SW8100917_CURRENT PERMIT_20211130

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8
DOC TYPE]
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
2 0 21 1 1 .3 o
YYYYMMDD
i

ROY COOPER
Governor
EUZABETH S. BISER
&=rtory
BRIAN WRENN
Mwilor
November 30, 2021
Lessee
Gregory G. Flynn, President
Bell Carolina, LLC
P.O. Box 507
West Linn, OR 97068
And
Owner
NORTH CAROLINA
EnAronmento/ Quality
Christopher P. Tessitore, Executive V.P. of NNN GP
For National Retail Properties, LP
450 South Orange Avenue, Suite 900
Orlando, FL 32801
Subject: Permit Renewal
Post -Construction Stormwater Management Permit No. SW8 100917
Taco Bell Shallotte
Brunswick County
Dear Mr.Flynn :
The Division of Energy, Mineral and Land Resources received a complete 8-year Permit Renewal Application for
the subject permit on November 10, 2021. The Division is hereby notifying you that permit SW8 100917 has
been renewed, updated, and re -issued on November 30, 2021, as attached. Please be aware that the renewal and
re -issuance of this stormwater permit does not imply that the site is currently in compliance.
This permit shall be effective until October 2, 2029, and does not supersede any other agency permit that may be
required. The project shall be subject to the conditions and limitations as specified therein. This permit does not
impose new or increased stormwater control requirements; it clarifies the rules and requirements of this program
to provide you with a better understanding of your obligations under this permit. Failure to comply with these
requirements will result in future compliance problems. Please note that this permit is not transferable except
after notice to and approval by the Division.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request
H).
an adjudicatory hearing by filing a written petition with the Office of Administrative Hearings (OAThe
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 concerning this permit, please contact Ashley Smith in the Wilmington Regional
Office, at [phone] or [e-mail]
Sincerely, {}
C� rV�1.., (�L( ( f LA
5�; Brian Wrenn, Director
Division of Energy, Mineral and Land Resources
D ra O%Z North Carolina Department of Envoonmental Quality I Dmston of Energy, Mneral and Land Resources
Wilmington Regional Office 1127 Cardinal Drive Extension I Wihmngton. North Carolina 28405
9107%7215

State Stormwater Permit No SW8 100917
Page 2 of 2
Enclosures
DES/ams
CC.
Attachment C — Permitting History
Renewal Application Documents
WStorrnwater\Permits & Pr jects\2010\100917 HD\2021 It permit 100917
Wihmngton Regional Office Stormwater File
r. D rk AVk North Carolina Department of Environmental Quality I Division of Energy. Mineral and Land Resources
./ Wilmington Regional Office 1127 Cardinal Drive Extension I Wimngtom North Carolina 28405
9107967215

State Stormwater Management
Permit # SW8 100917
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY SUBDIVISION DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws. Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Bell Carolina, LLC
Taco Bell - Shallotte
4461 Main Street, Shallotte, Brunswick County
FOR THE
construction, operation and maintenance of a wet detention pond in compliance with the provisions of
15A NCAC 2H 1000 and Session Law 2008-211 (hereafter collectively referred to as the "stormwater
rules') and as outlined in the application, approved stormwater management plans, supplement,
calculations, operation and maintenance agreement, recorded documents, specifications, and other
supporting data (the "approved plans and specifications") as attached and/or on file with and
approved by the Division of Energy, Mineral and Land Resources (the "Division" or "DEMLR") The
project shall be constructed, operated and maintained in accordance with these approved plans and
specifications The approved plans and specifications are incorporated by reference and are
enforceable part of this permit
This permit shall be effective from the date of issuance until October 2, 2029 and shall be subject to
the following specified conditions and limitations 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 condition 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 for cause as allowed by the laws, rules, and regulations contained in Title 15A
NCAC 2H 1000 and NCGS 143-215 1 et al
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
This stormwater system has been approved for the management of stormwater runoff as
described in Section 17 on page 2 of this permit The stormwater control has been designed to
handle the runoff from 29,476 square feet of impervious area
A 50' wide vegetative buffer must be provided adjacent impounded structures, streams, rivers
and tidal waters
4 The tract will be limited to the amount of built -upon area indicated on page 2 of this permit, and
per approved plans
Page 1 of 6

