SW8030120_HISTORICAL FILE_20160308

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 03 OIZO
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
2olb p 30 8
YYYYMMDD

PAT MCCRORY
Governor
DONALD R. VAN DER VAART
Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
March 8, 2016
Robert Exum, President
Waterford Master Commercial Association, Inc.
P.O. Box 1967
Wilmington, NC 28402
Subject: State Stormwater Management Permit No. SW8 030120 Mod
Waterford Way
High Density Subdivision Wet Detention Pond Project
Brunswick County
Dear Mr. Exum:
Secretary
TRACY DAVIS
Drrectnr
The Wilmington Regional Office received a complete, modified State Stormwater Management Permit
Application for Waterford Way on January 7, 2016. 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. We are forwarding modified Permit No. SW8 030120 Mod dated March 8, 2016,
for the construction, operation and maintenance of the BMP's and built -upon area associated with the
subject project.
This permit shall be effective from the date of issuance until February 4, 2018, and shall be subject to the
conditions and limitations as specified therein. Please pay special attention to the conditions listed in this
permit regarding the Operation and Maintenance of the BMP(s), recordation of deed restrictions,
certification of the BMP's, procedures for changing 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 certify the BMP's, to transfer the permit, or to renew
the permit, will result in future compliance problems.
The following modifications are included and covered by this permit:
The stormwater permit boundary now includes the Rogers Tract Lot#4 (undeveloped), previously
of the Magnolia Station permit (SW8 010917), now designated as Lot 5 in this permit. The
addition of this lot increases the permitted drainage area and allowable built -upon area (BUA) in
the permit. Please note that the permittee must submit a separate Offsite Stormwater
Management Permit application package to the Division and receive a permit prior to any .
construction on this lot.
2. Minor changes to the pond, such as raising the permanent pool and enlarging the orifice diameter
on the outlet structure, are required to handle the additional BUA.
3. All permitted BUA is being allocated into offsite permits for each of five (5) lots, which includes
Lot 1 (same as previous) and new Lots 2, 3, 4, & 5 (Rogers Tract Lot 44).
State of North Carolina I Environmental Quality I Energy, Nanerel and Land Resources
127 Cardinal Drive Extension I Wilmington, NC 28405
910 796 7215 T 1 910 350 2004 F I Into //oMal.ncdenr.or¢/we6/Ir/

State Stormwater Permit No. S W 8 030120
Page 2 of 2 r
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.
If you have any questions, or need additional information, please contact Steve Posey in the Wilmington
Regional Office, at [phone].
Sincer y,
_�¢�,��
.",Tracy Davis, .E., Director
Division of Energy, Mineral and Land Resources
GDS/sgp: \\\Stormwater\Permits & Projects\2003\030120 HD\2016 03 permit-2 030120
cc: Matt Haley, PE — Cape Fear Engineering
Brunswick County Inspections
Brunswick County Engineering
Wilmington Regional Office Stormwater File
State of North Carolma I Environmental Quality I Energy, Mmeral and land Resources
127 Cardinal Dnve Eztenvon I Wilmington, NC 29405
910 796 7215 T 1 9103502004 F I ban ://oorml.ncdenr.orrJ eb1l

State Stormwater Management Systems
Permit No. SW8 030120 Mod
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
Waterford Master Commercial Association, Inc.
Waterford Way
US 17 South at Poole Road, Leland, Brunswick County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with the
provisions of 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 Energy, Mineral and
Land Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until February 4, 2018, 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 1.5 on page 3 of this permit. The subdivision is
permitted for 5 lots, each allowed built -upon area (BUA) as follows:
Lot No.
Description
Lot Area, ac
Max. BUA, ac (sq ft)
1
1.42
1.29 56,397 sq ft
2
1.04
0 74 32,150 sq ft
3
1 88
143 62,500 sq ft
4
1.53
1.41 61,300 sq ft
5
Ro er's Tract #4
k 1.28
0.98 42,479 sq ft)
The total drainage area is 7.15 acres and the total built -upon area to be treated in
the pond is 5.85 acres or 254,826 ft2.
Page 3 of 10

