SW6091005_CURRENT PERMIT_20091202

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT. NO.
SW eo4o�
DOC TYPE
CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD

RUM
M
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
December 2, 2009
Mr. John Koenig, Managing Member
KAS Developers, LLC
6432 Yadkin Road,
Fayetteville, North Carolina 28303
LD_A-FA'El 14 2009
1tEFF6 01
Dee Freeman
Secretary
Subject: Phase II Post -Construction
StormwaterPermit No. SW6091005
Crosswinds, Cumberland County
Dear Mr. Keening:
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for
Crosswinds, on November 23, 2009. Staff review of the plans and specifications has determined that the
project, as proposed, will comply with the Stormwater Regulations set forth in Title 15A NCAC 2H.1000 and
Session Law 2006-246. We are forwarding Permit No. SW6091005, dated December2, 2009, for the.
construction, operation and maintenance of the subject project and the stormwater I3MPs.
This permit shall be effective from the date of issuance until December 1, 2019, and shall.be subject
to the conditions and limitations as specified therein. Please pay special attention to the Operation and
Maintenance requirements in this permit. Failure to establish an adequate system for inspection and
maintenance of the stormwater mapagement system will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right
to request an adjudicatory hearing upon written request within thirty (30) days following receipt of this
Permit. This request must be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh,
NC 27611-7447. Unless such demands are made this permit shall be final and binding.
This project will be kept on file at the Fayetteville Regional Office. If you have any questions, or
need additional.information concerning this matter, plmse contact Mike Randall at [phone]; or
[e-mail].
Sincerely, .
for Coleen H. Sullins
cc: Fayetteville Regional Office
Central Files
SPU Files
Wetlands and Stormwater Branch-
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 - 7.�One
Location: 512 N. Salisbury St Raleigh, North Carolina 27604 1 V oah Carolina
Phone: [phone] FAX [phone] Customer Service:1-877-623-6748 - �yI&
// Internet: www.nuNaterquality.org - _ - Na&iii_ .
An Equal Opportunity 1 Affirmative Action Employer .�/

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State Stormwater Permit
Permit No. SW6091005
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY . .
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY SUBDIVISION DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Ruies, and Regulations
PERMISSION IS HEREBY GRANTED TO
Mr. John Koenig, Managing Member
KAS Developers, LLC
Crosswinds
Crosswinds Drive, Hope Mills, Cumberland County
FOR THE
construction, operation and maintenance of. a three wet detention pond(s) in compliance
Iwith the provisions of Session Law 2006-246 and 15A NCAC 2H .1000 (hereafter
referred to as the "stormwater rules' and the approved stormwater management plans
and specifications and other supporting data as attached and on file with and approved
i
by the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until December 1, 2019 and
shall be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in attached wet detention supplement forms, SW401, of this
permit. The subdivision is permitted for 154 lots, each allowed a maximum of
2,755 square feet of built -upon area. .
3.1The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
4. The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
5. The design elements permitted for the three wet detention pond stormwater
facility as detailed on the attached supplement forms must be maintained at all
times.
Page 1 of 5

State Stormwater Permit
Permit No. SW6091005
II. SCHEDULE OF COMPLIANCE
1. No homeowner/lot owner/developer shall fill in, alter, or pipe any drainage feature
(such as swales) shown on the approved plans as part of the stormwater
management system without submitting a revision to the permit and receiving
approval from the Division.
2. The permittee is responsible for verifying that the proposed built -upon area for
the entire lot does not exceed the maximum allowed by this permit. Once the lot
transfer is complete, the built -upon area may not be revised without approval
from the Division of Water Quality, and responsibility for meeting the built -upon
area limit is transferred to the individual property owner.
3. If an Architectural Review Board or Committee is set up by the permittee to
review plans for compliance with the BUA limit, the plans reviewed must include
all proposed built -upon area. Any approvals given by the Board do not relieve the
homeowner of the responsibility to maintain compliance with the permitted BUA .
limit.
.4. 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 revised plans and certification in writing to the Director
that the changes have been made.
5. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
6. The. permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to the approved plans, regardless of size.
b. Project name change.
c. Transfer of ownership. .
d. Redesign or addition to the approved amount of built -upon area.
e. Further subdivision, acquisition, or sale of all or part of the project area.
The project area is defined as all property owned by the permittee, for
which Sedimentation and Erosion Control Plan approval or a CAMA Major
permit was sought.
fi Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.. .
7. The permittee shall submit for approval, final site layout and grading plans for
any permitted future development areas shown on the approved plans, prior to
construction. .
8. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
9. During construction, erosion shall.be kept to a minimum and any eroded areas of
the system will be repaired immediately.
Page 2 of 5