State Stormwater Management
Permit # SW8 100917
5 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
6 The runoff from all built -upon area within the permitted drainage area(s) of this project must be
directed into the permitted stormwater control system
7 The following design criteria have been provided
in the wet detention pond and must be
maintained at design condition
a Drainage Area, acres
1 14
Onsde, ft2
35,681
Offsite, ft2
13,765
b Total Impervious Surfaces, ft2
29,476
Onsite, ft2
22,307
Offsde, ft2
7,169
c Design Storm, inches
1 5
d Average Pond Design Depth, feet
3
e TSS removal efficiency
90%
f Permanent Pool Elevation, FMSL
22
g Permanent Pool Surface Area, ft2
3,109
h Permitted Storage Volume, ft3
6,728
1 Temporary Storage Elevation, FMSL
2328
t Pre-dev 1 yr-24 hr discharge rate, cfs
0 7
k Controlling Orifice
1 25"0 pipe
I Orifice flowrate, cfs
003
m Permitted Forebay Volume, ft3
2,395
n Fountain Horsepower
N/A
o Receiving Stream/River Basin
Woodward Branch / Lumber
p Stream Index Number
15-25-2-8
q Classification of Water Body
"C, SW, HQW'
II. SCHEDULE OF COMPLIANCE
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 the design condition 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 vegetated filter
d Immediate repair of eroded areas
e Maintenance of all slopes in accordance with approved plans and specifications
f Debris removal and unclogging of outlet structure, orifice device, flow spreader, catch
basins and piping
a Access to the outlet structure must be available at all times
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
5 Decorative spray fountains will not be allowed in the stormwater treatment system, as the
permanent pool volume is less than 30,000 cubic feet
Page 2 of 6

State Stormwater Management
Permit # SW8 100917
6 The facilities shall be constructed, operated and maintained in accordance with the provisions
of this permit, the approved plans and specifications, and the supporting documents attached
to this permit and on file with the Division
No person or entity, including the permittee, shall alter any component shown in the approved
plans and specifications Prior to the construction of any modification to the approved plans,
the permittee shall submit to the Director, and shall have received approval for modified plans,
specifications, and calculations including, but not limited to, those listed below For changes to
the protect or SCM that impact the certifications, a new or updated certification(s), as
applicable, will be required and a copy must be submitted to the appropriate DEQ regional
office upon completion of the modification
Any modification to the approved plans and specifications, regardless of size including
the SCM(s), BUA, details, etc
Redesign or addition to the approved amount of BUA or to the drainage area
Further development, subdivision, acquisition, lease or sale of any, all or part of the
project and/or property area as reported in the approved plans and specifications
Altering, modifying, removing, relocating, redirecting, regrading, or resizing of any
component of the approved SCM(s), the stormwater collection system and/or
vegetative conveyance shown on the approved plan
The construction of any allocated future BUA
The construction of any permeable pavement, #57 stone area, public trails, or
landscaping material to be considered a permeable surface that were not included in
the approved plans and specifications
Other modifications as determined by the Director
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
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
10 Access to the stormwater facilities for inspection and maintenance shall be maintained via
appropriate recorded easements at all times
11 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
12 The designated permit holder, Bell Carolina LLC, shall be responsible for meeting the
conditions and limitations specified in the permit As required for compliance, a copy of the
lease agreement that outlines Bell Carolina LLC's responsibilities for this stormwater system
must be kept with the permit and maintenance activity records
Page 3 of 6

