SW8200509_Current Permit_20200609

ROY COOPER
aavernor
MICHAEL S. REGAN
secretary
BRIAN WRENN NORTH CAROLINA
Ac-WV Director EnvkWW a dal Qttati'tY
June 9, 2020
CTC Brunswick Holding, LLC, co-permittee
CTC Brunswick Holding Member, Inc., Manager
Attn: Kent Conine, Manager
2013 Rolling Rock Road
Wake Forest, NC 27587
/\._ ece
Kent W. Colton & Kathryn P. Colton, co-permittee
936 Springhill Road
McLean, VA 22102
Subject: State Stormwater Management Permit No. SW8 200509
The Greenside Manors at Brick Landing Plantation
High Density Subdivision Project
Brunswick County
Dear Mr. Conine and Mr. and Mrs. Colton:
The Wilmington Regional Office received a complete, State Stormwater Management Permit Application
for the subject project on May 29, 2020. Staff review of the plans and specifications has determined that
the project, as proposed, complies with the Stormwater Regulations set forth in Title 15A NCAC
02H.1000 amended on January 1, 2017 (2017 Rules). We are hereby forwarding Permit No. SW8
200509 dated June 9, 2020, for the construction of the built -upon areas (BUA) and stormwater control
measures (SCMs) associated with the subject project.
This permit shall be effective from the date of issuance until June 9, 2028 and the project shall be subject
to the conditions and limitations as specified therein and does not supersede any other agency permit that
may be required. Failure to comply with these requirements will result in future compliance problems.
Please note that this permit is not transferable except after notice to and approval by the Division.
This cover letter, attachments, and all documents on file with DEMLR shall be considered part of this
permit and is herein incorporated by reference.
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 concerning this permit, please contact Garrett Zorda in the Wilmington
Regional Office, at [phone] or [e-mail].
Sincerely,
-J� Brian Wrenn, Acting Director
Division of Energy, Mineral and Land Resources
Enclosures: Attachment A — Designer's Certification Form
Application Documents
DES/gdz: \\\Stormwater\Permits & Projects\2020\200509 HD\2020 06 permit 200509
North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
Z5_ Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington, North Carolina 28405
01E
Noam CAROUNA
�^"+zl_ 910.796.7215

State Stormwater Permit No. SW8 200509
Page 2 of 2
cc: J. Christian Russell, PE, East Coast Engineering & Surveying
Brunswick County Engineering
Wilmington Regional Office Stormwater File

State Stormwater Management
Permit No. SW8 200509
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY SUBDIVISION DEVELOPMENT
In compliance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations promulgated and adopted by the North
Carolina Environmental Management Commission, including 15A NCAC 02H.1000 amended on
January 1, 2017 (2017 Rules) (the "stormwater rules"),
PERMISSION IS HEREBY GRANTED TO
CTC Brunswick Holding, LLC and Kent W. Colton & Kathryn P. Colton
The Greenside Manors at Brick Landing Plantation
Goose Creek Road, Ocean Isle Beach, Brunswick County
FOR THE
construction, management, operation and maintenance of built -upon area (BUA) draining to one (1)
wet detention pond ("stormwater control measures" or "SCMs") as outlined in the application,
approved stormwater management plans, supplement, calculations, operation and maintenance
agreement, recorded documents, specifications, and other supporting data (the "approved plans and
specifications") as attached and/or on file with and approved by the Division of Energy, Mineral and
Land Resources (the "Division" or "DEMLR"). The project shall be constructed, operated and
maintained in accordance with these approved plans and specifications. The approved plans and
specifications are incorporated by reference and are enforceable part of this permit.
This permit shall be effective from the date of issuance until June 9, 2028 and shall be subject to the
following specified conditions and limitations. 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 condition. 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.
BUA REQUIREMENTS. The maximum amount of BUA allowed for the entire project is 195,398
square feet. The runoff from all BUA within the permitted drainage area of this project must be
directed into the permitted SCM. The BUA requirements and allocations for this project are as
follows..
a. SCM BUA LIMITS. The SCM has been designed using the runoff treatment method to
handle the runoff from 195,398 square feet of BUA within the delineated drainage area. This
permit does not provide any allocation of BUA for future development within the delineated
drainage area(s).
b. BUA FOR INDIVIDUAL LOTS. Each of the 39 lots are limited to a maximum of 4,000 square
feet of BUA, as indicated in the approved plans and specifications. The maximum BUA
assigned to each lot via this permit and the recorded deed restrictions and protective
covenants may not be increased or decreased by either the individual lot owner or the
permittee unless and until the permittee notifies the Division and obtains written
approval from the Division.
Page 1 of 6

