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HomeMy WebLinkAboutSWA000119_Application Form_20220211DEMLR USt= ONLY Date Received Fee Paid Permit Number SW Program(s): ❑ Coastal SA-HQW F-1 Coastal SA-ORW ❑ Coastal FW-ORW ❑ Coastal Other ❑ Non -coastal HQW ❑ Non -coastal ORW ❑ Urbanizing Areas ❑ USMP NC DEQ Division of Energy, Mineral and Land Resources STATE STORMWATER FAST TRACK PROCESS: "AUTHORIZATION TO CONSTRUCT" (ATC) PERMIT APPLICATION FORM Link to Application Instructions A. ELIGIBILITY FOR FAST -TRACK PERMITTING To be considered for a Fast Track ATC Permit, all of the items below must be checked. If any item cannot be checked, then the project must apply under the Standard Permitting Process. ® The project and all SCMs (including existing SCMs associated with the project) will meet all applicable requirements of 15A NCAC 02H .1000 - .1062, including the Minimum Design Criteria (MDC), upon project completion. ® The project is not proposing an alternative design. ® The project is not claiming an exemption from the MDC based on vested rights, a waiver or a Director's Certification. ® The project is not out of compliance with an existing stormwater permit or any other environmental permit. ® The project is not applying for an offsite permit, an exemption, or a minor modification (as defined in 15A NCAC 02H .1002(25)) to an existing state stormwater permit. ® The project application bears the signature and seal of a professional licensed pursuant to either Chapter 89A or 89C of the NC General Statutes. ® I understand that at project completion, an application with the as -built stormwater plans (as described in 15A NCAC 02H .1044 must be submitted, and DEQ will review the as -built stormwater plans to confirm compliance with the MDC. Approval of the as -built stormwater plans will be required before the Erosion and Sedimentation Control Plan for the project may be closed out. ® I understand that the Fast Track ATC Permit will expire five years after the date of issuance. B. GENERAL INFORMATION 1 Project Name: Duncan's Creek 2. Previous Project Name (if applicable): NIA 3. Location of Project (street address): South of Old US-421 between Diann Street & Widgeon Way City: Lill ington County:Harnett Zip27546 4. Directions to project (from nearest major intersection): 1 st entrance driveway (right turn in) —4000 feet east of intersection of Old US-421 and Peach Farm Rd 2nd entrance driveway left turn in --1700 feet east of intersection of McDou ald Road and Peach Farm Rd "Coordinates given below for entrance along US-421 _ 5. Latitude:35° 24' 53.08" N Longitude:78� 53' 28.39" W of the main entrance to the project. C. PERMIT INFORMATION 1. Specify whether project is (check one): ® New, no previous application ❑ New, replacing a previous Fast Track ATC Permit -- provide previous permit number: SWA Storrnwater Fast Track ATC Application Form Page 1 of 12 Feb. 10. 2018 By choosing this option, you are also requesting that DEQ rescind the previous Fast Track ATC Permit upon issuance of the now Fast Track ATC Permit. 5tormwater Fast Track ATC Application Farm Page 2 of 12 Feb. 10, 2018 ❑ Major Modification, replacing an existing stormwater permit — provide existing permit number: SW Status of construction? ❑ Not Started ❑ Partially Completed ❑ Completed Major modifications must be submitted by the original permittee and are allowed only if the SW permit is not expired. Minor modifications must use Standard Permitting Process. By choosing this option, you are also requesting that DEQ rescind the previous SW Permit upon issuance of the now Fast Track A TC Permit. ❑ Transfer of existing Fast Track ATC Permit — provide existing ATC permit number: SWA 2. Applicable state stormwater program(s) (check all that apply): ❑ Coastal SA-HQW ® Urbanizing Areas (Phase 2) ❑ Coastal SA-ORW ❑ Non -Coastal HQW Is any portion of the project within 575 feet of SA-ORW waters? ❑ Yes ❑ No ❑ Non -Coastal ORW ❑ Coastal Freshwater ORW ❑ USMP ❑ Coastal — Other 3. Other Permits (as applicable; write "NA" for those permit types that are not applicable): Project Name PermitlAppl Issue Date Other Information No. CAMA Major NA Erosion & Disturbed Area Sedimentation Control acre NPDES Industrial NA Stormwater 