State Stormwater Management Systems
Permit No. SW8 030120 Mod
3. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
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 following design elements have been
permitted for this wet detention pond
stormwater facility, and must be provided
in the system at all times.
a. Drainage Area, acres:
7.15
Onsite, ftz:
311,454
Offsite, ft2:
None
b. Total Impervious Surfaces, ftz:
254,826
Lot #1, ftz:
56,397
Lot #2, ftz:
32,150
Lot #3, ftz:
62,500
Lot #4, ftz:
61,300
Lot #5 (Roger's Tract #4), ftz:
42,479
c. Pond Depth, feet:
7.0
d. TSS removal efficiency:
90%
e. Design Storm, inches:
1
f. Permanent Pool Elevation, FMSL:
22.0
g. Permitted Surface Area @PP, ftz:
10,964
h. Permitted Storage Volume, ft3:
21,461
i. Storage Elevation, FMSL:
23.7
j: Controlling Orifice:
2.0"0 pipe
k. Permanent Pool Volume, ft3:
38,489
I. Forebay Volume, ft3:
6,174
m. Maximum Fountain Horsepower:
1/6
n. Receiving Stream / River Basin:
Jackey's Creek / CPF17
o. Stream Index Number:
18-77-3
p. Classification of Water Body:
"C Sw"
II. SCHEDULE OF COMPLIANCE
No homeowner/lot owner/developer shall fill in, alter, or pipe any drainage feature
(such as swales) shown on the approved plans as part of the stormwater
management system without submitting a revision to the permit and receiving
approval from the Division.
The permittee is responsible for verifying that the proposed built -upon area for
the entire lot, including driveways and sidewalks, does not exceed the allowable
built -upon area. Once the lot transfer is complete, the built -upon area may not be
revised without approval from the Division of Energy, Mineral and Land
Resources, and responsibility for meeting the built -upon area limit is transferred
to the individual property owner.
If an Architectural Review Board or Committee is required to review plans for
compliance with the BUA limit, the plans reviewed must include all proposed
built -upon area. Any approvals given by the Board do not relieve the homeowner
of the responsibility to maintain compliance with the permitted BUA limit.
Page 4 of 10

State Stormwater Management Systems
Permit No. SW8 030120 Mod
4. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to the approved plans, regardless of size.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area.
e. Further subdivision, acquisition, or sale of all or part of the project area.
The project area is defined as all property owned by the permittee, for
which Sedimentation and Erosion Control Plan approval or a CAMA Major
permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
The Director may determine that other revisions to the project should require a
modification to the permit.
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.
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.
9. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
10. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification.
11. If the stormwater system was used as an Erosion Control device, it must be
restored to design condition prior to operation as a stormwater treatment device,
and prior to occupancy of the facility.
12. Permanent seeding requirements for the stormwater control must follow the
guidelines established in the North Carolina Erosion and Sediment Control
Planning and Design Manual.
13. The permittee shall at all times provide the operation and maintenance
necessary to assure that all components of the permitted stormwater system
function at optimum efficiency. The approved Operation and Maintenance Plan
must be followed in its entirety and maintenance must occur at the scheduled
intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of side slopes.
d. Immediate repair of eroded areas.
e. Maintenance of side slopes in accordance with approved plans and
specifications.
Page 5 of 10

