50
Pool
Sediment Removal Elevation -4.0 Volume
-------=--- ------
Bottom Elevation
MAIN POND
ECE9VEE
JUN 11 2013
RV ___. Page 3 o 4
1-ft
Storage

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Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:
BMP drainage area number:I
Print name:Thomas Nelson
Address:3075 AB Carter Rd, Fayetteville, NC 28312
Date: 4 — — /
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I,
a Notary Public for the State of
)� , If , , County of nP_ � �- , do hereby certify that
/7 oln 4 s Nd iso n personally appeared before me this _1-1771
C ) L
day of t A 1r__ and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,
SEAL
OFFICIAL SEAL
N0.11 P.b,, NOhICdOlin➢
HARNETT COUNTY
THEDA C POOLE
My commission expires % �) — �;— — J 7"
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ECEIVE
JUN 1 1 2013
6
BY: —
Form SW40I-Wet Detention Basin O&M-Rev.4
Page 4 of 4

Permit Number.
(to be provided by DWQ)
Drainage Area Number:
Filter Strip, Restored Riparian Buffer and Level Spreader
Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
— Immediately after the filter strip is established, any newly planted vegetation
will be watered twice weekly if needed until the plants become established
(commonly six weeks).
— Once a year, the filter strip will be reseeded to maintain a dense growth of
vegetation
— Stable groundcover will be maintained in the drainage area to reduce the
sediment load to the vegetation.
— Two to three times a year, grass filter strips will be mowed and the clippings
harvested to promote the growth of thick vegetation with optimum pollutant
removal efficiency. Turf grass should not be cut shorter than 3 to 5 inches and
may be allowed to grow as tall as 12 inches depending on aesthetic requirements
(NW,1993). Forested filter strips do not require this type of maintenance.
— Once a year, the soil will be aerated if necessary.
— Once a year, soil pH will be tested and lime will be added if necessary.
After the filter strip is established, it will be inspected quarterly and within 24 hours
after every storm event greater than 1.0 inch (or 1.5 inches if in a Coastal County).
Records of operation and maintenance will be kept in a known set location and will be
available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element
Potentialproblem:
How I will remediate theproblem:
The entire filter strip
Trash/debris is present.
Remove the trash/debris.
system
The flow splitter device
The flow splitter device is
Unclog the conveyance and dispose
(if applicable)
clogged.
of any sediment off -site.
The flow splitter device is
Make any necessary repairs or
damaged.
replace if damage is too large for
repair.
ECEQVE
JUN 1 1 2013
BY:
Form SWU401-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 Page 1 of 3

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BMP element
Potentialproblem:
How I will remediate theproblem:
The swale and the level
The swale is clogged with
Remove the sediment and dispose
lip
sediment.
of it off -site.
The level lip is cracked,
Repair or replace lip.
settled, undercut, eroded or
otherwise damaged.
There is erosion around the
Regrade the soil to create a berm
end of the level spreader that
that is higher than the level lip, and
shows stormwater has
then plant a ground cover and
bypassed it.
water until it is established. Provide
time and a one-time fertilizer
application.
Trees or shrubs have begun
Remove them.
to grow on the Swale or just
downslope of the level lip.
The bypass channel
Areas of bare soil and/or
Regrade the soil if necessary to
erosive gullies have formed.
remove the gully, and then
reestablish proper erosion control.
Turf reinforcement is
Study the site to see if a larger
damaged or ripap is rolling
bypass channel is needed (enlarge if
downhill.
necessary). After this, reestablish
the erosion control material.
The filter strip
Grass is too short or too long
Maintain grass at a height of
if applicable).
approximately three to six inches.
Areas of bare soil and/or
Regrade the soil if necessary to
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide time and a
one-time fertilizer application.
Sediment is building up on
Remove the sediment and
the filter strip.
restabilize the soil with vegetation if
necessary. Provide lime and a one-
time fertilizer application.
Plants are desiccated.
Provide additional irrigation and
fertilizer as needed.
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.
Nuisance vegetation is
Remove vegetation by hand if
choking out desirable species.
possible. If pesticide is used, do not
allow it to get into the receiving
water.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality local Regional Office, or the
outlet.
401 Oversight Unit at 919-733-1786.
E 0 E 0V
JUN 1 1 1013
I
Form SWU401-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 RV;_ Pane 2 of 3_