4041401 Permit Proposed Impacts I€lac 4. Local jurisdiction for building permits: Harnett County Point of Contact: Buildings Inspections Division Phone #: ( 910 ) 893-0311 D. CONTACT INFORMATION 1. Applicant/Financially Responsible Party (may be an Organization):Duncan's Creek Developers, LLC Signing Official Name & Title:Rob Bailey Street Address:1611 Jones Franklin Road, Ste 101 City:Raleigh Mailing Address (if different): City: State: NC Zip:27606 State: Zi Phone: (919) 446-6865 Fax: ( ) Email: Rob.Baileyareliabuilt.biz 2. If the Applicant is a Corporation or LLC (Address must match address on file with NC Dept of the Secretary of State): Name of Registered Agent.-Duncan's Ceek Devlopers, LLC Mailing Address:1611 Jones Franklin Road, Ste 101 City:RaI60 State:NC Zip:27606 Phone: (919) 446-6865 Fax: ( ) Email:Rob. Baley(a7reliabuilt.biz Stormwater Fast Track ATC Application Form Page 3 of 12 Feb. 10, 2018 3. The Applicant is the (check all that apply): ® Property Owner ❑ Lessee (Attach a copy of the lease agreement & complete Item 4.) ❑ Purchaser (Attach a copy of the pending sales agreement & complete Item 4.) ❑ Developer (Attach a copy of the development agreement & complete Item 4.) 4. If the Applicant is NOT the Property Owner (skip to Item 5 if the Applicant IS the Property Owner): Property Owner Name/Organization: Signing Official & Title: Street Address: C itv: Mailing Address (if applicable): City: Phone: ( ) Email: State: Zip: State: Zip: Fax: ( ) 5. The licensed Design Professional that will be retained for the duration of the project, who may provide information on the Applicant's behalf, and who will prepare and certify the as -built package: Consulting Engineer/Landscape Architect: Jeremy Keeny Consulting Firm: Morris & Ritchie Associates of NC, PC Mailing Address:5605 Chapel Hill Road, Ste 112 City -.Raleigh State -.NC Zip:27607 Phone: (984 ) 200-2103 Fax: ( ) Email: ikeenyCcDmragta.com 6. [OPTIONAL] If you would like to designate another person to answer questions about the project: Name & Title: Organization: Mailing Address: City: State: Zip: Phone: ( ) Fax: Email: E. PROJECT INFORMATION 1. Specify the type of project (check one): ® Low Density ❑ High Density 2. Briefly summarize how the stormwater runoff will be treated/conveyed: Stormwater Fast Track ATC Application Form Page 4 of 12 Feb. 10, 2018 The Stormwater Management Plan for this project utilizes the low -density option with less than 24% imervious area proposed. Proposed layout and associated grading have been designed to maximize dispersed flow through vegetated areas and miminize channelization of flow. In situations where this cannot be achieved stormwater runoff will be routed through roadside swales and a limited amount, of piping under intersections where necessary into existing wetlands. Design of vegetated swales and crossing culverts will be conveyed to prevent erosion during peak flow from the 10-year storm as is the standard NCDEQ requirement. 3. Stormwater runoff from this project drains to the Cape Fear River basin(s). 4. Receivinq water information (if more than 3 receivina waters, provide additional information on an attached sheet): Receiving Water 1 Receiving Water 2 Receiving Water 3 Receiving Stream Name Duncan's Creek Stream Classification C Stream Index Number 18-20-25 Stormwater Fast Track ATC Application Form Page 5 of 12 Feb. 10, 2018 Proiect area and densitv information: Total Property Area 9,291,193 sf Total Surface Water Area 114,139 sf Considered to include: • the normal pool of impounded structures; • the area between the banks of streams and rivers; and • the area below the Normal High Water (NHM line or Mean High Water (MHM line. Total Coastal Wetlands Area 0 sf Considered to include: coastal wetlands landward from the NHW (or MHWJ line. Total Project Area 9,177,054 sf Excludes the surface water area and coastal wetland area identified above. May or may not be the same as Property Area. Built -Upon Area (BUA) associated with Existing Development 0 sf "Existing development" means those projects that are built or those projects that have established a vested right under North Carolina law as of the effective date of the state stormwater program or applicable local government ordinance to which the project is subject. Proposed New BUA 2,214,904 sf Includes proposed new BUA that is not associated with existing development. `BUA" is defined in N. C. G.S. 143-214. 