SW6110603_CURRENT PERMIT_20110802

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

0 7 2099
NC®ENR
North Carolina Department of Environment and
Division of Water Quality
Beverly Eaves Perdue Colleen H. Sullins
Governor Director
August 2, 2011
Mr. Jeffrey L. Irvin
Concord Properties of the Carolinas, LLC
1338 Harding Place, Suite 100
Charlotte. NC 28204
Subject: Stormwater Permit No. SW6110603
Verizon — Skibo Road
High Density Commercial Bio-Retention Project
Cumberland County
Dear Mr. Irvin:
Natural Resources
wU.
Dee Freeman
Secretary
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application for
Verizon — Skibo Road on July 15, 2011 after additional information was requested on July 5, 2011. 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. SW6110603, dated August 2, 2011, for the construction, operation and
maintenance of the subject project and the stormwater BMPs.
This permit shall be effective from the date of issuance until August 1, 2021, 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 management 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 150E 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 Asheville Regional Office. If you have any questions, or need
additional information concerning this matter, please contact Brian Lowther at [phone]; or
[e-mail].
Sincerely, Q /—
for Coll H. Sullins
cc: Fayetteville Regional Office
SW6110603 File
Charles Garcia, Freeland & Kauffman, Inc.
Wetlands and Stormwater Branch
1617 Mail Service Center, Raleigh, Nodh Carolina 27699-1617
Location: 512 N, Salisbury St. Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone] Custorner Service: 1-877-623 6748
Internet: v .n=aterr lity.org
An Equal Opportunity 1 Affirmative Action Employer
None
rthCarci ina
Naturally

State Stormwater Permit
Permit No. SW6110603
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Concord Properties of the Carolinas, LLC
Verizon — Skibo Road
1956 Skibo Road, Fayetteville, Cumberland County
FOR THE
construction, operation and maintenance of a bioretention cell in compliance with 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 by
the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until August 1, 2021, and shall
be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
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 Section 1.7 on page 2 of this permit. The stormwater
control has been designed to handle the runoff from 13,939 square feet of
impervious area.
3. The tract will be limited to the amount of built -upon area as indicated in Section
1.7 of this permit, and per the application documents and as shown on the
approved plans. The total built -upon area for the development is limited to
35,719 square feet.
4. 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.
5. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
Page 1 of 6

State Stormwater Permit
Permit No. SW6110603
7
The following design criteria have been provided in the bioretention cell and must
be maintained at design condition:
a. Drainage Area, acres:
Onsite, ft :
Offsite, ftZ:
b. Total Imperviou� Surfaces, ftZ:
Onsite, ft :
Offsite, ftZ:
C. Design Storm, inches:
d. Max. Ponded Depth, feet:
e. Seasonal High Water Table, fmsl
f. Planting Media Depth, feet:
g. Cell Dimensions, feet:
h. Bottom Elevation, fmsl:
i. Top Surface Area, ft :
j. Permitted Storage Volume, W:
k. Bypass / Storage Elevation, fmsl:
I. Total number of plants provided:
M. Receiving Stream/River Basin:
n. Stream Index Number:
o. Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
0.42
18,295
0
13,939
13,939
0
1.0
9„
218'
2'
115 by 18
220
1,996
1,291.0
223.75
Grassed cell - Sod
Beaver Creek Pond / Cape Fear
18-31-24-5
..C..
1. 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.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all time provide the operation and maintenance necessary
to assure the permitted stormwater system functions 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 slopes and the filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans.
f. Debris removal and unclogging of all drainage structures, level spreader,
filter media, planting media, underdrains, catch basins and piping.
g. Access to the cell and outlet structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and
what actions were taken.
5. 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.
6. The facilities shall be constructed as shown on the approved plans. 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.
Page 2 of 6

State Stormwater Permit
Permit No. SW6110603
7. 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 other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A
modification may be required for those deviations.
8. 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.
9. Access to the stormwater facilities shall be maintained via appropriate recorded
easements at all times.
10. 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 any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease 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.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. A copy of the approved plans and specifications shall be maintained on file by
the Permittee for a minimum of ten years from the date of the completion of
construction.
13. 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.
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 may or may not be approved.
2. The permittee is responsible for compliance with all permit conditions 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
Page 3 of 6

