SW6140902_CURRENT PERMIT_20210614

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
DOC TYPE
LPq" CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
4a is1z4v
YYYYMMDD

ROY COOPER
Governor
JOHN NICHOLSON
Interim Secretary
BRIAN WRENN
Director
NORTH CAROLINA
Environmental Quality
June 14, 2021
Blackbridge Village Owners Association, Inc.
Attn: Thomas Radford Brown, Manager
c/o Southeastern HOA Management
2557 Ravenhill Drive, Suite 1C
Fayetteville, NC 28303
Subject: Permit Transfer
State Stormwater Management Permit SW6140902
Blackbridge Village Subdivision
Cumberland County
Dear Mr. Brown:
On May-13; 2021, the Fayetteville Regional Office of the Division of Energy, Mineral and Land Resources
(DEMLR) received a State Stormwater: Permit Transfer Application Form to transfer ownership of State
Stormwater Management Permit SW6140902, which was originally issued to Caviness Land Development,
Inc. on October 10, 2014 with a Minor Modification to the maximum built -upon area per lot (3,000 square
feet/lot to 4,000 square feet/lot) approved on March 17, 2016 for the subject project. DEMLR staff inspected
the project on June 9, 2021, determined that the documentation is in order, and that the project is compliant
with the terms and conditions of the permit and approved stormwater management plans.
By signing the transfer application form, you have accepted the responsibility for complying with the terms
and conditions outlined in this permit. The Division is hereby notifying you that the subject permit has been
transferred on June 14, 2021 and reminding you that this permit shall be effective until October 9, 2022.
The transferred and re -issued permit is enclosed. Please note that this transferred and re -issued permit
does not impose new or different terms; it merely restates and clarifies some of the previous terms to
provide you with a better understanding of your obligations under the permit.
Please be aware thatthe project's built -upon area and stormwater controls must be built and maintained
in compliance with the permit documents and the approved plans. Maintenance of the approved system
shall be performed in accordance with the signed and approved Operation and Maintenance
Agreement as incorporated into the recorded deed restrictions. Any modifications to this project must
be submitted to DEMLR and approved prior to construction. The issuance of this approval does not
preclude you from complying with all other applicable statutes, rules, regulations, or ordinances, which
may have jurisdiction over the proposed activity, and obtaining a permit or approval prior to
construction.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing by filing a written petition with the Office of Administrative Hearings (OAH).
The written petition must conform to Chapter 150B of the North Carolina General Statutes and must be filed
with the OAH within thirty (30) days of receipt of this permit. You should contact the OAH with all questions
regarding the filing fee (if a filing fee is required) and/or the details of the filing process at 6714 Mail Service
Center, Raleigh, NC 27699-6714, or via telephone at 919-431-3000, or visit their website at
www.NCOAH.com. Unless such demands are made, this permit shall be final and binding.
Q�v North Carolina Department of Environmental Quality I Division of Energy, Mineral and Land Resources
D Fayetteville Regional Office 1 225 Green Street. Suite 714 1 Fayetteville. North Carolina 28301
!KHIY GJ<%NV.
uewm<naewaa.m arm 910.433.3300

If you have any questions, please contact Mike Lawyer at [phone] or via e-mail at
mike. lawyer@ncd e n r. gov.
Sincerely
or Brian Wrenn, Director
Division of Energy, Mineral and Land Resources
ec: Watson G. Caviness, President— Caviness Land Developments, Inc.
PJ Gay — Caviness Land
Scott Brown, PE — 4D Site Solutions, Inc.
"FRO ^ —DEMLR= State Stocmwate�-Files3

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
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
Blackbridge Village Owners Association, Inc.
for
Blackbridge Village Subdivision
Black Bridge Road near the Town of Hope Mills, NC
Cumberland County
FOR, THE
construction, operation and maintenance of one infiltration basin 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, specifications and other supporting data as attached
and/or on file with and approved by the Division of Energy, Mineral and Land Resources (the "Division"
or "DEMLR") and considered an enforceable part of this permit.
This permit shall be effective from the date of issuance until October 9, 2022 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. The infiltration basin is approved for the management of stormwater runoff as described in the
application documents and as shown on the approved plans.
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.
4. The runoff from all built -upon area within the permitted drainage area of this project must be
directed into the permitted stormwater control system.
5. The built -upon areas associated with this project shall be located at least 30 feet landward of all
perennial and intermittent surface waters.
II. SCHEDULE OF COMPLIANCE
During construction, erosion shall be kept to a minimum and any eroded areas of the system
will be repaired immediately.