State Stormwater Permit
Permit No. SW6091005
10. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior. to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this.permit, the approved plans and
specifications, and othersupporting docume'6f6tion. Any deviations from the
approved plans and specifications must be noted on the Certification.
11. If the stormwater system was used as an Erosion Control device, it must be
restored to design condition prior to operation as a stormwater treatment device,
and prior to occupancy of the facility.
12. The permittee shall at all times provide the operation and maintenance
necessary to assure that all components of the permitted stormwater system
function at optimum efficiency. . The approved Operation and Maintenance Plan
must be followed in its entirety and maintenance must occur at the scheduled
intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
c. Mowing and re -vegetation of side slopes.
d. Immediate repair of eroded areas.
e. Maintenance of side slopes in accordance with approved plans.
f. Debris removal and unclogging of structures, orifice, catch basins. and
piping.
g. Access to all components of the system must be available at all times.
.13. Records of maintenance activities must be kept by the permittee. The records will
indicate the date, activity, name of person performing the work and what actions
were taken.
14. The permittee shall submit to the Division of Water Quality an annual summary
report of the maintenance and inspection records for each BMP. The report shall
summarize the inspection dates, results of the inspections, and the maintenance
work performed at each inspection.
15. This permit shall become void unless the facilities are constructed in accordance
with the conditions of this permit, the approved plans and specifications, and
other supporting. data.,
16. Prior to the sale of any lot, the following deed restrictions must be recorded:
a. The following covenants are intended to ensure ongoing compliance with
State Stormwater Management Permit Number SW6091005, as issued by
the Division of Water Quality under the stormwater rules.
b. .. The State of North Carolina is made a beneficiary of these covenants to
the extent necessary to maintain compliance with the Stormwater
Management Permit: ;.
c. These covenants are to run with the land and be binding on all persons
and parties claiming under them.
d. The covenants pertaining to stormwater may not be altered or rescinded
without the express written consent of the State of North Carolina, Division
of Water Quality.
e. Alteration of the drainage as shown on the approved plans may not take
place without the concurrence of the Division of Water Quality.
Page 3 of 5

State Stormwater Permit
Permit No. SW6091005
f.. The maximum built -upon area per lot is 2,755 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.
g. All runoff on the lot must drain into the permitted system. This may be
accomplished through providing roof drain gutters, which drain to the
street, grading the lot to drain toward the street, or grading perimeter
swales and directing them into the pond or street. Lots that will naturally
drain into the system are not required to provide these measures.
h.. Built -upon area in excess of the permitted amount will require a permit
modification.
i. If permeable pavement credit is requested, the property owner must
submit a request, with supporting documentation, to the permittee and
receive approval prior to construction of BUA.
IT A copy of the recorded deed restrictions must be submitted to the Division within
30 days of the date of recording the plat, and prior to selling lots. The recorded
copy must contain all of the statements above, the signature of the Permittee, the
deed book number and page, and the stamp/signature of the Register of Deeds.
18. Prior to transfer of the permit, the stormwater facilities will be inspected by DWQ .
personnel. The facility must be in compliance with all permit conditions. Any
items not in compliance must be repaired or replaced to design condition prior to .
the transfer. Records of maintenance activities performed to date will be.
required..
19. If permeable pavement credit is desired, the permittee must submit a request to
modify the permit to incorporate. such language as required by the Division of
Water Quality. The request to modify must include a soils report identifying the
type of soil, the Seasonal High Water Table elevation and the infiltration rate.
Upon the successful completion of a permit modification, the individual lot owners
that request to utilize permeable pavements must submit the necessary forms
and. documentation to the permittee and receive approval prior to construction of
the permeable pavement.
III. GENERAL CONDITIONS
1 This permit is not transferable except after notice to and approval by the Director.
In the event of a change of ownership, or a name change, the permittee must
submit a completed Name/Ownership Change form signed by both parties, to the
Division of Water Quality; accompanied by the supporting documentation as
listed on page 2 of the form. The approval of this request will be considered on its
merits and mayor may not be approved.
.2. The permittee is responsible for compliance with all permitconditions until such
time as the Division approves a request to. transfer the permit.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action_ by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
Page 4 of 5

State Stormwater Permit
Permit No. SW6091005
5. In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall. continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
fiiing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10.. 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
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes..
12.. The permittee shall submit a renewal request with all required forms and.
documentation at least 180 days prior to the.expiration date of this permit.
Permit issued this 2nd day of December, 2009.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 5 of 5

State Stormwater Permit
Permit No. SW6091005
Designer's Certification
i, as a duly registered in
the State of North Carolina, having been authorized to observe (periodically/weekly/full
time) the construction of the project,
(Project)