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Permit Number.
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:I C Life
BMP drainage area number:
Print name:Thomas Nelson
Title:Owner
Address:3075 AB Carter Rd, Fayetteville, NC 28312
Date: / . 4�-- / 3
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.
a Notary Public for the State of
County of /]/" / /1 e- t * , do hereby certify that
71 a rn /.s / Y a /,So /1 personally appeared before me this :!T�
day of J u ✓1 e 071, and acknowledge the due execution of the
forgoing filter strip, riparian buffer, and/or level spreader maintenance requirements.
Witness my hand and official seal,
OFFICIAL SEAL
9 rvoiary Purr¢ Norm B ,."
HARNETT COUNT
THEDA C POOLE
SEAL
My commission expires / �) - 5 - ) 7
4� .�_/16/�J
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OEUV E
"I'll",
Form SWU401-Level Spreader, Filter Strip, Restored Riparian Buffer O&M-Rev.3 Page

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DWQ USE ONLY
" Date Received
Fee Paid
Permit Number
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph 11- Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW /ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ Mgmt Plan:
State of North Carolina
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 E C E I V� E
1. GENERAL INFORMATION Ur
1. Project Name subdivision, facility, �Ua e � 2la
1 ( ty, or establishment name - should be consistent with ject name on plans,
specifications, letters, operation and maintenance agreements, etc.): f3Y:
2. Location of Project (street address):
Little Kinston Rd
City:Surf City County:Pender Zip:28445
3. Directions to project (from nearest major intersection):
At the function of Hwy 210 and Hwy 50 (CVS on corner) procedd on Hwy 50 toward Topsail Island. The last
left immediately before the swing bridge is Little Kinston Rd. The project is on the right one tenth of a mile
from Hwy 50.
4. Latitude:34° 26' 2.51" N Longitude:770 33' 14.44" W of the main entrance to the project.
1. a. Specify whether project is (check one): Z&New ®Modification ❑ Renewal w/ Modificationt
tRenemals urith modifications also requires SWU-102 - Renewal Application Form
b.If this application is
is, being submitted as the result of a modificatio t an existing permit, list the existing
permit number/,
�I Z R U rj , its issue date (if known) 11 l Z and the status of
construction: ®Not Started ❑Partially Completed* ❑ C mpleted* "provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, 5u1 )'.I)3 and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 1.45 ac of Disturbed Area
❑404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? ®No [-]Yes
If yes, see S.L. 2012-200, Part VI: httl2:/112ortal.ncdenr.org/web/wq/ws/su/"statesw/rules laws
Form SWU-101 Version 06Aug2012 Page I of 6

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III.. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:Thomas Nelson
Signing Official & Title:Thomas Nelson, Owner
b.Contact information for person listed in item la above:
Street Address:3075 AB Carter Rd
City:FEUetteville State:NC Zip:28312
Mailing Address (if applicable):
Phone: (910 ) 850-1445
Email:
State: Zip:
Fax: ( )
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that tl)e project is located on):
Property
Signing Official &
b.Contact information for person listed in item 2a above:
Street Address:
Mailing Address (if applicable):
Phone: ( ) Fax: ( )
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about thg project:
Other Contact
Signing Official &
b.Contact information for person listed in item 3a above:
Mailing
City: State: Zip: ttr:
Phone: f ) Fax: ( )
4. Local jurisdiction for building permits: Town of Surf City
Point of Contact -.Dixon Ivey Phone #: (910 ) 328-4131
Fonn S WU-101 Version 06Aug2012 Page 2 of 6
JUN 1 1 2013

.J.

