SW6100804_Application Form_20220611

DEMLR USE ONLY
Date Received Fee Paid Permit Number
STORMWATER PERMITTING FORM 7:
MINOR MODIFICATION
Standard Permitting Program — No Fee for Minor Modification
Express Permitting Program — See Express Fee Schedule
Only complete applications packages will be accepted and reviewed. This form and the required items (with
original signatures) must be sent to the appropriate DEMLR Regional Office, which can be determined by locating
the project on the interactive online map at: http.//deg.nc.gov/contact/regional-offices.
This form is to only to be used by the current permittee to notify the Division of a minor
modification. Pursuant to Rule 15A NCAC 02H .1002, a minor modification is a change to the project that:
1) does not increase the net built -upon area; and/or
2) does not change the size or design of the SCM(s).
A. GENERAL INFORMATION
1. State Stormwater Permit Number: SW6100804
2. Current Permit Holder's Company Name/Organization: VP Spout Springs, LLC
3. Signing Official's Name: Martin D Koon
4. Signing Official's Title: Manager/Member
5. Mailing Address: PO Box 843
City: Wilkesboro State: NC ZIP:28697
6. Street Address (if different): : 126 Executive Drive, Suite 200
City: Wilkesboro State: NC ZIP: 28697
7. Phone: [phone] Email: martykoon(aD-vpdevelopment.com
8. Describe the minor modifications that you are requesting, including any revised BUA allocations (attach
additional pages or supporting tables similar to Section IV.10 of the original application, if needed):
A portion of the original residential built -upon area will become commercial built -upon area.
The percentage of residential -built upon area is being reduced due to more accurate data related to
home footprints and driveway sizes. The built -upon areas for Food Lion and Outparcel No. 2 have been
updated to reflect as -built conditions.
B. SUBMITTAL REQUIREMENTS
Please mark "Y" to confirm the items are included with this form. Please mark X' if previously provided. If not
applicable or not available, please mark N/A.:
Y 1. Two hard copies (with original signatures) and one electronic copy of this completed form.
Y 2. Two hard copies and one electronic copy of the revised plan sheets (must be a revision of the
originally approved plan sheets).
Y 3. If there is reallocation of lot BUA, a copy of the revised recorded deed restrictions and protective
covenants OR the proposed recorded deed restrictions and protective covenants documenting
the changes and a signed agreement to provide the final recorded document.
N/A 4. If applicable, the appropriate Express review fee.
Stormwater Permit Form 7: Minor Modification Page 1 of 2 July 14, 2017

C. CONTACT INFORMATION
1. The Design Professional who is authorized to provide information on the Applicant's behalf:
Design Professional's Name:Jarrod E. Hilliard, PE, CFM
Consulting Firm: Hilliard Engineering, PLLC
Mailing Address:PO Box 249
City:Sanford
Phone: [phone]
Email::ihilliard(a�hilliardengineering.com
State:NC Zip:27331
Fax: ( 1
[OPTIONAL] If you would like to designate another person to answer questions about the project:
Name & Title:
Organization:
Mailing Address:
City:
Phone:
Email: :
D. CERTIFICATION OF PERMITTEE
State: Zip:
I, Martin D Koon , the current permittee, certify that I have authorized the minor
modifications listed in Section A and shown in the attached revised plan sheets. I further attest that this information is
accurate and coet t e my knowledge.
Signature:
Lt—k
ate: y" 26 _2-02 Z
I, _S hf,✓rl So L,A{l a Notary Public for the State of I V 0 (41k C&A 11 (Lo—�
County of 1/f i 11Ce S do hereby certify that rii 6-V, +iN a r`
persVaWyia9j?,pared before me this the-260+'" day of ri 20 ZZ., and
`�wePly e execution of the forgoing instrument. Witness my hand and official seal,
y� Notary Public yc�
Wilkes
(Nr� xp
.0 03-pg-2025
'A
CA R
Notar rSI H ure
My commission expires L/./)-- C)O
Stormwater Permit Form 7: Minor Modification Page 2 of 2 Oct 6, 2017

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, Martin D. Koon, 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:
1. The following covenants are intended to ensure ongoing compliance with State Stormwater
Management Permit Number SW6100804, 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 3,500 sf square feet. 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.
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
not required to provide these additional measures.
Form DRPC-3 Rev.2 05Nov2009 Page 1 of 2

High Density Residential Subdivisions
Deed Restrictions & Protective Covenances
Signature:_ Date
9-29-Z ozZ
U-`tCIr- , a Notary Public in the
State of S ) L-Ado UL� t nC— County of ly i � Y C:5
do hereby certify that p �i personally appeared
before me this the day of In1 2022, and acknowledge
the due execution of the foregoing instrument. Witness my hand and official s�P�'�B"So,,����
ot"Y Public yt %
Wilkes D
Signa ure County
My Commission expires �� ' o- oL �� %y M0 -og m' E"p•
S� O 2025
y CA'R
Form DRPC-3 Rev.2 05Nov2009 Page 2 of 2