State Stormwater Management
Permit # SW8 100917
13 Please be aware that it is the responsibility of the permit holder, Bell Carolina LLC to notify the
Division of any changes in ownership and request an ownership/name change for the
stormwater permit However, please be reminded that if the lease agreement or contract
between Bell Carolina LLC and National Retail Properties, LP is dissolved, cancelled or
defaults, and the Division is not notified by Bell Carolina LLC to transfer the permit, then the
responsibility for permit compliance reverts back to the property owner As the property
owner, National Retail Properties, LP must notify the Division immediately of the permit
ownership change and submit a completed Name/Ownership form to the Division within 30
days Otherwise National Retail Properties, LP will be operating a stormwater treatment
facility without a valid permit This 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, being taken against the property owner, National Retail Properties, LP
III. GENERAL CONDITIONS
1 CORRECTIVE ACTIONS REQUIRED If the facilities fail to perform satisfactorily, the
permittee shall take immediate corrective actions This includes actions required by this
Division and the stormwater rules such as the construction of additional or replacement on -site
stormwater systems These additional or replacement measures shall receive a permit from
the Division prior to construction
2 PERMIT RENEWAL A permit renewal request must be submitted at least 180 days prior to
the expiration date of this permit The renewal request must include the appropriate
application, documentation and the processing fee as outlined in Title 15A NCAC
02H 1045(3)
3 CHANGES TO THE PROJECT NAME, PERMITTEE NAME OR CONTACT INFORMATION
The permittee shall submit a completed Permit Information Update Application Form to the
Division within 30 days to making any one of these changes
4 TRANSFER This permit is not transferable to any person or entity except after notice to and
approval by the Director Neither the sale of the project and/or property, in whole or in part, nor
the conveyance of common area to a third party constitutes an approved transfer of the permit
TRANSFER REQUEST The transfer request must include the appropriate application,
documentation and the processing fee as outlined in 15A NCAC 02H 1045(2) This
request must be submitted within 90 days of the permit holder meeting one or more of
the following
i A natural person who is deceased,
u A partnership, limited liability corporation, corporation, or any other business
association that has been dissolved,
ni A person or entity who has been lawfully and finally divested of title to the
property on which the permitted activity is occurring or will occur through
foreclosure, bankruptcy, or other legal proceeding
IV A person or entity who has sold the property, in whole or in part, on which the
permitted activity is occurring or will occur
TRANSFER INSPECTION Prior to transfer of the permit, a file review and site
inspection will be conducted by Division personnel to ensure the permit conditions
have been met and that the project and the on -site stormwater system complies with
the permit conditions Records of maintenance activities performed to date may be
requested Projects not in compliance with the permit will not be transferred until all
permit and/or general statute conditions are met
Page 4 of 6

State Stormwater Management
Permit # SW8 100917
COMPLIANCE The permittee is responsible for compliance with the terms and conditions of
this permit until the Division approves the transfer request
a APPROVED PLANS AND SPECIFICATIONS A copy of this permit, approved plans,
application, supplement, operation and maintenance agreement, all applicable
recorded documents, and specifications shall be maintained on file by the permittee at
all times
b DIVISION ACCESS The permittee grants Division Staff permission to enter the
property during normal business hours to inspect all components of the permitted
project
c ENFORCEMENT Any individual or entity found to be in noncompliance with the
provisions of a stormwater management permit or the requirements of the stormwater
rules is subject to enforcement procedures as set forth in NCGS 143 Article 21
d ANNUAL CERTIFICATION The permittee shall electronically submit to the Division an
annual certification completed by either the permittee or their designee confirming the
projects conformance with permit conditions
e OBTAINING COMPLIANCE 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 modified plans and certification in writing to the Director that the
changes have been made
f OTHER PERMITS The issuance of this permit does not preclude the permittee from
complying with and obtaining any other permits or approvals that are required for this
development to take place, as required by any statutes, rules, regulations, or
ordinances, which may be imposed by any other Local, State or Federal government
agency having jurisdiction Any activities undertaken at this site that cause a water
quality violation or undertaken prior to receipt of the necessary permits or approvals to
do so are considered violations of NCGS 143-215 1, and subject to enforcement
procedures pursuant to NCGS 143-215 6
Permit renewed, updated and reissued this the 30th day of November 2021
NOORRTHC.AROLIIjNA ENVIRONMENTAL MANAGEMENT COMMISSION
V �A .2 /m
c rian�Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Page 5 of 6

Attachment C - Permitting History
Taco Bell Shallotte
Approval
permit Action
BIMS
Description of the Changes
Date
Version
1 1/2/2010
Original
1 0
not located on G drive
Approval
1/31/2011
Modification
1 1
modified plan sheets (C-2.1 and C-3 1)
from Family Foods, Inc. to Bell Carolina,
LLC
Also, addendum was added listed Bell
Carolina, LLC as responsible for meeting
8/12/2014
Transfer
1.2
permit conditions required by lease
agrement Requires Bell Carolina to notify
the Division of any changes in owners
and/or contract between themselves and
National Retail Properties, LP as noted in
the permit
11/30/2021
Renewal
20

