SW8121119_CURRENT PERMIT_20210710

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 t jc1
DOC TYPE
® CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
2021 0 11D
YYYYMMDD

f '1�
ROY COOPER
Governor
DIONNE DELL -GAT 1
sernrtmy
BRIAN WRENN
Director
July 10, 2021
Par 5 Development Group, LLC
Attn: Brian Clodfelter, Managing Member
2075 Juniper Lake Road
West End, NC 27376
NORTH CAROLINA
Fmironmentd QudBy
Subject: Permit Renewal
State Stormwater Management Permit No. SW8 121119
Dollar General- Long Ridge Drive
New Hanover County
Dear Mr. Clodfelter:
Effective August 1, 2013 the State Stormwater program has been transferred from the Division of Water Quality
(DWQ) to the Division of Energy, Mineral and Land Resources (DEMLR). All previous references to DWQ will
remain in older stormwater permits issued prior to August 1, 2013 until they are modified. Please note that this permit
will now reference DEMLR as the Division responsible for issuance of the permit
The Wilmington Regional Office received a complete 8 year Stormwater Management Permit Renewal Application for
the subject project on July 8, 2021. The Division is hereby notifying you that permit SW8 121119 has been renewed on
July 10, 2021, and shall be effective until February 21, 2029. For your records, please find enclosed a renewed,
updated, and re -issued permit and a copy of the renewal application_ Please keep this permit on file at all times. Please
note that the renewed, updated, and re -issued permit does not impose new or different terms; it merely restates some of
the previous terms to provide you with a better understanding of your obligations under the permit.
The renewal and reissuance of this stormwater permit does not imply that the site is currently in compliance with the
terms and conditions of this state stormwater permit The plans originally approved on February 21, 2013 will remain
in full force and effect in accordance with the regulations set forth in Title 15A NCAC 2H.1000.
This permit is 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, need additional copies of the permit or approved plans, please contact Ashley Smith in the
Wilmington Regional Office, at [phone] or [e-mail].
Sincerely,
C'�
Brian Wrenn, Director
Division of Energy, Mineral and Land Resources
lK North Caroliw Department of Environmental Qualhy I Division of Energy. Mineral and Land Resources
Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilnungton. North Carolina 2a405
°+��•��'� 910.796.7215

State Stormwater Permit No. SW8 121119
Page 2 of 2
Enclosures: Attachment A — Designer's Certification Form
Attachment C — Permitting History
Renewal Application Documents
DES/ams: \\\Stormwater\Permits & Projects\2012\121119 HD\2021 07 permit 121119
cc: Wilmington Regional Office Stormwater File
®w, �Z� North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
Wilmington Regional Office 1127 Cardinal Drive Extension I Wilmington, North Carolina 28405
.omv rxin�w.

State Stormwater Management Systems
Permit No SW8 121119
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY COMMERCIAL 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
Par 5 Development Group, LLC
Dollar General — Long Ridge Drive
93 Long Ridge Drive, Wilmington, New Hanover County
FOR THE
construction, operation and maintenance of one (1) infiltration basin in compliance with the provisions
of Session Law 2008-211 and 15A NCAC 2H .1000 (hereafter collectively and separately referred to
as the "stormwater rules') and the approved stormwater management plans and specifications and
other supporting data as attached and on file with and approved by the Division of Energy, Mineral
and Land Resources (the "Division" or "DEMLR") and considered an enforceable part of this permit.
This permit shall be effective from the date of issuance until February 21, 2029, and shall be subject
to the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater described in
the application and other supporting data.
This stormwater system has been approved for the management of stormwater runoff as
described in Section 1.8 of this permit. The stormwater control has been designed to handle
the runoff from 30,000 square feet of impervious area.
3. The infiltration basin is designed in accordance with Option 3 of Section 16.3.9 of the BMP
Manual, therefore, no offline bypass and no vegetated filter strip are required. This alternative
design meets the requirements of Section .1008 (h) of the stormwater rules. The basin
provides active storage volume for 2.5 times the regulated 1.5" design storm and infiltrates that
volume within 5 days using a soils infiltration rate of one-half the infiltration rate reported in the
soils report.
4. The tract will be limited to the amount of built -upon area indicated in Section 1.8 of this permit,
and as shown on the approved plans. The built -upon area for the future development is limited
to 1,740 square feet.
5. The runoff from all built -upon area within the permitted drainage area of this project must be
directed into the permitted stormwater control system.
6. All stormwater collection and treatment systems must be located in either dedicated common
areas or recorded easements. The final plats for the project will be recorded showing all such
required easements, in accordance with the approved plans.
Page 1 of 7

