SW8121105_CURRENT PERMIT_20130305

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 k z l 0 5
DOC TYPE
m CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
20►3 O 3 05
YYYYMMDD

NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCrory Charles Wakild, P. E.
Governor Director
March 5, 2013
Mr. Jude Herges, Owner
Lot 438, Section 3, Phase IV, Oyster Harbour Subdivision
3323 Stone Crab Ct
Supply, NC 28462
Subject: State Stormwater Management Permit No. SW8121105
Lot 438, Section 3, Phase IV, Oyster Harbour Subdivision
Single Family Lot with Permeable Pavement
Brunswick County
Dear Mr. Herges
John E. Skvarla, III
Secretary
The Wilmington Regional Office received a complete Stormwater Management Permit Application for Lot 438,
Section 3, Phase IV, Oyster Harbour Subdivision on February 27, 2013. Staff review of the plans and specifications
has determined that the project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A
NCAC 2H.1000, effective September 1,1995. We are forwarding Permit No. SW8121105, dated March 5, 2013, for
the construction, operation and maintenance of the permeable pavement associated with the subject project.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the conditions and
limitations as specified therein, and does not supersede any other agency permit that may be required. Please pay
special attention to the conditions listed in this permit regarding the Operation and Maintenance of the permeable
pavement, certification of the project when complete, procedures for changes of ownership, and transferring the
permit. Failure to establish an adequate system for operation and maintenance of the stormwater management
system, to certify the project or to transfer the permit in a timely manner, 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 150E 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 Kelly Johnson at
[phone]
Sincerely,
For Chat Waiild, P.E., Director
Division of Water Quality
GDS/kpj: S:IWQS1StormwatehPermits & Projects120121121105 Other12013 03 permit 121105
cc: Gary Gurganus, Gary Gurganus Land Surveying,1108 Sword St, Supply, NC 28462
Inspector, Brunswick County
Oyster Harbour Homeowners Association, Inc.,
C/o CAS Inc., 1213 Culbreth Dr, Suite 112, Wilmington, NC 28405
NCDOT District Engineer
Wilmington Regional Office Stormwater File
1617 Mail Service Center, Ralegh, North Carolina 27699-1617
Location: 512 N. Salisbury St. Ralegh, North Carolina 27604 One
Phone: [phone] FAX: [phone] DENR Assistance: 1-877-623-6748 NorthCarolina
Internet: w .ncwateraualitv.om
,Naturally

GARY GURGANUS LAND SURVEYING
3105 Holden Beach Rd
Supply, NC 28462
s
(Inside Martha Lee Realty office)
p 4
W®��E
I Danny Sparkman
S
j 910-512-5635
i [e-mail]

State Stormwater Management Systems
Permit No.SW8 121105
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
COVERED SINGLE FAMILY LOT WITH PERMEABLE PAVEMENT
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
Jude Herges
Lot 438, Section 3, Phase IV, Oyster Harbour Subdivision
3323 Stone Crab Ct, Supply, Brunswick County
FOR THE
construction, operation and maintenance of permeable pavement on a single family lot within the previously permitted
project Oyster Harbour Phase IV under SW8 020509 (in compliance with the provisions of Title 15A NCAC 2H .1000
(hereafter referred to as the "stormwater rulesl and the approved stormwater management plans and specifications, and
other supporting data as attached and on file with and approved by the Division of Water Quality and considered a part of
this permit.
The Permit shall be effective from the date of issuance until rescinded and shall be subject to the following specific
conditions and limitations:
I. DESIGN STANDARDS
1. The maximum permitted amount of built -upon area for this lot shall not be exceeded due to the installation of the
permeable pavement; the permeable pavement is appropriately designed; and the permeable pavement will be
maintained by the permittee.
2. Per SW8 020509, for Oyster Harbour Phase IV, this lot is limited to a maximum of 6,500 square feet of built -upon
area (BUA). The maximum built -upon area limit for this lot is also referenced in the Deed Restrictions and
Protective Covenants recorded on September 14, 2000 in Deed Book 1402 at Page 1427 of the Brunswick
County Register of Deeds office.
3. This lot proposes 1,985 square feet of permeable concrete pavement with a 4.0 inch gravel base, which is
assigned a 50% managed grass credit, resulting in a net effective BUA for the permeable pavement area of 993
square feet.
4. The soils under the permeable pavement must maintain a minimum hydraulic conductivity of 0.52" per hour, and
the Seasonal High Water table must be located a minimum of 2 feet below the bottom of the washed stone layer.
5. The slope of the completed permeable pavement must be 0.5% or less.
6. Take a direct measurement of the soil's infiltration rate immediately after excavation and before the aggregate is
placed. Infiltration rate testing shall be conducted by an appropriately -qualified professional. The results of the
testing shall be given to the designer of record for review. If the soil test shows an infiltration rate(s) that are lower
than the rate(s) used in the final design, then the designer shall check the calculations and may need to adjust the
design.
II. SCHEDULE OF COMPLIANCE
1. The permeable pavement must be protected during construction such that no sediment -laden runoff is directed
across the permeable pavement surface. Areas upslope of the permeable pavement must be stabilized with a
substantial stand of permanent grass cover prior to construction of the permeable pavement.
Page 2 of 4