Permit Number.
(to be provided by DWQ)
Drainage Area Number.
Wet Detention 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.
The wet detention basin system is defined as the wet detention b
pretreatment including forebays and the vegetated filter if one is
This system (check one):
❑ does ® does not
This system (check one):
❑ does ® does not
DEC 10 2010
incorporate a vegetated filter at the
incorporate pretreatment other than a forebay.
Important maintenance procedures:
— Immediately after the wet detention basin is established, the plants on the
vegetated shelf and perimeter of the basin should be watered twice weekly if
needed, until the plants become established (commonly six weeks).
— No portion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
— Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
— If the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
— Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected 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 should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the wet
Areas of bare soil and/or
Regrade the soil if necessary to
detention 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
Vegetation is too short or too
Maintain vegetation at a height of
long
approximately six inches
Form SW401-Wet Detention Basin O&M-Rev.4 Page 1 of 4

Permit Number.
(to be provided by DWQ)
Drainage Area Number:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The inlet device: pipe or
The pipe is clogged.
Unclog the pipe. Dispose of the
swale
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to
swale.
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion
The forebay
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design depth for
possible Remove the sediment and
sediment storage.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
mattmg or riprap if needed to
prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying
The vegetated shelf
Best professional practices
Prune according to best professional
show that pruning is needed
practices
to maintam 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.
Weeds are present.
Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than s ram .
The main treatment area
Sediment has accumulated to
Search for the source of the
a depth greater than the
sediment and remedy the problem if
original design sediment
possible Remove the sediment and
storage depth
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over
Consult a professional to remove
50% of the area
and control the algal growth
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
the basin surface
with pesticide (do not spra
�/ L
DDC 10 2010
Form SW401-Wet Detention Basin O&M -Rev 4 t�:'_ Page 2 of 4

Permit Number.
(to be provided by DWQ)
Drainage Area Number
BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
Shrubs have started to grow
Remove shrubs immediately
on the embankment.
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
A tree has started to grow on
Consult a dam safety speciahst to
the embankment
remove the tree
An annual inspection by an
Make all needed repairs
appropriate professional
shows that the embankment
needs repair if applicable)
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 local NC Division of
damage have occurred at the
Water Quality Regional Office, or
outlet
the 401 Oversight Unit at 919-733-
1786
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads 6.00 feet in the main
sediment shall be removed.
When the permanent pool depth reads 6.00 feet in the forebay, the
shall be removed.
Sediment Removal
Bottom
BASIN DIAGRAM
ill in the blanks)
Permanent Pool Elevation 22 00
DEC 10 Z010
1610 i Pe anen Pool
------------------ Volume Sediment Removal Elevation 16 00 Volume
5500 -ft Min. --------------------------- ----------- ------
Sedtment Bottom Elevation 15.00 1-ft r
Storage Sedtmei
Storage
FOREBAY MAIN POND
Form SW401-Wet Detention Basin O&M-Rev.4
Page 3 of 4

Permit
(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: Shallotte Taco Bell
BMP drainage area number:
Print name: I�nlnrn;e. 1s. (� Y4-4Aeci S
Address: 10191 Ramsey Street, Linden, NC 28304
Phone: [phone]
Signature: �ti 1_y� k tA. ca'—)
Date: /.J\-7-1 o
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, / 14) �(,� `C yt�� a Notary Public for the State of
/4lfn �A , County of do hereby certify that
a1mi e 13, 1#4Wie6d5 personally appeared before me this 7d,
day of 7)e6 2 (m A a ��/i� , and acknowledge the due execution of the
forgoing/ /wet detention basin maintenance requirements. Witness my hand and official
seal,
SEAL
My commission expires 7 - 3 - w /5
DEC 10 2010
Form SW401-Wet Detention Basin O&M-Rev.4
Page 4 of 4