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
All runoff will be collected from lots via gutters and grading and directed to the road where it will sheet flow
to the wet detention basin inlet flume. The wet basin is designed for 90% TSS removal. The outfall of the
basin is direccted to a LSVF which serves as a secondary BMP.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.lf claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area: 3.11 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+:3.11 acres
Total project area shall be calculated to exclude the following the normal yool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHM line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 23.3 (50.0 of
uplands) %
9. How many drainage areas does the project have?l (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 _
Drainage Area _
Drainage Area
Receiving Stream Name
Topsail Sound
Stream Class *
SA;HQW
Stream Index Number *
18-87-10
Total Drainage Area (so
63,316 (L4
cc
On -site Drainage Area (so
63,316
Off -site Drainage Area (s.0
0
Proposed Impervious Area** (so
31,658
% impervious Area** total
50
Impervious- Surface Area
Drainage Area _
Drainage Area _
Drainage Area _
Drainage Area _
On -site Buildings/Lots (so
20,430
On -site Streets (so
9,108
(Street & Curb)
On -site Parkin (sf)
0
On -site Sidewalks (so
2,120
_
Other on -site (so
0
Future (so
0
lots
Off -site (so
0
JWL
r
Existing BUA*** (so
Total (so:
1 31,658
* Stream Class and Index Number can be determined at: http.- portal.nedenr.orgAweb/wq&slcsulclassjfications
Form SWU-101 Version 06Aug2012 Page 3 of 6

Imgqermous 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.
11. How was the off -site impervious area listed above determined? Provide documentation. NA
Projects in Union County: Contact DWQ Central ice stafto check ifthe project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15A NCAC 01B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
fromht!p://portal.ncdenr.org/web/wq/WS/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklistsareavailablefromhttp://portal.ncdenr.org/web/wq/ws/su/statesw/forms docs. Thecomplete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at http:/ /portal.ncdenr.org/web/wq/ws/su/maps.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http://portal.ncdenr.org/web/wq/ws/su/statesw/forms docs.
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http://www.envhelp.org/Rages/onestopexl2ress.htm] for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within rh mile of the site boundary, include the rh
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal�e Bp ®�
i. Dimensioned property/project boundary with bearings & distances. 4� WY
j. Site Layout with all BUA identified and dimensioned. V� 2�13
k. Existing contours, proposed contours, spot elevations, finished floor elevations14�rS2
1. Details of roads, drainage features, collection systems, and stormwater controls.
BV:.-----
Form SWU-101 Version 06Aug2012 Page 4 of 6

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m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required). i' I
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xll" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHWT prior
to submittal, [phone].) n,
10. A copy of the most current property deed. Deed book: 4143 Page No:197 6- A
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 21-1.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
h!W://www.secrgW.state.nc.US/Coiporations/CSearch.asi2x
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
http://portal.ncdenr.org/web/wq/ws/su/statesw/forms docs. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forma; available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DWQ and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf fo sttchgts-
addressing requests for additional information). tl 9i fJ=
Consulting Engineer:Michael C. Gallant PE
Consulting Firm: Michael C. Gallant PE PA
Mailing Address:PO Box 4039
City:Surf City
Phone: (910 ) 448-1046
Email: gallantmc@yahoo. corn
State:NC Zip:28445
Fax: ( )
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) NA , certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item la) with (print or type name of organization listed in
Contact Information, item la) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version 06Aug2012 Page 5 of 6

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As,the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without a valid permit I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature: / Y A- Date:
I, a Notary Public for the State of . County of
do hereby certify that personally appeared
before me this _ day of . and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission
X. APPLICANTS CERTIFICATION
I, (print or type name of person listed in Contact Information, item 1a) Thomas Nelson
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 21-I.1000 and any other applicable state stormwater requirements.
before me this
a stormwater permit.
L') 0 J-- _ Date: b - S - 13
O /
0 l e- a Notary Public for the State o - I County of
do hereby certify that % A b ryl Cc S 1 V e✓ S O /1 personally appeared
of ju A 2 03 and acknowl dge due exec of the application for
Witness my hand and official seal, 90---eC _
OFFICIAL SEAL
Notary glelic wm' Carollo
HARNETT COUNT
THEDA C POOLE
SEAL
commission expires L 2 /
ECEO tl9 E
JUN 112013
Form SWU-101 Version 06Aug2012 Page 6 of 6

I
~
1 .

