HomeMy WebLinkAboutSW8980412_HISTORICAL FILE_19980708STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 c- 12
DOC TYPE
❑ CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
I aIS 07 02
YYYYMMDD
Stateof North Carolina
Department of Environment
and Natural Resources
Wilmington Regional Office
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Division of Water Quality
Mr. Brian Smith, Owner
S T Group, LLC
1903 Inverness Lane
Wilmington, NC 28405
Dear Mr. Smith:
drZIN
• : •
i
lie
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
July 8, 1998
Subject: Permit No. SW8 980412
Perkins Restaurant
High Density Commercial Stormwater Project
New Hanover County
The Wilmington Regional Office received the Stormwater Management Permit Application for Perkins Restaurant on April
7, 1998, with final information on July 7, 1998. 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
Permit No. SW8 980412 dated July 8, 1998, for the construction of Perkins Restaurant.
This permit shall be effective from the date of issuance until July 8, 2008, and shall be subject to the conditions and
limitations as specified therein. Please pay special attention to the Operation and Maintenance requirements in this permit.
Failure to establish an adequate system for operation and maintenance of the stormwater management system will result
in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to request an
adjudicatory hearing upon written request within thirty (30) days following receipt of this permit. This request must be
in the form of a written petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed with the
Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-7447. Unless such demands are made this
permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please contact Linda Lewis, or me at
(910) 395-3900.
Sincerely,
Rick Shiver
Water Quality Regional Supervisor
RSS/arl: S:\WQS\STORMWAT\PERMIT\980412.JUL
cc: Phil Tripp, P.E.
Tony Roberts, New Hanover County Inspections
Beth Easley, New Hanover County Engineering
Linda Lewis
Wilmington Regional Office
Central Files
127 Cardinal Dr. Ext., Wilmington, North Carolina 28405 Telephone 910-395-3900 FAX 910-350-2004
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper
State Stormwater Management Systems
Permit No SW8 980412
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
� ' u� u ►Y '
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
S T Group, LLC
Perkins Restaurant, Ogden
New Hanover County
FOR THE
construction, operation and maintenance of an infiltration basin 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 Water Quality and considered a part of
this permit.
This permit shall be effective from the date of issuance until July 8, 2008 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 on page 3 of this
permit, the Project Data Sheet. The stormwater control has been designed to handle the runoff from 34,642 square
feet of impervious area. This pond is designed to be operated with a 50' vegetated filter.
3. Approved plans and specifications for this project are incorporated by reference and are enforceable parts of the
permit.
4. The tract will be limited to the amount of built -upon area indicated on page 3 of this permit, and per approved
plans.
2
In
State Stormwater Management Systems
Permit No. SW8 980412
DIVISION OF WATER QUALITY
PROJECT DATA SHEET
Project Name:
Perkins Restaurant, Ogden
Permit Number:
SW8 980412
Location:
New Hanover County
Applicant:
Mr. Brian Smith, Owner
Mailing Address:
S T Group, LLC
1903 Inverness Lane
Wilmington, NC 28405
Application Date:
April 7, 1998
Water Body Receiving Stormwater Runoff:
Howe Creek
Classification of Water Body:
"SA ORW"
If Class SA, chloride sampling results:
n/a
Basin Depth, feet:
4
Bottom Elevation, FMSL:
44
Total Impervious Surfaces, ft2:
34,642
Building, ft2
4,400
Parking, ft2
28,352
Sidewalk, ft2
1,890
Offsite Area entering Pond, ft2:
n/a
Required Storage Volume, ft3:
22,963
Provided Storage Volume, ft3:
24,214
Temporary Storage Elevation, FMSL:
Seasonal High Water Table Elevation, FMSL:
Type of Soil:
Expected Infiltration Rate:
Time to Drawdown:
Controlling Orifice:
48
41
Kureb Sand
6" per hour (.5 cf/ hour/ sf)
13 hours
n/a-system handles the 25 year storm without bypassing
3
State Stormwater Management Systems
Permit No SWR 980412
All runoff from all built -upon area associated with the project must be directed into the permitted stormwater
control system.
6. The permittee is responsible for verifying that the proposed built -upon area does not exceed the allowable built -
upon area.
7. The following items will require a modification to the permit:
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.
C. Further subdivision of the project area.
f. Filling in, altering, or piping of any vegetative conveyance shown on the approved plan.