State Stormwater Management Systems
Permit No. SW8 121119
The project shall provide a 50' wide vegetated buffer adjacent 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.
8. The following design criteria have been permitted for the alternative design infiltration basin
and must be provided and maintained at design condition:
a.
Drainage Area, acres:
1.056
Onsite, ft2:
46,000
Offsite, ft2:
0
b.
Total Impervious Surfaces, ft2:
30,000
Buildings, ftZ:
9,100
Parking, ft2:
16,775
Sidewalks, ft2:
2,385
Future, ft2:
1,740
c.
Design Storm, inches:
3.75" (2.5 x 1.5")
d.
Basin Storage Depth, feet:
1.36
e.
Bottom Elevation, FMSL:
31.25
f.
Bottom Surface Area, ft2:
5,629
g.
Emergency Overflow Elevation, FMSL:
32.61
h.
Top Elevation, FMSL:
33.5
h.
Provided Storage Volume, ft3:
9,244
i.
Type of Soil:
Group A
j.
Expected Infiltration Rate, in/hr:
3.0
k.
Seasonal High Water Table, FMSL:
29.25
I.
Time to Draw Down, hours:
13.2
m.
Receiving Stream/River Basin:
UT of Smith Creek
n.
Stream Index Number:
CPF17 18-74-63
o.
Classification of Water Body:
'C; Sw"
II. SCHEDULE OF COMPLIANCE
The stormwater management system shall be constructed in its entirety, vegetated and
operational for its intended use prior to the construction of any built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of the system
will be repaired immediately.
3. The facilities shall be constructed, operated and maintained in accordance with the provisions
of this permit, the approved plans and specifications, and the supporting documents attached
to this permit and on file with the Division.
4. 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.
5. Access to the stormwater facilities shall be maintained via appropriate easements at all times.
6. The permittee shall at all times provide the operation and maintenance necessary to assure
the permitted stormwater system functions at the design condition. The approved Operation
and Maintenance Plan must be followed in its entirety and maintenance must occur at the
scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and specifications.
f. Debris removal and unclogging of bypass structure, infiltration media, flow spreader,
catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all times.
Page 2 of 7

State Stormwater Management Systems
Permit No. SW8 121119
Records of maintenance activities must be kept for each permitted BMP. The reports will
indicate the date, activity, name of person performing the work and what actions were taken.
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. A modification may be required for those deviations.
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.
10. No person or entity, including the permittee, shall alter any component shown in the approved
plans and specifications. Prior to the construction of any modification to the approved plans,
the permittee shall submit to the Director, and shall have received approval for modified plans,
specifications, and calculations including, but not limited to, those listed below. For changes to
the project or SCM that impact the certifications, a new or updated certification(s), as
applicable, will be required and a copy must be submitted to the appropriate DEQ regional
office upon completion of the modification.
a. Any modification to the approved plans and specifications, regardless of size including
the SCM(s), BUA, details, etc.
b. Redesign or addition to the approved amount of BUA or to the drainage area.
C. Further development, subdivision, acquisition, lease or sale of any, all or part of the
project and/or property area as reported in the approved plans and specifications.
d. Altering, modifying, removing, relocating, redirecting, regrading, or resizing of any
component of the approved SCM(s), the stormwater collection system and/or
vegetative conveyance shown on the approved plan.
e. The construction of any allocated future BUA.
f. The construction of any permeable pavement, #57 stone area, public trails, or
landscaping material to be considered a permeable surface that were not included in
the approved plans and specifications.
g. Other modifications as determined by the Director.
11. Prior to transfer of the permit, a file review and site inspection will be conducted by Division
personnel to ensure the permit conditions have been met and that the project and the on -site
stormwater system complies with the permit conditions. Any items not in compliance must be
repaired, replaced restored, or resolved prior to the transfer. Records of maintenance activities
performed to date may be requested.
III. GENERAL CONDITIONS
1. Any individual or entity found to be in noncompliance with the provisions of a stormwater
management permit or the requirements of the stormwater rules is subject to enforcement
procedures as set forth in NCGS 143 Article 21.
2. The issuance of this permit does not preclude the permittee from complying with and obtaining
any other permits or approvals that are required for this development to take place, as
required by any statutes, rules, regulations, or ordinances, which may be imposed by any
other Local, State or Federal government agency having jurisdiction. Any activities undertaken
at this site that cause a water quality violation or undertaken prior to receipt of the necessary
permits or approvals to do so are considered violations of NCGS 143-215.1, and subject to
enforcement procedures pursuant to NCGS 143-215.6.
3. If the facilities fail to perform satisfactorily, the permittee shall take immediate corrective
actions. This includes actions required by this Division and the stormwater rules such as the
Page 3 of 7

