SW6211101_Supplement-EZ Form_20220105

SUPPLEMENT-EZ COVER PAGE
LOAD SUPPLEMENT FORMS
PROJECT INFORMATION
1 1 Project Name
MASON RIDGE SUBDIVISION
2
Project Area ac
33.61
3
Coastal Welland Area ac
4
Surface Water Area (ac)
1.49
5
Is this ro ect High or Low Density?
LOW
6
Does this project use an off -site SCM?
No
COMPLIANCE WITH 02H .1003(4)
7 ;Width of ve elated setbacks provided (feet
8 IWIII the vegetated setback remain vegetated?-
-9 lis BUA other that as listed in .1003(4)(c-d) out i
10 I Is streambank stabilization proposed on this
setback?
No
YNUMBER AND TYPE OF SCMS:
11 ; Infiltration System _ 0
12 Bioretention Cell 0
13
Wet Pond
0
14
Stormwater Wetland
0
15
Permeable Pavement
0
16
Sand Filter
0
17
Rainwater Harvesting RWH
0
18
lGreen Roof _
0
_
Level Spreader -Filter Strip (LS-FS)
0
20
Disconnected Im ervious Surface DIS
0
F19
21
Treatment Swale — n 7 mi
16
22
Pond
0
23
StofmFifter
0
24
Silva Cell
0
25
Bayfifter
0
26
Filterra _
0
LOAD SUPPLEMENT FORMS
DESIGNER CERTIFICATION
27 ; Name and Title: KEN W. BRIGHT
28
O anization:
KEN BRIGHT ASSOCIATES PLLC
29
Street address:
2305 CARTHAGE ST
30
City, State, Zip:
SANFORD, INC 27330
31
Phone numbers :
919-776-3444
32
Email:
[e-mail]
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
with the information provided here.
Sic-.
t'•
SEAL
17535IV
.
,ft. - �& b 4 tsy
Signatur of Designer
//5/ 20 Z Z
Date