SW8971225_CURRENT PERMIT_20220802

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 Ot-1 1225
DOC TYPE
® CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
2022 oso 2
YYYYMMDD

ROY COOPER
Governor
EUZABETH S. BISER
Seery
BRIAN WRENN
Director
August 2, 2022
2200 Wrightsville Owners Association
Attn: John Fatabow, President
PO Box 10267
Wilmington, NC 28404
NORTH CAROLINA
EnvOnnmmfaf Quartty
Subject: Permit Renewal
Post -Construction Stormwater Management Permit No. SWS 971225
2200 Wrightsville Owners Association
New Hanover County
Dear Mr. Farabow:
Effective August 1, 2013 the Post -Construction Stormwater Management Program has been transferred from the
Division of Water Quality ("DWQ") to the Division of Energy, Mineral and Land Resources ("DEMLR"). All
previous references to DWQ will remain in older permits issued prior to August 1, 2013 until they are modified.
Please note that this permit will now reference DEMLR as the Division responsible for enforcement of the permit.
On August 5, 2009, the Governor signed Session Law 2009406. This law impacted any development approval
issued by the former Division of Water Quality under Article 21 of Chapter 143 of the General Statutes, which
was current and valid at any point between January 1, 2008, and December 31, 2010. The law extended the
effective period of any permit that was set to expire during this time frame to three (3) years from its current
expiration date. On August 2, 2010, the Governor signed Session Law 2010-177, which granted an extra year for
a total of four (4) years extension.
The Division of Energy, Mineral and Land Resources received a complete 8-year Permit Renewal Application for
the subject permit on August 1, 2022. The Division is hereby notifying you that permit SW8 971225 has been
renewed, updated, and re -issued on August 2, 2022, as attached. As requested, a copy of the current operation
and maintenance agreement is also enclosed. 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 23, 2028, which includes all available extensions, and does not
supersede any other agency permit that may be required. 'rhe 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
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.
This project will be kept on file at the Wilmington Regional Office. If you have any questions concerning this
permit, please contact Ashley Smith in the Wilmington Regional Office, at [phone] or
[e-mail].
Sincerely,
Brian Wrenn, Director
� North Carolina Department of Environmental Quality I Division of Energy, Mineral and land Resources
—C� J{/t wdmington Regional Office 1127 Cardinal Drive Extension I Wilmington. North Carolina 28405
wmH rxwvrvx
��•e+�-++v+. 910.796.7275

State Stormwater Permit No. SW8 971225
Page 2 of 2
Division of Energy, Mineral and Land Resources
Enclosures: Attachment C — Permitting History
Renewal Application Documents
Copy of the current operation and maintenance agreement
DES/ams: \\\Stormwater\Permits & Projects\1997\971225 HD\2022 08 permit 971225
cc: Wilmington Regional Office Stormwater File
rsraurneye.rr�
North Carolina Department of Environmental Quality I Division of Energy, Minerel and Land Resources
Wilmington Regional Office 1127 Cardinal Drive Extension I Wilmington. North Carolina 26405
910.796.7215

Post -Construction Stormwater Management
Permit No. SW8 971225
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
POST -CONSTRUCTION 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
2200 Wrightsville Owners Association
2200 Wrightsville Owners Association
2200 Wrightsville Avenue, Wilmington, New Hanover 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 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 23, 2028 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.
2. This stormwater system has been approved for the management of stormwater runoff as
described in Section 1.6 on page 2 of this permit. The stormwater control has been designed to
handle the runoff from 92,173.6 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated on page 2 of this permit, and
per approved plans.
4. All stormwater collection and treatment systems must be located in either dedicated common
areas or recorded easements. The final plats for the project will be recorded showing all such
required easements, in accordance with the approved plans
5. The runoff from all built -upon area within the permitted drainage area of this project must be
directed into the permitted stormwater control system.
Page 1 of 5