State Stormwater Management Systems
Permit No. SW8 121119
construction of additional or replacement on -site stormwater systems. These additional or
replacement measures shall receive a permit from the Division prior to construction.
4. Permit Transfer: This permit is not transferable to any person or entity except after notice to
and approval by the Director. The permittee shall submit a completed and signed "Permit
Transfer Application Form" (available on the Division website) accompanied by the required
fee and supporting documentation as listed on the form, to the Division at least 60 days prior
to any one or more of the following events:
a. The sale or conveyance of the project area in whole or in part, except in the case of an
individual lot sale that is made subject to the recorded deed restrictions and protective
covenants;
b. Dissolution of the partnership, corporate, or LLC entity, subject to NCGS 55-14-05 or
NCGS 57D-6-07 and 08.
C. Bankruptcy,
d. Foreclosure, subject to the requirements of Session Law 2013-121,
5. Current Permittee Name or Address Changes: The permittee shall submit a completed
"Permit Information Update Application Form" (available on the Division website) to the
Division within 30 days to making any one or more of the following changes:
a. A name change of the current permittee;
b. A name change of the project;
C. A mailing address change of the permittee;
6. The permittee is responsible for compliance with all terms and conditions of this permit until
the Division approves the transfer request. 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.
7. The permittee grants Division Staff permission to enter the property during normal business
hours to inspect all components of the permitted project.
8. The permit issued shall continue in force and effect until the permittee files a request with the
Division for a permit modification, transfer, renewal, or rescission; however, these actions do
not stay any permit conditions.
9. Approved plans, application documents, supplements, calculations, operation and
maintenance agreement, and specifications for this project are incorporated by reference and
are enforceable parts of the permit. A copy of this permit, application, supplements, operation
and maintenance agreement, and approved plans and specifications shall be maintained on
file by the permittee.
10. Unless specified elsewhere, permanent seeding requirements for the on -site stormwater
system must follow the guidelines established in the North Carolina Erosion and Sediment
Control Planning and Design Manual.
11. 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 for cause as allowed by the
laws, rules, and regulations contained in Title 15A NCAC 2H.1000 and NCGS 143-215.1 et.al.
12. A permit renewal request must be submitted at least 180 days prior to the expiration date of
this permit. The renewal request must include the appropriate application, documentation and
the processing fee as outlined in Title 15A NCAC 02H.1045(3).
Page 4 of 7

State Stormwater Management Systems
Permit No. SW8 121119
Permit renewed, updated and reissued this the 10th day of July 2021.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
C.,K1Aa o /Q
.�,, nan Wrenn, Uirector
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Page 5 of 7

State Stormwater Management Systems
Permit No. SW8 121119
Dollar General — Long Ridge Drive
Stormwater Permit No. SW8 121119
New Hanover County
Attachment A
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 included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Certification Requirements:
Page 6 of 7