2. The permittee shall at all times provide the operation and maintenance necessary to assure the
permitted infiltration basin 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. Semi-annual 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 and specifications.
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.
3. Records of maintenance activities must be kept for the infiltration basin and made available upon
request to authorized personnel of the Division of Energy, Mineral and Land Resources. The
records will indicate the date, activity, name of person performing the work and what actions
were taken.
4. The permittee shall submit an annual summary report of the maintenance and inspection
records for the infiltration basin. The report shall summarize the inspection dates, results of the
inspections, and the maintenance work performed at each inspection.
5. The infiltration basin shall be constructed in accordance with the approved plans and
specifications, the conditions of this permit, and with other supporting data.
6. 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 infiltration basin 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.
7. 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.
8. 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 was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the approved plan.
9. A copy of the approved plans and specifications shall be maintained on file by the Permittee for
a minimum of eight years from the date of the completion of construction.
10. 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.

11. All Stormwater Control Measures (SCMs) and associated maintenance accesses on privately
owned land except for those located on single family residential lots shall be located in
permanent recorded easements. The SCMs shall be shown and labeled within the easement.
These easements shall be granted in favor of the party responsible for enforcing the stormwater
program under which the SCMs were approved. SCMs must have access and maintenance
easements to provide the legal authority for inspections, maintenance personnel and equipment.
The entire footprint of the SCM system must be included in the access and maintenance
easement, plus an additional ten or more feet around the SCM to provide enough room to
complete maintenance tasks. The SCM system includes the side slopes, forebay, riser structure,
SCM device, outlet structure, dam embankment and emergency spillway. -
GENERAL CONDITIONS
This permit is not transferable to any person or entity except after notice to and approval by the
Director. In the event of a change in ownership, the appropriate form must be completed and
submitted to the Division accompanied by any applicable fee, documentation from both parties
involved and other supporting materials as may be appropriate. The project must be in good
standing with the Division. 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. Neither the sale of the project area in whole
or in part, nor the conveyance of common area to a third party, constitutes an approved permit
transfer
3. Any individual or entity found to be in noncompliance with the provisions of this stormwater
management permit or the requirements of the Stormwater rules is subject to enforcement
procedures as set forth in NCGS 143 Article 21.
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 Division 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 the permittee files a request with the
Division for a permit modification, transfer, renewal, or rescission; however, these actions do not
stay any permit conditions.
& 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 permit renewal application with all required forms, documentation,
and processing fee at least 180 days prior to the expiration date of this permit.
Permit transferred and re -issued this the 141 day of June 2021.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
forl3rigfi Wrenn, Directcff
Division of Energy, Mineral and Land Resources
by Authority of the Environmental Management Commission
State Stormwater Management Permit SW6140902

"-'--'-- - "-- "' U-MIH U1 iE ONLY - ---""---
Date Received Fee Paid Permit Number
NC DEQ Division of Energy, Mineral and Land Resources
STATE STORMWATER:
PERMIT TRANSFER APPLICATION FORM
Pursuant to 15A NCAC 02H.1045 and other applicable statues as reference within
Only complete applications packages will be accepted and reviewed. This form and the required items (with
original signatures) must be sent to the appropriate DEMLR Regional Office, which can be determined by locating
the project on the interactive online map at. http://deg.nc.pov/contacbreoional-offices.
After this application is accepted, DEMLR will conduct a compliance inspection and report any deficiencies to the
current permittee and/or the proposed permittee. Per the state stormwater rules and the state stormwater permit
conditions, the permit shall not be transferred until:
1. the current permittee resolves all non-compliance issues identified in the inspection report;
2. the current permittee negotiates a resolution with the proposed permittee (in writing and signed by both
entities. The negotiated resolution must identify the necessary actions, the responsible party(ies), and the
timelines to correct the deficiencies. The site must either be found in compliance or a copy of the
negotiated resolution must be submitted prior to the transfer of the permit.); or
3. in the case where a transfer falls under G.S. 143-214.7(c2) (see also SL 2011-256), the proposed
permittee resolves all non-compliance issues upon acquiring the permit.
Signature requirements for the named signing official (for current and proposed permittee) must meet the following.
• Corporation - a principal executive officer of at least the level of vice-president;
• Limited Liability Company (LLC) - the designated manager, (Documentation from the NC Secretary of
State or other official documentation must be provided that states the titles and positions held by the
person who signed the application (pursuant to 02H.1040) that shows they have legal authority to sign for
the LLC)
• Municipality - a ranking official or duly authorized employee;
• Partnership or limited partnership - the general partner,
• Sole proprietor;
• The signature of the consultant or other agent shall be accepted on this permit transfer application only if
accompanied by a letter of authorization signed by one of the signatories noted in a-e above, as
applicable.
A. GENERAL INFORMATION
1. State Stormwater Permit Number:
2. Project name: Blackbridge Village Subdivision
Is this an updated project name from the current permit? ❑ Yes ® No
3. Reason for the permit transfer request:
Property is being transferred from the original developer to the HOA
RECEIVED
MAY 13 2021
DEMLR
Fayetteville Regional Office
Stormwater Permit Transfer Application Form Page 1 of 7 April 27, 2018