State Stormwater Management Systems
Permit No.SW8 121105
2. No direct or concentrated runoff from roof gutters or other surfaces is allowed to be discharged onto the
permeable pavement.
3. To achieve the stated managed grass credit, the permeable pavement must be constructed as designed and
permitted.
4. No more than 100 axles per day (50 cars) shall be allowed on the permeable pavement surface.
5. The permeable pavement should not be sited where trees will overhang the surface.
6. The underlying subgrade soils must be protected from compaction during installation of the permeable pavement.
7. The permeable pavement must be installed by a qualified individual, certified in the specific construction
techniques required for permeable pavements.
8. During construction, erosion shall be appropriately restrained on the lot and any eroded areas will be repaired and
revegetated immediately.
9. The permittee shall at all times provide and perform the necessary operation and maintenance procedures as
specified in the signed Operation and Maintenance Agreement, such that the permeable pavement system
functions as designed and permitted. The permittee shall retain all invoices for work performed and shall keep
written records of the maintenance activities performed including the type of maintenance activity, the date that
maintenance activity was performed and who performed it. Upon the sale, conveyance, transfer or foreclosure of
this property, these records shall be provided to the new lot owner.
10. The permittee shall submit to the Director and shall have received approval for revised plans, specifications, and
calculations prior to construction, for any revision to the approved plans, including, but not limited to the type,
square footage and/or slope of the proposed permeable pavement and/or the gravel base depth.
it. The permittee shall submit all information requested by the Director or his representative within the time frame
specified in the written information request.
12. The permittee shall be responsible for verifying that the lot's proposed built -upon area does not exceed the
permitted maximum allowable built -upon area. The maximum allowable permitted built -upon area for the lot may
not be revised without the prior approval of Oyster Harbour Homeowners Association, Inc. and the Division of
Water Quality. If the allocated maximum built -upon area on the lot is exceeded without the prior approval of
Oyster Harbour Homeowners Association, Inc. and the Division, the lot owner is subject to enforcement action by
the Division of Water Quality.
13. Within 30 days of completion of the project, the permittee must certify in writing that the permeable pavement has
been constructed within substantial intent of the approved plans and specifications. Any deviation from the
approved plans must be noted on the Certification.
14. This lot is subject to the referenced deed restrictions and protective covenants of record. The State of North
Carolina is a third party beneficiary for purposes of enforcing the stormwater permit conditions.
15. 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.
III. GENERAL CONDITIONS
1. Failure to abide by the conditions and limitations contained in this permit may subject the Permittee to an
enforcement action by the Division of Water Quality, in accordance with North Carolina General Statutes 143-
215.6A to 143-215.6C.
2. The permit issued shall continue in force and effect until modified, revoked or terminated.
3. Approved plans and specifications for the permeable pavement installation covered by this permit are
incorporated by reference and are enforceable parts of the permit.
Page 3 of 4