State Stormwater Permit
Permit No. SW6091005

State Stormwater Permit
Permit No. SW6091005

13�sw I
On be provided by DWCO
Project name
Contact person
Phone number
Date
Drainage area number
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT:
This form must be filled out, printed and submitted
The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information.
Tributary to Basin 81 -
o�Op W ATFgOG
II:DESIGN INFORMATION.. ,` .'.y"^zr vt::.` ..U%� : . fn' q :..rsif�..s? _,y^e .�..i,•+`".`a, k , a . 's`e�F?:".xaP-', 4c;7r t r n w -
Site Characteristics
Drainage area 1,347,342 ff'
Impervious area, post -development - 390.953 hr
%impervious - 29.02 %
Design rainfall depth 1.0 in
Storage Volume: Non -SA Waters
Minimum volume required '
Volume provided ,
Storage Volume: SA Waters
1.5' runoff volume
Pre -development 1-yr, 24-hr runoff
Post -development 1-yr. 24-hr runoff
Minimum volume required
Volume provided
Peak Flow Calculations
Is the prelpost control of the iyr 24hr storm peak flow required?
1-yr, 24-hr rainfall depth
Rational C, pie -development
Rational C, post -development
Rainfall intensity: 1-yr, 24-hr storm
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak flow
PrelPost 1-yr, 24-hr peak flow control
Elevations
Temporary pool elevation .
Permanent pool elevation
SHWT elevation (approx. at the perm. pool elevation)
Top of 1011 vegetated shelf elevation
Bottom of tOR vegetated shelf elevation
Wiment cleanout, top elevation (bottom of pond)
Sediment cleanout, bottom elevation
Sediment storage provided
Is there additional volume stored above the state -required temp, pool?
Elevation of the lop of the additional volume
34,939 ft3
OK
36,422 ff'
-
OK, volume provided is equal to or in excess of volume required,
fl'
it
rya
It
it, .
Approved S10rmwater Permit Documents
Construction ir, accoldatce witio these documents is
Y (Y or N)
required by the storniwater parrrlit. North Carolina
3.0 in
rules require 'hat 9:e stcrmwater system designer
Inspect during conSlructioi:; certify conformity with the
0.35 (unitless)
plans and specs; and certiFy cm-npliance with the
0.52 (unitless)
stormwater. rules. (15A NCAC "H A008(j))
0,13Mr
Okfenmit#_Sk?b.091P_0.5 Date_[ �y
140 ft1/sec
by � ' G P!C Division of Water Quality
2.09 flaisw
Sheet It__Lof2—Revision Date-10-38 0Y
0.69 ether
178.90 fmsl
177.40 final
176.70 fmsl
177.90 final .
176.90 imsl
171.40 fmsl
170.40 fmsl
1.00 It
N (Y or N)
fmsl
Farm SW401-Wet Detention Basin-Rev.8-9117/09 Parts I. a 11. Design Summary, Page 1 of