State Stormwater Permit
Permit No. SW6110603
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.
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
filing 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 August 2011.
NORTH
,JC1AROLINAENVIRONMENTAL MANAGEMENT COMMISSION
Z-�
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

State Stormwater Permit
Permit No. SW6110603
Verizon — Skibo Road
Stormwater Permit No. SW6110603
Cumberland County
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 Name)
for (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 included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 5 of 6

State Stormwater Permit
Permit No. SW6110603
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Trash rack is provided on the outlet/bypass structure.
8. All slopes are grassed with permanent vegetation, per the vegetation plan.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Fayetteville Regional Office
Cumberland County Building Inspections
Page 6 of 6

r r
A
SDWQUS&ONLY
s "
Date Received
Fee Paid
Permit Number
C K
18 3.5 -5o
Sw to k 1 1) LP b3
Applicable Rules:
❑ Coastal SW -1995
❑ Coastal SW - 2008
❑ Ph II - Post Construction
(select all that apply)
❑ Non -Coastal
SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M
mt 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.):
Verizon - Skibo Road
2. Location of Project (street address):
1956 Skibo Road
City:Fayetteville County:Cumberland Zip: AB31
3. Directions to project (from nearest major intersection):
Approximately 1600 feet north of the intersection of Skibo Rd and Cliffdale Rd
4. Latitude:35° 08' 51" N Longitude:78* 58' 07" W of the main entrance to the project.
❑. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑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, Cumb-20110620-7 and the previous name of the project, if different than currently
proposed,
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
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 1.32 ac of Disturbed Area
❑404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide tit ct Name, Project/Permit Number,
issue date and the type of each permit: 0
JUN 2 g 201l
Form SWU-101 Version 07Jun2010 Page I of 6

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 project):
Applicant/Organization: Ieffrev L. Irvin - Concord Properties of the Carolinas, LLC
Signing Official & Title: Jeffrey L. Irvin
b. Contact information for person listed in item la above:
Street Address: 1338 Harding Place, Suite 100
City: Charlotte State:NC Zip:28204
Mailing Address (if applicable):
City: State: Zip:
Phone: (704 ) 405-9400 Fax: (704 ) 731-0964
Emaii:[e-mail]
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
City:
Mailing Address (if
City:
Phone: (
Sta
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:
'9'l" ,F�.,,,y
Other Contact Person/Organization: Mike Stephens
Signing Official & Title: Construction Manager
b. Contact information for person listed in item 3a above:
Mailing Address:
City:
Phone: (704 ) 604-1163
Email:[e-mail]
Fax: (704 ) 785-8795
Form SWU-101 Version 07Jun2010 Page,.2 o f 7 ,..

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
There is 0.66 AC of existing impervious coverage on the site The proposed improvements will increase the
impervious area 0.18 AC. A bio-retention pond is proposed to treat 0.42 AC of the site of which 0.32 AC
will be impervious. All run-off will be routed into an underground detention system before connectingto o the
DOT storm drain system.
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 Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area: 1.16 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+:1.16 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 (NHW) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Nan -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 = 71 %
9. How many drainage areas does the project have?] (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property 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 Infoimation ' -
_"Drama `e,Area 1 �
�'Dcaina ge Area 2 ,
D aina e^Area _
�Draina e-Area
Receiving Stream Name
Beaver Creek
Pond
Stream Class
C
Stream Index Number *
1$ , 3 , vt•s
Total Drainage Area (so
0.96
On -site Drainage Area (so
0.96
Off -site Drainage Area (so
0
Pro osed Impervious Area** s
35,719
impervious Area** total
85%
Im ` ervious"`-:Surface Area .. . ,.
'.Drain e Area 1,
Drama" e?Area .,1
.Drama" e Area'. .
Draiiia e Arean,.
On -site Buildings/Lots (so
6,300
On -site Streets (so
0
On -site Parking (so
27,387
On -site Sidewalks (so
2,032
Other on -site (so
0
Future (so
0
Off -site (so
0
Existing BUA*** (so
28,750
Total (so:
35,719
* Stream Class and Index Number can be determined at: lnttl2.aortal.ucdeur.otX web/wq/ps/csu/classifications
Form SWU-101 Version 07Jun2010 Page 3 of