In addition, the Director may determine that other revisions to the project should require a modification to the
permit.
8. 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.
II. SCHEDULE OF COMPLIANCE
The permittee will comply with the following schedule for construction and maintenance of the stormwater
management system:
a. The stormwater management system shall be constructed in it's entirety, vegetated and operational for its
intended use prior to the construction of any built -upon surface except roads.
b. During construction, erosion shall be kept to a minimum and any eroded areas of the system will be
repaired immediately.
2. The permittee shall at all times provide the operation and maintenance necessary to assure the permitted stormwater
system functions at optimum efficiency. The approved Operation and Maintenance Plan must be followed in its
entirety and maintenance must occur at the scheduled intervals including, but not limited to:
a. 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.
f. Debris removal and unclogging of vegetated filter,catch basins and piping.
g. Access to the basin must be available at all times.
h. The vegetated filter will be kept grassed with no erosion. The spreader mechanism will be kept clear.
3. Records of maintenance activities must be kept and made available upon request to authorized personnel of DWQ.
The records will indicate the date, activity, name of person performing the work and what actions were taken.
Decorative spray fountains will not be allowed in the basin.
4
State Stormwater Management Systems
Permit No. SW8 980412
5. 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.
6. Upon completion of construction, prior to issuance of a Certificate of Occupancy, and prior to operation of this
permitted facility, a certification must be received from an appropriate designer for the 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 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.
8. Prior to the sale of any portion of the property, an access/maintenance easement to the stormwater facilities shall
be granted in favor of the permittee if access to the stormwater facilities will be restricted by the sale of any portion
of the property.
III. GENERAL CONDITIONS
This permit is not transferable. In the event there is a desire for the facilities to change ownership, or there is a
name change of the Permittee, a formal permit request must be submitted to the Division of Water Quality
accompanied by an application fee, documentation from the parties involved, and other supporting materials as may
be appropriate. The approval of this request will be considered on its merits and may or may not be approved.
2. Failure to abide by the conditions and limitations contained in this permit may subject the Permittee to enforcement
action by the Division of Water Quality, in accordance with North Carolina General Statute 143-215.6A to 143-
215.6C.
3. 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.
4. 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.
5. The permittee grants DENR Staff permission to enter the property for the purpose of inspecting all components
of the permitted stormwater management facility.
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.
Permit issued this the 8th day of July, 1998.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
A r 14 A-e h
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission.
Permit Number SW8 980412
5
State Stormwater Management Systems
Permit No. SW8 980412
Perkins Restaurant
Stormwater Permit No. SW8 980412
New Hanover County
Engineer's Certification
1, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically/weekly/full time) the construction of the project,
for (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.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
0
Br*07/1998 09:30 9107635631 TRIPP ENGINEERING PAGE 01
0 TRIPP ENGINEERING, P.C.
507 Chestnut Street
Wilmington, North Carolina 28401
Phone: (910) 763-5100 Fax: (910) 763-5631
July 7, 1998
NCDENR
Division of Environmental Management
Water Quality Section
127 Cardinal Drive
Wilmington, NC 284053945
Attn: Ms. Unda Lewis i
Re: Perkins Family Restaurant
New Hanover, NC
TE 99013
Dear Linda:
Her are the calculations requested qp July 2, 1998. TO calculations shown on Ow
routing were done with zero infiltration.
1. Available storage in pt
2. Storage accumulated ii
23,104,00 cu ft
3. This is a calculation sh
infiltrate out_ The rate
Please review for approval
you.
Sincerely,
Tripp Engineering, P.C.
Charlo D. Cazier, EXT.
CDC: jsa
Enc.
6d — 23,104.09 ou R
pond from 25 year atorm and zero infiltration
Owing the time It takes for the volume of the pond to
:was taken from a previous soils test result.: '
I
nd contact us with questions ar cotiunents, Thank
d
4GW
POT
Pwkne ReemveM
Inftttmft Pww RwAft
25-yaar Stone
9=3
WATERSHED DATA
.e,:L • a :1 • .,, I -t,
W
1,5 ACRES
HYORAUUC OTH
400 FT
61 H 10
6
OEF. 10,
0.25
F CO 0 •NTR
5.00 MIN
INTENS R
8 N It
as. 3.06 CFS
0e - PRF,09VELOPED PEAK DISCHARGE
COMPUTE DEPTH OF RUNOFF
Pi''. '15.7'INCHES ,25yr', Stir PRECIPITATION
CN= 87
0.0000ACN)-10
S • 1.49
Depth (D) - (17-0,20)•2!(P+O.ao)
D a 4.23 IN -2V, Ohr RUNOFF DEPTH
3ET VOLUME AND COMPUTE TIME TO PEAK
Tp a 1(4•6)(0)(Aea)l A Ov
Tp- 3'a70 MINUTES
CALCULATE Ks AND h
.r- ..