B. PERSON(S) WHO HAVE SIGNED THIS FORM (select only one response below)
® 1. Both the current and proposed permittees
❑ 2. Only the current permittee of a condominium or planned community (skip Part F & G).
In accordance with G. S. 143-214.7(c2) (see also SL 2011-256), this type of transfer is allowed only
when all of the following items can be truthfully checked:
❑ Any common areas related to the operation and maintenance of the stormwater management
system have been conveyed to the unit owners' association or owners' association in
accordance with the declaration;
❑ The declarant has conveyed at least fifty percent (50%) of the units or lots to owners other than
a declarant (provide documentation per submittal requirements below),
❑ The stormwater management system is in compliance with the stormwater permit.
NOTE: If subdivision was built prior to 1999, the Declarant's Attorney can make a determination that
the elements of the Planned Community Act (see §47F) have been met by the Declarant for the
subdivision. If the Declarant chooses to use this type of transfer, the determination must be in
writing, signed by the attorney, and submitted to DEMLR with this form.
❑ 3. Only the proposed permittee (skip Part D below).
In accordance with G.S. 143-214.7(c5) (see also SL 2013-121), this type of transfer is allowed only
when all of the following items can be truthfully checked:
❑ a. The proposed permittee is either (select one of the following):
❑ The successor -owner who holds title to the property on which the permitted activity is
occurring or will occur,
❑ The successor -owner who is the sole claimant of the right to engage in the permitted
activity.
❑ b. The current permittee is (select at least one of the following, but all that apply):
❑ A natural person who is deceased.
❑ A partnership, Limited Liability Corporation, corporation, or any other business
association that has been dissolved
❑ A person who has been lawfully and finally divested of title to the property on which the
permitted activity is occurring or will occur.
❑ A person who has sold the property on which the permitted activity is occurring or will
occur.
❑ Other (please explain):
❑ c. The proposed permittee agrees to the following requirements (all must be selected):
❑ There will be no substantial change in the permitted activity.
❑ The permit holder shall comply with all terms and conditions of the permit until such
time as the permit is transferred.
❑ The successor -owner shall comply with all terms and conditions of the permit once the
permit has been transferred.
Stormwater Permit Transfer Application Form Page 2 of 7 April 27, 2018

C. SUBMITTAL REQUIREMENTS
Please mark "Y" to confirm the items are included with this form. Please mark "X" if previously provided. If not
applicable or not available, please mark N/A.:
Y 1. A processing fee of five hundred and five dollars ($505.00) per G.S. 143-215.3D(e)(2).
Y 2. Two hard copies (with original signatures) and one electronic copy of this completed form and the
required items.
Y 3. For proposed permittees that are corporations or LLC's, documentation from the NC Secretary of
State demonstrating that the proposed permittee is a legal and viable entity able to conduct
business in North Carolina.
Y 4. If Part B, Items 1 or 3 of this form is selected, the signed and notarized
applicable O&M agreement(s) from the proposed permittee, as required by the permit.
Y 5. Legal documentation that the property has transferred to the proposed permittee (such as a
recorded deed for the property, uncompleted development and/or common areas) or legal
documentation demonstrating that the proposed permittee is the sole claimant of the right to
engage in the permitted activity.,
X 6. If required by the permit and if the project has been built, a signed, sealed and dated certification
document from a licensed professional stating that the stormwater management system has been
inspected and that it has been built and maintained in accordance with the approved plans.
Y 7. A copy of the recorded covenants and deed restrictions, if required by the permit. If the project has
been built, documentation that the maximum allowed per lot built -upon area or the maximum
allowed total built -upon area has not been exceeded. If the project has not been built, the new
owner shall provide a_signed agreement to submit final recorded deed restrictions and protective
covenants.
8. If transferring under G.S. 143-214.7(c2) (i.e., Part B, Item 2 of this form is selected),
documentation verifying that 50% or more of the lots have been conveyed to individuals (not
builders). Copies of the deeds of conveyance or a chart listing the lot number, lot address,
owner's name, conveyance date and deed book and page number are acceptable.
9. If transferring under G.S. 143-214.7(c5) (i.e., Part B, Item 3 of this form is selected), provide legal
documentation supporting the dissolution of the corporation or documentation supporting the
current permittee was lawfully and finally divested of title of the property.
10. A copy of the lease agreement if the proposed permittee is the lessee.
11. A copy of the pending sales agreement if the proposed permittee is the purchaser.
12, A copy of the development agreement if the proposed permittee is the developer.
Stormwater Permit Transfer Application Form Page 3 of 7 April 27, 2018