Permit No. 5\-Jl is 1103
i (to be povided by DWO)
VA
0 0'E W ^ ZE
WNR
C
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
Via Required Items Checklist (Part III) must be panted, filled out and submitted abng with all of the required information,
I. PROJECT INFORMATION
Project name
I C Life
Contact person
Michael C. Gallant, PE
Phone number
910.448.1046
Date
61102013
Drainage area number
1
II. DESIGN INFORMATION
Site Characteristics
Drainage area
63,316 it'
Impervious area, post -development
31,658 6'
%impervious
50.00 %
Design minfell depth
3.8 in
Storage Volume: Non•SA Waters
Minimum volume required
to
Volume provided
to
Storage Volume: SA When
1.5' runoff volume
Pre -development 1-yr, 24-hr mno0
Post -development 1-yr, 24-hr runoff
Minimum volume required
Volume provided
Pak Flow Calculations
Is the prelpost control of the tyr 24hr storm peak Bow required?
t-yr, 20r rairdall depth
Rational C, pre -development
Rational C, post -development
Rainfall intensity: l-yr, 24-ty 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 eordrol
Ekvstions
Temporary pool elevation
Permanent pod elevation
SHWT elevation (approx. at the perm. pod elevation)
Top of 10ft vegetated shelf elevation
Sobm of 10ft vegetated shelf elevation
Sediment deanout, top elevation (bottom of pond)
Sediment deanout, bottom elevation
Sediment storage provided
Is there additional volume stood above the state -required temp. pool?
Elevation of the top of the additional volume
54
987 fte
9,869 to
8,882 f?
11,073 ft
Y (Y or N)
3.8 in
0.24 (w-dess)
0.57 (unifless)
0.16 iolhr OK
0.06 f e/sec
0.13 ft /sec
0.07 ft'Isec
5.40 Ind
2.50 fmsl
3.00 final
3.00 fast
2.00 Imsl
Data not needed for caladallon option #1, but OK 8 provided.
-4.00 hill
5.00 hnsl
Data not needed for calculation option #1, but OK 8 provided.
1.00 ft
N (Y or N)
ECEIVV E
5.4 final
OK
AUG 16 2013
Form SW401-Wet Detention Besir •Rev.94/18/12 Pads I. a 11. Design Summary, Page 1 of 2

_.-._ Jr
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Ida �� ._
_ ..
—

Permit No.
(to be provdad by DWQ)
II. DESIGN INFORMATION
Surface Areas
Area, temporary pad
3,920 f?
Area REQUIRED, permanent pod
2,723 8
SAIDA ratio
4.30 (unitiess)
Area PROVIDED, permanent pod, A�ym
2.739 ff
Area, bottom of 108 vegetated shelf, Ate"
1,767 fl
Area, sediment deanout, top elevation (bottom of pond), Aroma
1,437 ff
Volumes
Volume, temporary pod
11,073 fe
Volume, permanent pod, Vpe,,
11,564 63
Volume, frebay (sum of forebays if more than one frebay)
2,539 f?
Forebay %of permanent pool volume
22.0% %
SAIDA Table Data
Design TSS removal
Coastal SAIDA Table Used?
Mountain/Piedmont SAIDA Table Used?
SAIDA ratio
Average depth (used in SAIDA fade):
Calculation option 1 used? (See Figure 10-2b)
Volume, permanent pod, Vp,,,,_p„i
Area provided, permanent pod, A m, xd
Average depth calculated
Average depth used in SAIDA, d„, (Round to nearest 0.511)
Calculation option 2 used? (See Figure 10-2b)
Area provided, permanent pool, Aga _,,
Area, bottom of 10ft vegetated shelf, Abii_ ,
Area, sediment deanout, top elevation (bottom of pond), A,.,
'Depth' (distance 1Vw bottom of 10111 shelf and top of sediment)
Average depth calculated
Average depth used in SAIDA, dr, (Round to down to nearest 0.511)
Drawdown Calculations
Drawdown through od8ce?
Diameter of orifice IN circular)
Area of odflce (id -non -circular)
Coefficient of discharge (Co)
Driving head (Ha
Drawdown through weir?
Weir type
Coefficient of discharge (Ce)
Length of weir (L)
Driving tread (H)
Pre -development 1-yr, 24-hr peak flax
Post -development 1-yr, 24-hr peak flow
Storage volume discharge rate (through discharge orifice or weir)
Storage volume drawdown time
Additional Infonmatlon
Vegetated side slopes
Vegetated shelf slope
Vegetated shelf with
Length of flowp nth to width ratio
Length to with ratio
Trash rack for overflow & orifice?
Freeboard provided
Vegetated filter provided?
Recorded drainage easement provided?
Capures all runoff at ultimate bui -out?
Drain mechanism for maintenance or emergencies is:
90 %
Y (Y or N)
N (Y or N)
4.30 (unAless)
Y (Y or N)
11,564 ft3
2,739 ft2
4.22 ft
4.0 It
N (Y or N)
2,739 fe
1,767 It'
1,437 fe
6.00 It
It
Y (Y or N)
1.00 in
m2
0.60 (unidess)
1.08 ft
N (Y or N)
limitless)
(uritless)
it
It
0.06 ft3lsec
0.13 felsec
0.03 ff /sec
4.00 days
or N)
or N)
or N)
or N)
KA
OK
OK
OK
OK
OK draws down in 2-5 days.
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
ECEIVE
AUG 16 2013
Form SW401-Wet Detenaon Bas!nReve-V18112 Pans I. a II. Design Summary, Page 2 of 2