Post -Construction Stormwater Management
Permit No. SW8 971225
C1
The following design criteria have been provided in the wet detention pond and must be
maintained at design condition:
a. Drainage Area, acres:
Onsite, ft2:
Offsite, ft2:
b. Total Impervious Surfaces, ft2:
C. Design Storm, inches:
d. Pond Depth, feet:
e. TSS removal efficiency:
f. Permanent Pool Elevation, FMSL:
g. Permanent Pool Surface Area, ft2:
h. Permitted Storage Volume, ft':
i. Temporary Storage Elevation, FMSL:
j. Controlling Orifice:
k. Permitted Forebay Volume, ft':
I. Receiving Stream/River Basin:
M. Stream Index Number:
n. Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
3.94
83,526.3
8,647.3
92.173.6
1
7.5
90%
21
5,600
17,744
22.5
VO pipe
3,899
Mineral Springs Branch / Cape Fear
18-74-63-2-1
"C Sw"
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.
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.
The permittee shall at all times 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 revegetation 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.
4. 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 are allowed in the pond, subject to the following criteria:
a. The minimum permanent pool volume is 30,000 cubic feet.
b. The fountain must draw its water from less than 2' below the permanent pool surface.
C. 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.
d. The fountain may not be placed into the forebay.
e. The falling water from the fountain must be centered in the main pond, away from the
shoreline.
f. The maximum horsepower for a fountain in this pond is 1/2 horsepower.
6. During construction, erosion shall be kept to a minimum and any eroded areas of the system
will be repaired immediately.
Page 2 of 5

Post -Construction Stormwater Management
Permit No. SW8 971225
7. Upon completion of construction, prior to issuance of a Certificate of Occupancy, and prior to
operation of this permitted facility, a certification must be received from an appropriate
designer for the system installed certifying that the permitted facility has been installed in
accordance with this permit, the approved plans and specifications, and other supporting
documentation. Any deviations from the approved plans and specifications must be noted on
the Certification. A modification may be required for those deviations.
8. If the stormwater system was used as an Erosion Control device, it must be restored to design
condition prior to operation as a stormwater treatment device, and prior to occupancy of the
facility.
9. Access to the stormwater facilities shall be maintained via appropriate easements at all times.
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. 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 project 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.
a. Any modification to the approved plans and specifications, regardless of size including
the SCM(s), BUA, details, etc.
b. Redesign or addition to the approved amount of BUA or to the drainage area.
C. 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.
d. 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.
e. The construction of any allocated future BUA.
f. 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.
g. Other modifications as determined by the Director.
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.
Page 3 of 5

Post -Construction Stormwater Management
Permit No. SW8 971225
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;
ii. A partnership, limited liability corporation, corporation, or any other business
association that has been dissolved;
iii. 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;
V. The assignment of declarant rights to another individual or entity,
vi. The sale or conveyance of the common areas to a Homeowner's or Property
Owner's Association, subject to the requirements of NCGS 143-214.7(c2);
b. 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.
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.
Page 4 of 5

Post -Construction Stormwater Management
Permit No. SW8 971225
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 2nd day of August 2022.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Brian Wren?t, Dire&tor
Division of Energy. Mineral and Land Resources
By Authority of the Environmental Management Commission
Page 5 of 5

Attachment C - Permitting History
2200 Wrightsville Owners Association
Permit No. SW8 971225
Approval
Permit
BIMS
Description of the Changes
Date
Action
Version
4/16/1998
Original
10
Approval
I . Removed 0.5 feet of pond depth
2. Removed 0.5 FMSL of permanent pool elevation
3. Removed 15,199 square feet of impervious area
4. Increased 3,022 square feet of offsite area
5. Removed 168 square feet of required surface area
1/31/2000
Modification
N/A
6. Removed 2,485 square feet of provided surface area
7. Added 336 cubic feet of required storage volume
8. Removed 1,947 cubic feet of provided storage volume
9. Removed 0.25 FMSL of temporary storage elevation
10. Reduced orifice to I inch
10/23/2006
Modification
1.1
The pond got significanly bigger
Transferred from The Caper Corporation to 2200 Wrightsville
12/19/2008
Modification
1.2
Buinsess Association
Transferred from The Caper Corporation to 2200 Wrightsville
1/15/2009
Correction
N/A
Buinsess Association; Page 2
8/2/2022
Renewal
2.0
Expires 10/23/2028