D. CURRENT PERMITTEE INFORMATION AND CERTIFICATION Please be sure to provide Email.
1. Current Permit Holder's Company Name/Organization: Caviness Land Development, Inc
2. Signing Official's Name: Watson Caviness
3. Signing Official's Title: President
4. Mailing Address: 639 Executive Place, Suite 400
City: Fayetteville State: NC ZIP : 28305
5. Street Address: 639 Executive Place, Suite 400
City: Fayetteville State: NC ZIP: 28305
6. Phone: [phone] Email: watsonncavinessandcates.com
I, Watson Caviness , the current permittee, am submitting this application for a
transfer of ownership for the above listed stormwater permit under the General Statute and Session Law identified
on Page 1 of this application. I hereby notify DEMLR of the sale or other legal transfer of the property/project
and/or the stormwater system associated with this permit. I have provided a copy of the following documents to
the proposed permittee named in this application form: (select all that apply)
® the most recent permit;
® the designer's certification for each SCM;
® any recorded deed restrictions, covenants, common areas, drainage easements or plats;
® the approved plans and/or approved as -built plans,
® the approved operation and maintenance agreement;
❑ past maintenance records from the previous permittee (where required);
® a copy of the most recent inspection report,
I further attest that this application and request for a permit transfer is accurate and complete to the best of my
knowledge. I attest that I have provided all of the required items per the law to transfer this permit. I understand
that if all required parts of this request are not completed or if all required supporting information and attachments
listed above are not included, this request package will be returned as incomplete I assign all rights and
obligations as permittee to the proposed permittee named below. I understand that this request to transfer the
permit may not be approved by the DEMLR unless and until the facility is in compliance with the permit.
Signature: Date:
`' F�
I, Voc�e�5c. S. �� a Notary Public for the State of
that
County of do hereby certify
personally appeared before me
this the CNri� day of 'ice e c c 20 �� , and acknowledge the due
uuaunn
executiofdrg7 %instrument. Witness my hand and official seal,
My
My
EXPIRES
Stormwater Permit Transfer Application Form Page 4 of 7 April 27, 2018

E. PROPOSED PERMITTEE INFORMATION
The proposed permittee is the:
® Property owner (Also complete Part F.)
® Home Owners Association (HOA), Property Owners Association (PDA), or Unit Owner Association
(UOA) (Also complete Part F.)
❑ Lessee - Attach a copy of the lease agreement. Both the lessee and the property owner will appear on
the permit as co-permittees. If the lease is terminated, responsibility for the permit reverts to the property
owner. (Also complete Parts F & G.)
❑ Purchaser -Attach a copy of the pending sales agreement. The permit will require submission of a copy
of the recorded deed after the purchase has taken place. if the purchase agreement is cancelled the
permit reverts to the property owner. (Also complete Parts F & G.)
❑ Developer - Attach a copy of the development agreement. Both the developer and the property owner
will appear on the permit as co-permittees. If the development agreement is terminated, responsibility for
the permit reverts to the property owner. (Also complete Parts F & G.)
2. Proposed permittee name (check one of the following and provide the name):
❑ Corporation, LLC, Partnership, Municipality name:
® HOA/ POA/UOAname: _13GAcK4rrdA'.v UtttF-6-t, Owe4,
❑ Sole Proprietor
3. Proposed permittee contact information:
Please be sure to provide Email:
a. Signing Official's Name: //'%A-vr R4-D0;neQ -9/20—J
b. Signing Official's Title: S(.u.Var Ji.0 U,(La,
c. Mailing Address: %So 7e.,J Floµ MA&4*64 --✓T-1 Zrk7 c Dn S4e-. IC
City: FrrYf.Tr-e jI C L <6 State: _rtt�zlp : 2-9303
d. Street Address: JfG. / G
City: t,e, State: NG ZIP: Zkf3°j
e. Phone: /0 45 - 37Li Email:_ fnt'FD koc., to-t
4. If there is a Management Entity that manages the property for an HOA, PDA or UOA, please provide:
Please be'sure'to provide Email.
a. Management.Company or Business name: Sou�r/tapsrwJ fi0� yv�gy lgTre ram,+-�T
b. Contact Name: %TR,44DFb8D Bi2o..�) Title: fV A. A4-_4�
c.. Mailing Address: ASS'-% RAve.-JlVr4a. Dr. t<f-E-e ICE
d. City: FArY-esf .,t—C.p, State: A.)(- ZIP: ZX-343
e: Phone: ( A y93- 3-767 Email: tam_
Stormwater Permit Transfer Application Form Page 5 of 7 April 27, 2018