,DEMLRUSEONLYa,' " ',i
Date R ai ed
Fee Paid
Permit Number
3 0005 (60
,LAJ 8 100917
1029930 NC DEQ Division of Energy, Mineral and Land Resources Shallotte 3003036
STATE STORMWATER:
PERMIT RENEWAL APPLICATION FORM
In accordance with 15A NCAC 2H 1045(3), the current permit holder shall renew their high density�pegpit, J,8Ika �
poor to its expiration Renewed pennits are valid for a period of 8 years per Session Law 2011-398 (S '781) V
WI
Section 60. (c) This application form is for permit renewals only NOV 02 0
A. PROJECT INFORMATION DENRUNDOUAL"
BTORMWATER PERMITTING
1 State Stormwater Permit Number SW8 100917MOD
2 Project name Taco Bell #3003036
3 Project street address 4461 Main Street
City Shallotte County Brunswick ZIP 28470
4. What, if any, changes have been made to the project as permitted? none
If the project has changed from the original approved plans, please complete SWU-101 for a Ma/or
Modification or Minor Modification Application form available at https //deg nc gov/about/divisions/energv-
mineral-land-resources/energy-mineral-land-rules/stormwater-pros ram/post-construction.
B. PERMITTEE INFORMATION
If changes to the permittee or project name have been made, please complete either the Permit Update form
or the Permit Transfer form available at https //deg nc gov/about/dwisions/enemy-mineral-land-
resources/energy-mineral-land-rules/stormwater-program/post-construction State Stormwater Permits do not
automatically transfer with the sale of the property
1. Current Permit Holder's Company Name/Organization: Bell Carolina LLC
2. Signing Official's Name Gregory G Flynn
3. Signing Official's Title President
4. Mailing Address P.O. Box 507
City West Linn State. OR zip 97068-0507
5. Street Address 6200 Oak Tree Blvd, Suite 250
City. Independence State nH ZIP 44j_2•1
6 Phone 5! 03 1 722-2825 Email licensing,@a flvnnrg corn
C�
NOV 10
2021
Stormwater Permit Renewal Form Page 1 of 3 May 11, 2018

C. SUBMITTAL REQUIREMENTS
Submit the application package to the appropriate DEMLR Regional Office (Coastal, SA Waters) or DEMLR
Central Office (Urbanizing Areas Ph 2, USMP, Non -Coastal HQW/ORIh9 Only applications packages that
include all required items listed below will be accepted and reviewed.
Initial each item below to indicate that the required information is provided in the application package.
`Qr 1. A permit application processing fee of $505.00 payable to NCDEQ.
2. One original signed hard copy and one electronic copy of this completed form. The signing official
named on this application to represent the current permittee must meet one of the following*
a. Corporation — a principle executive officer of at least the level of vice-president,
b Limited Liability Company (LLC) — a manager or company official as those terms are defined
in G.S. 57D "North Carolina Limited Liability Company Act,"
c Public Entity — a principal executive officer, ranking official, or other duly authorized employee,
d. Partnership or limited partnership — the general partner,
e Sole proprietor, or
f. Letter of authorization signed by one of the signatories noted in a — e above authorizing the
signature of another entity.
3 One hard copy and one electronic copy of recorded documents required by the original permit that
have not yet been received by DEMLR, including deed restrictions, protective covenants,
condominium/planned community declaration and easements. If the project has been built, include
documentation that the maximum BUA per lot or maximum total BUA has not been exceeded. If
the project has not been built, include a signed agreement that the final recorded deed restrictions
and protective covenants will be submitted at a later date
4 O&M Agreements, Please select one
❑ I have a copy of the current recorded O&M Agreement for all SCMs, and I will continue to
keep this on file with the permit, or
❑ I do not have a copy of the current recorded O&M Agreement for all SCMs and am
requesting a copy be sent to me. I agree to keep this on file with the permit
/ter 5 Designer Certifications, Please select one
❑ A copy of the certification(s) confirming that the project was built in accordance with the
approved plans have been previously provided to the Division; or
❑ A copy of the certification(s) confirming that the project was built in accordance with the
approved plans are enclosed, or
❑ The project has not yet been built
6. [IF APPLICABLE] If the project has been built, one original hard copy and one electronic copy of a
signed, sealed, and dated letter from a licensed professional stating that the SCMs have been
inspected, and that they have been built and maintained in accordance with the permit
7 [IF APPLICABLE] When the permittee is a corporation or a limited liability corporation (LLC):
tkrl Provide one hard copy and one electronic copy of documentation from the NC Secretary of State,
or other official documentation, which supports the titles and positions held by the persons listed in
Section C 2 per 15A NCAC 2H. 1043(3)(b).
https //www.sosnc gov/online services/search/by title/ Business Registration
c�
Nov 10 20?1
Stormwater Permit Renewal Application Form Page 2 of 3 BV -` May 11, 2018