DEMLR USE ONLY
Date Received
Fee Paid
Permit Number
`e
2022
`i11225
STATE STORMWATER:
PERMIT INFORMATION UPDATE APPLICATION FORM
There is NO FEE for updating project name or permittee information.
This form is to only to be used by the current permittee to notify the Division of.,
1) changes to the Point of Contact (signing official) for the current permittee (LLC, Corporation, HOA or POA);
2) changes to the mailing address, phone number or email address of the current permittee;
3) changes to the name of the project; and
4) changes to the legal corporate name as documented by a Name Change or Merger filed with the NCSOS.
A. NEW PERMIT INFORMATION
Stale Stormwater Permit Number: 5W ZJ "1 112W
Are you updating
(check all that apply):
If so, please provide the updated information:
❑ Project name
_
❑ Corporation Name'
Permit Contact Name2 .'
Permit Contact Title
(�
C9 Mailing Address'
1 Wi
Phone number
(OQ1
Email address
G �rf e t(DC#ka4
Provide documentation such as a Name Change /Merger filed with the NCSOS.
Provide supporting documentation such as NCSOS filing. The permit contact's position must be in accordance
with 15A NCAC 02H .1040(11.
If more than one point of contact or mailing address is being changed, please attach a separate sheet.
B. CERTIFICATION OF PERMITTE
ti urrent permittee, hereby notify DEMLR that I am making the changes as listed
in eclion bov . I fu h r attest that this application for an update to the permit information currently on file is accurate
and co plate the best ol my knowledge.
Signa ure: Date:
zb zezz
^c/1Il1'(•��MM�111,FF a Notary Public for the State o�f�py�� IiNU�/jjG�
County of kl�uj C W U1l a do hereby certify that YV
1
personally appeared before me this the i �0 day of Ulu 20r)0L, and acknowledge the due
execution of the forgoing Instrument. Witness my hand and official seal,
(Notary Seal)
Notary Signature
My commission e
Slormwator Permit Information Update Form Page 1 of 1
ECEIVE
p" p(PRY AUG 0 1 2022
May 11, 2017

V/ � ET

.1
'WET DETENTION BASIN OPERATION AND MAINTENANCE AGREEMENT
1
The wet de;cntion basin system is defined as the wet detention basin, pretreatment including forebays and the
vegetated filter if one is provided.
This symm (check one) 0 does 1I dues nol incorporate a vegetated filter at the outlet.
This system (check one) D does V does not incorporate pretreatment other than.a forebay.
Mainienanec activities shall be performed as follows:
Afler every significant runoff producing rainfall event and at least monthly:
a. Inspect the wet detention system for sediment accumulation: erosion, trasb accumulation,
vegetated cover, and general eDndiiiDiL
b. Check and clear the orifice of any obstructions such that drawdown of the temporary pool occurs
within 2 to 5 days as designed.
2. Repair eroded areas immediately, ro-seed a9 necessary to maintain good vegetative cover, mow vegetative
cover to maintain a maximum height of six inchcs, and remove trash as needed.
;. Inspect and repair the collection system (Le. catch basins, piping, swales, riprap, etc.) quarterly to .
maintain proper functiouirig.
4. Remove accumulated sediment from the wet detention basin system semi-annually or when depth is
reduced to 75% of the original design depth (see diagram below). Removed sediment shall be disposed
of in an appropriate manner and shall not be handled in a manner that will adversely impact water quality
(i,e, stockpiling near a wet detention basin or stream, etc.).
The measuring device used to detenume the sediment elevation shall be such that it will give an accurate
depth reading and not readily penetrate into accumulated sediments.
When the pennarient pool depth reads 5.25 feet in the main pond_ the sediment shall be removed.
When the permanent pool depth reads
Sediment Re nova] El. 15_75
Bottom El vation 14
5.25 feet in the forebay, the sediment shall be removed.
BASIN DIAGRAM
(fill in the blan1u)
Permanent Pool Elevation 21
Sediment Removal Elevation 1575 75%
Bottom Elevation 14 25%,
TOREBAP MAIN POND
A