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Permit
(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.
Pagel Plan
iti Is Sheet No.
C u F'" 1. Plans (1" - 50' or larger) of the entire site showing:
U /(L 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),
BoundOverflow device,odrainage
and
Le/ z -Boundaries of drainage easement.
i t5 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.
1 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.
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
12 entire drainage area is stabilized.
L- Z . , Y The supporting calculations.
Gµcc�4i�'I
i
8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
(I 9. A copy of the deed restrictions (if required).
Al 10. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. County
4 crv1. soil maps are not an acceptable source of soils information.
Form SW401-Wet Detention Basin-Rev.9-4/18/12
ECEI V E
JUN 1 1 1013 V.
BY:
Part III. Required Items Checklist, Page 1 of 1

S��rzi�o3
o���
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
LEVEL
SPREADER - VEGETATED FILTER STRIP (LS-VFS) SUPPLEMENT
This form must be completely filled out printed, initiated, and submitted.
I. PROJECT INFORMATION
Project name
I C Life
Contact name
Michael Gallant, PE
Phone number
910.448.1046
Date
June 10, 2013
Drainage area number
1
II. DESIGN INFORMATION
—71
The purpose of the LS-VFS
SW Rule: 10-yeardmwdown from Wet Pond
Stomnvater enters LS-VFS from
A BMP
Type of VFS
Engineered filter ship (graded 8 sodded, slope <8%)
Explanation of any 'Other' responses above
9 Stormwater Enters the LS-VFS from the Drainage Area
Drainage area
fiz
Do not complete this section of the form.
Impervious surface area
fe
Do not complete this section of the form.
Percent impervious-_
%
Do not complete this section of the forth.
_ _
Rational C coefficient
Do not complete this section of the form.
Peak flow from the l inmr storm
cis
Do not complete this section of theform.
Time of concentration
min
Do not complete this section of the forth.
Rainfall intensity, 10-yr storm
inthr
Do not complete this section of the form.
Peak flow from the 10-yr storm
Cis
Do not complete this section of the form.
Design storm
10-year storm
Maximum amount of flow directed to the LS-VFS
CIS
Do not complete this section of the form.
Is a flow bypass system going to be used?
(Y or N)
Do not complete this section of the forth.
Explanation of any 'Other' responses above
If Stomrwater Enters the LS-VFS from a BMP
Type of BMP
Wet detention pond
Peak discharge from the BMP during the design storm
0.0 } '0:88. CIS
Peak discharge from the BMP during the 10-year storm
0.88 CIS
Maximum capacity of a 100-foot long LS-VFS
10 cis
Peak flow directed to the LS-VFS
0.88 cis
Is a flow bypass system going to be used?
N (Y or N)
Explanation of any "Other" responses above
ECEI V E
JUN 112013
Form SW401 - LS-VFS - 29June2012 - Rev.10 BY. page 1 of 3