State Stormwater Management Systems
Permit No.SW8 121105
• 4. 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.
5. 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 Title
15A of the North Carolina Administrative Code, Subchapter 2H.1000; and North Carolina General Statute 143-
215.1 et. al.
6. To ensure that future owners of this lot are aware of the permeable pavement requirements, the permittee shall
amend the deed for this lot and make it subject to the requirements of this permit number SW8121105, and the
associated permeable pavement supplement form and the signed Operation and Maintenance Agreement. The
permittee shall submit a copy of the new recorded deed to the Division within 30 days of completing the
installation of the permeable pavement.
As long as the permittee is the lot owner, the permittee is responsible for compliance with all permit conditions.
Upon accepting the amended deed for this lot, the new owner will become responsible for compliance with all
permit conditions.
8. 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), which
have jurisdiction. If any of those permits result in revisions to the plans, a permit modification must be submitted.
9. The permittee grants permission to DENR Staff to enter the property during normal business hours for the
purposes of inspecting the permeable pavement.
10. This permit does not take the place of a review and approval by the subdivision's HOA or POA for compliance
with any required Architectural Standards or Guidelines. This permit only documents that the maximum permitted
amount of built -upon area for this lot has not been exceeded due to the installation of the permeable pavement,
and ensures that the permeable pavement is appropriately designed, installed and will be maintained by the
permittee.
Permit issued this the 511 day of March 2013.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
--�� s _---u------
/.' or Charles aki., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 4

Permit Number:--!</V
(to be provided by DWQ)
Drainage Area / Lot Number:
Permeable Pavement 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.
At all times, the pavement shall be kept free of:
- Debris and particulate matter through frequent blowing that removes such
debris, particularly during the fall and spring.
- Piles of soil, sand, mulch, building materials or other materials that could deposit
particulates on the pavement.
- Piles of snow and ice.
- Chemicals of all kinds, including deicers.
The permeable pavement will be inspected once a quarter. 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. P _ _ al probleu
The perimeter of the I Areas of bare soil
permeable pavement
The surface of the
permeable pavement
erosive gullies
or
A vegetated area drains
toward the pavement.
How to rem_ediate the problem:
Regrade the soil if necessary to
remove the gully, then plant ground
cover and water until established.
Regrade the area so that it drains
away from the pavement, then plant
ground cover and water until
Trash/debris present
I Remove the trash/debris.
Weeds
Do not pull the weeds (may pull out
media as well). Spray them with a
systemic herbicide such as
glyphosate and then return within
the week to remove them by hand.
(Another option is to pour boiling
__
Sediment [
water on them or steam_ them.)_
Vacuum sweep the pavement.
Rutting, cracking or slumping I
onsult a _
Cn appropriate professional.
or damaged structure
Water present more than five
Clean out clogged underdrain pipes.
days after a storm event I
Consult an appropriate professional
I
for clnvoed snil
is
Form SW401-Permeable Pavement O&M-Rev.4 10/03/2012
the sign.__ t� ply ry—E—
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NOV 0 5 2012
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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.
Projeciname: LoT 438 SEClr(orl 3 Pn11SE1V 6i5,rEQ M,gg&,4g
BMP drainage area or lot number: 43 8
Print
Title:
Phone: 11/0— Sf/ 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, WAISIUS , a Notary Public for the State of
e C �_, County of &)cNdtL.k , do hereby certify that
TVpy_ kgGr; 9 personally appeared before me this 2-
day of Ly(w•g , 24XZ , and acknowledge the due execution of the
forgoing permeable pavement maintenance requirements. Witness my hand and official
seal, C—��N (�tuon�ti,, ,
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C9� �pTAq` N S
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My commission expires 24 2a13 NOV 0 5 2012
BY:
Form SW40 I -Permeable Pavement O&M-Rev.4 10/03/2012 Page 2 of 2

DWQ USE ONLY
Date Received
F Q e Paid
Permit Number
S '
Applicable Rules:
❑ Coastal SW -1995 ❑ Coastal SW - 200 ❑ Ph II - 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
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
LeT 43g t SEcTlca 3 PHAsf IVY o`tSTER HAR6vuR SK80iVlStonl
2. Location of Project (street address):
3323 5-rorJE C11266 Cou2T
City: SweeLY County: [3AwrA5tJlC1< Zip: 28462
3. Directions to project (from nearest major intersection):
TAkiE t.X Woy F30 • Tyari 91&wr on SR1140 - Affitwkr1A LY'Z htL7_CAJ2 i Qt4wr7
o„-% 5Q 1137 • AP912oxtn4'rs-i Zntce$ tw ,, ��G1tT /atTo "bYS�rE(L
KAl�60uR 34QDtJtSlOn!
4. Latitude: 33 ° 55 ' 29. 5" N Longitude: 18 ° Zo ' S0• ` - W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): New ❑Modification ❑ Renewal w/ Modificationt
tRenewals with modifications also requires SM-102 - Renewal Application Form
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number tJIA , its issue date (if known) tJ1A . and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ❑High Density ❑Drains to an Offsite Stormwater System TZOther
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, t-11A and the previous name of the project, if different than currently
proposed, _ PkA
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):
OCAMA Major ❑Sedimentation/Erosion Control: _
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
5.
ac of Disturbed Area
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: rJ IAl
is me project located within 5 miles of a public airport?
If yes, see S.L. 2012-200, Part Vl: htt
NOV 0 5 2012
Form SWU-101 Version 06Aug2012 Page 1 of BY.

