SW6100902_Renewal Application_20220421

UtMLK USE UNLY-
Date Re eived
Fee Paid
Permit Number
NC DEQ Division of Energy, Mineral and Land Resources RECEIVED
STATE STORMWATER: till 71I
PERMIT RENEWAL APPLICATION FORM APR 21 2022
DEMLR
In accordance with 15A NCAC 2H.1045(3), the current permit holder shall renew their hi& ,dgifl,u i l Office
prior to its expiration. Renewed permits are valid for a period of 8 years per Session Law 2011-398 (SB 781)
Section 60. (c). This application form is for permit renewals only.
A. PROJECT INFORMATION
1. State Stormwater Permit Number: �5,tiv 6 /® (ego ;I-
2. Project name: 1W e-D6-,e-iFr e-LD Doti-c..^� /���o�i�'►°Tian
Project street address: 15iZc-1GK /<d'/, 9
City: _R/#E0:02 1`> County:
4. What, if any, changes have been made to the project as permitted? NO V
ZIP: a.-V326
If the project has changed from the original approved plans, please complete SWU-101 for a Major
Modification or Minor Modification Application form available at. https://deg.nc..qov/about/divisions/energy
mineral-land-resources/energy-mineral-land-rules/stormwater-program/post-construction.
B. PERMITTEE INFORMATION
If changes to the permittee or project name have been made, please complete either the Permit Update form
or the Permit Transfer form available at. https://deg.nc.gov/about/divisions/energy-mineral-land-
resources/energy-mineral-land-rules/stormwater-program/post-construction. State Stormwater Permits do not
automatically transfer with the sale of the property.
1. Current Permit Holder's Company Name/Organization: /it%aFiec p C7w,�•e,� /� S�t%1�4770
2. Signing Official's Name: 1-1ow4iLD /)q q S,0,J
3. Signing Official's Title: Az"�-& "r- (A)/,
4. Mailing Address: y TfJ Ml i- L- RoA z
City: _A/It'F-ok=A State: IYC, ZIP :;-$3°7(
5. Street Address: /S yia7S /yl ALL R/+-D
City: _ 12,+e p, P-D State: /VC— ZIP : a(3376
6. Phone: (,QX) 690-- (S-'i.33 Email: 01c-CX421-0wA) •e2r+1'r-& ® %04"-i (,C-0
RECEIVED
11,zlbyl
APR 21 2022
DEMLR
Fayetteville Regional Offic=-,
Stormwater Permit Renewal Form Page 1 of 3 May 11, 2018

C. SUBMITTAL REQUIREMENTS
Submit the application package to the appropriate DEMLR Regional Office (Coastal, SA Waters) or DEMLR
Central Office (Urbanizing Areas Ph 2, USMP, Non -Coastal HQW/ORM. Only applications packages that
include all required items listed below will be accepted and reviewed.
Initial each item below to indicate that the required information is provided in the application package:
1. A permit application processing fee of $505.00 payable to NCDEQ.
)4-- 2. One original signed hard copy and one electronic copy of this completed form. The signing official
named on this application to represent the current permittee must meet one of the following:
a. Corporation — a principle executive officer of at least the level of vice-president;
b. Limited Liability Company (LLC) — a manager or company official as those terms are defined
in G.S. 57D "North Carolina Limited Liability Company Act;"
c. Public Entity — a principal executive officer, ranking official, or other duly authorized employee;
d. Partnership or limited partnership — the general partner;
e. Sole proprietor; or
f. Letter of authorization signed by one of the signatories noted in a — e above authorizing the
signature of another entity.
�C 3. One hard copy and one electronic copy of recorded documents required by the original permit that
have not yet been received by DEMLR, including: deed restrictions, protective covenants,
condominium/planned community declaration and easements. If the project has been built, include
documentation that the maximum BUA per lot or maximum total BUA has not been exceeded. If
the project has not been built, include a signed agreement that the final recorded deed restrictions
and protective covenants will be submitted at a later date.
4. O&M Agreements, Please select one:
P9, I have a copy of the current recorded O&M Agreement for all SCMs, and I will continue to
keep this on file with the permit; or
❑ I do not have a copy of the current recorded O&M Agreement for all SCMs and am
requesting a copy be sent to me. I agree to keep this on file with the permit.
>� 5. Designer Certifications, Please select one:
A copy of the certification(s) confirming that the project was built in accordance with the
approved plans have been previously provided to the Division; or
❑ A copy of the certification(s) confirming that the project was built in accordance with the
approved plans are enclosed; or
❑ The project has not yet been built.
6. [IF APPLICABLE] If the project has been built, one original hard copy and one electronic copy of a
signed, sealed, and dated letter from a licensed professional stating that the SCMs have been
inspected, and that they have been built and maintained in accordance with the permit.
7. [IF APPLICABLE] When the permittee is a corporation or a limited liability corporation (LLC):
Provide one hard copy and one electronic copy of documentation from the NC Secretary of State,
or other official documentation, which supports the titles and positions held by the persons listed in
Section C.2 per 15A NCAC 2H. 1043(3)(b).
https://www.sosnc.gov/online services/search/by title/ Business Registration
Stormwater Permit Renewal Application Form Page 2 of 3 May 11, 2018