State Stormwater Management
Permit No. SW8 200509
2. PERVIOUS AREA IMPROVEMENTS. At this time, none of the pervious area improvements
listed in G.S. 143-214.7(b2) or the Stormwater Design Manual have been proposed for this
project. Pervious area improvements will be allowed in this project if documentation is provided
demonstrating those improvements meet the requirements of the stormwater rule.
3. OFFSITE LOT REQUIREMENTS. Each non-residential lot whose ownership is not retained by
the permittee shall submit a separate off -site stormwater permit application to the Division and
receive approval prior to constr uctioi �. Prior to the discharge of stormwater runoff from any lot
into the approved stormwater system, the permittee shall ensure that the owner of the non-
residential lot has obtained the separate off -site stormwater management permit.
4. SCM REQUIREMENTS. The SCM requirements for this project are as follows:
a. SCM DESIGN. The SCM is permitted based on the design criteria presented in the sealed,
signed and dated supplement and as shown in the approved plans and specifications. This
SCM must be provided and maintained at the design condition.
b. PLANTING PLAN. The SCM landscape planting plan shown in the approved plans shall be
followed in its entirety during construction. After the plants are established, the operation
and maintenance agreement must be followed.
c. FOUNTAINS. At this time, a decorative spray fountain has not been proposed within the wet
pond. Decorative spray fountains will be allowed in the wet pond if documentation is
provided demonstrating that the proposed fountain will not cause resuspension of sediment
within the pond or cause erosion of the pond side slopes.
d. IRRIGATION. If the wet pond is to be used for irrigation, it is recommended that some water
be maintained in the permanent pool, the vegetated shelf is planted with appropriate species
that can handle fluctuating conditions, and human health issues are addressed.
5. STORMWATER OUTLETS. The peak flow from the 10-year storm event shall not cause erosion
downslope of the discharge point.
6. VEGETATED SETBACKS. A 50-foot wide vegetative setback must be provided and maintained
in grass or other vegetation adjacent to all surface waters as shown on the approved plans. The
setback is measured horizontally from the normal pool elevation of impounded structures, from
the top of bank of each side of streams or rivers, and from the mean high waterline of tidal
waters, perpendicular to the shoreline.
a. BUA IN THE VEGETATED SETBACK. The runoff from the entire BUA of the development
is collected, treated, and discharged so that it passes through a segment of the vegetated
buffer and is managed so that it otherwise complies with all applicable State and federal
stormwater management requirements. This allows BUA to be placed within the vegetated
setback as shown on the approved plans. BUA may not be added to the vegetated setback
except as shown on the approved plans or in the following instances where the BUA has
been minimized and channelizing runoff from the BUA is avoided:
i. Water dependent structures; and
ii. Minimal footprint uses such as poles, signs, utility appurtenances, and security
lights that cannot practically be located elsewhere.
b. RELEASE OF STORMWATER NOT TREATED IN AN SCM. Stormwater that is not treated
in an SCM must be released at the edge of the vegetated setback and allowed to flow
through the setback as dispersed flow.
7. RECORDED DOCUMENT REQUIREMENTS. The stormwater rules require the following
documents to be recorded with the Office of the Register of Deeds prior to the sale of individual
lots or groups of lots:
a. ACCESS AND/OR EASEMENTS. The entire stormwater conveyance system, including any
SCMs, and maintenance accesses must be located in public rights -of -way, dedicated
common areas that extend to the nearest public right-of-way, and/or permanent recorded
easements that extend to the nearest public right-of-way for the purpose of inspection,
operation, maintenance, and repair.
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State Stormwater Management
Permit No. SW8 200509
b. OPERATION AND MAINTENANCE AGREEMENT. The operation and maintenance
agreement must be recorded with the Office of the Register of Deeds.
c. FINAL PLATS. The final recorded plats must reference the operation and maintenance
agreement and must also show all public rights -of -way, dedicated common areas, and/or
permanent drainage easements, in accordance with the approved plans.
d. DEED RESTRICTiONS AND PROTECTIVE COVENANTS. Recorded deed restrictions and
protective covenants must include, at a minimum, the following statements related to
stormwater management:
i. The following covenants are intended to ensure ongoing compliance with State
Stormwater Management Permit Number SW8 200509, as issued by the Division of
Energy, Mineral and Land Resources (the "Division") under 15A NCAC 02H.1000,
effective January 1, 2017.
ii. The State of North Carolina is made a beneficiary of these covenants to the extent
necessary to maintain compliance with the Stormwater Management Permit.
iii. These covenants are to run with the land and be binding on all persons and parties
claiming under them.
iv. The covenants pertaining to stormwater may not be altered or rescinded without
the express written consent of the Division.
V. Alteration of the drainage as shown on the approved plans may not take place
without the concurrence of the Division.
vi. The maximum built -upon area (BUA) per lot is 4,000 square feet. This allotted
amount includes any BUA 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
not shown on the approved plans. BUA has the same meaning as G.S. 143-214.7,
as amended.
vii. The maximum allowable BUA shall not be exceeded on any lot until the permit is
modified to ensure compliance with the stormwater rules, permit, and the approved
plans and specifications.
viii. All runoff from the BUA on the lot must drain into the permitted system. This may
be accomplished via grading, a stormwater collection system and/or a vegetated
conveyance.
ix. A 50-foot wide vegetative setback must be provided and maintained adjacent to all
surface waters in accordance with 15A NCAC 02H.1003(4) and the approved
plans.
X. 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.
e. DEEDS FOR INDIVIDUAL LOTS. The permittee shall record deed restrictions and protective
covenants prior to the issuance of a certificate of occupancy to ensure the permit conditions
and the approved plans and specifications are maintained in perpetuity.
8. CONSTRUCTION. During construction, erosion shall be kept to a minimum and any eroded
areas of the on -site stormwater system will be repaired immediately.
a. PROJECT CONSTRUCTION, OPERATION AND MAINTENANCE. During construction, all
operation and maintenance for the project shall follow the Erosion Control Plan requirements
until the Sediment -Erosion Control devices are converted to SCMs or no longer needed.
Once the device is converted to a SCM, the permittee shall provide and perform the
operation and maintenance as outlined in the applicable section below.
b. SCM RESTORATION. If one or more of the SCMs are used as an Erosion Control device
and/or removed or destroyed during construction, it must be restored to the approved state
Storm design condition prior to close-out of the erosion control plan and/or project
completion and/or transfer of the state stormwater permit. Upon restoration, a new or
updated certification will be required for the SCM(s) and a copy must be submitted to the
appropriate DEQ regional office.
c. LOT GRADING. The permittee shall assure that all lots are graded such that the runoff from
all built -upon area on the lot is collected and drains toward the street and/or into the
approved stormwater collection system.
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State Stormwater Management
Permit No. SW8 200509
9. MODIFICATIONS. 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), stormwater collection system and/or vegetative
conveyance shown on the approved plan.
e. The construction of any allocated future BUA.
f. Adding the option to use permeable pavement or #57 stone within the lots as a permeable
surface. The request may require a proposed amendment to the deed restrictions and
protective covenants for the subdivision to be submitted and recorded.
g. The construction of any permeable pavement, #57 stone area, public trails, or landscaping
material within the common areas to be considered a permeable surface that were not
included in the approved plans and specifications.
h. Other modifications as determined by the Director.
10. DESIGNER'S CERTIFICATION. Upon completion of the project, the permittee shall determine if
the project is in compliance with the approved plans and take the necessary following actions:
a. If the permittee determines that the project is in compliance with the approved plans, then
within 45 days of completion, the permittee shall submit to the Division one hard copy and
one electronic copy of the following:
i. The completed and signed Designer's Certification provided in Attachment A
noting any deviations from the approved plans and specifications. Deviations
may require approval from the Division;
ii. A copy of the recorded operation and maintenance agreement;
iii. Unless already provided, a copy of the recorded deed restrictions and
protective covenants; and
iv. A copy of the recorded plat delineating the public rights -of -way, dedicated
common areas and/or permanent recorded easements, when applicable.
b. If the permittee determines that the project is not in compliance with the approved plans, the
permittee shall submit an application to modify the permit within 30 days of completion of the
project or provide a plan of action, with a timeline, to bring the site into compliance.
11 OPERATION AND MAINTENANCE. The permittee shall provide and perform the operation and
maintenance necessary, as listed in the signed operation and maintenance agreement, to
assure that all components of the permitted on -site stormwater system are maintained at the
approved design condition. The approved operation and maintenance agreement must be
followed in its entirety and maintenance must occur at the scheduled intervals.
a. CORRECTIVE ACTIONS REQUIRED. If the facilities fail to perform satisfactorily, the
permittee shall take immediate corrective actions. This includes actions required by the
Division and the stormwater rules such as the construction of additional or replacement on -
site stormwater systems. These additional or replacement measures shall receive a permit
from the Division prior to construction.
b. MAINTENANCE RECORDS. Records of maintenance activities must be kept and made
available upon request to authorized personnel of the Division. The records will indicate the
date, activity, name of person performing the work and what actions were taken.
12. PERMIT RENEWAL. 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 15A NCAC 02H.1045(3).
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State Stormwater Management
Permit No. SW8 200509
13. CURRENT PERMITTEE NAME OR ADDRESS CHANGES. The permittee shall submit a
completed Permit Information Update Application Form 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.
14. TRANSFER. This permit is not trdrisierable to any person or entity except after, notice to and
approval by the Director. Neither the sale of the project and/or property, in whole or in part, nor
the conveyance of common area to a third party constitutes an approved transfer of the permit.
a. TRANSFER REQUEST. The transfer request must include the appropriate application,
documentation and the processing fee as outlined in 15A NCAC 02H.1045(2) and must be
submitted upon occurrence of any one or more of the following events:
i. The sale or conveyance of the project and/or property area in whole or in part,
except in the case of an individual residential lot sale that is made subject to the
recorded deed restrictions and protective covenants;
ii. The assignment of declarant rights to another individual or entity;
iii. The sale or conveyance of the common areas to a Homeowner's or Property
Owner's Association, subject to the requirements of NCGS 143-214.7(c2);
iv. Dissolution of the partnership, corporate, or LLC entity, subject to NCGS 55-14-05
or NCGS 57D-6-07 and 08;
V. Bankruptcy;
vi. Foreclosure, subject to the requirements of Session Law 2013-121,
b. TRANSFER INSPECTION. 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.
Records of maintenance activities performed to date may be requested. Projects not in
compliance with the permit will not be transferred until all permit and/or general statute
conditions are met.
15. COMPLIANCE. The permittee is responsible for complying with the terms and conditions of this
permit and the approved plans and specifications until the Division approves the transfer
request.
a. REVIEWING AND MONITORING EACH LOT FOR COMPLIANCE. The permittee is
responsible for verifying that the proposed BUA on each individual lot and for the entire
project does not exceed the maximum amount allowed by this permit. The permittee shall
review all individual lot plans for new construction and all subsequent modifications and
additions for compliance. The plans reviewed must include all proposed BUA, grading, and
driveway pipe placement. The permittee shall not approve any lot plans where the maximum
allowed BUA limit has been exceeded or where modifications are proposed to the grading
and/or to the stormwater collection system and/or to the vegetated conveyance unless and
until a permit modification has been approved by the Division. The permittee shall review
and routinely monitor the project and each lot to ensure continued compliance with the
conditions of the permit, the approved plans and specifications, and the recorded deed
restrictions and protective covenants. 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 timely
resolution.
b. ARCHITECTURAL REVIEW BOARD (ARB) OR COMMITTEE (ARC). The permittee may
establish an ARB or ARC to conduct individual lot reviews. However, any approval given by
the ARB or ARC on behalf of the permittee does not relieve the permittee of the
responsibility to maintain compliance with the conditions of the permit and the approved
plans and specifications.
c. APPROVED PLANS AND SPECIFICATIONS. A copy of this permit, approved plans,
application, supplement, operation and maintenance agreement, all applicable recorded
documents, and specifications shall be maintained on file by the permittee at all times.
d. DIVISION ACCESS. The permittee grants Division Staff permission to enter the property
during normal business hours to inspect all components of the permitted project.
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State Stormwater Management
Permit No. SW8 200509
e. ENFORCEMENT. 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.
f. OBTAINING COMPLIANCE. 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 modified plans and certification in writing to the Director that the changes have
been made.
g. OTHER PERMITS. The issuance of this permit does not preclude the permittee from
obtaining and complying with any and all other permits or approvals that are required for this
development to take place, as required by any statutes, rules, regulations, or ordinances,
which are 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.
Permit issued this the gch day of June 2020.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Brian Wrenn, g Dire
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW8 200509
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State Stormwater Management
Permit No. SW8 200509
Attachment A
Certification Forms
The following blank Designer Certification forms are included and specific for this project:
• As -Built Permittee Certification
• As -Built Designer's Certification General MDC
• As -Built Designer's Certification for Wet Detention Pond Project
A separate certification is required for each SCM. These blank certification forms may be copied and
used, as needed, for each SCM and/or as a partial certification to address a section or phase of the
project.
Page 1 of 1