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 nroiect):
Applicant/Organization: StiDE FlER4E5
Signing Official & Title: auDE H ER(.E5 Ow06K
b. Contact information for person listed in item la above:
Street Address: 332-3 5'TorsE CRAB CcmRT
City: SctPPL`( State: AG Zip: z8w62
Mailing Address (if applicable): 3323 SToNE CRAB Cou2^C
City: suPPLY State: r-G Zip: Z8462
Phone: ( 910 1 RW6 ^ LI5215 Fax:
Email: Lo YA Hop Cor1
c. Please check the appropriate box. The applicant listed above is:
The property owner (Skip to Contact Information, item 3a)
Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization: /JkA
Signing Official & Title:_ '31/1
b. Contact information for person listed in item 2a above:
Street Address: to (A
City: . \1A State: is Zip: jt I I /}
Mailing Address (if applicable):__
City: 0I& State: NUk Zip: r-X 4
Phone: ( 1 O (/1t Fax: ( ) JA A
Email: & t A
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization: (.TA f?i Ct u(ZGAP9,6 LA OIN SU00 E Y1p.�(,
RECEUVFRI
Signing Official &
GA X-T
b. Contact information for person listed in item 3a above:
Mailing Address: 1109 5L4oals �aa < ,-T by:
-
city: S 4 PPL`f State: p-1 2 64&2-
Zip:
Form SWU-101 Version 06Aug2012 Page 2 of 7

Phone: ( ID ) 233• 96a5 Fax:
Email: &A(s`rC,KR e 67t)A1L . Cot-N
4. Local jurisdiction for building permits: NZ 10K (f01A„ t'T'e
Point of Contact: bC-LArJ6'f Ai (cock Phone#: ( QID ) Z53• 2050
IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
LtT121rJ(^ PEKnFA N G P61JE(1E AT Fog 0P4Q6 uAY
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the L �m (3E(L River basin.
4. Total Property Area:_ Z . 16 acres
5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: rJ1A acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area': acres
Total project area simll be calculated to exclude the following the normal pool of inn ounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NP line or Mean High Water
(MHW) line, and coastal wetlands landward front the NHW (or MH1M 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 =
9. How many drainage areas does the project have? tjJA (For lugh dennsitir, 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.
NOV 0 5 2012
by:
Form SWU-101 Version 06Aug2012 Page 3 of 7

cjb6Ql'nNS
XIS
1M1, �tR'V.Co cM1'�
Qy,c-v.ctis �occ.•
Stream Name
Draina a Area
Draina a AreaDraina
6-71LElassdex
a Area
Draina a Area
WInformationrmation
Number *
5 \S Linage
aLrainage
Area (so
Area (sf)rainage
Area (sf)
Pro osed Impervious Area** s
% lmj2ervious Area** total
Im ervious`" Surface Area
Draina a Area _
^ u / t
Draina a Area _
w d�
Draina e Area
Draina a Area
Bn-S'te-B"ifamg�tar� (st)
ee sf)
5 0. z3
1 O
_
5 0 �t
D
Onsr�sf)
f p 4—�
85RS
3
°�sid�watts-fsq
othera7»site-(sf)
3 5
\ 5
off-sit'a4so
Total (sf):
* .StrvOm CIncc rind I ... ov
N Q
(o ti
.. vc uc.c//n/neu in; nrrp.1/poriai Iicaeiir Org/ioeh/wq/ps/csli/classt cations
" in vtons 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 B UA.
11. How was the off -site impervious area listed above determined? Provide documentation.
Projects in Union County: Contact DWQ Central Office staff to check ifthe project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15A NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from h!W:ZZportal.ncdenr.org/web/w2/ws/sulbmp-manual.
Vi. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from hM:Zlportal.ncdenr.orizZweb/wg/ws/sU/statesw/forms dots. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at http:/ /portal.ncdenr.org/web/­wnZwslsu/map .)
Please indicate that the following required information have been Provided by initial in 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 ht!R:Zlportal.ncdenr.orgZweb/wq/ws/suZstatesw/forms dots.
1. Original and one copy of the Stormwater Management Permit Application Form. e4liti 4s
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 Q
agreement(s) for each BMP. p,
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review,�refer.to—
htto:/Zwww.envhelp.org/pages/onestopexpress html for information on the Express program G lt=
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.) H NOV5 2012
Form SWU-101 Version 06Aug2012 Page 4 of BY:___.__.___
LO