F. PROPOSED PERMITTEE CERTIFICATION
7�m�s (Znorbao 3row.� ram....
I, ��at° k� etc L4lfcye. o� . t ycroa hereby notify the DEMLR that I have acquired through sale, lease,
development agreement, r other legal transfer, the project/property covered by the stormwater management
permit and/or the responsibility for constructing and/or operating and maintaining the permitted stormwater
management system. I acknowledge and attest that I have received a copy of: (select all that apply):
® the most recent permit;
the designer's certification for each SCM;
any recorded deed restrictions, covenants, common areas, drainage easements or plats;
® the approved plans and/or approved as -built plans;
® the approved operation and maintenance agreement;
past maintenance records from the previous permittee (where required);
a copy of the most recent inspection report;
❑ Check here if the proposed permittee agrees to be the entity responsible for addressing any compliance
issues outlined in the Compliance Inspection Report. If checked, the proposed permittee must provide a
written document statement, with a `plan of action and schedule" addressed to this office stating that they will
bring the project into compliance upon receipt of the transferred permit. This written plan of action and
schedule" must be received by the Division before the Division will transfer the permit.
I have reviewed the permit, approved plans and other documents listed above, and I acknowledge that I will
comply,with the terms and conditions of the permit. I will construct the project's built -upon area as shown on the
approved plans; and I will (construct), operate and maintain the approved stormwater management system
pursuant to the requirements listed in the permit and in the operation and maintenance agreement.
Date: ?-
G
Signa//t��ure: � /' ��/6 '''�/ ��
i, 4I1 d re- t UaUtQ I" a Notary Public for the State of l ll d
County of ba,�iA do hereby certify that... )kAdkKal
��(1�-- ``%
personally appeared before me this the rla� o�f.^,202�, and
acknowledge the due execution of the forgoing instru lent. Witness my 4gq and official seal,
C NOTgo Z _
°LC
Notary Signature
My commission expires
1Lv
Stormwater Permit Transfer Application Form Page 6 of 7 April 27, 2018

G. PROPERTY OWNER INFORMATION AND CERTIFICATION
Fill out this section only if the property owner is different from the proposed permittee. The permit will revert to
the property owner if the purchase agreement, development agreement or lease expires or is terminated.
Company Name/Organization:
Signing Official's Printed Name:
Signing Official's Title:
Mailing Address: _
City: State: ZIP:
Phone: (_) Email:
I, , hereby certify that I currently own the property identified in
this permit transfer document and acknowledge that the Proposed Permittee listed in Part F will be purchasing the
property, developing the property on my behalf, and/or leasing the property from me. A copy of the purchase
agreement, development agreement or the lease agreement, which names the party responsible for the
construction and/or operation and maintenance of the stormwater system, has been provided with the permit
transfer request.
I agree to notify DEMLR within 30 days if there are any changes to the purchase, developer or lease agreements
and will submit the applicable completed and signed Permit Information Update Form, or Permit Transfer
Application Form to address these changes. As the legal property owner, I acknowledge, understand, and agree
by my signature below, that the permit will revert to me and I will be responsible for complying with the DEMLR
Stormwater permit if the property purchase, lease or developer agreement/contract is cancelled or defaults. I
understand that any individual or entity found to be in noncompliance with the provisions of the stormwater
management permit or the stormwater rules, is subject to enforcement action as set forth in NC General Statute
(NCGS) 143, Article 21.
Signature of the property owner
a Notary Public for the State of
Date:
County of , do hereby certify that
personally appeared before me this the day of
20 , and acknowledge the due execution of the forgoing instrument. Witness
my hand and official seal,
(Notary Seal)
Notary Signature
My commission expires_
Stormwater Permit Transfer Application Form Page 7 of 7 April 27, 2018