5A5i-j i
Permit No.
(lo be vk.-W by DWQ:
ll> DESIGN INFORMATION' , " �Vh.•i;r, ..* ` ,.. st;,, '., r... �*. , r '" h�.±`?• $ .�<
Surface Areas
Area, temporary pool -
26,193 ft'
Area REQUIRED, permanent pool
19,536 ft2
SAIDA ratio
1.45 (unitless)
Area PROVIDED, permanent pool, Ao,,,p,,
21,970 it' OK
Area, bottom of 10H vegetated shelf, Ab, as .
18,809
;Area, sediment cleanout, top elevation (bottom of pond), Ab,p,+a
7,522 fl`
Volumes
Volume, temporary pool ..
36,422fl OK
Volume, permanent pool, Vp,,,_o„i
84,818 it'
Volume, forebay (sum of forebays if mom than one forebay).
17,467 fts
Forebay % of permanent pool volume -
20.6% % OK
SAIDA Table Data
Design TSS removal
90 %
Coastal SAIDA Table Used?
N (Y or N)
Mountain/Piedmont SAIDA Table Used?
Y (Y or N)
SAIDA ratio
1.45 (unilless)
Average depth (used in SAIDA table):
. .
Calculation option i used? (See Figure 10-2b)
N (Y or N)
Volume, permanent pool, Vp,,,p„
84,818 ft'
Area provided, permanent pool, A,_,,
21,970 ft'
Average depth calculated
it OK -
Average depth used in SAIDA, d,,, (Round to nearest 0.511)
it
Calculation option 2 used? (See Figure 10-2b)
Y (Y or N)
Area provided, permanent pool, A.,, -
21,970 fe
Area, bottom of 1Oft vegetated shelf, AW(,b,r
18,809 ft'
Area; sediment cleanout, lop elevation (bottom of pond), Ab,p„I
- 7,522 ft'
.Depth' (distance h1w bottom of 100 shelf and lop of sediment)
5.50 it
Average depth calculated
4.31 ft
_ Average depth used in SAIDA, cl , (Round to nearest 0.511)
4.5 it
Drawdown Calculations
Drawdown through orifice?
Diameter of orifice (if circular)
Area of orifice (if -non -circular)
Coefficient of discharge (Co)
Driving head (H,)
Diewdown through weir?
Weir type.
Coefficient of discharge (C,)
Length of weir (L)
Driving head (H) .
Pre -development 1-yr, 24-fir peak flow
Post -development 1-yr, 24-hr peak flow
Storage volume discharge rate (through discharge orifice or weir)
Storage volume drawdown time -
Additional Information
Vegetated side slopes
Vegetated shelf slope
Vegetated shelf width
Length of towpath to width ratio
Length to width ratio '
Trash rack for overflow & orifice?
Freeboard provided
Vegetated filter provided?
Recorded drainage easement provided?
Capures all runoff at ultimate build -out?
Drain mechanism for maintenance or emergencies is:
Y (Y or N)
2.50 in
m'
0.66 limitless)
0.50 It
N (Y or N)
limitless)
(unilless)
ft
it
1.40 fusee
2.09 italsec
0.13 fie/sec
3.30 days
3 :1
10 :1
10.0 it
2 :1
2.0 :1
OK
Qkppruvecl _l rrv;atert'errn;tDocuments
Construct," ir+ acc,rr:a: gee yr th 1h- Be documents is
required by the steam+eaLr pamdt. North Carolina
rules require that the storm•seter system designer
Inspect during cwnstmcP,;!: 7,j,;jify conformity with the
plans and specs: and ce.ti y ., : "Hance with the
storrnwater rules. (15A NCAC 3ti .1008 (j) ))
Permit flL�/lo0%/ 5 ..-- Dated Z/-ZA9q
SdC. Division of Water Quality
Street vision Date_/��ZOOy
OK, draws down in 2-5 days.
OK
OK
OK
Insufficient flow path to width ratio. Must not shod -circuit pond.
OK
Y (Y or N)
OK
1.0 it
OK
Y (Y or N)
OK
Y (Y or N)
OK
Y (Y or N)
OK '
Drain valve and pump(s)
Form SW401-Wet Detention Basin-Rev.8-9117109 - Parts I. E It, Design Summary, Page 2 d 2

(ro be p oyided by DWQ)
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This fair must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
o�0F WA7'F90G
7
O Y
('PROJECT -INFORMATION-
Project name Crosswinds Section 4, Pad 2
Contact person James M. Kizer, Jr., PFJBIake Ball
Phone number [phone]
Dale 8-Od-09
Drainage area number Tributary to Basin #2
((:';DESIGN INFORMATION?Fs
Site Characteristics
Drainage area 1,201,545 fl�
Impervious area, post -development 365,634 ry�
%impervious 30.43
Design rainfall depth 1.0 in
Storage Volume: Non -SA Waters
Minimum volume required
Volume provided
Storage Volume: SA Waters
1.5' runoff volume
Pre -development 1-yr, 24hr runoff
Post -development 1-yr, 24hr runoff .
Minimum volume required
Volume provided
Peak Flow Calculations
Is the pre/post control of the tyr 24hr storm peak Flow required?
1-yr, 24hr rainfall depth
Rational C, pre -development
Rational C, post -development
Rainfall intensity: 1-yr, 24hr storm
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24hr peak flow
Pre/Post 1-yr, 24hr peak flow control
Elevations -
Temporary pool elevation
Permanent pool elevation
SHWT elevation (approx. at the perm. pool elevation)
Top of 10ft vegetated shelf elevation
Bottom of 1011 vegetated shelf elevation
Sediment cleanout, top elevation (bottom of pond)
Sediment cleanout, bottom elevation
Sediment storage provided
Is there additional volume stored above the state -required temp. pool?
Elevation of the top of the additional volume
32,429 ry1
37,879 ft1'
ft3
ft3
ft3
If
ft3
Y (Y or N)
3.0 in
0.35 (unifless)
0.53 (unifless)
0.13 inthr
126 fe/sec
1.91 fl1/sec
0.65 fl1/sec
178.00 fmsl
176.50 fmsl
173.20 first
177.00 first
'176.00 fmsl
170.50 fmsl
169.50 fmsl
1,00 it
N (Y or N)
fmsl
OK
OK, volume provided is equal to or in excess of volume required.
Apprcvzd "ormwater 7 Armit Documents
Construction, is accordance w:ln these documents is
required by the slc;rmvater perrnit. North Carolina
rules require ilia! the stormwater system designer
Inspect during consinx;iur,; certify conformity with the
plans and spars; and oerti`y a+mpiiance with the
stormwater rules. (15A NCAC 2H .1008 (j) )
Permit# .5W10go fleas Date_A zAZ1510
by__-7LVI�ll:_, iiivislon of Water Quality
Sheet #_ , __Z___Revisinn Date_;
OK
Form SW401-Wet Detention Basin-Rev.8-9117/09 Pans I. & 11. Design Summary, Page l of 2