State Stormwater Management Systems
Permit No. SW8 030120 Mod
f. Debris removal and unclogging of structures, orifice, catch basins and
piping.
g. Access to all components of the system must be available at all times.
14. Records of maintenance activities must be kept and made available upon
request to authorized personnel of DEMLR. The records will indicate the date,
activity, name of person performing the work and what actions were taken.
15. Prior to the sale of any lots, the following deed restrictions must be recorded:
a. The following covenants are intended to ensure ongoing compliance with
State Stormwater Management Permit Number SW8 030120 Mod., as
issued by the Division of Energy, Mineral and Land Resources under
NCAC 2H.1000.
b. The State of North Carolina is made a beneficiary of these covenants to
the extent necessary to maintain compliance with the Stormwater
Management Permit.
C. These covenants are to run with the land and be binding on all persons
and parties claiming under them.
d. The covenants pertaining to stormwater may not be altered or rescinded
without the express written consent of the State of North Carolina, Division
of Energy, Mineral and Land Resources.
e. Alteration of the drainage as shown on the approved plans may not take
place without the concurrence of the Division of Energy, Mineral and Land
Resources.
f. The maximum built -upon area per lot is as follows:
Lot No.
Description
Max. BUA, ac (sq ft)
1
1.29 56,397 sq ft
2
0.74 32,150 sq ft
3
1.43 62,500 sq ft
4
1.41 61,300 sq ft
5
Ro er's Tract #4
0.98 42,479 s ft
This allotted amount includes any built -upon area constructed within the
lot property boundaries, and that portion of the right-of-way between the
front lot line and the edge of the pavement. Built upon area includes, but is
not limited to, structures, asphalt, concrete, gravel, brick, stone, slate,
coquina and parking areas, but does not include raised, open wood
decking, or the water surface of swimming pools.
g. The runoff from all built -upon areas on the lot must drain into the permitted
system. This may be accomplished through providing roof drain gutters
which drain to the street, grading the lot to drain toward the street, or
grading perimeter swales and directing them into the pond or street. Lots
that will naturally drain into the system are not required to provide these
measures.
h. Built -upon area in excess of the permitted amount will require a permit
modification.
i. Each lot within the subdivision whose ownership is not retained by the
permittee, must submit a separate Offsite Stormwater Management Permit
application package to the Division of Energy, Mineral and Land
Resources and receive a permit prior to any construction on the lot.
16. A copy of the recorded deed restrictions must be submitted to the Division within
30 days of the date of recording the plat, and prior to selling lots. The recorded
copy must contain all of the statements above, the signature of the Permittee, the
deed book number and page, and the stamp/signature of the Register of Deeds.
Page 6 of 10

State Stormwater Management Systems
Permit No. SW8 030120 Mod
17. Decorative spray fountains will be allowed in the stormwater treatment system,
subject to the following criteria:
a. The fountain must draw its water from less than 2' below the permanent
pool surface.
b. Separated units, where the nozzle, pump and intake are connected by
tubing, may be used only if they draw water from the surface in the deepest
part of the pond.
C. The falling water from the fountain must be centered in the pond, away from
the shoreline.
d. The maximum horsepower for the fountain's pump is based on the
permanent pool volume. The maximum pump power for a fountain in this
pond is specified in Section 1.6 (m) of this permit.
18. Prior to transfer of the permit, the stormwater facilities will be inspected by
DEMLR personnel. The facility must be in compliance with all permit conditions.
Any items not in compliance must be repaired or replaced to design condition
prior to the transfer. Records of maintenance activities performed to date will be
required.
19. This permit shall become voidable unless the facilities are constructed in
accordance with the conditions of this permit, the approved plans and
specifications, and other supporting data.
III. GENERAL CONDITIONS
This permit is not transferable to any person or entity except after notice to and
approval by the Director. In the event there is either a desire for the facilities to
change ownership, or there is a name change of the Permittee, a
"Name/Ownership Change Form" must be submitted to the Division of Energy,
Mineral and Land Resources, signed by both parties, and accompanied by
appropriate documentation as listed on page 2 of the form. The project must be
in good standing with DEMLR. 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 of the terms and conditions
of this permit until such time as the Director approves the transfer request.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Energy, Mineral
and Land Resources, 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), which have 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 permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and reissuance or
termination does not stay any permit condition.
7. Permittee grants permission to staff of the DEMLR to access the property for the
purposes of inspecting the stormwater facilities during normal business hours.
Page 7 of 10

State Stormwater Management Systems
Permit No. SW8 030120 Mod
8. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes within 30 days.
9. 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.
Permit modified and reissued this the 8th day of March, 2016.
CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Page 8 of 10

