SW3220304_Application Form_20221114

DEMLR USE ONLY
Date Received Fee Paid Permit Number
STORMWATER PERMITTING FORM 7:
MINOR MODIFICATION
Standard Permitting Program — No Fee for Minor Modification
Express Permitting Program — See Express Fee Schedule
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://de .nc.gov/contact/regional-offices.
This form is to only to be used by the current permittee to notify the Division of a minor
modification. Pursuant to Rule 15A NCAC 02H .1002, a minor modification is a change to the project that:
1) does not increase the net built -upon area; and/or
2) does not change the size or design of the SCM(s).
A. GENERAL INFORMATION
1. State Stormwater Permit Number: SW3220304
2. Current Permit Holder's Company Name/Organization: Krysta Cearlev / Aldi, Inc., Salisbury Division
3. Signing Official's Name: Krysta Cearlev
4. Signing Official's Title: Vice President, Salisbury Division
5. Mailing Address: 1985 Old Union Church Road
City: Salisbury State: NC ZIP: 28146
6. Street Address (if different):
City: State: ZIP:
7. Phone: [phone] Email: krysta.cearley(a-)aldi.us
8. Describe the minor modifications that you are requesting, including any revised BUA allocations (attach
additional pages or supporting tables similar to Section IV.10 of the original application, if needed):
Revised project driveway alignment resulting in reduced BUA (20,470 SF net reduction). Refer to
highlighted sections of revised permit application attached.
Realignment of stormwater ditches to match new driveway configuration.
B. 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. Two hard copies (with original signatures) and one electronic copy of this completed form.
Y 2. Two hard copies and one electronic copy of the revised plan sheets (must be a revision of the
originally approved plan sheets).
N/A 3. If there is reallocation of lot BUA, a copy of the revised recorded deed restrictions and protective
covenants OR the proposed recorded deed restrictions and protective covenants documenting
the changes and a signed agreement to provide the final recorded document.
N/A 4. If applicable, the appropriate Express review fee.
Stormwater Permit Form 7: Minor Modification Page 1 of 2 July 14, 2017

C. CONTACT INFORMATION
1. The Design Professional who is authorized to provide information on the Applicant's behalf:
Design Professional's Name:Todd Fisher
Consulting Firm: Bolton & Menk, Inc., dba ColeJenest & Stone
Mailing Address:200 S. Tryon Street, Suite 1400
City:Charlotte State:NC Zip:282
Phone: [phone] Fax: [phone]
Email::todd.fisher(a)bolton-menk.com
2. [OPTIONAL] If you would like to designate another person to answer questions about the project:
Name & Title:
Organization:
Mailing Address:
City: State: Zip:
Phone: ( ) Fax:
Email:
D. CERTIFICATION OF PERMITTEE
I, K Sj"a �D C tuYJ to , the current permittee, certify that I have authorized the minor modifications listed
in Section A and shown in the attached revised plan sheets. I further attest that this information is accurate and
complete to
Signature:
Date: 10 13 11 )-(-) )-
I, Ma✓keLlI a IQ (X�h—,a Notary Public for the State of N01(fh &e0lina.,
County of _ 00.6a.r✓uS do hereby certify that a
personally appeared before me this the 31 day of Ijr}M6C y 20-&-.21- and
acknowledge the du7MARKEYLA
theor ocnstrument. Witness my hand and official seal,
R WHITAKER
blic, North Carolina
arrus County
(Notary Seal) mission Expires
►y 24, 2027
Notary Signature A)�L 2-
My commission expires 7�a J4
Stormwater Permit Form 7: Minor Modification Page 2 of 2 Oct 6, 2017

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Project will be permitted as low density. To the extent possible, runoff from new impervious areas will sheet
overland through existing wooded areas or will be routed within new grass swales to existing vegetated
discharge points. All drainage outlets will discharge to existing vegetated areas at least 300' upland of any
mapped streams.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Yadkin-PeeDee River basin.
4. Total Property Area: 273.3 acres
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 1.35 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area+:271.95 acres
+ Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NEIM line or Mean High Water
(MHM line, and coastal wetlands landward from the NHW (or MHM line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHM line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 2.3 (excludes
existing impervious) %
9. How many drainage areas does the project have?2 (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.
Form SWU-101 Version Oct. 31, 2013 Page 3 of 7

Basin Information
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
Receiving Stream Name
Crane Creek
Town Creek
Stream Class *
C
C
Stream Index Number *
12-115-2
12-115-3
Total Drainage Area (sf)
4474530
7371470
On -site Drainage Area (sf)
4474530
7371470
Off -site Drainage Area (sf)
0
0
Proposed Impervious Area** sf
97,520
150,730
% Impervious Area** total
2.57
2.17
Impervious' Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
On -site Buildings/Lots (sf)
4,100
0
On -site Streets (sf)
770
47,750
On -site Parking (sf)
89,770
102,800
On -site Sidewalks (sf)
2,880
180
Other on -site (sf)
0
0
Future (sf)
0
0
Off -site (sf)
0
0
Existing BUA*** (sf)
1 679,550
431,230
Total (sf):
1 777,070
581,960
* Stream Class and Index Number can be determined at: http.Y portalaicdenr.orglzveb/wq/Ls/csu/classirications
Im ervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidpewalks, 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. N/A
Proiects in Union County: Contact DEMLR Central Office 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 1 SA NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from htttD://Dortal.ncdenr.ora/web/wo/ws/su/bmD-manual.
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
http://portal.ncdenr.org/web/wq/ws/su/statesw/forms does. 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/maps.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http://!,2ortal.ncdenr.org/web/wq/­ws/su/statesw/­forms does.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http:/ /www.envhelp.org/12ages/onestopexl2ress.html for information on the Express program
Form SWU-101 Version Oct. 31, 2013 Page 4 of 7