State Stormwater Management Systems
Permit No. SW8 121119
1. The drainage area to the system contains approximately the permitted acreage.
2. The drainage area to the system contains no more than the permitted amount of built -
upon area.
3. All the built -upon area associated with the project is graded such that the runoff drains
to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The bypass structure weir elevation is per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the bypass structure.
8. All slopes are grassed with permanent vegetation.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-circuiting of the
system.
11. The permitted amounts of surface area and/or volume have been provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
New Hanover County Building Inspections
Page 7 of 7

Attachment C - Permitting History
Dollar General- Long Ridge Drive
Permit No. SW8 121119
Approval
Date
Permit
Action
BIMS
Version-
'Descriptionofthe 'Changes
2/21/2013
Original
Approval
I.0
7/10/2021
Renewal
2.0

Permit Number.
(to be provided by DWQ)
Drainage Area Number:
Infiltration Basin Operation and Maintenance Agreement
IV -f /a063
1 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:
— The drainage area will be carefully managed to reduce the sediment load to the
infiltration basin.
— Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
— No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
— The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basin is established, it will be inspected once a quarter and within
24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance 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 1 will remediate the problem:.
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin
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.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
Swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
E(CF9V .
NOV 15 2012
Br:
Form SW40I-Infiltration Basin O&M-Rev.3
Page I of 3

Sws 12 r ►►J
BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred or
Provide additional erosion
riprap is displaced.
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 pesticides are used, wipe
them on the plants rather than
spraying.
The main treatment area
A visible layer of sediment
Search for the source of the
has accumulated.
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP. Replace any media that
was removed in the process.
Revegetate disturbed areas
immediately.
Water is standing more than
Replace the top few inches of filter
5 days after a storm event.
media and see if this corrects the
standing water problem. If so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Weeds and noxious plants are
Remove the plants by hand or by
growing in the main
wiping them with pesticide (do not
treatment area.
The embankment
Shrubs or trees have started
-spray).
Remove shrubs or trees
to grow on the embankment.
immediately.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
oI 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 NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
ou tlet.
733-1786.
Form SW401-Infiltration Basin O&M-Rev.3
EE(CDo--U VIF
NOV 15 2012
13Y:
Page 2 of 3

Permit Number: Sag 1 21 11 `
(to be provided by DR/Q)
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:Dollar General - Long Ridge Drive
BMP drainage area number:
Print name:B
Title:Manaae
Address:2860-B NC Flwy 5, Aberdeen, NC 28315
Phone
Signat
�16117t�ri_ • .
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
County of %] 0 lip, do hereby certify that
personally appeared before me this I�
rj
day of a(j,�} and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
9O�PH T SCyF?''.
O NotCVY Public
Moore County
MY Co OWx Ires=
/rnninnwa
SE -AL
My commission expires
Form SW40 I -Infiltration Basin O&M-Rev.3
riIf IN %I
NOV 15 2012
bY:—Page 3-of-3

DEMLH USE ONLY
Date ec ived
Fee Paid
Permit Number
510 G
hJ191111
NC DEQ Division of Energy, Mineral and Land Resources
STATE STORMWATER:
PERMIT RENEWAL APPLICATION FORM
In accordance with 15A NCAC 2H.1045(3), the current permit holder shall renew their high density permit 180 days
prior to its expiration. Renewed permits are valid for a period of 8 years per Session Law 2011-398 (SB 781)
Section 60. (c). This application form is for permit renewals only.
A. PROJECT INFORMATION
1. State Stormwater Permit Number: c5W a 0 110l
2. Project name:
3. Project street a
City: Mm
4. What, if any, changes have been made to the project as permitted?
If the project has changed from the original approved plans, please complete SWU-101 for a Major
Modification or Minor Modification Application form available at: httl)s://deg.nc.gov/about/divisions/energy-
m i neral-land-resources/energv-m i neral-la nd-rules/stormwater-prog ram/post-construction.
B. PERMITTEE INFORMATION
If changes to the permittee or project name have been made, please complete either the Permit Update form
or the Permit Transfer form available at: https://deg.nc.gov/abouUdivisions/energv-mineral-land-
resources/energv-mineral-land-rules/stormwater-program/post-construction. State Stormwater Permits do not
automatically transfer with the sale of the property.
1. Current Permit Holder's Company Name/Organization: �R 15 De_GIROUPi LLG
2. Signing Official's Name: L3121Qn C1od�el+ex
3. Signing Official's Title:
4. Mailing Address: Zp5 Jim= 1..t�-m F�l'`Dti)I
city: We -St End� State: WC zip: 2jal(D
5. Street Address:
City:
6. Phone: BI—G)
Email:
ZIP:
JUL 0 8 2021 1
Stormwater Permit Renewal Form Page 1 of 3 May 11, 2018