&A510z
Permit No.
no be prs &.d Sy OWW
Il.-,DESIGN INFORMATION
Surface Areas -
Area, temporary pod.
27,639 h2
Area REQUIRED, permanent pool
20,426 W
SAIDA ratio
1.70 (unitless)
Area PROVIDED, permanent pool. Ao,,,,y„r
21352 fl`
OK
Area, bottom of 1011 vegetated shelf, As,u,w
17,912 8'
Area, sediment cleanout, top elevation (bottom of pond), Apap„y
5,283 8'
Volumes -
Volume, temporary pool
37,879 8s
OK
Volume, permanent pool. Voe,,,y,a
80,734 8'
Volume, forebay (sum of forebays if more than one forebay)
15,292 84
Forebay %of permanent pool volume
18.9% %
OK
SAIDA Tattle Data -
Design TSS removal
90 %
Coastal SAIDA Table Used?
N (Y or N)
Mountain/Piedmanl SAIDA Table Used?
Y (Y or N)
SAIDA rato
1.70 (unitless)
_ Average depth (used in SAIDA table):
Calculation option 1 used? (See Figure 10-2b)
N (Y or N)
Volume, permanent pool, V,,,,,-noa
80.734 Its
Area provided, permanent pool, A,,,
21,352 8z
Average depth calculated -
If
OK -
Average depth used in SAIDA, d„, (Round to nearest 0.58)
8
Calculation option 2 used? (See Figure 10-2b)
Y (Y or N)
Area provided, permanent pool, A,„o oa
21,352 8a
Area, bottom of 100 vegetated shell A� ,M1,r
17,912 1?
Area, sediment cleanout, top elevation (bottom of pond), Ate_, o, ..
5,283 ff'
-
"Depth' (distance b1w bottom of 108 shelf and top of sediment)
5.50 8
-
Average depth calculated
4.02 it
OK _
Average depth used in SAIDA, d„, (Round to nearest 0.58)
4.0 8
OK
Drawdown Calculations
Drawdown through orifice?
Diameter of orifice (if circular)
Area of entice (ifnon-circular)
Coefficient of discharge (Ca)
Driving head (Ho)
Drawrimn through weiR
Weir type
Coefficient of discharge (C.)
Length of weir (L) -
Driving head (H)
Pre- levelopment 1-yr, 24-hr peak flow
Post -development 1-yr. 24-hr peak flow
Storage volume discharge rate (through discharge orifice or weir)
Storage volume drawdown time
Additional Information
Vegetated side slopes
Vegetated shelf slope.
Vegetated shelf width .
Length of flowpath to width rate
Length to width ratio
Trash rack for overflow & orifice?
Freeboard provided
Vegetated filter provided?
Recorded drainage easement prwided?
Capures all runoff at ultimate buildoul?
Drain mechanism for maintenance or emergencies is:
Y (Y or N)
2.25 in
in2
0.66 (unitless)
0.67 8
N (Y or N)
(unitless)
If
It
1.26 Wise,
1.91 8s/sac
0.12 fts/sec
3.67 days
3 :1
10 :1
10.0 4
4 :1
2.0 :1
Approved t;µ.r;r.• veter Pcrrn:t D.ocumentw
Conslrucfier; :, ),:xcgdar:cfe %,j! thsse documents is
required ,y the ntorin�raalar p<;rmil. North Carolina
rules require that the slorrrevater system designer
Inspect during constn;t ;i<;n; r.Bgify conformity with the
plans and specs; ant efVfy c:^mphance with Iha
stormwater rules. ('I SA'•iC%,C, ?11 .10D8 (j) )
Permit ll, j(,� BOOS _ Date -
by L L ZOO Jr
_'%27. _ ry—__
�'---.._,.....,� -'4C.. ,v, ion of VVatar Quality
Sheet 77Zaf L i'tevislDn Datu'l[/Z3 /Iod>
OK, draws down in 25 days.
OK
OK
OK
OK
OK
Y (Y or N)
OK
1.0 It
OK
N (Y or N)
OK
Y (Y or N)
OK
Y (Y or N)
OK
Drain valve and pump(s)
Form SW401.Wet Detention Basin-Rev.8-9/17/09 - Parts 1. & II. Design Summary, Page 2 or 2