State Stormwater Permit
Permit No. SW6140902
Caviness Land Development, Inc,
Blackbridge Village Subdivision
Town of Hope Mills in Cumberland County
Designer's Certification
RECEIVED
MAY 13 2021
DEMLR
Fayetteville Regional OffirP
C. Scott Brown Civil Engineer
as a duly registered in the
State of North Carolina, having been authorized to observe f periodically/ weekly/
full time) the construction of the project,
Blackbridge Village Subdivision
(Project Name)
for Caviness Land Development, Inc
(Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the prdject
construction such that the construction was observed to be built within substantial -='=
compliance and intent of the approved plans and specifications.
Noted deviations from approved plans and specification:
(�t
Signature \
Registration Number 27452
Date July 7, 2020
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Energy. Mineral
ant! Land Resour-ces
E N V �RONMCNTAI. OIIALI'(Y
March 17, 2016
Mr. Watson G. Caviness
Caviness Land Development Company
639 Executive Place, Suite'400
Fayetteville, North Carolina 28305
PAT NICCRURY
f�pl.(flleu
DONALD R. VAN DER VAART
Subject: Stormwater Permit No. SW6140902 — Minor Revision
Blackbridge Village Subdivision
High Density Commercial Infiltration Basin Project
Cumberland County
Dear Mr. Caviness:
..,noun
TRACY DAVIS
The Stormwater Permitting Unit received a complete revision package to the existing
Stormwater Management Permit SW6140902 for the Blackbridge Village Subdivision project on
March 16, 2016. Staff review of the plans and specifications has determined that the project, as
revised, will comply with the Stormwater Regulations set forth in Title 15A NCAC 2H.1000 and
Session Law 2006-246. We are forwarding this revision approval letter dated March 17, 2016, to
Permit No. SW6140902, originally issued October 10, 2014, for the construction, operation and
maintenance of the subject project and the revised stormwater BMPs.
This permit expiration date shall not change and shall be effective from the original date of
issuance until October 9, 2022 and shall be subject to the conditions and limitations as specified
therein, and does not supersede any other agency permit that may be required. Please pay
special attention to the conditions listed in this permit regarding the Operation and Maintenance
of the BMP(s), recordation of deed restrictions, procedures for changes of ownership,
transferring the permit, and renewing the permit. Failure to establish an adequate system for
operation and maintenance of the stormwater management system, to record deed restrictions,
to follow the procedures for transfer of the permit, or to renew the permit, 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 by filing a written petition with the Office of
Administrative Hearings (OAH). The written petition must conform to Chapter 150E of the North
Carolina General Statutes. Per NCGS 143-215(e) the petition must be filed with the OAH within
thirty (30) days of receipt of this permit. You should contact the OAH with all questions
regarding the filing fee (if a filing fee is required) and/or the details of the filing process at 6714
Mail Service Center, Raleigh, NC 27699-6714, or via telephone at 919-431-3000, or visit their
website at www.NCOAH.com. Unless such demands are made this permit shall be final and
binding.
Stale of North Carolina i Eneiron,mnial Quality I Encrgy. Mimml am LarW Resources
Address I i Addms 2 1 City, State ZIP
000 000 0000 1'

After thirty days from the date of this letter, this project will be kept on file at the NCDENR
Division of Energy, Mineral and Land Resources, Land Quality Section, Fayetteville Regional
Office. If you have questions after that time, please contact Mike Lawyer,
[e-mail], or Tim LaBounty, tim.labounty(a�ncdenr.gov, of that office. Until that
time, if you have any questions or need additional information concerning this permit, please
contact Bill Diuguid at [phone]; or [e-mail].
Sincerely,
Original Signed by William H. Diuguid
William H. Diuguid, AICP, Plans Reviewer
for Tracy E. Davis, P.E., CPM
Director, Division of Energy,
Mineral and Land Resources
ec: Scott Brown, P.E., 4DSiteSolutions, Fayetteville
Tim LaBounty, NCDENR DEMLR, Land Quality Section, Fayetteville Regional Office,
Mike Lawyer, NCDENR DEMLR Land Quality Section, Fayetteville Regional Office
cc: Stormwater Permitting Unit Files — SW6140902
Attachments