5. 1 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
r.14,A
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the 1/2
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.
UUQAa--
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified dimensioned.
and
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
in. 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).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify G7Q
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"xil" 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 verifij the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: _I US Page No: 40 D g,&
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC rt1A
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http:/lwww.secretaEy.state.nc.us/CorparationsZCSearch.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
hqp://portal.ncdenr.org/web/wqZwsZsu/stateswZforms does. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claimin
under them, that they will run with the land, that the required covenants cannot be changed or deleted g
without concurrence from the NC DWQ and that they will be recorded prior to the sale of anylot.0 —
NOV 0 5 2012
Form SWU-101 Version 06Aug2012 Page 5 of 7
BY:

VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer.
Consulting
Mailing Ad
City:
Phone: (
State: Zip;
Fax: ( 1
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or hjpe name of person listed in Contact Infonnation, item 2a) _ J upE H Lea,( S certify that I
own the property identified in this permit application, and thus give permission to (print or hjpe name of person
listed in Contact Information, item 1a) with (print or hjpe name of organization listed in
Contact Infonnation, item ]a) 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.
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 prajfies of up to $25,000 per day, pursuant to NCGS 143-215.6.
Date: 11 — a —12,
11 `� K t" c -' ^A��S a Notary Public for the State of. 9OQ(14 942 IMA 'Countyof
do hereby certify that �,TdVE. z&5 personally appeared
before me this 'Z day of gWEb j33 g 2012 and �ac')knowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal. (L td ("�UO7nr l.
URGq��,.
2� GN
_ �OTAHY
F'UB��G 2:
9G
- �//IIIIIINI\\
SEAL
My commission expires_
Form SWU-101 Version 06Aug2012 Page 6 of 7
EC; IEBVIEF
I "I 0 5 l",
�v:

X. ,APPLICANT'S CERTIFICATION
L (print or hype name of person listed in Contact Infonnation, item 1a)
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 stormari r les under 15A NCAC 2H .1000 and any other applicable state stormwater requirements.
Date: 11 .'A -/ 2,
1,CIPGAI405? f'id
a Notary Public for the State of M 6hi?dJ W A , Countyof
-F-5¢ 04 SVl ILK do hereby certify that ;liQE W— "5 personally appeared
before me this 2 day of f-�D_!WOER 6M and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, MM 4214�
�ptAgr L
'OU80c, 2:
9
oil
W
SEAL
My commission expires_ [n-24.260
? �= rF=
1
" NOV 0 5 2012
Form SWU-101 Version 06Aug2012 Page 7 of 7

1 � �� ';
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Permit No. %l I)Lkk 5
"� (to be PW~by DWQ)
of WArE,y
O
RA STORMWATER MANAGEMENT PERMIT APPLICATION FORM o4E NWENR 401 CERTIFICATION APPLICATION FORM
EXISTING RESIDENTIAL LOT " PERMEABLE PAVEMENT SUPPLEMENT
This form must be completely filled out, printed and submitted.
The Required Items Checklist (Part Iil) must be printed, filled out and submitted along with all of the required information.
Project Name
Contact Person
Phone Number
Date
Lot Number
Lot Owner's Signature
Solis Report Summary
Hydrologic soil group (HSG) of subgrade
Infiltration rate
Pavement Design Summary
Permeable Pavement (PP) design type
SA of PP being proposed (Ap)
Resulting BUA counted as Impervious for main application form
Adjacent BUA directed to PP (Ar)
Ratio of Ar to AP
Flow from pervious surfaces Is directed away from PP?
Total BUA allocated to this lot
Remaining lot 6UA available
Design rainfall depth
Permeable pavement surface course type
Layer 1 - Washed aggregate size (ex. No. 57)
Layer 1- Aggregate porosity (n)
Layer 2 - Washed aggregate size (ex. No. 57)
Layer 2 -Aggregate porosity (n)
Minimum total aggregate depth for design rainfall (D,,,a)
Drawdown/infiltration time for 0.
How is 30-yr, 24-hr stone handled?
Aggregate depth to infiltrate 10-yr, 24-hr storm (D2s)
Drawdown/infiltration time of 10-yr, 24-hr storm
Actual provided total aggregate depth
Top of aggregate base layer elevation
Storage elevation of design rainfall depth
Overflow elevation
Bottom elevation at subgrade
SH WT elevation
Underdrain diameter
Lot
Harbour
910846-4525
-- ---
212612013
2.16 Acres
C
0.54-1.25
In/hr
BU_A Credit for Permeable Pavement Footprint
Infiltration - HSG C/D
50% BUA Credit
1,985
ft2
993
ft2
0
it,
OK
0.00
(unitless)
Yes
OK
6,500.00
ft2
5,507.50
ft2
1.5"
in
PC
57
0.40
(unitless)
OK
WA
0.00
(unitless)
OK
3.8
in
0.3
days
OK
infiltrated
3.0
in
1.20
days
4.0
In
OK
30.17
fmsl
29.94
fmsl
N/A
fmsl
29.84
fmsl
#REF!
26.80
fmsl
N/A
In
FICEIVE
FEB 2 7 2013
Form SW401-Pemreablo Pavement-Rev.4-October 16, 2012 EAsgng Residential Late, Page 1 of 3