State Stormwater Management
Permit No. SW8 200509
AS -BUILT PERMITTEE CERTIFICATION
I hereby state that I am the current permittee for the project named above, and I certify by my
signature below, that the project meets the below listed Final Submittal Requirements found in NCAC
02H.1042(4) and the terms, conditions and provisions listed in the permit documents, plans and
specifications on file with or provided to the Division.
❑ Check here if this is a partial certification. Section/phase/SCM #?
❑ Check here if this is part of a Fast Track As -built Package Submittal.
Printed Name
Signature
I, , a Notary Public in the State of
County of , do hereby certify that
personally appeared before me this day of 20
and acknowledge the due execution of this as -built certification. (SEAL)
Witness my hand and official seal
My commission expires
Permiitee's cn tZAC .1042(4)
Pew ' d'
N/A
A. DEED RESTRICTIONS I BUA RECORDS
1. The deed restrictions and protective covenants have been recorded
Y or N
and contain the necessary language to ensure that the project is
maintained consistent with the stormwater regulations and with the
permit conditions.
2. A copy of the recorded deed restrictions and protective covenants
Y or N
has been provided to the Division.
3. Records which track the BUA on each lot are being kept. (See Note
Y or N
1
S. MAINTENANCE ACCESS
1. The SCMs are accessible for inspection, maintenance and repair.
Y or N
2. The access is a minimum of 10 feet wide.
Y or N
3. The access extends to the nearest public right-of-way.
Y or N
C. EASEMEWM
1. The SCMs and the components of the runoff collection / conveyance
Y N
system are located in recorded drainage easements.
or
2. A copy of the recorded plat(s) is provided.
Y or N
D. SINGLE FAIYII_Y RESIDENTIAL LOTS P4ts forresidential Iota that
Y N
have an SCM indude the foll y -:. .
or
1. The specific location of the SCM on the lot.
Y or N
2. A typical detail for the SCM.
Y or N
3. A note that the SCM is required to meet stormwater regulations and
that the lot owner is subject to enforcement action as set forth in
Y N
NCGS 143 Article 21 if the SCM is removed, relocated or altered
or
without prior approval.
E. OPERATION AND MAINTENANCE AGREEMENT
Y or N
1. The O&M Agreement is referenced on the final recorded plat.
Y or N
2. The O&M Agreement is recorded with the Register of Deeds and
Y N
appears in the chain of title.
or
F. OPERATION N AND RMINTENANCE PLAN— mciiitenarme rewrds are
bsa ng kept in a kno%m set 'r i cn for each.SCM cod are available for
Y or N
Page 1 of 6

State Stormwater Management
Permit No. SWS 200509
E}�sltxt
Note 1- Acceptable records include ARC approva
Off.,911W, I
surveys, and county tax records.
Provide an explanation for every requirement that was not met, and for every "NIA" below. Attach
additional sheets as needed.
Page 2 of 6