D. PERMITTEE'S CERTIFICATION
#0M-­*1?_D I IA-sal.i , the person legally responsible for the permit, certify that I have
a copy of the Permit and O&M Agreement on site (or I will obtain a copy and it will be kept on site), that I am
responsible for the performance of the maintenance procedures, and the site has been and will be maintained
according to the O&M Agreement and approved plans. I agree to notify DEMLR of any problems with the SCMs
or built -upon area and to submit the proper forms to modify or transfer the permit prior to any changes to the
project, SCMs, or owngrship. All information provided on this permit renewal application is, to the best of my
knowledge, corct ao}-cprnple e.
Date.`
NOTARIZATION: 1 1
' I,a Notary Public for the State of
0421)U Qn County of , do hereby certify
that -N(A-,L) P"Zl> U hso (\J personally appeared before me
this the of ill fe day of �� �� 20�, and acknowledge the due
exO%pt�•© •thE. ,.rip�g instrument. Witness my hand and official seal,
NOTARY
(Alota�y Senlj —
'• PUBOo
tio•. '
Not rg}
My commission expires l J 2C722
Stormwater Permit Renewal Application Form Page 3 of 3 May 11, 2018

UtMLI Ubt ONLY . i
DEMLR
In accordance with 15A NCAC 2H.1045(3), the current permit holder shall renew their hi_#j< g6, i 1 Office
prior to its expiration. Renewed permits are valid for a period of 8 years per Session Law 2011-398 (SB 781)
Section 60. (c). This application form is for permit renewals only.
A. PROJECT INFORMATION
1. State Stormwater Permit Number: '6,1V610 o90 -I-
2. Project name: /4-c-00c--1Ai-/;J
3. Project street address: /,?,z0C K 7,047
City: 124,Erco21-5 County: / 0),ce zip: a4326
4. What, if any, changes have been made to the project as permitted? / o,v�S
If the project has changed from the original approved plans, please complete SWU-101 for a Major
Modification or Minor Modification Application form available at. https://deg.nc.gov/about/divisions/energy-
mineral-land-resources/energy-mineral-land-rules/stormwater-program/post-construction.
B. PERMITTEE INFORMATION
If changes to the permittee or project name have been made, please complete either the Permit Update form
or the Permit Transfer form available at. https://deg.nc.gov/about/divisions/energy-mineral-land-
resources/energy-mineral-land-rules/stormwater-program/post-construction. State Stormwater Permits do not
automatically transfer with the sale of the property.
1. Current Permit Holder's Company Name/Organization: �✓�'�=t� Fl7ezp ��"'" o'r�s�e�a nu
2. Signing Official's Name: M q,.(0, ;
3. Signing Official's Title: f�lZA�7' oP-�
4. Mailing Address:
City: State: /VC- ZIP
_ r c a-__L n