D. PERMITTEE'S CERTIFICATION
I, Gregory G. Flynn , the person legally responsible for the permit, certify that 1 have a copy of the Permit
and O&M Agreement on site (or I will obtain a copy and it will be kept on site), that I am responsible for the
performance of the maintenance procedures, and the site has been and will be maintained according to the O&M
Agreement and approved plans I agree to notify DEMLR of any problems with the SCMs or built -upon area and
to submit the proper forms to modify or transfer the permit prior to any changes to the project, SCMs, or
ownership All information provided on this permit renewal application is, to the best of my knowledge, correct
and complete.
Signature Date
NOTARIZATION
that
this the
day of
, County of
execution of the forgoing instrument. Witness
(Notary Seal) /P
Notary Signature:
My
and official seal,
a Notary Public for the State of
do hereby certify
personally appeared before me
20 , and acknowledge the due
NOV 10 b
2021
Stormwater Permit Renewal Application Form Page 3 of 3 May 11, 2018

CALIFORNIAALL-PURPOSE• r • [.
P�f.P�J.PS..IY.P</y"tSrc� .wY.s�trN .u�</y�tlgt!i��VPXt'n�✓Pt P<.ti<.c� PS..� 'T<.N q<!i�<.Pt.Nt nt.Pf�i�2.Pt.P .
I
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document
State of C
County of
On / ����� before me,
Date
personally appeared
Here Insert Name and Title of the
Names) of Signer(s) _
who proved to me on the basis of satisfactory evidence to be YieersonA whose name Is ace
scribed to the within instrument and ackn ged to me th t he executed the e m
hi authorized capacity(ies), and that hi becftbeir signat ) on the instrument the persor1(6)1
the entity upon behalf of which the person(s) ed, executed the instrument
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
■ . o.., MAFLENEGONZAGA ADAMSON
111 Notary Public-Cahforma
San Franosco County Signature
Commazion p 2237669 $j ature of Notary Public
My Comm Expires Mar 18,2022
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s)
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
l Other
Signer Is Representing:
Number of Pages:
Signer's Name -
El Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other,
Signer Is
Representing:
n"✓. ctV '✓ YS�V 'JKb e/y�V.:{q[i<�/c'e/chVAer<'V,1'+_/pNV{\V_<N. _ a.{<E.�>.«b 'Yti'{�'/{<{{<eryA..e '/eySY q%Hv, -V{�
Q r • • 1 • 1 • • • 1 irr i�� i •�
i
Fi•� I ( 1