C. SUBMITTAL REQUIREMENTS
Submit the application package to the appropriate DEMLR Regional Office (Coastal, SA Waters) or DEMLR
Central Office (Urbanizing Areas Ph 2, USMP, Non -Coastal HQW/ORW). Only applications packages that
include all required items listed below will be accepted and reviewed.
Initial each item below to indicate that the required information is provided in the application package:
��/(JC.� 1. A permit application processing fee of $505.00 payable to NCDEQ.
2. One original signed hard copy and one electronic copy of this completed form. The signing official
named on this application to represent the current permittee must meet one of the following:
a. Corporation — a principle executive officer of at least the level of vice-president;
b. Limited Liability Company (LLC) — a manager or company official as those terms are defined
in G.S. 57D "North Carolina Limited Liability Company Act;"
c. Public Entity — a principal executive officer, ranking official, or other duly authorized employee;
d. Partnership or limited partnership — the general partner;
e. Sole proprietor; or
f. Letter of authorization signed by one of the signatories noted in a — e above authorizing the
signature of another entity.
3. One hard copy and one electronic copy of recorded documents required by the original permit that
have not yet been received by DEMLR, including: deed restrictions, protective covenants,
condominium/planned community declaration and easements. If the project has been built, include
documentation that the maximum BUA per lot or maximum total BUA has not been exceeded. If
the project has not been built, include a signed agreement that the final recorded deed restrictions
and protective covenants will be submitted at a later date.
4. O&M Agreements, Please select one:
I have a copy of the current reserded O&M Agreement for all SCMs, and I will continue to
keep this on file with the permit; or
❑ I do not have a copy of the current recorded O&M Agreement for all SCMs and am
requesting a copy be sent to me. I agree to keep this on file with the permit.
5. Designer Certifications, Please select one:
❑ A copy of the certification(s) confirming that the project was built in accordance with the
approved plans have been previously provided to the Division; or
❑ A copy of the certification(s) confirming that the project was built in accordance with the
approved plans are enclosed; or
❑ The project has not yet been built.
6. [IF APPLICABLE] If the project has been built, one original hard copy and one electronic copy of a
signed, sealed, and dated letter from a licensed professional stating that the SCMs have been
nspected, and that they have been built and maintained in accordance with the permit.
i7. [IF APPLICABLE] When the permittee is a corporation or a limited liability corporation (LLC):
Provide one hard copy and one electronic copy of documentation from the NC Secretary of State,
or other official documentation, which supports the titles and positions held by the persons listed in
Section C.2 per 15A NCAC 2H. 1043(3)(b).
httos://www.sosnc.gov/online services/search/by title/ Business Registration
I
JUL 082021
BY:_
Stormwater Permit Renewal Application Form Page 2 of 3 , May 11, 2018

D. PERMITTEE'S CERTIFICATION
I, Bpnon CI Zip. -ki+ek , the person legally responsible for the permit, certify that I have
a copy of the Permit and O&M Agreement on site (or I will obtain a copy and it will be kept on site), that I am
responsible for the performance of the maintenance procedures, and the site has been and will be maintained
according to the O&M Agreement and approved plans. I agree to notify DEMLR of any problems with the SCMs
or built -upon area and to submit the proper forms to modify or transfer the permit prior to any changes to the
project, SCMs, or ownership. All informatio provided on this permit renewal application is, to the best of my
knowledge, correct a comple
Signature: Date: Lb - Z8" 2021
NOTARIZATION: __(f��,,
I, ltnni4m Vyinc h&-el; a Notary Public for the State of
,IORAY) CA9101 160L County of MooRe , do hereby certify
that BRIUn _ Cwo e_l+ell personally appeared before me
this the Z a}h day of
execution of the forgoing instrument. Witness my hand and official seal,
(Notary Seal)
Notary Signature:
My commission expires O
20 2-1 , and acknowledge the due
JENNIFER VM CKLH
NOTARY FER
PUBLIC
Moore County
North Carolina
I My Cammbelon Fjores April2f, 2028
[C6o�0 w
JUL 0 8 2021 I
Stormwater Permit Renewal Application Form Page 3 of 3 May 11, 2018