UtMLK USE UNLY
Date Received Fee Paid Permit Number
STATE STORMWATER:
PERMIT INFORMATION UPDATE APPLICATION FORM
There is NO FEE for updating project name or permittee information.
This form is to only to be used by the current permittee to notify the Division of.-
1) changes to the Point of Contact (signing official) for the current permittee (LLC, Corporation, HOA or POA);
2) changes to the mailing address, phone number or email address of the current permittee;
3) changes to the name of the project; and
4) changes to the legal corporate name as documented by a Name Change or Merger filed with the NCSOS.
A. NEW PERMIT INFORMATION
State Stormwater Permit Number: -�W 610D90 2 --
Are you updating
(check all that apply):
If so, please provide the updated information:
❑ Project name
❑ Corporation Name'
Permit Contact Name2 ,3
Vo w4'e 0 /3JSon
Permit Contact Title
/0R'--siotvT 6A&!>6-,e-F164,b OWA-)'-e---j 1+"906//+170-0
® Mailing Address3
/8.)- Y47-f--f iYIiLL STR T r--�,er� fiiG 28326
Phone number
�f"/ _ 6 �® -6731?
ZLEmail address
du-clkJr-owAJe.ti er-p�se� ®d�of•�.� �,u,,,�
Provide documentation such as a Name Change / Merger filed with the NCSOS.
Provide supporting documentation such as NCSOS filing. The permit contact's position must be in accordance
with 15A NCAC 02H .1040(1).
If more than one point of contact or mailing address is being changed, please attach a separate sheet.
B. CERTIFICATION OF PERMITTEE
I, How,*P-b MA- coJ , the current permittee, hereby notify DEMLR that I am making the changes as listed
in Section A above. I further attest that this application for an update to the permit information currently on file is accurate
and complete to thq�bes#-of my kn�Feoge.
Signature
16-, 6��L 24
I, �al�= i�S � Q.0 f1C 2 a Notary Public for the State of _�)DO,) ( nIZ.t'jU t..) �
County of �-k CAt7l, do hereby certify that �-I()LORV-1> LAf�so o
pesog?N, gl,before me this the y dayof AP( -IL. 20�, and acknowledge the due
exec grpg instrument. Witness my hand and official seal,
: 'Y i
PU50G.:,``
'1��� WUN ����► 1 V
My commi�S� Wexpires IC)) `JQCQ S
Stormwater Permit Information Update Form Page 1 of 1 May 11, 2017

STATE OF NORTH CAROLINA
DEPARTMENT OF THE SECRETARY OF STATE
STATEMENT OF CHANGE OF REGISTERED
OFFICE AND/OR REGISTERED AGENT
Pursuant to §55D-31 of the General Statutes of North Carolina, the undersigned entity submits the following for the purpose .of
changing its registered office and/or registered agent in the State of North Carolina.
INFORMATION CURRENTLY ON FILE!
The name of the entity is: Wedgefield Owners Association
The street address and county of the entity's registered office currently on file is:
Number and Street: 605 South Reilly RoadSuite 101
City: Fayetteville
State: NQ zip Code: 28314
County: Cumberland
The mailing address if different from the street address of the registered office currently on file is:
Number and Street:
City:
State: NC' Zip Code County:
The name of the current registered agent is: ThOt10S R. Carroll
.NEW INFORMATION'
1. The street address and county of the new registered office of the entity is:
(complete this item only if the address of the registered office is being changed)
Number and Street: 182Yates Mill Road
City: Raeford State: NQ Zip Code: 28376
2. The mailing address ffdlfferent from the street address of the new registered office is:
(complete this item only if the address of the registered office is being changed)
Number and Street
City:
State: NC Zip Code:
County: Hoke
County:
3. The name of the new registered agent and the;new agent's consent to appoi tment appe ow:
(complete this item only if the name of the registered agent is being than d),--
Howard Mason --- -
rs .4- ffn
Type or Print Name of New Agent ignatztre & Title
4. The address of the entity's registered office and the address of the business office of its registered agent,: as changed,
will be identical.
5. This statement will be effective upon filing, unless a date and/or time is specified -
This is the 36 day -of March 2022 Wedge
fetd_Owners Association
EntityNan
Sigtta tre
Board President
Notes: Filing fee IsS5.00. This document must be tiled with the Secretary of State. Type or Print Name and Title'
* Instead of signing here; the new registered agent may sign a separate written consent to the appointment, which must be attached to Misstatement.
BUSINESS' REGISTRATION DIVISION P. O. BOX 29622 RALEIGH, NC 27626-0622
Revised July2017 Form BE-06