State Stormwater Management
Permit No. SW8 200509
AS -BUILT DESIGNER'S CERTIFICATION GENERAL MDC
I hereby state that I am a licensed professional and I certify by my signature and seal below, that I
have observed the construction of the project named above to the best of my abilities with all due care
and diligence, and that the project meets the below listed General MDC found in NCAC 02H.1050 in
accordance with the permit documents, plans and specifications on file with or provided to the
Division, except as noted on the "AS -BUILT" drawings, such that the intent of the stormwater rules
and statutes has been preserved.
❑ Check here if this is a partial certification. Section/phase/SCM #?
❑ Check here if this is a part of a Fast -Track As -Built Package Submittal per .1044(3).
❑ Check here if the designer did not observe the construction, but is certifying the project.
❑ Check here if pictures of the SCM are provided.
Printed
Name
NC Registration
Number Date
SEAL:
Signature
Consultant's Mailing Address:
City/State/ZIP
Phone Number
Consultant's Email address:
O Circle N if the as -built value differs from the Plan. If N is circled, provide an explanation on Page 2.
OO N/E = not evaluated (provide explanation on page 2) OO N/A = not applicable to this SCM or project.
Consukant's Cetticati ri t,,�CAC .1003((3) & General k,tDC
OAS -belt
OVE
GIVA
.1050
A. ifREAMEW REQUIREIVENIM
1. The SCM achieves runoff treatment.
Y or N
2. The SCM achieves runoff volume match.
Y or N
3. Runoff from offsite areas and/or existing BUA is
Y or N
bypassed.
4. Runoff from offsite areas and/or existing BUA is directed
Y or N
into the permitted SCM and is accounted for at the full
build -out potential.
5. The project controls runoff through an offsite permitted
Y or N
SCM that meets the requirements of the MDC.
6. The net area of new BUA increase for an existing project
Y or N
has been accounted for at the appropriate design storm
level.
7. The SCM(s) meets all the specific minimum design
Y or N
criteria.
B. VEGETATED SETBACKS 113UA
1. The width of the vegetated setback has been measured
Y or N
from the normal pool of impounded waters, the MHW
line of tidal waters, or the top of bank of each side of
rivers or streams.
2. The vegetated setback is maintained in grass or other
Y or N
vegetation.
3. BUA that meets the requirements of NCGS 143-214.7
Y or N
b2 2 is located in the setback.
4. BUA that does not meet the requirements of NCGS 143-
Y or N
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State Stormwater Management
Permit No. SW8 200509
214.7 (b2)(2) is located within the setback and is limited
to:
a. Publicly funded linear projects (road, greenway
sidewalk)
b. Water -dependent structures
c. Minimal footprint uses (utility poles, signs, security
lighting and appurtenances)
5. Stormwater that is not treated in an SCM is released at
Y or N
the edge of the setback and allowed to flow through the
setback as dispersed flow.
(DAs bv'R
0 N/E
G N/A
C.STORM—WAMN OUTLETS — ttm cutlet handles the peak
,M N
flow from the 10 year sftm with no domstope erosion.
or
D. VARIATIONS
1. A variation (alternative) from the stormwater rule
Y N
provisions has been implemented.
or
2. The variation provides equal or better stormwater control
Y N
and equal or better rotection of surface waters.
or
COMPEUME WITH OTHER REGULATORY
Y or N
met.
F. 30ING - . volume t#* SCT41 fikes rupoi
suftoes nQ account and is su�fficient to handle the required
Y or N
storm 't'n.
G. CONTAI i HATED SOILS -- eiiltrabrig SC Vs are not
Y or N
located in or on areas with owtaminated soils.
H. StDE SLOPES
Y or N
1. Vegetated side slopes are no steeper than 3H:1 V.
2. Side slopes include retaining walls, gabion walls, or
Y or N
other surfaces that are steeper than 3H:1 V.
3. Vegetated side slopes are steeper than 3H:1 V (provide
Y or N
supporting documents for soils and vegetation).
I. EROSION PROTEC71ON
1. The inlets do not cause erosion in the SCM.
Y or N
2. The outlet does not cause erosion downslope of the
Y or N
discharge point during the peak flow from the 10 year
storm.
J. EXCESS FLOWS —An ov l -hypau has be
Y
vided.
or .N
. method to rawda_ wn s ,ng �
Y or N
been vided to faditate maintenance and i n.
CLEANOUT AFTI R CONSTRUCTION — ttm SCM has been
Y or N
Cleaned cut ri' d converted to its Npfoved deftdeftn zMe.
N1 MAINTENANCE ACCESS
1. The SCM is accessible for maintenance and repair.
Y or N
2. The access does not include lateral or incline slopes
Y or N
>3:1.
N. DESIGNER QUALIFICAYMS= AST- NM —
The desigrnar is laoensed under Chapters 89A, 89C, BgE, or
Y or N
89F of the Gera, Statutes.
Provide an explanation for every MDC that was not met, and for every item marked "N/A" or "WE",
below. Attach additional pages as needed:
Page 4 of 6

State Stormwater Management
Permit No. SW8 200509
AS -BUILT DESIGNER'S CERTIFICATION FOR WET DETENTION POND PROJECT
I hereby state that I am a licensed professional and I certify by my signature and seal below, that I
have observed the construction of the project named above to the best of my abilities with all due care
and diligence, and that the project meets all of the MDC found in NCAC 02H.1053, in accordance with
the permit documents, plans and specifications on file with or provided to the Division, except as
noted on the "AS -BUILT" drawings, such that the intent of the stormwater rules and the general
statutes has been preserved.
❑ Check here if this is a partial certification. Section/phase/SCM #?
❑ Check here if this is part of a Fast -Track As -Built Package Submittal per. 1044(3).
❑ Check here if the Designer did not observe the construction, but is certifying the project.
❑ Check here if pictures of the SCM are provided.
Printed
Name Signature
NC Registration Number
SEAL:
Date
Consultant's Mailing Address:
City/State/ZIP
Phone Number
Consultant's Email address:
O Circle N if the as -built value differs from the Plan/permit. If N is circled, provide an explanation on
page 2
©N/E = not evaluated (provide explanation on page 2) nN/A = not applicable to this project or SCM.
This Certification must be completed in conjunction with the General MDC certification under NCAC
02H.1050
Consultant's Certification (WC .1053)
0As-bu'k
ONYIE
®N/A
A. Fonbl!My I pqpft i FountuAn
1. The available Sediment storage is consistent with the
Y N
approved plan and is a minimum of 6 in.
or
2. Water flow over the forebay berm into the main pond
Y N
occurs at a non -erosive velocity.
or
3. The provided Forebay Volume is 15%-20% of the main
Y N
pool volume.
or
4. The Forebay entrance elevation is deeper than the exit
Y N
elevation into the pond.
or
5. The Average Design Depth of the main pond below the
permanent pool elevation is consistent with the permitted
Y or N
value?
6. Fountain documentation is provided.
Y or N
B. Side slopes I Banks I Vegetated Shell
1. The width of the Vegetated Shelf is consistent with the
Y N
approved plans and is a minimum of 6 feet.
or
2. The slope of the Vegetated Shelf is consistent with the
Y N
approved plans and is no steeper than 6: 1.
or
C. As -built Main Pool I Areas / Volumes I Elevations
1. The permanent pool surface area provided is consistent
Y N
with the permitted value.
or
2. The Temporary Pool Volume provided is consistent with
Y N
the permitted value_
or
Page 5 of 6