Permit
(to be provided by D WQ)
®���
2aFWA7FgQ6
0
STORMWATER MANAGEMENT PERMIT APPLICATION FORM o aY
NCDENR
401 CERTIFICATION APPLICATION FORM
INFILTRATION 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.
I. PROJECT INFORMATION
Project Name
Contact Person
Phone Number
Date
Drainage Area Number
II. DESIGN INFORMATION
Site Characteristics
Drainage area
952,695.00
fl2
Impervious area
Percent impervious
275,527.00
28.92
ff2
%
i
��(N;IC+ llp
. Q
Design rainfall depth
1.00
in
Peak Flow Calculations
Q "
1-yr, 24-hr rainfall depth
3.02
in
SEAL . =_
1-yr, 24-hr intensity
0.13
in/hr
"- '%-027452
Pre -development 1-yr, 24-hr discharge
0.85
ft3lsec
Post -development 1-yr, 24-hrdischarge
0.00
ft'Isec%
�1
�1'FNGINE.e':�
Pre/Post 1-yr, 24-hr peak Flow control
-0.85
ft'Isec
�,� S`L.O�
Storage Volume: Nori Waters
eQ,O
2j�r,,,,,,,,�``�-f
I'I
Minimum design volume required
24,610.00
h'
D4•
fi�'
"�
Design volume provided
186,766.00'
h'
OK for non -SA waters
Storage Volume: SA Waters
1.5' runoff volume
ft3
Pre -development 1-yr, 24-hr runoff volume
0
Post -development 1-yr, 24-hr runoff volume
ft3
Minimum required volume
ft3
Volume provided
ft3
Soils Report Summary
Soil type
Loamy Sand
Infiltration rate
1.29
inlhr
SHWT elevation
fmsl
Basin Design Parameters
Drawdown time
1.50
days OK
Basin side slopes
3.00
:1 OK
Basin bottom elevation
151.00
fmsl OK
Storage elevation
152.38
fmsl r• 1 5
Storage Surface Area
11,346.00
ff2
Top elevation
162.00
fmsl
Basin Bottom Dimensions
Basin length
220.00
ft
Basin width
36.00
It
Bottom Surface Area
7,894.00
ff2
Form SW401-Infiftmfion Basin-Revb 11Apr2011 Parts I. & II. Design Summary, Page 1 of 2

Permit
(to be provided by DWQ)
Additional Information
Maximum runoff to each inlet to the basin?
ac-in
Length of vegetative filter for overflow
ft
Distance to structure
23.00
If
OK
Distance from surface waters
3,000.00
It
OK
Distance from water supply well(s)
150.00
it
OK
Separation from impervious soil layer
If
Naturally occuring soil above shwt
fl
Bottom covered with 4-in of clean sand?
Y
(Y or N)
OK
Proposed drainage easement provided?
Y
(Y or N)
OK
Capures all runoff at ultimate build -out?
Y
(Y or N)
OK
Bypass provided for larger storms?
Y
(Y or N)
OK
Pretreatment device provided
Forebay
Form SW401-Infiltration Basin-Rev.5 11 Apf2011 Pans I. & 11, Design Summary, Page 2 of 2

Permit Number: Sfj(o140g0 Z.
(to be provided by DWQ)
Drainage Area Number:
Infiltration Basin 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 maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the
. infiltration basin.
Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
— No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
— The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basin is established, it will be inspected once a quarter 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.
OCT 1 6 K!';
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin
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 or
The pipe is clogged (if
Unclog the pipe. Dispose of the
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.
Form SW401-Infiltration Basin O&M-Rev.3 Page 1 of 3

BMP element:
Potentialproblem:
How I will remediate theproblem:
The forebay
Sediment has accumulated
Search for the source of the
and reduced the depth to 75 %
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred. or
Provide additional erosion
riprap is displaced.
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticides are used, wipe
them on the plants rather than
spraying.
The main treatment area
A visible layer of sediment
Search for the source of the
has accumulated.
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP. Replace any media that
was removed in the process.
Revegetate disturbed areas
immediately.
Water is standing more than
Replace the top few inches of filter
5 days after a storm event.
media and see if this corrects the
standing water problem. If so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Weeds and noxious plants are
Remove the plants by hand or by
growing in the main
wiping them with pesticide (do not
treatment area.
spray).
The embankment
Shrubs or trees have started
Remove shrubs or trees
to grow on the embankment.
immediately -
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose
of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
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-Infiltration Basin O&M-Rev.3 Page 2 of 3