gosw 3
Permit No.
(lobe Provided by DWQ)
Y !s Jij..'
STORMINATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
.This form must be filled out, printed and submitted
The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information.
o�OF Wit rf9q
h � r
7 �
U P.ROJECTrINFORMATION v i --- v
W
Proled name Crosswinds Section 4, Part 2
Contact person James M. Kizer, Jr., PE/Blake Ball
Phone number (9f0)484-5191
Date and-09
Drainage area number Tributary to Basin M3
11.5DESIGNINFORMATION''€:�:.. ,.k..: .: .- . �:. -;. 1 w:._'.. Y.,. .".n.`,'I'.e ,� ... '.?.,;1J xr^ .,..�„�rt; ..� .�',., Y....,<. 'j?.-�: t'7
Site Characteristics
Drainage area
Impervious area, post -development
% impervious -
Design rainfall depth
Storage Volume: Non -SA Waters
Minimum volume required
Volume provided -
Storage Volume: SA Waters
1.5'runoff volume
Pre -development 1-yr, 20r runoff
Post -development 1-yr, 24hr runoff
Minimum volume required
Volume provided
Peak Flow Calculations
Is the prelpost control of the lyr 24hr storm peak Flow required?
1 yr, 24hr rainfall depth
Rational C, pre -development
Rational C, post -development
Rainfall intensity: 1-yr, 24hr storm
Pre -development 1-yr, 24hr peak flow
Post -development 1-yr, 24hr peak flow
-Pre/Post 1-yr, 24hr peak flow control
Elevations
Temporary pool elevation
Permanent pool elevation
SHWT elevation (approx. at the perm. pool elevation)
Top of 10ft vegetated shelf elevation
&Ittom of 10ft vegetated shelf elevation
Sedment cleanout, top elevation (bottom of pond)
Sediment cleanout, bottom elevation
Sediment storage provided
Is there additional volume stored above the stale -required temp. pool?
Elevalion of the lop of the additional volume
Form SW401-Wet Detention Basin-Rev.8-9117/09
115,796 h2
38.375 h2
33.14 %
1.0 in
3.361 rya
5.859 h'
P
rys
to
fl°
Y (Y or N)
3.0 in
OK
OK, volume provided is equal to or in excess of volume required.
0.35 (unitless)
0.55 (unitless) -
0.13 in/hr OK
0.12 fl'/sec
0.19 h'/sec
0.07 ft'/sec
172.50 trust
171.50 fmsl
not found fmsl
172.00 fmsl
171.00 first
166.00 fmsl
165.00 fmsl
1.00 It
N(Y or N)
first
Approv.�J Permrit Jecunnsnts
Cons tructien in accord-inc2 vriih these documents is
required by the s tormwater p-rmit. North Carolina
rules require thai the slorrre.ater system designer
Inspect during conformity with the
plans and specs; and ao& - ;rgo6ance with the
stormwater rules. (I 5A NC ,_.2iA.1008(j))
Permit Date
i vision of Water Oualiiy
Sheet # of L _-_Revision Date4_�Aeif
Pala 1. 811. Design Summary, Page 1 of 2