DEMLR USE ONLY
ate
ived
ee Paid
Permit N tuber
'
I
Applica I Wes:
❑ Coastal SW -1995 ❑ CoaA61 SW - 2008 ❑ Ph II - Post Constniction
(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 Energy, Mineral and Land Resources
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.):
Waterford Way
2. Location of Project (street address):
City:Leland County:Brunswick Zip:28451
3. Directions to project (from nearest major intersection):
Located along the north Right -of -Way on Highway 17 at the intersection of Highway 17 and Olde Waterford
4. Latitude:34013' 02" N Longitude:78' 01' 14" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ❑New ®Modification ❑ Renewal w/ Modificationt
tRmewals with modifications also requires SWU-102 - Renewal Application Form
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numberSW8 030120 , its issue date (if known)07/02/07 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
3. If this application is being submitted as the result of a previously returned applic
DEMLR requesting a state stormwater management permit applicationgEp
if assigned,
Proposed,_
and the previous name of the
4. a. Additional Project Requirements (check applicable blanks; information (14
obtained by contacting the Customer Service Center at 1-877-623-6748): B'
❑CAMA Major ❑Sedimentation/Erosion Control: _
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
❑Other
or a letter from
W#-Fraiect number,
state Dermits"can be
ac of Disturbed Area
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? ®No ❑Ye
If yes, see S.L. 2012-200, Part VI: httD:Hportal.ncdenr.org/web/Ir/rules-and-regulations
Fonn SWU-101 Version Oct. 31, 2013 Page 1 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:Waterford Master Commercial Association, Inc.
Signing Official & Title:Robert Exum, President
b.Contact information for person listed in item la above:
Street Address:503 Olde Waterford Way
City:Leland State:NC Zip:28451
Mailing Address (if applicable):P.O. Box 1967
City:Wilmineton, NC State:NC Zip:28402
Phone: (910 ) 392-9325 Fax: ( )
Email:
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 Owner/Organization:
Signing Official & Title:
b. Contact information for person listed in item 2a above:
Street Address:
City: State: Zip:
Mailing Address (if applicable):
City: State: Zip:
Phone: ( ) Fax: ( )
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:
Signing Official & Title:
b. Contact information for person listed in item 3a above:
Mailing Address:
City: State: Zip:--
Phone: ( ) Fax: r V L�� .
Email: JAN 0 % ZQ{j
4. Local jurisdiction for building permits: Town of Leland
Point of Contact: Phone #:
Form SWU-101 Version Oct. 31, 2013 Page 2 of 7

IV.' PROJECT INFORMATION
i. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Runoff from 5 outparcels will be treated in a wet detention basin
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: Existing Stormwater Permit Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
® Coastal SW -1995 ❑ Ph I1- Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area: 7.15 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*:7.15 acres
Total project area shall be calculated to exclude thefollowing: 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 MHK9 line. The resultant project area is used to
calculate overall percent built upon area (BLIA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 81.8 %
9. How many drainage areas does the project have?1 (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.
EGEB E--a
JAN 0 7 201
BY:
Form SWU-101 Version Oct. 31, 2613 Page 3 of 7

Basin Information
Drainage Area 1
Drainage Area _
Drainage Area _
Drainage Area _
Receiving Stream Name
Jackeys Creek
Stream Class *
C; SW
Stream Index Number *
18-77-3
Total Drainage Area (so
7.15 AC (311,454
SF
On -site Drainage Area (so
0
Off -site Drainage Area (so
7.15 AC (311,454
SF
Proposed Impervious Area'' (so
5.85 AC (254,826
SF
Impervious Area" total
81.8 %
Impervious' Surface Area
Drainage Area 1
Drainage Area _
Drainage Area _
Drainage Area _
On -site Buildings/Lots (so
0
On -site Streets (so
0
On -site Parking (so
0
On -site Sidewalks (so
0
Other on -site (so
0
Future (so
0
Off -site (so
5.85 AC (254,826
SF
Existing BUA*** (so
0
Total (so:
5.85 AC (254,826
SF
* Stream Class and Index Number can be determined at: http.Vlportal.ncdenr.org/web/wq[ps/csu/classifications
** 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. Construction Plans
for individual Lots/ Ou tparcels
Projects in Union County: Contact DEMLR Central Ojjice staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15A NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS - CF i V F
The applicable state stormwater management permit supplement and operatio d in�intenanw (Odown & forms
must be submitted for each BMP specified for this project. The latest versions o e forms can be acted
fromh!W://portal.ncdenr.org/web/wq/ws/su/bmp-manual. BY:
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
hqp://portal.ncdenr.org/web/wq/ws/su/statesw/forms docs. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map at http://portal.ncdenr.org/web/wq/ws/su/mals.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. AB original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http://portaI.ncdenr.org/web/wg/ws/su/statesw/forms docs.
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 VII below)
Form SWU-101 Version Oct. 31, 2013 Page 4 of 7