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: Blackbridge Village Subdivision
BMP drainage area number: 1
Print name: Watson Caviness
Address: 639 Executive Place, Suite 400, Fayetteville NC 28305
Phone:[phone]
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, C Oh L t`fCc k✓. /—ay pc-ld yl) a Notary Public for the State of
County of (✓umber/aho( , do hereby certify that
%vim t5el) La ✓i cress personally appeared before me this /6Vh
day of �Z&p7�elk6 i- 0/y , and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
`a A�cieoJcc� a.�`
Az,Q/�
NOTARy
PUBLIC .
ft cc
SEAL
My commission expires
Form SW40 I -Infiltration Basin O&M-Rev3 Page 3 of 3

High Density Residential Subdivisions
Deed Restrictions & Protective Covenances
In accordance with Title 15 NCAC 2H.1000 and S.L. 2006-246, the Stormwater Management Regulations,
deed restrictions and protective covenants are required for High Density Residential Subdivisions where
lots will be subdivided and sold and runoff will be treated in an engineered stormwater. control facility. Deed
restrictions and protective covenants are necessary to ensure that the development maintains a "built -upon"
area consistent with the design criteria used to size the stormwater control facility.
I, Watson Caviness , acknowledge, affirm and agree by my signature below, that I will cause
the following deed restrictions and covenants to be recorded prior to the sale of any lot:
1. The following covenants are intended to ensure ongoing compliance with State Stormwater
Management Permit Number,,5A 54o 90 Z , as issued by the Division of Water Quality under the
Stormwater Management Regulations.
2. The State of North Carolina is made a beneficiary of these covenants to the extent necessary to
maintain compliance with the stormwater management permit.
3. These covenants are to run with the land and be binding on all persons and parties claiming under
them.
4. The covenants pertaining to stormwater may not be altered or rescinded without the express written
consent of the State of North Carolina, Division of Water Quality.
5. Alteration of the drainage as shown on the approved plan may not take place without the concurrence
of the Division of Water Quality.
6. The maximum allowable built -upon area per lot is _3, 000 square feet. This allotted amount includes
any built -upon area constructed within the lot property boundaries, and that portion of the right-of-way
between the front lot line and the edge of the pavement. Built upon area includes, but is not limited to,
structures, asphalt, concrete, gravel, brick, stone, slate, coquina and parking areas, but does not
include raised, open wood decking, or the water surface of swimming pools.
OR, if the proposed built -upon areas per lot will vary, please REPLACE #6 above with the following:
6. The maximum built -upon area per lot, in square feet, is as listed below:
Lot # BUA Lot # BUA Lot # BUA Lot # BUA
This allotted amount includes any built -upon area constructed within the lot property boundaries, and
that portion of the right-of-way between the front lot line and the edge of the pavement. Built upon area
includes, but is not limited to, structures, asphalt, concrete, gravel, brick, stone, slate, coquina and
parking areas, but does not include raised, open wood decking, or the water surface of swimming
pools.
7. Each lot will maintain a 30** foot wide vegetated buffer between all impervious areas and surface
waters.
**50 foot for projects located in the 20 coastal counties.
8. All runoff from the built -upon areas on the lot must drain into the permitted system. This may be
accomplished through a variety of means including roof drain gutters which drain to the street, grading
the lot to drain toward the street, or grading perimeter swales to collect the lot runoff and directing them
into a component of the stormwater collection system. Lots that will naturally drain into the system are
not required to provide these additional measures.
Form DRPC-') Rev.2 05Nov2009 Page t of 2

High Density Residential Subdivisions
Deed Restrictions & Protective Covenances
Date:
a Notary Public in the
State of /V 0/'Y-n LAI'O // 1)a— ,County of C,Vkb t'P1a /1Q-
do hereby certify that (Nf 7&41V d 11;Ale5/S personally appeared
before me this the /DYE / day of �L°/�T�//L D L�/ ` 20, and acknowledge
the due execution of the foregoing instrument. Witness my hand and `�ffil d'%tf,,
,CI /R
SEAL -.'(
Signaty e � Jo. NOTARY . -
My Commission expires O6G/2 e P�BCIC
Form DRPC-3 Rev.2 05Nov2009 Page 2 of 2