SOUTHEASTERN
HOA MANAGEMENT LLC
To: NCDEQ Division of Energy, Mineral and Land Resources
Re: Renewal of Stormwater Permit SW6100902 for Wedgefield Owners Association
Date: April 3, 2022
To Whom It May Concern:
I, Howard Mason, state that to the best of my knowledge that the maximum BUA per lot or the
maximum total BUA for the permit has not been exceeded.
Re,flor fully,
oward Mason President of Wedgefield Owners Asociation
2557 Ravenhill Drive, Ste. I-C
Fayetteville, NC 28303
910.493.3707
[e-mail]
www.southeasternhoa.com

State Stormwater Permit
Permit No. SW6100902
Wedgef(eld 7
Hoke Countv
Designer's Certification
t, C. Scott Brown , as a duly registered Engineer in
the State of North Carolina, having been authorized to observe erlodieallw eeklylfull
time) the construction of the project,
Wedgefield. Subdivision
(Project)
for _ Thomas Family Business, Inc (Project Owner) hereby state that,; to the
best of my abilities, due care and diligence was used in the observation of the project:
construction such that the construction was -observed to be built within substantial
compliance and' intent of the approved plans and specifications.
The checklist of items on page 2 of. this form is a pait:of this, Certification.
Noted deviations from approved plans and specifications:
4D=Site Solutions, Inc is -not the engineer of record. The design engineer is no longer in business. 4D did not
witness any of the pond construction: The pond was constructed and most of the surrounding homes built prior
to our involvement. 4D`surveyed the pond and compared to the design drawings. The wetlands plants along
the vegetated shelf have not been installed to date. Ground cover on the vegetated shelfis progressing. The
owner has. had a dif iicult�time in establishingpermanent ground cover. However, no significant erosion ha&been
observed along the bares SEAL
Signature
Registration Number 027452 N ,
ass'- ti
Date October 15,2019
Page 1 of 2
SEAL -
027452 -
7T ��O``.�`
•�rrrrurr" rl

State Stormwater Permit
Permit No. SW6100902
Certification Requirements:
X 1. The drainage area to the system contains approximately the permitted
acreage.
X 2. The drainage area to the system contains no more than 'the permitted
amount of built: --upon area. ,
X 3. All the built -upon area associated with the project is graded such that the
runof drains to the- system.
X 4. All roof drains are located such that the runoff 'is directed into the system.
X • 5. The outlet/bypass structure elevations are perthe approved plan.
X 6. The outlet structure is located per the approved plans.
X 7. Trash rack its provided on the outlet/bypass structure,
8. All slopes are grassed with permanent vegetation,
X 9. Vegetated slopes are no steeper than 3:1.
X 10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
X 11. The permitted amounts of surface area-and/or=volume have been
provided.
X 12. Required drawdown devices are correctly sized per the approved plans.
X 13. All required design depths are provided.
X 14. All required parts of the system are provided, such as a vegetated shelf, a
forebay, and the vegetated filter.
X 16. The required dimensions of the system are provided, per the. approved
plan.
cc: NCDi NR-DEMLR Fayetteville Regional Office
Page 2 of 2

The posting of this certificate certifies that an erosion and sedimentation control .plan
has been approved for this project by the North Carolina Department of Environment
and Natural. Resources in accordance with North Carolina General Statute 113A - 57(4) and
113A - 54 (d) (4)-and North Carolina Administrative Code, Title 15A, Chapter 48.O1O7 (c).
This certificate must be posted at the primary entrance of the job site before construction
begins and until establishment of .permanent groundcover as required by North Carolina
Administrative Code, Title 15A, Chapter 4B.O127 (b).
Wedeeffeld —Hoke `Coup
Project Name and Location
September 8, 2010
Date of Plan Approval' Regional Engineer
W® NR