State Stormwater Management
Permit No. SW8 200509
3.
The permanent pool elevation is consistent with the
Y
N
permitted value.
or
4.
The temporary pool elevation is consistent with the
Y
N
permitted value.
or
OJs-built
ONIE
3WA
D. Inieis l Ouftt 1 down
1.
The design volume draws down in 2-5 days.
Y
or
N
2.
The size of the Orifice is consistent with the permitted
Y
N
value.
or
3.
A trash rack is provided on the outlet structure.
Y
or
N
4.
Hydrologic impacts to the receiving channel are minimized
Y
N
from the 1 yr 24 hr storm discharge?
or
5.
The inlets and the outlet location are situated per the
Y
N
approved plan and avoid short-circuiting.
or
E. N
ton :
1.
The vegetated shelf has been planted with a minimum of 3
Y
N
diverse species.
or
2.
The vegetated shelf plant density is consistent with the
approved plans and is no less than 50 plants per 200 sf or
Y
or
N
no less than 24 inches on center.
Provide an explanation for every MDC that was not met, and for every item marked "N/A" or "N/E"
below. Attach additional pages as needed:
Page 6 of 6

Operation & Maintenance Aq reement
Project Name:
Project Location:
The Greenside Manors
Adjacent to '1853 Goose Creek Road, Ocean Isle Beach NC
Maintenance records shall be kept on the following BMP(s). This maintenance record shall 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 isle pollutant removal efficiency ai the BMP(s).
The BMP(s) on this project include (check all that apply & corresr
Bioretention Cell
Quantity:
Dry Detention Basin
Quantity:
Grassed Swale
Quantity:
Green Roof
Quantity:
Infiltration Basin
Quantity:
Infiltration Trench
Quantity:
Level SpreaderNFS
Quantity:
Permeable Pavement
Quantity:
Proprietary System
Quantity:
Rainwater Harvesting
Quantity:
Sand Filter
Quantity:
Stormwater Wetland
Quantity:
Wet Detention Basin
Quantity:
Disconnected Impervious Area
Present:
User Defined BMP
Present:
ing O&M tables will be adds
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
1 Location(s):
No Location(s):
No Location(s):
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed for each BMP
above, and attached O&M tables. I agree to notify NCDENR of any problems with the system or prior to any changes to the system or
responsible party.
* Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Email:
Kent Colton & Kathryn Colton
Owner
936 Spring Hill Road
McLean, VA 22102-1324
kcoltonllc mall.com
Signature: /� �r//V Date: 5 _
`, r
I, Z , a Notary Public for the State of V
County of , do hearby certify that
personally appeared before me this —poll day of IAP 1 and
acknowledge the due execution of the Op ns and Mainten reement .
Witness my hand and official seal,
seal
SAMUEL. ZERAI
NOTARY PUBLIC
COMMONWEALTH OF VIRGII IIA
MY COMMISSION EXPIRES FEBA 8, 2023
COMMISSION # 7508412
My commission expires 2( 15;q ZA Z5
STORM-EZ 5/7120
Version 1.4 O&M Manual Page 1 of 4

Operation & Maintenance Agreement
Project Name:
Project Location:
The Greenside Manors
Adjacent to 1853 Goose Creek Road, Ocean Isle Beach NC
Maintenance records shall be kept on the following BMP(s). This maintenance record shall 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 pollutant removal efficiency of the BMP(s).
The BMP(s) on this project include (check all that apply & correspc
Bioretention Cell
Quantity:
Dry Detention Basin
Quantity:
Grassed Swale
Quantity:
Green Roof
Quantity:
Infiltration Basin
Quantity:
Infiltration Trench
Quantity:
Level Spreader/VFS
Quantity:
Permeable Pavement
Quantity:
Proprietary System
Quantity:
Rainwater Harvesting
Quantity:
Sand Filter
Quantity:
Stormwater Wetland
Quantity:
Wet Detention Basin
Quantity:
1
Disconnected Impervious Area
Present:
o
RNo
User Defined BMP
Present:
O&M tables wil
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
De aaaea a
TE
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed
for each BMP above, and attached O&M tables. I agree to notify NCDENR of any problems with the system or prior to any
changes to the system or responsible parry.
* Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Email:
Signature:
Kent Conine
Manager, CTC Brunswick Holding, LLC
2013 Rolling Rock Road
Rolling Rock Road, Wake Forest NC 27587-6271
972-386-6600
[e-mail]
Wen a Notary Public for the State of
Date: ?
County of cti,k, do hearby certify that ' Con % n e-
personally appeared before me this I day of Mq p • p and
acknowledge the due execution of tthe, `Operations and Maintenance
/A�greemen .
Witness my hand and official seal, Vv�'►�[.�4 vrw
}�'
El
WENDY B CHBINDER MAY 21 2020Notary Public, State of Texas+�� Comm. Expir s 07-12-1020`;�`` Notary i 84027
--
ST RM-EZ 5/7/2020
Version 1.4 O&M Manual Page 1 of 6

Wet Detention Pond Maintenance Requirements
The wet detention basin system is defined as the wet detention basin, pretreatment including forebays and the vegetated filter if
one is provided.
Important maintenance procedures:
Immediately after the wet detention basin is established, the plants on the vegetated shelf and perimeter of the
basin should be watered twice weekly if needed, until the plants become established (commonly six weeks).
No portion of the wet detention pond should be fertilized after the first initial fertilization that is required to
establish the plants on the vegetated shelf.
_ Stable groundcover should be maintained in the drainage area to reduce the sediment load to the wet detention
basin.
If the basin must be drained for an emergency or to perform maintenance, the flushing of sediment through the
emergency drain should be minimized to the maximum extent practical.
- Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected once a month and within 24 hours after every storm event
greater than 1.0 inches (or 1.5 inches if in a Coastal County). Records of operation and maintenance should be kept in a
known set location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired immediately.
BMP element:
Potential problem:
How I will remediate the problem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the BMP
Areas of bare soil and/or
Regrade the soil if necessary to remove the gully, and then plant a
erosive gullies have formed.
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 approximately six inches.
long.
The inlet device
The pipe is clogged.
Unclog the pipe. Dispose of the sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to smooth it over and provide erosion
swale.
control devices such as reinforced turf matting or riprap to avoid future
problems with erosion.
Stone verge is clogged or
Remove sediment and replace with clean stone.
covered in sediment (if
applicable).
The forebay
Sediment has accumulated to
Search for the source of the sediment and remedy the problem if
a depth greater than the
possible. Remove the sediment and dispose of it in a location where
original design depth for
it will not cause impacts to streams or the BMP.
sediment storage.
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 a ride is used, wipe it
on the plants rather than spraying.
The vegetated shelf
Best professional practices
show that pruning is needed
to maintain optimal plant
health.
Prune according to best professional pra esej a
KIP:
AZT
Plants are dead, diseased or
Determine the source of the problem: soils, hydrology, disease, etc.
dying.
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.
STORM-EZ 5/7/2020
Version 1.4 O&M Manual Page 3 of 5