WATE SHED AR19
1.5 ACRES
HYDRAULI , Nu I m
4UU F
ANGE 1 EI
6 FT
RUNG EF.'
0.67
TIME OF G NC N rH
101) MI
INTENSITY Yq
8.1 IN/HA
Op= 0.10 CFO
OP - POST-DEVELOPEO PEAK DISCHARGE
6ET NpRMAIL ELEVATION AT =
44.01) feat
SURFACE AREA AT N.E.
3,204 aq R
S Z
- CONTOUR
INCR
ACCUM
CONTOUR AREA
VOL
VOL STAGE
In S
In Z
Z ast
(sg ft)
(Ou ft)
(Cu R) (ft)
(R)
44.0 3,533
0
0
0
0
D
0
45D 4,696
4.114
4.114
1.0
8.3222
0
I m
45.0 5,928
5,312
9,426
2.0
9.1512
0.6931
1.65
47.0 7,230
8,552
18,008
3.0
0.880e
1.006
2,97
48A 8,514
7,925
23,933
4.0
10.0830
1.3863
4.0E
.t.
Ra9rass0on Output.
r
efu Kea 4042
X Coefficient 8,30
Pawns ROVAUrant 96D73
POT Inlatrall0n Pond Routing
•. 2&Year Sbrm
CNAINSAW METHOD FOR
RISER BARREL ROUTING
STORM DATA
Oa -
3.00 CIS
0p =
a.19 cts
Tp a
39.7 min
dT a
4 min
BASIN DA FA
Ke a
4042
b4
1.28
ZO a
44.D R
Nomad water alley -
44.0 R
Box Weir Length a
0 R
ow-
3.0
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0 in
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0.6
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Pk Outflow a 000 Cta
Nldxaf101II6toragaa Z3104.97 ft R AVAIL APt,Z, O
S'dDrfal.F1
State Orifice: Dia a 0.00 In
Inv = 44.0 R
Tone
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Stage
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W Weer
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(min)
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(cfe)
(oh)
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8
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16
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24
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P7407/1998
09:30
9107635631
TRIPP ENGINEERING
PAGE 04
4W7
Perlpns Restaurant
96013
POT
In66w W Pend Routing
2S-yaor 9term
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07107/1998 09:30 9107635631
TRIPP ENGINEERING
PAGE 05
Date
Job
Design
Sheet
5
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For
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Job No.
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May 26, 1998
TRIPP ENGINEERING, P.C.E-4WIWO
ED
507 Chestnut Street
Wilmington, North Carolina 2840198
Phone: (910) 763-5100 • Fax: (910) 763-5631 WL
NCDENR �URI�%I WATER
Division of EnvironmentalManagement
Water Quality Section
127 Cardinal Drive
Wilmington, NC 28405-3845
Attn: Ms. Linda Lewis
Re: Perkins
New Hanover County, NC
SW8 980412
TE 98013
Dear Linda:
We enclose two (2) sets of revised plans. In response to your correspondence of
May 18, 1998, we provide the following:
1. Enclosed is a properly executed O & M agreement-.
2. Dimensions for infiltration basin and building are now provided on sheet Cl.
3. We have enclosed a section detail of infiltration basin, noting the required 3:1
side slopes, the bottom, storage and top elevations.
4. We have provided a flume section detail into the pond with elevations, and
slopes. '
5. We have provided a 15" CMP at -the end of the energy dissipators-with -4.,legs
to distribute runoff evenly to the infiltration basin.
6. We have provided a 50' vegetated filter -at the emergency overflow spillway.
7. We have enclosed infiltration calculations to satisfy required volumes and
drawdown rate.
Please review for approval and contact us -with questions or comments. -Thank
you.
Sincerely,
Tripp Engineering, P.C.
/ , Y
Phillip G. Tripp,-P.E.