6�sla 3
Permit No-
(lo be provided by DWO)
ILDES IGNINFORMAT ION
-
Surface Areas
Area, temporary pool
6,557 ft
Area REQUIRED, permanent pool
2,409 it'
SAIDA ratio
208 (unitless)
Area PROVIDED, permanent pool, Ar,,,,,,4
4,785 ftr OK
Area, bottom of tOtt vegetated shelf; Abe ,,,
3,433 ft
Area, sediment cleanout, lop elevation (bottom of pond), Ab ,,,a
147 ft`
Volumes
Volume, temporary pool
5,859 fl' OK
Volume, permanent pool, Vr,,,',a
10,894 ft'
Volume, forebay (sum of forebays if more than one forebay)
2,355 ft'
Forebay% of permanent pool volume
21.6% % OK
SAIDA Table Data
Design TSS removal
90 %
Coastal SAIDA Table Used?
N (Y or N)
Mounlain/Piedmont SAIDA Table Used?
Y (Y or N)
SAIDA ratio
2.08 (unitless)
Average depth (used in SAIDA table):
Calculation option 1 used? (See Figure 10-2b)
N (Y or N)
Volume, permanent pool, Vr, ,.,
10,894 ft'
Area provided, permanent pool, A,,,a _
4,785 f1`
Average depth calculated
If OK
Average depth used in SAIDA, d,,,, (Round to nearest 0.511)
1
Calculation option 2 used? (See Figure 10-2b)
Y (Y or N)
Area provided, permanent pool, AI
4,785 W
Area, bottom of IN vegetated shelf, Ab,u,hw
3,433 ftr
Area, sediment cleanout, top elevation (bottom of pond), Ab,ty„4
147 ft'
`Depth' (distance h1w bottom of 10ft shelf and top of sediment)
5.00 ft
Average depth calculated
303 A OK
Average depth used in SAIDA, d,,, (Round to nearest 0.511)
3.0 If - OK
Drawdown Calculations
Dmwdown through orifice?
Diameter of orifice (if circular)
Area of orifice (if-nontircular)
Coefficient of discharge (Co)
Driving head (H,)
Drawdown through weir? -
Weir type
Coefficient of discharge (C,)
Length of weir (L) -
Driving head (H)
Pre -development 1-yr, 24-hr peak flow
Post -development 1-yr, 24-hr peak Flaw
Storage volume discharge rate (through discharge orifice or weir)
Storage volume drwdown time
Additional Information
Vegetated side slopes
Vegetated shelf slope
Vegetated shelf width
Length of flowpath to width ratio
Length to width ratio
Trash rack for overflow & orifice?
Freeboard provided
Vegetated filter provided?
Recorded drainage easement provided?
Capures all runoff at ultimate build -out?
Dmin mechanism for maintenance or emergencies is:
Y (Y or N)
2.00 in
inr
0.66 (unitless)
0.331
N (Y or N)
(unitless)
(tailless)
It
8
0.12 ry'/sec
0.19 8'/sec
0.02 fl'/sec
4.07 days
3 :1
10 :1
10.0 It
2 :1
20a
Y (Y or N)
10It
APpm4vt;:£ ^t,n r a4eY E'arm f Documents
Construction :icccrdunce 'hese documents is
required by ths,IGrmwater k^r:,li?. North Carolina
rules require that the sicrrrf•atr,r system designer
Inspect during ccnstru gon; cer',, y conformity with the
plans and specs; and reaffy cor±pliance, with the
stormwater rules. (15A trC=,C rH .1008Op
Permit # �j(,r1GQQ�QJrDate /L� �2oaf
by_%lu..aC NC Division of Water Qualify
Sheet #_ Zof Z — Rceis!Dn Date_7MMV 07
OK, draws down in 2-5 days.
OK
OK
OK
Insufficient flow path to width ratio. Must not short-circuit pond.
OK
OK
161111
N (Y or N) OK
Y (Y or N) OK-
Y (Y or N) OK
Drain valve and pump(s)
Form SW401-Wet Detention Basin-Rev.8-9117m9 Parts I. & It. Design Summary, Page 2 of 2

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
0
0)
W o9 I6o
Applicable Rules:
(select all that apply)
❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Storm water Management Plan
❑ Other WQ Mgmt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
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.):
Crosswinds, Section 4, Part 2 (includes Stormwaler Management for entire Crosswinds, Section 4)
2. Location of Project (street address):
(addresses have not been assigned)
City:Hope Mills ' County:Cumberland Zip:28348
3. Directions to project (from nearest major intersection):
From the intersection of S. Eastern Blvd. (I-95 Bus. Rt. S./US Hwy 301) dr NC Hwy. 87 (MLK, Jr. FwyJ go
southwest on S. Eastern Blvd. for 1.4 mi. Turn right onto Owen Dr. for 0.5 mi. Turn left onto Southern Ave
for 1.6 mi (Southern Ave becomes Legion Rd.). Tom left onto Countrytown Dr. for 0.1 mi. Turn right onto
Crosswinds Dr. for 0.3 mi. Turn left onto Bellgrove Dr for 0.3 miles to Site.
4. Latitude:34° 59 34" N Longitude:78° 55' 00" W of the main entrance to the project.
sq-CHW 79.1147
11. PERMIT INFORMATION:
1. a. Specify whether project is (check one): NNew ❑Modification
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
3. If this application is being submitted as the result of a previously returned application or a letter from
DWQ requesting a state stormwater management permit application, list the stormwater project number,
if assigned, 09-W51 and the previous name of the project, if different than currently
proposed, Crosswinds, Section 4, Part 2
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 ❑Sedimentation/Erosion Control: 27 ac of Disturbed Area
❑NPDES Industrial Stormwater N404/401 Permit: Proposed Impacts 0.093 Acres
b.If any of these permits have already been acquired please provide the Project Name,
Number, issue date and the type of each permit:Crosswinds, Section 4, Part2; Proieci
July 6, 2009; Sedimentation/Erosion Control

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 eject):
App&cant/Organization:KAS Developers, LLC
Signing Official & Title:lohn Koenig, Managing Member
b.Contact information for person listed in item la above:
Street Address:6432 Yadkin Road
City:Fayetteville State:NC Zip:28303
Mailing Address (if applicable):Post Office Box 25490
City:Fayetteville State:NC Zip:28314
Phone: (910 ) 391-2977 Fax: (910 ) 864-0015
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
Signing Official &
b.Contact information for person listed in item 2a above:
Street Address:
Mailing Address (if4
Phone:
State:
State:
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:
Signing Official & Title:
b.Contact information for person listed in item 3a above:
Mailing Address:
City: State: Zip:
Phone: ( ) Fax:
4. Local jurisdiction for building permits: Cumberland County
Point of Contact:Planning dr Inspections Dept. Phone #: (919 ) 321 6636