Wet Detention Pond Maintenance Requirements (Continued)
The main treatment area
Sediment has accumulated to
Search for the source of the sediment and remedy the problem if
a depth greater than the
possible. Remove the sediment and dispose of it in a location where
original design sediment
it will not cause impacts to streams or the BMP.
storage depth.
Algal growth covers over 50%
Consult a professional to remove and control the algal growth.
of the area.
Cattails, phragmites or other
Remove the plants by wiping them with pesticide (do not spray).
invasive plants cover 50% of
the basin surface.
The embankment
Shrubs have started to grow
Remove shrubs immediately.
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and consult a professional to remove
beaver activity is present.
beavers.
A tree has started to grow on
Consult a dam safety specialist to remove the tree.
the embankment.
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 Department of Environment and Natural
damage have occurred at the
Resources Regional Office.
outlet.
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.
IN 4
viAV, I 12020
By:
STORM-EZ 5/7/2020
Version 1.4 O&M Manual Page 4 of 5

Wet Detention Pond surnmiry
Wet Pond Diaor-W
WET POND ID FOREBAY MAIN POND
POND 1
Permanent Pool El.
14
Permanent Pool El.
14
Temporary Pool El:
16.2
Temporary Pool El:
16.2
Pretreatment other No
Clean Out Depth:
5
Clean Out Depth:
12
than forebay?
Sediment Removal El:
9
Sediment Removal El:
2
Has Veg. Filter? No
Bottom Elevation:
8 J
Bottom Elevation:
1
STORM-EZ 5/7/2020
Version 1.4 O&M Manual Page 5 of 5

r
DEMLR USE ONLY
Date eceived
Fee Paid 4(6 p
Permit Number
as
aoov= 10 a "`'
005 D
Applicable Rules- ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph H - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
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.):
The Greenside Manors at Brick Landing Plantation
2. Location of Project (street address):
Goose Creek Road (SR1155) Adjacent 1853 Goose Creek Road
City: Ocean Isle Beach County:Brunswick Zip:28469
3. Directions to project (from nearest major intersection):
From the intersection of NC 179 and Goose Creek Road, travel south on Goose Creek Road for approximately
1 mile, project on the left.
4. Latitude:33° 54' 17.68" N Longitude:-78° 24' 20.99" 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 SWl i 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 , its issue date (if known), , 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 ❑Other
If this application is being submitted as the result of a previously returned application or a letter from
DEMLR requesting a state stormwater management permit application, list the stormwater project
number, if assigned, 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 MSedimentation/Erosion Control: 9.83 ac of Disturbed Area
❑NPDES Industrial Stormwater 0404/401 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 W. http://portal.ncdenr.org/web/Ir/rules-and-regulations
1`
BY
Form SWU-101 Version Oct. 31, 2013 Page 1 of 6

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 1rp ect):
Applicant/Organization: Kent W. Colton & Kathryn P. Colton
Signing Official & Title: Kent Colton, Owner
b. Contact information for person listed in item 1a above:
Street Address:936 SpringjM Rd.
City: McLean State: VA Zip:22102
Mailing Address (if applicable):SAME
City: State: Zip:
Phone: (202 ) 340-5577 Fax: ( )
Email:kcoltonUc@p_mail.com
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:
Signing Official & Title:
b. Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if
State: Zip:
City: State: Zip:__
Phone: ( ) Fax: ( )
Email:
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: East Coast Engineering & Surveying, PC
Signing Official & Titlej. Christian Russell, P.E. - Project Engineer
b. Contact information for person listed in item 3a above:
Mailing Address:PO Box 2469
City:Shallotte
Phone: (910 ) 754-8029
Email:[e-mail]
4. Local jurisdiction for building permits: Brunswick
Point of Contact:Tim Evans
State:NC
Zip:28459
Fax: (910 ) 754-8049
Phone #: (910 ) 842-6080
Form SWU-101 Version Oct. 31, 2013 Page 2 of 6
MAY 21 20
J
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 project):
Applicant/Organization:CTC Brunswick Holding, LLC
Signing Official & Title:Kent Conine, Manager
b. Contact information for person listed in item 1a above:
Street Address:2013 Rolling Rock Road
City:Wake Forest State:NC Zip:27587-6271
Mailing Address (if applicable):SAME
City:
State: Zip:
Phone: (972 ) 386-6600 Fax:
Email:[e-mail]
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:
Signing Official &
b. Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if applicable):
City:
Phone: ( )
Email:
State: Zip:
State: Zip:
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 the project:
Other Contact Person/Organization: East Coast Engineering & Surveying, PC
Signing Official & Titlej. Christian Russell, P.E. - Project Engineer
b. Contact information for person listed in item 3a above:
Mailing Address:PO Box 2469
City:Shallotte State:NC Zip:28459
Phone: (910 ) 754-8029 Fax: (910 ) 754-8049
Email:[e-mail]
4. Local jurisdiction for building permits:
Point of Contact:Tim Evans
BY:
Form SWU-101 Version Oct. 31, 2013 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Stormwater runoff will sheet flow from impervious surfaces and roadways to curb inlets then to an onsite
stormwater pond for treatment before being released.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
ElApproval 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 H - Post Construction
3. Stormwater runoff from this project drains to the Lumber River basin.
4. Total Property Area: 9.83 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+:9.83 acres
+ Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHM line or Mean High Water
(MHM line, and coastal wetlands landward from the NEW (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 MHM line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 45.6 %
9. How many drainage areas does the project have?2 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below. L-06\
Basin Information
Drains a Area 1
Drains a Area 2
Drains a Area 3
Drains a Area _
Receiving Stream Name
Goose Creek
Goose Creek
Goose Creek
Stream Class *
C;Sw
C;Sw
C;Sw
Stream Index Number *
15-25-2-16-4-(1)
15-25-2-16-4-(1)
15-25-2-16-4-(1)
Total Drainage Area (sf)
428,201
313,238
114,963
On -site Drainage Area (sf)
428,201
313,238
114,963
Off -site Drainage Area (so
0
0
0
Proposed Impervious Area" s
195,398
144,416
50,982
% Impervious Area** total
45.6
46.1
44.3
Im ervioue' Surface Aiea
Drainage Area 1
Drainage Area 2
Drainage Area 3
Drainage Area
On -site Buildings/Lots (sf)
156,000
120,000
36,000
On -site Streets (sf)
39,398
24,416
14,982
On -site Parking (sf)
0
On -site Sidewalks (sf)
0
Other on -site (sf)
1 0
Future (sf)
0
Off -site (sf)
0
Existing BUA*** (sf)
0
Total (sf):
195,398
144,416
50,982
* Stream Class and Index Number can be determined at: http.Y&ortal.ncdenr.orq[ps/csu/ciassifications
Im ervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidpewalks, gravel areas, etc.
*** Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new BUA.
Form SVJU-101 Version Oct. 31, 2013 Page 3 of 6