Permit
No'�1��(��/
to, be Provided by DWQ)
xJCHI
027452 _
L,
r
C� s !1!GINEE "10 orOFwarFyo
NCDENR
�70
•• oo .. eP
.
STORMWATER MANAGEMENT P�f2MiT,gPRhIOAYION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be filled out printed and submitted
The Required items Checdst
(Part III) must be printed, filled out and submitted along with all of the required information
I PROJECT INFORMATION
I'
Project name
Shallotte Taw Bell
Contact person
Scott Brown
Phone number
910426-6777
Date
1-Dec-10
Drainage area number
1
II! DESIGN'INFORMATION,
_
Site Characteristics
Drainage area
49,446 r?
Impervious area, post -development
29,476 ft'
%Impervious
5961 %
Design rainfall depth
15 In
Storage Volume Non-SAWaters
Minimum volume required
3,662 it OK
Volume provided
6,728 fta
OK, volume provided is equal to or In excess of volume required
Storage Volume. SA Waters
1 5" runoff volume
fit'
Pre -development 1-yr, 24-hr runoff
it,
Post -development 1-yr, 24-hr runoff
it,
Minimum volume required
it,
Volume provided
to
Peak Flow Calculations
RECEIVED
Is the pre/post control of the Iyr 24hr storm peak flow required? y (Y or N)
1-yr, 24-hr rainfall depth
37 in DEC 10 2010
Rational C. pre -development
025 (unitless)
Rational C, post -development
072 (unitless)
Rainfall intensity 1-yr, 24-hr storm
2461Nhr OK BY;
Pre -development 1-yr, 24-hr peak flaw
070 f0tsec
Post -development 1-yr, 24-hr peak flow
196 fit'/sec
Pre/Post 1-yr, 24-hr peak flow control
126 ft'Tsec
Elevations
Temporary pool elevation
2328 hnsl
Permanent pod elevation
2200 fmsl
SHWT elevation (approx at the pen pool elevation) 2183 fmsl
Top of 1 Oft vegetated shelf elevation
2250 fmsl
Bottom of 1 Oft vegetated shelf elevation
2150 fmsl Data not needed for calculation option #1, but OK If provided
Sediment cleanout, top elevation (bottom of pond)
1600 fmsl
Sediment deanout, bottom elevation
1500 fmsl Data not needed for calculation option #1, but OK if provided
Sediment storage provided
100 it
Is them additional volume stored above the state -required temp pool? y (Y or N)
Elevation of the tap of the additional volume
233 fmsl OK
Form SW401-Wet Detenbon BasIFRev 6-9/17109 Paris I B 11 Design Summary, Page 1 of 2

Permit No
(Io be pmvrded by DWD)
II.. DESIGNIINFORMATIM
Surface Areas
Area, temporary pool 4,796 ft'
Area REQUIRED, permanent pool
3,788 ft'
SAIDA ratio
766 (umdess)
Area PROVIDED, permanent pool, Ap,.,,, pw
3,109 ft`
Area, bottom of 10R vegetated shelf, A,,, a,er
1,656 ft
Area, sediment deanoul, top elevation (bottom of pond), A�.d
1,483 It,
Volumes
Volume, temporary pool
6,728 ft'
Volume, permanent pool, V._,,,
11,674 ft'
Volume, forebay (sum of forebays 1f more than one forebay)
2,395 ft'
Forebay % of permanent pool volume
20 5% %
SAIDA Table Data
Design TSS removal
90 %
Coastal SAIDA Table Used?
y (Y or N)
MountalnlPledmont S VDA Table Used?
(Y or N)
SAIDA ratio
7 66 (unites)
Average depth (used in SArDA table)
Calculation option 1 used? (See Figure 10-2b)
y (Y or N)
Volume, permanent pool, VI-PW
11,674 ft'
Area provided, permanent pool, Ap s,,_py
3,109 W
Average depth calculated
375 It
Average depth used in SAIDA, d.., (Round to nearest 0 5ft)
30 It
Calculation option 2 used? (See Figure 10-2b)
n (Y or N)
Area provided, permanent pool, A _pw
3,109 ft
Area, bottom of 1 Oft vegetated shelf, Am ,im
1,656 ft
Area, sediment deanoul, top elevation (bottom of pond), A,.,
1,483 ftz
'Depth' (distance btw bottom of 1 Oft shelf and top of sediment)
5 50 It
Average depth calculated
If
Average depth used in SAIDA, it., (Round to nearest 0 5ft)
ft
Drawdown Calculations
Drawdown through onficev
y (Y or N)
Diameter of onfice (it circular)
125 in
Area of onfice (if -non -circular)
in2
Coefficient of discharge (Co)
0,60 (umdess)
Driving head (Ho)
0 51 ft
Drawdown through well?
n (Y or N)
Weir type
(umdess)
Coefficient of discharge (Ca)
(unNess)
Length of weir (L)
ft
Driving head (H)
ft
Pre -development 1-yr, 24-hr peak flow
070 ft/sec
Post -development 1-yr, 24-hr peak flow
019 Osec
Storage volume discharge rate (through discharge onfice or weir)
003 fts/sec
Storage volume drawdown time
270 days
Additional Information
Vegetated side slopes
3 1
Vegetated shelf slope
10 1
Vegetated shelf width
100 It
Length of flowpath to width mho
4 1
Length to width ratio
39 1
Trash rack for overflow & onfice?
y (Y or N)
Freeboard provided
10 It
Vegetated filter provldedo
n (Y or N)
Recorded drainage easement provided?
y (Y or N)
Capums all runoff at ultimate build -out?
y (Y or N)
Dram mechanism for maintenance or emergencies is
pump out
Insufficient permanent pool surface area
OK
lT
OK
Insufficient Check calculation
OK, draws down 1n 2-5 days
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
DEC 10 2010
Form SW401-Wet Detention Basin -Rev &91UM9 Paris 1 & 11 Design Summary, Page 2 of 2