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
hqp://www.envhelp.org/paages/onestopexpress.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/ 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.
mt�
fiTnA
PAT"
ff'` ry
7. Sealed, signed and dated calculations (one copy). _MKIA
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including: V"A—
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
In. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
I. Details of roads, drainage features, collection systems, and stormwater control measures.
in. Wetlands delineated, or a note on the plans that none exist (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify 1st A
elevations in addition to depths) as well as a map of the boring locations with the existing ejA5f1 It.Aa
elevations and boring logs. Include an 8.5"xll" copy of the NRCS County Soils map with the L 1-01VATQ.
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 DEMLR to verify the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: Page No:
11. 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 15A NCAC 2H.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
hU://www.secretaKy.state.nc.us/Corporations/`CSearch.aspx
JAN0]203
BY:--------- —
WAr" r%1h
N \f%
CSWAG or- J
�'V1Ctf� J
Form SWU-101 Version Oct. 31, 2013 Page 5 of 7

VIP. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each 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 htW:Hl2ortal.ncdenr.org/web/Ir/state-stormwater-
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 DEMLR, 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:Matthew T. Haley, PE
Consulting Firm: Cape Fear Engineering, Inc.
Mailing Address:151 Poole Road, Suite 100
City:Belville State:NC Zip:28451
Phone: (910 ) 383-1044
Email: matt.haleyQcapefearengineering.com
Fax: (910 ) 383-1045
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type 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 type name of person
listed in Contact Information, item la) with (print or type name of organization listed in
Contact Information, 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.
ECER "i"
JAN 0 7 203
BY:
Fonn SWU-101 Version Oct. 31, 2013 Page 6 of 7

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 DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR 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 . 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,
01Y.110
My commission
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item la) Robert Exum
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 21-1.1000 and any other applicable state stormwater requirements.
Signature: Date:
AIAI a Notary Public for the State ofNDi:/i1 6/vl/ 4%&fX
#Ad, County of fdo he eby certify that &OU� &� &UA07 personally appeared
before me this -#— day ofand acl o ledge due execution of the application for
a stormwater permit. Witness my hand and official seal, 1
\\o`xxx. K
GGGTE/yN���i
,•
r'•
NorA9' -
z
4�:AveLIC 1
9�
OVER 1CG\\\\\\xN�
SEAL
My commission expires 3 '2-7'/*-
rJ®'FWE
EAN 0 7 2016
BY:------�—
Form SWU-101 Version Oct. 31, 2013 Page 7 of 7

Pusey, Steven
From:
Matt Haley <[e-mail]>
Sent:
Monday, March 07, 2016 11:06 PM
To:
Pusey, Steven
Cc:
'Maria Jones
Subject:
Re: SW8 010917 & 030120
Steve,
As we discussed in the phone this afternoon, the subject Rogers Tract Lot 4 is currently undeveloped and still owned by
the permittee. An offsite permit will be submitted in the future once the lot is developed or sold. Please let me know if
you have any questions or need anything else.
Thanks,
Matthew Haley, P.E.
Cape Fear Engineering, Inc.
On Mar 7, 2016, at 4:50 PM, Pusey, Steven <[e-mail]> wrote:
Matt,
We will need an application for an offsite permit for the Roger's Tract Lot #4 of SW8 010917
since it is being removed from the permit. Have you already submitted this new application
and an application to modify SW8 010917? 1 am currently working on master permit SW8
030120 and have included this offsite lot as "Lot 5" on this modified permit. Please advise ASAP
so I can get this permit modified as quickly as possible. Let me know if you have any questions.
Thanks,
cnav¢ic Q. vm&"y.
Environmental Engineer
Division of Energy, Mineral and Land Resources — State Stonnwater Program
Department of Environmental Quality
910 796 7215 office
910 796 7334 direct
steven. ouseyoncden r.00v
127 Cardinal Drive Ext.
Wilmington, NC 28405
<image001.png>
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.
<image002.jpg> Before printing this email, please consider your budget and the environment