11. How was the off -site impervious area listed above determined? Provide documentation.
Projects in Union County: Contact DEMLR Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 1 SA NCAC 02B . 0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater man.agemen..t permitsupplement and operation and rooiritenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http://portal.ncdenr.org/web/wg/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
http://12ortal.ncdenr.org/web/wq/ws/su/statesw/forms_docs. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map athttp://12ortal.ncdenr.org/web/wg/ws/su/ma2s.)
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
hop://portal.ncdenr.org/web/wg/ws/su/statesw/forms does.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. MR I
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part V11 below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M "J(
agreement(s) for each BIVIP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
h2g://www.envhelp.org/pages/onestopexl2ress.htmi 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/management for
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the Z&
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.
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. ' '•r
j. Site Layout with all BUA identified and dimensioned. tf
k. Existing contours, proposed contours, spot elevations, finished floor elevations. MAY
1. Details of roads, drainage features, collection systems, and stormwater control measureR �
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a �Y•
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).
Form SWU-101 Version Oct. 31, 2013 Page 4 of 6

9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to
A e the w 11 f th b 1 ti th th tin
a ma
p ) as— as p e orwi o mg oca ons a exis g
elevations and boring logs. Include an 8.5"x11" 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 DEMLR to verifij the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 02842 Page No: 0455
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 1a, 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.
httg://www.secretaly.state.nc.us/Corporations/CSearch.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 http://portal.ncdenr.org/web/Ir/state-
stormwater-forms 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 claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMLR, 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 for this project (such as
addressing requests for additional information).
Consulting Engineer:T. Christian Russell, P.E.
Consulting Firm: East Coast Engineering & Surveying, PC
Mailing Address -PO Box 2469
City:Shallotte State:NC Zip:28459
Phone: (910 ) 754-8029
Email:[e-mail]
Fax: (910 ) 754-8049
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) , 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 1a) with (print or type name of organization listed in
Contact Information, item 1a) 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.
y
---------------------
Form SWU-101 Version Oct. 31, 2013 Page 5 of 6

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 DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR 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 i a viol4Uk7 of NC General Statue 143-215.1 and may result in appropriate enforcement
action including sessivil penalties of un to $25.000 ver day, pursuant to NCGS 143-215.6.
Date: S % U
I, W-CA,ati `1E3
uGkvJ% r1 Cke-r
a Notary Public for the State of
County of
-N:)0.N\g4
, do hereby certify
that YMv1l Co-r -%\ •n e.-
personally appeared
before me this -i day of AO , and acknowledge the duel execution of the application for
a stormwater permit. Witness my hand and official seal, 11iMl�w►d�
WENDY BUCHBINDER
Notary Public, State of Texas
Comm. Expires 07-12-2020
Notary ID 84027
X. APPLICANT'S CERTIFICATION
SEAL
My commission expires _'11t a \ a0
I, (print or type name of person listed in Contact Information, item 1a) Kent Conine, Manager
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 reSqr4rVand that the proposed project complies with the requirements of the
applicable stormwate es un CAC 2H .1000 and any other applicable state stormwater requirements.
Signature: Date: S %
I, i IH61 rXA-` , a Notary Public for the State of `�'G�°��t 5 County of
3C6'Wltct-i , do hereby certify that Vven t CUn r% G. personally appeared
before me this day of '22 2P and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
WENDY BUCHBINDER
Notary Public, State of Texas
' e Comm. Expires 07 12-2020
Notary ID 84027
SEAL.
My commission expires l J a L a o
T .pr
2020 'I
�9
Form SNNU-101 Version Oct. 31, 2013 Page 6 of 6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my des'gnated
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 DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is m responsibility to notify DEMLR 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: Date:.
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 expires
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item 1a) Kent Colton. Owner
certi that the information included on this permit application form is, to the best of my knowledge, correct and
that a 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 stormwat rules 15A NCAC 2H .1000 and any other applicable state stormwater requirements.
Signature: Date:/7 �d
1. YYI IrL� e— _ 1 a Notary Public for the State` of County of
do hereby certify that '�`��'�' w . C� U 11�- personally appeared
before me this day of mow
cq3 and acknow the due ea the application for
a stormwater permit. Witness my hand and official seal,
SAMUEL ZEAAI
NOTARY PUBLIC
COMMONWEALTH OF VIRGINIA
MY COMMISSION EXPIRES FEB, 28, 2023
COMMISSION * 7508412
SEAL
My commission expires_21� (�� Z3
MAY 1
BY
Form SWU-101 Version Oct. 31, 2013 Page 6 of 6

SUPPLEMENT-EZ COVER PAGE
r— FORMS LOADED I
PROJECT INFORMATION
1
1 Proiect Name THE GREENSIDE MANORS
2
Proffiect Area ac) 9.83
3
Coastal Wetland Area (ac)
0
4
Surface Water Area (ac)
0
5
Is this project High or Low Density?
i
6
Does this project use an off -site SCM? NO
NTH
1 9 1 Is BUA other that as listed in .1003(4)(cd) out of the setback?
1 10 Its strearnbank stabilization proposed on this Droiect?
NUMBER AND TYPE OF SCMs:
1 11
Infiltration %Istem
0
12
-
Bioretention Cell
0
13
Wet Pond
14
Stormwater Wetland
0
15
Permeable Pavement
0
16
Sand Filter
0
17
Rainwater Harvesting (RWH)
0
18
Green Roof
19
Level Spreader -Filter Strip (I-S-FS)
0
20
Disconnected Impervious Surface (DIS)
0
21
Treatment Swale
0
22
Dry Pond
0 1
23
Storm Filter
0
24
25
Silva Cell 0
Bay liter 0
26
Filterra 0
I FORMS LOADED
DESIGNER CERTIFICATION
27
Name and Title:
J. Chrisban Russell, .F.E./PrdeqEn . j_ _9.ineer
28
Organization:
Street address:
City, State, Zip:
1 Phone number(s):
1 Email:
ii
East Coast Lnginepring &.qurvring Eq .
4918 Main Street
Sballotte, NC
910-754-8029
[e-mail]
29
30
1 31
32
Certification Statement
I certify, under penalty of law that this Supplement-EZ form and all supporting information were prepared under my direction or supervision,
that the information provided in the form is, to the best of my knowledge and belief, true, accurate, and complete, and that the engineering
plans, specifications, operation and maintenance agreements and other supporting information are consistent vAh the information provided
here
X%111111111' f
CARP
35054 Z
5-28-2020 !.J
"Vis. I Nse.
tiR
.--
Signature of Designer
RECE"vE�
MAY is � `'
Date
5-28-2020