'* 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 BUA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation.
Projects in Union County: Contact DWQ Central OjJice staff to check if the project is located within a Threatened &
Endangered Species watershed that maybe 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 http://portal.iicdenr.org/web/wq/`ws/sii/bmp-minual.
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://portal.ncdenr.org/web/wcl/ws/su/statesw/forms does. 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://portaLncdennorg/web/wq/ws/su/maps.)
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 http://portal.ncdenr.org/web/wq/ws/su/statesw/forms dots.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part NJ below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http://www.envheII2.org/pages/oiiestopexi2ress.htnil 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/managementfor
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or'the
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arroyo.
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 wetlandsjandward 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.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
V
Form SWU-101 Version 07Jun2010 Page 4of6

Q
A copy of the most current property deed. Deed book: 2568 Page No: 243
For corporations and limited liability corporations (LLC): Provide documentation from the NC
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 21-1.1003(e).'fhe
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.
hyp://www.secretaLy.state.nc.us/Coroorations/CSearch.aspx
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
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 drainagde (including off -site), drainage easements, pipe sizes, runoff calculations.
o. ramage areas a meated (included in the main set of plans, not as a separate document .
p. Vegetated buffers (where required). -1i* V)Q, W�1) JePA v;A'N a b,1g4
Copy of any applicable soils report with the associated SHWT elevations (Please identify _
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].)
—vl�
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 lot 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://portal.ncdenr.org/web/wq/ws/su/statesw/forms does. Download the latest versions for each submittal.
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:Charles Garcia
Consulting Firm: Freeland & Kauffman, Inc.
Mailing Address:209 West Stone Ave.
City:Greenville State:SC Zip:29609
Phone: (864 ) 672-3430 Fax: (864 ) 233-8915
Email:[e-mail]
IX. PROPERTY OWNER AUTHORIZATION (if Can tact nofornation, item 2 has been filled out, complete this
section)
I, (print or hype name of person listed in Contact Information, item 2a) , certify that I
own the property identified in this permit application, and thus give permission to (print or hype name of person
listed in Contact Information, item 1a) with (print or type name of organization listed in
Contact btforniation, item la) 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.
Form SWU-101 Version 07Jun2010 Page 5 of 6

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 Stormwater 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 I County of
do hereby certify that
before me this _ day 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 1
1, (print or hype name of person listed in Contact Information, item 1a) u ` � 7 L ✓/Al
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,. that the proposed project complies with the requirements of the
applicable stormw_" ^ unde!�Ij' q C 2H .1000, SL 2006-246 (Ph. 11- Post Construction) or SL 2008-211.
• 03•,;z0/i
1, _�, ! = a Notary
, Public for the State of "I W01 /VK, County of
63 do hereby certify that c r¢ i i� . L/1yt personally appeared
before me this — ay of �u ✓tL 'ZO(( and ac4novyledge th due execution of the application for
a stormwater permit. Witness my hand and official seal,
EYFLr i
[Y Public
` Mecklenburg County
/ZO r
ry CA Rin IO�,�P`ss`;:
SEAL
My commission expires D /�
Form SWII-101 Version 07Jun2010 Page 6 of

Permit Number:
(to be provided by DWQ)
OF WaTEq
®� 02 OG
%9 y
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part /I/) must be printed, filled out and submitted along with all of the required information.
I:. PROJECTANFORMATION u. m r -. o
Project name Verizon - Skibo Road
Contact name Jeff Edney
Phone number 864-672-3432
Date
Drainage area number
June 30, 2011
II::;DESIGN.INF,ORMATION
Site Characteristics
Drainage area
18,295 ft'
Impervious area
13,939 rya
Percent impervious
76.2% %
Design rainfall depth
1.0 inch
Peak Flow Calculations
Is pre/post control of the 1-yr, 24-hr peak flow required?
n (Y or N)
1-yr, 24-hr runoff depth
in
1-yr, 24-hr intensity
in/hr
Pre -development 1-yr, 24-hr peak flow
It3/sec
Post -development 1-yr, 24-hr peak flow
ft3/sec
Pre/Post 1-yr, 24-hr peak control
ft'/sec
Storage Volume: Non-SAWaters
Minimum volume required
1,128.0 ft'
Volume provided
1,291.0 ff 3
OK
Storage Volume: SA Waters
1.5' runoff volume
h3
Pre -development 1-yr, 24-hr runoff
ft3
Post -development 1-yr, 24-hr runoff
ft3
Minimum volume required
0 ff3
Volume provided
ft 3
Cell Dimensions
Pending depth of water
9 inches
OK
Ponding depth of water
0.75 ft
Surface area of the top of the bioretention cell
1,996.0 ft2
OK
Length:
11511
OK
Width:
18 ft
OK
-or- Radius
a
Media and Soils Summary
Drawdown time, ponded volume
9 hr
OK
Drawdown time, to 24 inches below surface
18 fir
OK
Drawdown time, total:
27 fir
In -situ soil:
Soil permeability
in/hr
Planting media soil:
Soil permeability
1.00 in/hr
OK
Soil composition
• Sand (by volume)
87%
OK
• Fines (by volume)
9%
OK
%Organic (by volume)
4%
OK
Total: 100%
Phosphorus Index (P-Index) of media
20 (unitless)
OK
Form SW401-Bioretention-Rev.8