Detention eystems (skip for infilhation systems)
Diameter of orifice in
CoAcient of discharge (Co) (unitless)
Driving head (H.) ft
Storage volume discharge rate (through discharge orifice) ft'/sec
Storage volume drawdown time
Pre -development 1-yr, 24-hr peak Row
Post -development i-yr, 24-hr peak Row
Additional Infomlatlon
Slope of soil subgrade at bottom of permeable pavement
Slope of the permeable pavement surface
Construction sequence minimizes compaction to soils?
Subsoil preparation specified (must select one)
Meets industry standards for structural requirements?
Washed stone is specified for the aggregate?
Required signage specified on plans?
Number of observation wells provided
Distance to structure
Distance to surface waters
Distance to water supply well(s)
Application Approved
Application Rejected
Reason for re*1ing application:
Signature of permittee i HOA:
Date
days
ft'/sec
ft'/sec
0.30
%
OK
0.30
%
OK
Yes
OK
ripped
Yes
OK
Yes
OK
Yes
OK
N/A
OK
0.00
ft
500«
it
OK
N/A
it
OK
Permit No. �Kyt i QmO
00 be provided by DIMy
FrjIEi,VF—
FEB 2 7 203
Form SW401-Permeable P6vement-Rev.4-0Uober 16, 2012 Exiedng Resider ial Lote, Page 2 of 3

Perms No.�f.L -6 ��w.3S
(to be Pahlavi by OWQ)
Please Indicate tte 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 ImW in the space provided to indicate the following design requirements
have been met. If the applicant has designated an agent, to agent may initial below, If a requiremer, has not been met, attach Justification.
1. Plans (1' = 50' or larger) of the entire site showing:
, J
- Design at ultimate bulldout,
- Off -site drainage (R applicable),
- Delineated drainage basins (include Rational C coefficient per
basin),
- Location of permeable pavement,
- Roof and other surface flow directed away from permeable
pavement,
- Location of the permeable pavement sign(s).^
2. Section view of the permeable pavement (1' - 20' or larger)
S�
showing:
- All layers (Induding details about the surface course), and
3. A derail of what the permeable pavement sign.
4. A site specific soils report that is based upon an actual field
Investigation, soil borings, and Infiltration tests within the
footprint of the proposed permeable pavement. The soils
Investigation shall state the infihation rate, SHWT elevation, and
information about any confining layers. County soil maps are not
an acceptable source of sobs Information.
(Projects in the WIRO - The results of the soils report most be
verified in the field by DW(X by completing & submitting the soils
Investigation request form.)
A Q
5. A construction sequence that shows how the permeable
�Kl�
pavement will be protected from sediment until the entire
drainage area Is stabilized.
6. The supporting calculations.
7. A copy of the signed and notarized operation and maintenance
- rl„r
(O&M) agreement.
n�
8. A copy of the deed restrictions (t requlredi.
Pagel Plan Sheet No.
SEAL�?
025971
(NEEP
GIsl�lssP`.
2}8-2ot3
Finn SW401-PW eabb Pav6nW4-Rev./-Oclaber 18. 2012 Edsang Reddy " LW, Pepe J ar J