DRAINAGE AREAS
1 Is this a high density project?
2 If so, number of drainage areas/SCMs 1
Is all/part of this project subject to previous rule i
3 versions? ; No v
FORMS LOADED
DRAINAGE
AREA INFORMATION
Entire Site
1
4
Type of SCM
WETPOND
5
_
Total BUA in project!
_
R
6permitting)
New BUA on subdivided lots (subject to
s ft¢
"
7permitting)
New BUA outside of subdivided lots (subject to
s
sf
+ 8
Offsite - total area ft
_ _195938
sf
- ~-~-� sf
9
Offsite BUA s ft----
10
Breakdown of new BUA outside subdivided lots:
-Parking s ft
Sidewalk (sq ft
- Roof (sq ft_
- Roadwaysq ft) _
-Future (sq ft
- Other, please specify in the comment box
below (sq ft_
New infiltrating permeable pavement on
subdivided lots ft
New infiltrating permeable pavement outside of
lots ft
156000 sf
39398 sf_
11
12 isubdivided
13permitting)
Ebsitng BUA that will remain (not subject to
s ft_
E)dsting BUA that is already permitted (sq ft) _ ^�—
E)dsting BUA that will be_removed ft
Percent BUA '
14
1 15
_
16
46%
17
Design storm inches
-
1.5 in _
�24659 cf�~
18 IDesign
_
volume of SCM cu ft
19 I Calculation method for design volume
ADDITIONAL INFORMATION __. _ _ �,
Please use this space to provide any additional information about the
20 ldrainage area(s).
Rational
The design volume is 24,659 CF The actual volume of the SCM�is 25,036
CIF

WET POND
flDrainage area number
3
Is the SCM sized to treat the SW from all surfaces at build -out? YES
J 4
_ _
Is the SCM located away from contaminated soils? Y.ES '
5
What are the side slopes of the SCM (H:V)?
6
?i 7
r
Does the SCM have retaining walls, gabion walls or other engineered
side slopes? _ YES _
Are the inlets, outlets, and receiving stream protected from erosion
(10-year storm)? YES
8
Is there an overflow or bypass for inflow volume in excess of the
design volume? YES
9
What is the method for dewatering the SCM for maintenance?
i Pump (preferred)
10
If applicable, will the SCM be cleaned out after construction?
11
Does the maintenance access comply with General MDC (8)?
YES
12
Does the drainage easement comply with General MDC (9)?
j YES
13
If the SCM is on a single family lot, does (will?) the plat comply with
General MDC (10)?
14
Is there an 0&M Agreement that complies with General MDC (11)?
YES
15
Is there an 0&M Plan that complies with General MDC (12)?
_
16
Does the SCM follow the device specific MDC?
_ _YES
YES
17 Was the SCM designed by an NC licensed professional? j y�
YES
WET POND MDC FRQM Off," .1053
18 Method used $A/pq
19
Has a stage/storage table been provided in the calculations? F YES _
20
Elevation of the excavated main pool depth (bottom of sediment i
removal) (fmsl) 1.00
21
_
Elevation of the main pool bottom -(top of sediment removal) (fmsq 2.00
22
Elevation of the bottom of the vegetated shelf (fmsl) _ 13.00
23
Elevation of the permanent pool (fmsQ 14.00�
24
eva ion Ot the top of the vegetated Shelf s
20
Elevation or the temporary pool ms'-
Surface area of the main permanent pool (square feet)
26
27
Volume of the main permanent pool (cubic feet)
�43443 CF
28
Average depth of the main pool (feet)
6.40 ft
29
Average depth equation used
Equation 3
30
31
If using equation 3, main pool perimeter (feet)
It using equation 3, width of submerged veg. shelf ee
403,6 ft
volume of the forebay (Cubic feet)
IS this o Of e volume ;n the main poore
ciean-oUt depthor forebay (inches)rn
Design volume o cu
36j
Is the outlet an orifice or a weir?
ORIFICE '
37
If orifice, orifice diameter (inches)
2.5_i_n
38
If weir, weir height (inches)
_ —
it weir, weir length (Inches)
Drawdowri time forlhe temporary pool (days)
'
; 41
Are the inlet(s) and outlet located in a manner that avoids short-
circuiting?
YES
42
Are berms or baffles provided to improve the flow path?
_ _
43
Depth of forebay at entrance (inches)
- �- 78 in '
44
Depth of forebay at e)dt (inches)
72 in
45
Does water flow out of the forebay in a non -erosive manner?
YES _
4 46
Width of the vegetated shelf (feet)
6 ft - �-
47
Slope of vegetated shelf (H:V)`-
48
Does the orifice drawdown from below the top surface of the
permanent pool?
—
YES
49
Does the pond minimize impacts to the receng channel from the 1- ivi
yr, 24-hr storm?
YES_
50
Are fountains proposed? (If Y. please provide documentation that
MDC(9) is met.)
_
NO
51
Is a trash rack or other device provided to protect the outlet system?
YES_
52
Are the dam and embankment planted in non -dumping turf grass?
_
53
Species of turf that will be used on the dam and embankment
' SOD-
SOD-
*41
*
Has a planting plan been proMded for the vegetated she t
-- YES`
"ADDITIONAL INFORMAT1_0N µ '
i Please use this spaceto prov a ariy additional information about the
55 wet pond(s):
__
THIS POND USES VERTICAL WALLS ABOVE THE TOP OF THE SHELF
FOR THE TEMPORARY STORAGE VOLUME
Wet Pond 3 3:48 PM 5/28/2020

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, Kent Conine , 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:
i. The following covenants are intended to ensure ongoing compliance with State Stormwater
Management Permit Number , as issued by the Division of Energy, Mineral and
Land Resources 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 Energy, Mineral and Land Resources.
5. Alteration of the drainage as shown on the approved plan may not take place without the concurrence
of the Division of Energy, Mineral and Land Resources.
6. The maximum allowable built -upon area per lot is _4,000 square feet. This allotted amount includes
any built -upon area constructed within the lot properly boundaries, and that portion of the right-of-way
between the front lot line and the edge of the pavement. Built upon arcs 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
riot required to provide these additionai measures.
0"CrEIVEM
Form DRPC-3 Rev.2 05Nov2009 Page 1 of 2
Blf�

High Density Residential Subdivisions
Signature:
State of
Deed Radrictions & Protective Covenances
' Date: -� ?
a Notary Public in the
County of "�a l l a y ,
do hereby certify that CDn'ty-te personally appeared
before me this the day of YY\(X , 2020 , and acknowledge
the due execution of the foregoing instrument. Witness my hand and official seal,
Signature
My Commission expires :2 l } a.' 2KQ
SEAL
WENDY B BIN EF(
TexaE
Notary Public, State o
Comm. Expires 07 12 2020
Notary IL27==
Form DRPC-3 Rev.2 05Nov2009 Page 2 of 2

f
Signature:
High Density Residential 3 bdivisi, ions
Deed Restrictions & Protective Covenanges
W pl�-�
8-161�m
a Notary Public in the
State of \j t!r%rt t;, County of i2zr
r• `
do hereby certify that Ar e-�k Vim' `- !2s , personally appeared
before me this the ay of , 20 , and acknowledge
the due execution of the foregoing instrument. Witness my hand and official seal,
SEAL
SignatCM
My Commission expires Z I IT l � � SAMUEL ZE
NOTARY PUBLICc
Al
-� t COMMONWEALTH OF VIRGINIA
MY COMMISSION EXPIRES FEB. 28, 202.9
COMMISSION # 7508g12
Form DRPC-3 Rev.2 05Nov2009 Page 2 of 2