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Bioretention Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important operation and maintenance procedures: j
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will be taken to prevent sediment from entering the bioretention cell.
— Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month and within 24
hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblems:
How I will remediate theproblem:
The entire BMP
Trash/debris is resent.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
bioretention cell
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
Form SW40 I -Bioretention O&M-Rev.3 Page 1 of

BMP element:
Potentialproblems:
How I will remediate theproblem:
The pretreatment area
Flow is bypassing
Regrade if necessary to route all
pretreatment area and/or
flow to the pretreatment area.
gullies have formed.
Restabilize the area after grading.
Sediment has accumulated to
Search for the source of the
a depth greater than three
sediment and remedy the problem if
inches.
possible. Remove the sediment and
restabilize the pretreatment area.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand.
The bioretention cell:
Best professional practices
Prune according to best professional
vegetation
show that pruning is needed
practices.
to maintain optimal plant
health.
Plants are dead, diseased or
Determine the source of the
dying.
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Tree stakes/wires are present
Remove tree stake/wires (which
six months after planting.
can kill the tree if not removed).
The bioretention cell:
Mulch is breaking down or
Spot mulch if there are only random
soils and mulch
has floated away.
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Soils and/or mulch are
Determine the extent of the clogging
clogged with sediment.
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
possible.
An annual soil test shows that
Dolomitic lime shall be applied as
pIi has dropped or heavy
recommended per the soil test and
metals have accumulated in
toxic soils shall be removed,
the soil media.
disposed of properly and replaced
with new planting media.
Form SW401-Bioretention O&M-Rev.3 Page 2 of 4

BMP element:
Potentialproblems:
How I will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdraur system.
if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-Bioretention O&M-Rev.3 Page 3 of 4

Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:Verizon - Skibo Road
BMP drainage area number:
e:�" '-
Print name: �C -e L .
Title: r" l 4 h tl
r cl 4
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I, A.�!b ItV f WC( 2-� , a Notary Public for the State of
Met" CAIVI YL�A/ , County of ff " do hereby certify that
L . .( ✓I persona y appeared before me this Z34
day of ::Y t i1e, 2D It , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal, A�'
Notary Public
Mecklenburg County
'111PH NnC P' pk �p
SEAL
My commission expires
Form SW401-Bioretention I&M-Rev. 2 Page 4 of 4
z '�"Z,y