5. Renwve eatcails and other wdigenous wedand plants Mlhen they corer 5O`1", of the basin surfac_. Thest
plants shall be encouraged to groW along Lht vegetaud shelf and forebay berm.
6. Lf the'bnsin muse be drah,ed f'or an emergency or to perform rnainttnance, the flushing of sedimestl
through t'he emergency drain shall be mininus,cd to the mtu;imurr, tveni possible.
7. 6Jl components of the v, et detention basin system.shall be maintained iu good unrldxig order.
) aClrno„'Iedgt and agree by my signature bclm, - tluv I am resporrsibic for the, perfo mance of Lhc seven
maintenance procedures listed above. 1 agret; to noun- DV O of any problems wiCh the system or poor to any
change; to tirr system or responsible, parry.
Print name: Walter Pancoe
Ti11e: President, 2200 Wrightsville Owners Assoc.
Ad.dres.:
c/o Caper Corporation, 1901 Kent Street, Suite E, Wilmington, NC 28405
Phone
5igua
Date:
[phone]
ldnre: 7ue is Dalh resnonsibI-- part should no! be a nomeovmera ass ociedW: unless mare thec 50 ui are Iots neve beer sold and
a resident or tnt subdivision has beco named tnc pmzjden'
1. J ( . a NoiaP' Pubtie f_,r the Mate of NDrrlb Carolina
count" of de berebv ce, if? Iha! ��—/�1©2�'0�
ptrsonL0v ar `v drP.G oelor`, m Oii:; W day Oj ll i, L�VYLI±�,� and acknmvl:'dge tLe du`
exr u on of the forgoing wel detention basin maintenance requires Dots. Witness my hod and official se 1
•• ~• �O
co ®1PA/�ySs'd c: e
• � a a
•/;Ch•^o
SEAL
My commission expires /

E

DEMLR USE ONLY
.• Date Received
Fee Paid
Permit Number
25 22
1Tf 5100 $ g50 5.2L
sv4 12Z5
NC DEQ Division of Energy, Mineral and Land Resources
STATE STORMWATER:
PERMIT RENEWAL APPLICATION FORM
In accordance with 15A NCAC 2H.1045f31, the current permit holder shall renew their high density permit 180 days
prior to its expiration. Renewed permits are valid for a period of 8 years per Session Law 2011-398 (SB 781)
Section 60.(c). This application form is for permit renewals only.
A. PROJECT INFORMATION
1. State Stormwater Permit Number: 6 `V ICI vS
2. Project name: Q 1r11' 1'
3. Project street address: �nikbV1(�kRBL
City: \ 1 MAh11 County: M1,^aN&AMICIL -zip:
1V_
4. What, If any, changes have been made to the project as permitted? we_
If the project has changed from the original approved plans, please complete SWU-101 for a Major
Modification or Minor Modification Application form available at: https:/Ideg.nc.gov/abouUdivisions/energy-
mineral-la nd-resourceslenergy-mineral-land-rules/stormwater-program/postconstruction.
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/abouUdivisions/energy-mineral-land-
resources/enercy-mineral-land-rules/stormwater-orogranilpost-construction. State Stormwater Permits do not
automatically transfer with the sale of the property. _ _ n I i
1. Current Permit Holders Company Name/Organization: / 1 I
2. Signing Official's Name: aA d 7 :Ln:: J
3. Signing Official's Title: nnPM1F,i,5 S 0
4. Mailing Address: 90. 1' 01 MLD—I
City: \Q'A - �Cn State:
5. Street Address:
City: _
6. Phone:
Email: I OoLkr"1 -c e Y1Cel. ccr'y\
�j, n►,r, o � 2022
t�I
ZIP
ZIP :
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 HQ W/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:
Vti1. A permit application processing fee of $505.00 payable to NCDEO.
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 duty 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.
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):
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:/Iwww.sosnc.gov/online serviceslsearch/bv title/ Business Registration
Stormwater Permit Renewal Application Form Page 2 of 3 May 11, 2018

D. PERMITTEE'S CERTIFICATION
I, T�4 /J W PV nV'
�� the person legally responsible for the permit, certify that I 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 alntenance procedures, and the site has been and will be maintained
according to the O&M Agreement and -proved plans. I agree to notify DEMLR of any problems with the SCMs
or built -upon area and to submit the pr er forms to modify or transfer the permit prior to any changes to the
project, SCM , or nership. All Infor Lion provided on this permit renewal application is, to the best of my
knowledge, orreci s d complete.
Signature: Date:
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NOTARIZATI N: pp��
I, l Cole K r1 a Notary Public for the State of
Ir t/h/� —,County of MrOOVIer , do hereby certify
that John GboW r. personally appeared before me
this the 2(0 day of . kw. 2Q 22 , and acknowledge the due
execution of the forgoing instrument. Witness my hand and official seal,
(Notary Seal)
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Notary Signature: O� ' 0'n'
My commission expires ► SS 1 Z Z
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Stormwater Permit Renewal Application Form Page 3 of 3 May 11. 2018

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