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Wet Detention Basins
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Dale:
❑ Other: Date:
b.Identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 0 Ph II - Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area: 6C677 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+:64.677 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 (NIM line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHIq line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 26.51 %
9. How many drainage areas does the project have?3 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole properly 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.
Basin Information
Drainalze Area 1
Drainage Area 2
Drainage Area 3
Drainage Area
Receiving Stream Name
Big Sandy Run
Big Sandy Run
Big Sandy Run
_
Stream Class *
C
C
C
Stream Index Number *
18-31-25
18-31-25
18-31-25
Total Drainage Area (sf)
1,347,342
1,201,545
115,796
On -site Drainage Area (sf)
1,085,283
1,075,246
115,796
Off -site Drainage Area (sf)
262,059
126,299
0
Proposed Impervious Area'"
(sf)
390,953
365,634
38,375
% Impervious Area' (total)
29.02
30.43
33.14
Impervious- Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area 3
Drainage Area _
On -site Buildings/Lots (so
187,340
201,115
27,550
On -site Streets (so
118,324
127,055
8,949
On -site Parking (sf)
0
0
0
On -site Sidewalks (sf)
29,270
30,922
1876
Other on -site (sf)
0
0
Future (so
0
0
Off -site (sf)
56,019
6,542
n/a
Existing BUA*** (sf)
0
0
0
Total (sf):
390,953
365,634
38,375
Stream Class and Index Number can be determined at: httpl/h2o enr state nc usMims/reports/reportsWB html
` Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.

'Report only that amount of existing BLIA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new B UA.
11. How was the off -site impervious area listed above determined? Provide documentation. Exisiting
impervious areasdigitized from 2008 Cumberland County digital orthophotos
Proiects in Union County: Contact DWQ Central Office slafflo check ifthe project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from htil)://h2o.enr.state.nc.us/su/bmn forms.htm.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality
(DWQ). A complete package includes all of the items listed below. A detailed application instruction sheet
and BMP checklists are available from http://h2o.enr.sLate.nc.us/su/bmp forms.htm. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at http://h2o.enr.state.nc.us/su/msi maps.htm.)
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 ht!P:L/h2o.enr.state.nc.us/su/­bmp-f—orms.htm.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. &t6 roa-%HV,.Jtc
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants 66t6 rwi.SM K K
Form. (if required as per Part VII below)
1 Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M bras C04 3e+K,J t<
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to 6&9. rc c .3 t-tay t.
http://www.envhelp.org/pages/onestoMxl2ress.html 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 GC-9CA IMK,J2
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the �cn g Kda
receiving stream drains to class SA waters within V2 mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations. fl" ewe tr+x lF
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including: Qo B rvs drrKac
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.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
L Details of roads, drainage features, collection systems, and stormwater control measures.
in. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
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).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify $k6 Q*J*4kA
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xll" 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 DWQ to verify the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book Page No:(M"Y ) ti c1 Ob fc"A .Z.4 ca to
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC 3C� g cuc,ltlK, a It-,
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 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.
http://www.se(xetarv.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 tot 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://h2o.enr.state.nc.us/su/bmp forms htm#deed restrictions. Download the latest versions for each
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 DWQ, 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:James M. Kizer, Jr,,PE PdDct
�pal Engineer
Consulting Firm: Moorman, Kizer 6r Reitzel Inc.
Mailing Address:115 Broadfoot Avenue
City:Fayetteville
Phone: [phone]
[e-mail]
State:NC Zip:28305
Fax: (910 ) 484-0388
IX PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name ofperson 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 In)ormation, item 1a) with (print or type name of organization listed in
Contact Information, item 1b) 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 DWQ Stormwaler
permit reverts back to me, the property owner. As the property owner, it is my responsibility to notify DWQ
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.
a Notary Public for the State of
do hereby certify that
before me this _ day of
County of
personally appeared
, and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission
X. APPLICANT'S CERTIFICATION
or type name of person listed in Contact Information, item 2) fohn Koenig, Managing Member, KAS Developers,
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 recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 2H .1000, SL 2006-246 (Ph. H - Post Construction) or SL 2008-211.
1,
Date: /fJ-- 6 - cl
a Notary Public for the State of ftUALhIR(A (14l , County of
do hereby certify that _ )QV'0 Y
before we this(- day of er , \OQ R 2mf� and
a stormwater permit. Witness my hand and official seal, A
` Gy ST 9S O-
'CD
'. Lp<
� NORZ
SEAL
personally appeared
My commission expires a/ ; q go l V