Permit Number:
(to be provided by DWQ)
Basin Elevations
Temporary pool elevation
Type of bioretention cell (answer "Y' to only one of the two
following questions):
Is this a grassed cell?
Is this a cell with trees/shrubs?
Planting elevation (top of the mulch or grass sod layer)
Depth of mulch
Bottom of the planting media soil
Planting media depth
Depth of washed sand below planting media soil
Are underdrains being installed?
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
the bottom of the cell to account for underdrains
Bottom of the cell required
SHWT elevation
Distance from bottom to SHWT
Internal Water Storage Zone (IWS)
Does the design include IWS
Elevation of the top of the upturned elbow
Separation of IWS and Surface
Planting Plan
Number of tree species
Number of shrub species
Number of herbaceous groundcover species
Additional Information
Does volume in excess of the design volume bypass the
bioretention cell?
Does volume in excess of the design volume flow evenly distributed
through a vegetated filter?
What is the length of the vegetated filter?
Does the design use a level spreader to evenly distribute flow?
Is the BMP located at least 30 feet from surface waters (50 feet if
SA waters)?
Is the BMP located at least 100 feet from water supply wells?
Are the vegetated side slopes equal to or less than 3:1?
Is the BMP located in a proposed drainage easement with access
to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
Is the area surrounding the cell likely to undergo development in
the future?
Are the slopes draining to the bioretention cell greater than 20%?
Is the drainage area permanently stabilized?
Pretreatment Used
(Indicate Type Used with an'X' in the shaded cell)
Gravel and grass
(flinches gravel followed by 3-5 ft of grass)
Grassed swale
Forebay
Other
223.75 fmsl
y (Y or N) OK
(Y or N)
223 fmsl
0 inches Insufficient mulch depth, unless installing grassed cell.
221 fmsl
Zit
0 ft
y (Y or N)
3 OK
10 OK
1 ft
220 fmsl
218 fmsl
2 ft OK
n (Y or N)
fmsl
223 it
0
0
1 Recommend more species.
y (Y or N) OK
y (Y or N) OK
5 ft
n (Y or N) Show how flow is evenly distributed.
y (YorN)
OK
y (Y or N)
OK
y (Y or N)
OK
y (Y or N)
OK
ft/sec
n (Y or N)
OK
n (YorN)
OK
y (YorN)
OK
x
OK
Form SW401-Rioretention-Rnv A

Permit No:
(to be assigned by DWQ)
III. REQUIRED ITEMS CHECKLIST
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Pagel Plan
I 'ti
Sheet No.
13
1.1
SAW
1. Plans (1' - 50' or larger) of the entire site showing:
- Design at ultimate build -out, �•Z,
-
Off-sitedrainage(if applicable), N ��
- Delineated drainage basins (include Rational C coefficient per basin),
-
Celldimensions, L
-Pretreatment system, - e--fj
- High flow bypass system, c-i
-Maintenance access, S
-Recorded drainage easement and public right of way (ROW), (.- 5
- Clean out pipe locations, e.—I;
-
Overflowdevice,and 4-5
- Boundaries of drainage easement. 4r_19
2. Plan details (1' = 30' or larger) for the bioretention cell showing:
-Cell dimensions L— S
- Pretreatment system, C_
- High flow bypass system,(--,
- Maintenance access, G S
- Recorded drainage easement and public right of way (ROW), S
- Design at ultimate build -out, l- 7,
- Off -site drainage (if applicable), a
- Clean out pipe locations, L;'
- Overflow device, and 4�
- Boundaries of drainage easement. L S
- Indicate the P-Index between 10 and 30 4Ab
VieQeV-N f App.. %,k % (Ni)
3. Section view of the biorelenlion cell (1" = 20' or larger) showing: C Ip
- Side slopes, 3:1 or lower 6_;
- Underdrain system (if applicable), and L S
- Bioretention cell layers [ground level and slope, pre-treatment, ponding depth, mulch depth, fill media
depth, washed sand, filler fabric (or choking stone if applicable), #57 stone, underdrains (if applicable),
SHWT tevel(s), and overflow structure] (- ro
4. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWQ, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information. All
elevations shall be in feet mean sea level (fmsl). Results of soils tests of both the planting soil and the in
situ soil must include: 10
-Soil permeability, 0 f/.h ^ �a-5�9n a � /�
-Soil compad�lio (%sand,%fines,%organic), and AA � aQ.S��jn Its (:10
- P-index. r
5. A detailed plant r p an 11" = 20' oPiarger) prepared by a qualified individual showing:
- A variety of suitable species,
- Sizes, spacing and locations of plantings,
- Total quantity of each type of plant specified,
- A planting detail,
- The source nursery for the plants, and
- Fertlizer and watering requirements to establish vegetation.
6. A construction sequence that shows how the bioretenton cell will be protected from sediment until the
p entire drainage area is stabilized. 1J` q" �•�S
7. The supporting calculations (including underdrain calculations, if applicable).
B. A copy of the signed and notarized inspection and maintenance (I&M) agreement. e
9. A copy of the deed restriction. A
Form SW401-Bioretention-Rev.7 pan III, Page 1 of 1