LS-VFS Design
Forebay surface area
Depth of forebay at stomiwater entry point
Depth of forebay at stomlwater exit point
Feet of level lip needed per de
Computed minimum length of the level lip needed
Length of level lip provided
Width of VFS
Elevation at downslope base of level lip
Elevation at the end of the VFS that is farthest from the LS
Slope (from level lip to the end of the VFS)
Are any draws present in the VFS?
Is there a collector swale at the end of the VFS?
Bypass System Design (if applicable)
Is a bypass system provided?
Is there an engineered flow splitting device?
Dimensions of the channel (see diagram below):
M
B
W
y (flow depth for 10-year storm)
froeboard(during the 10-year storm)
Peak velocity in the channel during the 10-yr storm
Channel lining material
Does the bypass discharge through a wetland?
Does the channel enter the stream at an angle?
Explanation of any "Other' responses above
sQ it
in
in
10 fucfs
9 ft Ten feet is the minimum level spreader length.
10 It
50 it
2.50 fmsl
2.50 fmsl
0.00 %
N (Y or N) OK
Y (Y or N)
(Y or N)
(Y or N)
It
It
It
It
ft
It/sec
Pick one:
XV
i B i
(Y or N)
(Y or N)
ECEI V E
JUN 1 1 2013
Form SW401 - LS-VFS - 29June2012 - Rev.10 page 2 of 3

III. REQUIRED ITEMS CHECKLIST
EDIT 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 projecL 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.
Requried Rem:
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),
- Forebay (g applicable),
- High flow bypass system,
- Maintenance access,
- Proposed drainage easement and public right of way (ROW), and
- Boundaries of drainage easement.
2. Plan details (1' = 30' or larger) for the level spreader showing:
-Forebay (ff applicable),
- High flow bypass system,
- One foot topo lines between the level lip and top of stream bank,
- Proposed drainage easement, and
- Design at ultimate build -out
3. Section view of the level spreader (1' = 20' or larger) showing:
-Underdmin system (if applicable),
- Level lip,
- Upslope channel, and
- Downslope fi ter fabric.
4. Plan details of the flow splitting device and supporting calculations (if applicable).
5. A construction sequence that shows how the level spreader will be protected from
sediment until the entire drainage area is stabilized,
Initials
Page or plan sheet number and any notes:
4,6 - C4,4
6. If a non -engineered VFS is being used, then provide a photograph of the VFS showing /k
that no draws are present
7. The supporting calculations.
6. A copy of the signed and notarized operation and maintenance (00) agreement
Form SW401 - LS-VFS - 29June2012 - Rev.10
4?V. x+'29'T ' P& s q-� r
A rz.
ECEI M
JUN 1 1 2013
I
BY, 9e 3 of 3

�1
$ r
„ High Density Residential Subdivisions
Deed Restrictions & Protective Covenances
In accordance with Title 15 NCAC 2H.1000 and S.L. 2006-246, the Stormwater Management Regulations,
deed restrictions and protective covenants are required for High Density Residential Subdivisions where
lots will be subdivided and sold and runoff will be treated in an engineered stormwater control facility. Deed
restrictions and protective covenants are necessary to ensure that the development maintains a "built -upon"
area consistent with the design criteria used to size the stormwater control facility.
I, Thomas Nelson , acknowledge, affirm and agree by my signature below, that I
will cause the following deed restrictions and covenants to be recorded prior to the sale of any lot:
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 the
Stormwater Management Regulations.
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.
6. The maximum allowable built -upon area per lot is _2,043 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.
OR, if the proposed built -upon areas per lot will vary, please REPLACE #6 above with the following:
6. 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 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.
7. Each lot will maintain a 30** foot wide vegetated buffer between all impervious areas and surface
waters.
**50 foot for projects located in the 20 coastal counties.
8. 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 lot runoff and directing them
into a component of the stormwater collection system. Lots that will naturally drain into the system are
not required to provide these additional measures. Er.61 yE
jui g Z013
Form DRPC-3 Rev.2 05Nov2009 Page 1 of 2

Hi-gh Density Residential Subdivisions
Deed Restrictions & Protective Covenances
State of IN - L- - . County of
do hereby certify that
a Notary Public in the
appeared
before me this the 5 day of Tt A 20/--3, and acknowledge
the due execution of thef regoin strument. Witness my hand and official seal,
SEAL
G`
ignature
My Commission expires %� ' S - / OFFICIAL SEAL
HARNETT COUNTY
THEDA C POOLE
Form DRPC-3 Rev.2 05Nov2009 Page 2 of 2

r.. 1
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