7(b2), It includes, but is not limited to: buildings, roads, parking areas, sidewalks, and some gravel areas. The design volume of SCMs must take into account the runoff from build out from all surfaces draining to the SCM in accordance with 15A NCAC 02H .1050(1). Project Density w/ Existing Development: Project Density = [New BUA]/(Total Project Area — Existing BUA] x 100 or 24.1 % w/o Existing Development: Project Density = [New BUA]/Total Project Area] x 100 6. Anticipated construction start date Ocober 15, 2021 7. Is the project located within 5 miles of a public airport? ® No ❑ Yes If `Yes,'see S.L. 2012-200, Part VI: http://www.ncleg.net/Sessions/2011/BiIls/Senate/PDFIS229v6.pdf and DEO Stormwater Design Manual Chapter E-4 Airports. 8. For projects in Union County: Contact DEMLR Central Office Stormwaterstaff at 919-707-9200 to determine if the project is located within a Threatened & Endangered Species watershed that may be subject to more stringent stormwater requirements per 15A NCAC 02B .0600. Stormwater Fast Track ATC Application Form Page 6 of 12 Feb. 10, 2018 F. 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 HOWIORW). Only application 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: Initials JK 1. Two original signed hard copies and one electronic copy of this State Stormwater Fast Track Process "Authorization to Construct" (ATC) Permit Application Form. JK 2. Permit application processing fee of $505 payable to NCDEQ. JK 3. Two hard copies and one electronic copy of a USGS map identifying the project location and GPS coordinates for the project. If the receiving water is Class SA or the receiving water drains to Class SA waters within'h mile of the project boundary, include the '/z mile radius on the map. If the project is within 575 feet of Class SA-ORW waters, include the 575-foot radius on the map. JK 4. Two original signed hard copies and one electronic copy of a site plan depicting the boundary of the project or project phase currently being permitted, including the locations of SCMs, streams, wetlands, and buffers. JK 5. Two hard copies and one electronic copy of a construction sequence that discusses how any future development on the project may be phased. JK 6. A copy of the most current property deed. Deed book: 4096 Page No: 455-456 JK 7. [IF APPLICABLE] When the applicant is a corporation or a limited liability corporation (LLC): Provide two hard copies 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). The corporation or LLC must be listed as an active corporation in good standing with the NC Department of the Secretary of State; otherwise, the application will be returned. https://www.sosnc.gov/search/index/corp NIA 8. [IF APPLICABLE] When the applicant is a Partnership or other person engaging in business under an assumed name, attach a copy of the Certificate of Assumed Name. 9. [IF APPLICABLE] When the applicant is not the property owner: Provide two hard copies and one electronic copy of lease agreements, affidavits, pending sales agreement, development agreement, or other documents showing that the applicant has obtained legal rights to submit a stormwater permit application within the proposed project area. NIA 10. [IF APPLICABLE] If modifying an existing permit for completed or partially completed projects, a copy of the designer's certification. Stormwater Fast Track ATC Application Form Page 7 of 12 Feb. 10, 2018 G. CERTIFICATION OF APPLICANT/ FINANCIALLY RESPONSIBLE PARTY The Applicant, who is also the Financially Responsible Party, identified in Section D of this form must sign and have notarized the following guaranty: LL� � 1, (print or type name of Applicant/Financially Responsible Party) C C certify that the information included on this permit application form is, to the best of my kn wledge, correct and that: 1. the design has been or will be completed in accordance with the MDC as set forth in Rules 15A NCAC 02H .1050 through .1062, to the best of my knowledge; 2. the completed design meets or will meet the