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��• Permit No. Sks o (Z 1 (( 9
t Ito be provided by DWQ)
or�p W / TEq�G
'AA STORMWATER MANAGEMENT PERMIT APPLICATION FORM p�<"
NCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT �V % /�0& 3
This form must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
Contact Person
Phone Number
Date
Drainage Area Number
Dollar General - Long Ridge Drive
J. Phillip Noms, P.E./ Norris & Tunstall Consulting Engineers, P.C.
910-287-5900
02-05-13
II. "DESIGN INFORMATION
Site Characteristics
Drainage area
46,000.00
f2
Impervious area
30,000.00
h'
Percent impervious
65.22
%
Design rainfall depth
1.50
in
Peak Flow Calculations
1-yr, 24-hr rainfall depth
1-yr, 24-hr intensity
Pre -development 1-yr, 24-hr discharge
Post -development 1-yr, 24-hr discharge
Pre/Post 1-yr, 24-hr peak Sow control
Storage Volume: Non -SA Waters
Minimum design volume required
Design volume provided
Storage Volume: SA Waters
1.5' runoff volume
Pre -development 1-yr, 24-hr runoff volume
Post -development 1-yr, 24-hr runoff volume
Minimum required volume
Volume provided
Soils Report Summary
Soil type
Infiltration rate
SHWT elevation
Basin Design Parameters
Drawdown time
Basin side slopes
Basin bottom elevation
Storage elevation
Storage Surface Area
Top elevation
Basin Bottom Dimensions
Basin length
Basin width
Bottom Surface Area
3.80
in:
0.16
in/hr
0.31
ft'Isec
2.92
ft3/sec
2.61
Ns/sec
9,235.00 it' — 2.510< ".s,g•v i«L 8-(P4sS " 51911"
9,244.00 it' OK for non -SA waters
Sand
1.50 inmr tl2 t.0114E vo)jn" t.+FV' 9A.1d
29.25 fmsl
0.55 days OK TIA0 1201- 10 M4WDct"1 A
4.00 :1 OK
31.25 imsl OK
32.61 fmsl
8,000.00 ftz
33.50 fmsl
169.19 it F
�IFIVF-
5,629.00 33.27 fe FEB 0 9 2013
Form SW401-Infttration Basin-Rev.5 11Ap2011 Paris I. & II. Design Summary, Page 1 of 2

Permit No. SW 9 1 'Z 1 1 1 g
• (to be provided by DWQ)
Additional Information
Maximum runoff to each inlet to the basin?
0.43
ac-in
OK
Length of vegetative filter for overflow
NIA
It
OK—1161r�i' E} 104Nf— VF5 c"196
Distance to structure
15.00
It
OK 0
Distance from surface waters
50+
ft
OK
Distance from water supply well(s)
50+
fit
OK
Separation from impervious soil layer
2+
It
OK
Naturally occuring soil above shwt
3.75
It
OK
Bottom covered with 4-in of clean sand?
Y
(Y or N)
OK
Proposed drainage easement provided?
NIA
(Y or N)
OK
Capures all runoff at ultimate build -out?
Y
(Y or N)
OK
Bypass provided for larger storms?
Y
(Y or N)
OK
Pretreatment device provided
Sheet Flow
to drop inlets
�{;FOVoF_
FEB 0 7 2013
Form SW401-Infiltration Basin-Rev.5 11Ap2011 Pans I. & 11. Design Summary, Page 2 of 2