Permit No 'S'C'ye9
(to be provided by DWQ)
III!, REQUIREDIITEMSICHECKLIST IF -
Please Indicate the page or plan sheet numbers where the supporting documentation can be found An incomplete submittal package vnll
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
Initials Sheet No.
SB
1 Plans (1" - 50' or larger) of the entire site shoving.
- Design at ultimate build -out,
- Off -site drainage (d applicable),
- Delineated drainage basins (include Rational C coefficient per basin),
- Basin dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Proposed drainage easement and public night of way (ROW),
- Overflow device, and
- Boundaries of drainage easement
2 Partial plan (1" = 30' or larger) and details for the wet detention basin shoving
- Outlet structure with trash rack or similar,
- Maintenance access,
- Permanent pool dimensions, R RCEIVED
- Forebay and main pond with hardened emergency spillway,
1 0
-Basincross-section, DEC 201U
- Vegetation specification for planting shelf, and
- Fitter strip $j(:
Sf�
3 Section view of the wet detention basin (1" = 20' or larger) showing
- Side slopes, 31 or lower,
- Pretreatment and treatment areas, and
- Inlet and outlet structures
S 3
4 If the basin is used for sediment and erosion control during construction, clean out of the basin is specified
on the plans prior to use as a wet detention basin
S13
5 A table of elevations, areas, incremental volumes & accumulated volumes for overall pond and for Forebay,
to verify volume provided
S�
6 A construction sequence that shows how the wet detenbon basin will be protected from sediment until the
entire drainage area is stabilized
5 l3
7 The supporting calculations.
S 3
8 A copy of the signed and notarized operation and maintenance (0&M) agreement
I p'
NSA
9 A copy of the deed restrictions (if required)
S 1 10 A soils report that is based upon an actual field investigabon, soil borings, and infiltration tests County
soil maps are not an acceptable source of soils informabon
Form SW401-Wet Detention Basin -Rev 8-9117/09 Part III Recluved Items Checklist, Page 1 of 1

State Stormwater Management Systems
Permit No. SW8 100917
Shallotte Taco Bell
Stormwater Permit No. SW8 100917
Brunswick County
Designer's Certification
i, t.s-A ?'rbvw , as a duly registered n o ;.VJJ en iete-- in the
State of North Carolina, having been authorized to ob erve (periodically/ weekly/ full
time) the construction of the project,
for rMn; , Fuels f TnC. (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 specifications: /]
CQ'w4441 Oli4i AQ(1 �/ on Mqy 6' ZD// To Tvn
on or;01e1' No CvrrcA� S, vs• ),u �ccr1 Cera�c4c?�
(� SEAL
Signature '��"ti't' `,,�•�.cA�,,,,,.,,.
Registration Number 2-7ys,2 ;x_ 9§sj ! '
Date D 8-1
Page 6 of 7
02 452
� •�'�!�!QItJE� Oy�:
og

State Stormwater Management Systems
Permit No. SWB 100917
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.
'f3. 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 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 structure.
8. All slopes are grassed with permanent vegetation.
`�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.
�1. The permitted amounts of surface area and/or volume have been
provided.
✓f2. Required drawdown devices are correctly sized and located per the
approved plans.
-�'l3. 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
✓16. All components of the stormwater BMP are located in either recorded
common areas, or recorded easements.
cc: NCDENR-DWo Regional Office
Brunswick County Building Inspections
Page 7 of 7