MDC and that the percentage BUA that is the basis for the design shall not be exceeded, to the best of my knowledge; and 1 As the applicant, I shall maintain a licensed professional of record for the duration of the project who will prepare and certify the as -built package. If I retain another licensed professional before the project is complete, then I shall provide an updated guaranty with the current licensed professional's seal. A licensed professional shall inform the Division if he is no longer associated with this project. The above information is true and correct to the best of my knowledge and belief and was provided by me under oath I agree to provide corrected information should there be any change in the information provided herein. ype/16prin name Title or Authority <.. G� Signature Date z1/Q z2- , it 6, �Y1% • 1 a Notary Public for the State of N G County of VV 0,1<0 do hereby certify that t l" personally appeared before me this 0 day of R b r\, and acknowledge the due execution of the application for a stormwater permit. Witness my hand and official seal, MARY K CLIFFORD NOTARY PUBLIC WAKE COUNTY STATE OF NORTH CAROLINA SEAL My commission expires A'O Stormwater Fast Track ATC Application Form Page 8 of 12 Feb. 10, 2018 Stormwater Fast Track ATC Application Form Page 9 of 12 Feb. 10, 2018 H. DESIGN PROFESSIONAL'S CERTIFICATION To be completed by the Design Professional identified in Section D.5. 1, Jeremy M. Keeny, PE, PLS , attest to the following: 1. This application has been reviewed by me and is accurate and complete, to the best of my knowledge; 2. The design has been completed in accordance with the MDC as set forth in Rules 15A NCAC 02H .1050 through .1062, as applicable; 3. The percentage built -upon area that is the basis for the design will not be exceeded; and 4. 1 have the expertise, education, and experience required to design the SCMs proposed in this application in accordance with the MDC as set forth in Rules 15A NCAC 02H .1050 through .1062. 5. 1 will provide all documents and certified as -built plans in hard copy and electronic format related to this permit to a new Applicant/Property Owner and to DEMLR upon transfer of this permit to a new Applicant/Property Owner. Note: In accordance with N.C.G.S. 143-215.6A and 143-215.613, any person who knowingly makes any false statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation. In addition, any person who knowingly makes any false statement, representation, or certification in any application may be reported to the appropriate NC professional licensing board. Signature: l Date: 2111122 �N C'41�0< = s� AL A397O9 `.• 2 /11/2 2,�Z F• •.,�My� MY`' SEAL Stormwater Fast Track ATC Application Form Page 10 of 12 Feb. 10, 2018 I. PROPERTY OWNER'S AUTHORIZATION (IF APPLICANT IS NOT THE PROPERTY OWNER) I, (print or type name of the Property Owner) , certify that I own the property identified in this permit application, and thus give permission to (print or type name of Applicant) with (print or type name of Applicant's organization) to develop the project as currently proposed. A copy of the lease agreement or pending property sales contract has been provided with the submittal, which indicates the party responsible for the operation and maintenance of the stormwater system. As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their lease agreement, or pending sale, responsibility for compliance with the 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 is a violation of NC Generai 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: a Notary Public for the State of County of , do hereby certify that Date: personally appeared before me this day of 1 , and acknowledge the due execution of the application for a stormwater permit. Witness my hand and official seal, I.yyGll My commission expires Stormwater Fast Track ATC Application Form Page 11 of 12 Feb. 10, 2015 J. CERTIFICATION OF CURRENT PERMITTEE (COMPLETE ONLY IF PERMIT TRANSFER IS REQUESTED) 1, (print or type name of the Current Permittee) am submitting this request for a transfer of Fast Track ATC permit # SWA With the submission of this transfer request I am providing a copy of the most recent permit, all related documents and as - built plans certified by my design professional in hard copy and electronic format to the Proposed Perm itteefApplicant identified in Section G of this application and to (DEMLR . I further attest that this request for a permit transfer is accurate and complete to the best of my knowledge. I assign all rights and obligations as permittee to the proposed permittee named in Section G of this form. Signature: County of personally appeared before me this a Notary Public for the State of do hereby certify that day of (Date: , and acknowledge the due execution of the application for a stormwater permit. Witness my hand and official seal, SEAL My commission expires Stormwater Fast Track ATC Application Form Page 12 of 12 Feb. 10, 2018 SOS1D: 2346500 Date riled: 1/31/2022 8:28:00 AM ,.State of'North Carolina Elaine F. Marshall North Carolina Secretary of State Department of the Secretary of State C2022 028 01847 Limited Liability Company ARTICLES OF ORGANIZATION Pursuant to §57D-2-20 of the General Statutes of North Carolina, the undersigned does hereby submit these Articles of Organization for the purpose of forming a limited liability company. 1, The name of the limited liability company is: Duncan's Creel( Developers, LLC (see Item I of the Instructions for appropriate entity designation) 2. The name and address of each person executing these articles of organization is as follows: (State whether each person is executing these articles of organization in the capacity of a member, organizer or both by checking all applicable boxes.) Note: This document must be signed by all persons listed. Name Business Address Capacity Paige Marchbanks 1611 Jones Franklin Rd., Ste 101 Raleigh, NC 27606 OMemberMOrganizer ❑Member ❑Organizer ❑Member []Organizer 3. The name of the initial registered agent is: RtR Development Group Of NC, LLC 4. The street address and county of the initial registered agent office of the limited liability company is: Number and Street 1611 Jones Franklin Rd., Ste 101 CityRaleigh State: NC Zip Code: 27606 County: Wake 5. The mailing address, if different from the street address, of the initial registered agent office is: Number and Street City State: NC Zip Code: County: 6. Principal office information: (Select either a or b.) a. The limited liability company has a principal office. The principal office telephone number: 91 9-239-4747 x110 The street address and county of the principal office of the limited liability company is: Number and Street: 1611 Jones Franklin Rd., Ste 101 City: Raleigh State: NC Zip Code: 27606 County: Wake BUSINESS REGISTRATION DIVISION P.O. BOX 29622 Raleigh, NC 27626-0622 (Revised August. 2017) Form L-01 The mailing address, ifdifferent from the Street address, of the principal office ofthe company is: Number and Street: City: State: Zip Code: County; b. ❑ The limited liability company does not have a principal office. 7. Any other provisions which the limited liability company elects to include (e.g., the purpose of the entity) are attached. 8. (Optional): Listing of Company Officials (See instrtrctiuns on the iruportance of listing the company officials in the rrn9iinn dn"limrnt Name Title Business Address Richard L Van Tassel, 11 Manager 1611 Jones Franklin Rd., Ste 101 Raleigh, NO 27606 Rob Bailey Manager 1611 Jones Franklin Rd., Ste 101 Raleigh, NO 27606 9. (Optional): Please provide a business e-mail address: Paige,Marchbanks@Reliabuilt.biz The Secretary of States Office Will c-marl tile business automatically at the address provided above at no cost when a document is filed. The e-mail provided will not be viewable on the website. For more information on wlly this service is offered, please see the instructions for this doctu11cr1t. 10. These articles will be effective upon filing. unless a future date is specified: This is the 28 day of January 2022 Type or Print Name and Title The below space to be used if more than one organizer or member is listed in Item 42 above. gnature Type and Print Name and Title Signature Type and Print Name and Title NOTE: I. Filing fee is S125, This document must be tiled with the Secretary of State. BUSINESS REGISTRATION DIVISION P.O. BOX 29622 Raleigh. NC 27026-0622 (Rerlsed : f ugmv. 2017) Form L-01