PGT:jss
Dote Job Design Sheet
5 TMPP ENGII1EgBRiG, P.C. ce or
507 Chestnut street For Check Job No.
RSlmington, North Caroline 28401
Ii, 1 77 Li
Ir�1r-I -rlorJ =Cot �N2 o S ��
Jim
2nr
State of North Carolina
PF
Department of Environment
and Natural Resources
Acme
Wilmington Regional Office
James B. Hunt, Jr., Governor
NCDENR
Wayne McDevitt, Secretary
NORTH CAROLINA DEPARTMENT OF
Division of Water Quality
ENVIRONMENT AND NATURAL RESOURCES
May 18, 1998
Mr. Phil Tripp, P.E.
Tripp Engineering
507 Chestnut Street
Wilmington, NC 28401
Subject: ACKNOWLEDGEMENT OF RECEIPT AND
REQUEST FOR ADDITIONAL INFORMATION
Stormwater Project No. SW8 980412
Perkins Restaurant
New Hanover County
Dear Mr. Tripp:
The Wilmington Regional Office received a Stormwater Management Permit Application for Perkins
Restaurant on April 7, 1998. A preliminary review of that information has determined that the application
is not complete. The following information is needed to continue the stormwater review:
t/ 1. A signed Operation and Maintenance Plan.
2. Provide dimensions for the infiltration basin, and building.
3. Provide a section detail of the infiltration basin, noting the required 3:1 side slopes, the
bottom, storage and top elevations.
1/ 4. Provide a flume section detail into the pond, with elevations and slopes.
l� 5. Provide a mechanism to ensure even distribution of the runoff in the basin, and detail on the
plans.
6. Provide a 50' vegetated filter for all overflows from the basin.
�7. If no bypass is provided, the calculations must address the required volume based on the 25
Yjyear storm, the provided volume, and the drawdown rate. Only pre- and post-developmentrunoff rates are covered by the submitted calculations. Please demonstrate compliance with
the infiltration requirements.
127 Cardinal Dr. Ext., Wilmington, North Carolina 28405 Telephone 910-395-3900 FAX 910-350-2004
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post -consumer paper
Mr. Tripp
May 18, 1998
Stormwater Project No. SW8 980412
Please note that this request for additional information is in response to a preliminary review. The
requested information should be received by this Office prior to June 18, 1998, or the application will be
returned as incomplete. The return of a project will necessitate resubmittal of all required items, including
the application fee.
If you have any questions concerning this matter please feel free to call me at (910) 395-3900.
RSS/arl:
Sincerely,
Ms. Linda Lewis
Environmental Engineer
S:\WQS\STORMWAT\ADDINFO\980412.MAY
cc: Linda Lewis
Central Files
127 Cardinal Dr. Ext., Wilmington, North Carolina 28405 Telephone 910-395-3900 FAX 910-350-2004
An Equal Opportunity Affirmative Action Employer 50% recycled/10 % post -consumer paper
MOFFICE?.USE ONLY
Date Received
IFee Paid
Permit Number
4 �- 9
0o id
St✓ oyiZ
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
T his form may be pholocopied for use as an original
1. GENERAL INFORMATION
1. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
S T Group, LLC
2. Print Owner/Signing Official's name and title (the person who is legally responsible for the facility and
its compliance):
Brian Smith, Owner
3. Mailing Address for person listed in item 2 above:
City: Wilmington State: NC Zip: 28405
Telephone Number (910) 2564791
4. Project Name (subdivision, facility, or establishment name — should be consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
Perkins Family Restaurant
5. Location of Facility (street address):
Market Street (US Hwy 17)
City: Wilmington County: New Hanover
6. Directions to facility (from nearest major intersection):
Approx. 400 if South from the intersection of US Hwy 17 and SR 2048
7. Latitude: N1Z04VE5or Longitude: w?JTo�CJ of facility
8. Contact person who can answer questions about the facility:
Name: Phillip G. Tripp Telephone Number (910) 763-5100
11. PERMIT INFORMATION:
L Specify whether project is (check one): X New Renewal Modification
2. If this application is being submitted as the result of a renewal or modification to an existing permit, list
The existing permit number and its issue date (if known)
Form SWU-101 January 1998 Page I of
3. Specify the type of project (check one):
Low Density X High Density Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
CAMA Major X Sedimentation/Erosion Control _ 404 Permit
Ill. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed
narrative (one to two pages) de cribing ormwater m agement for the project.
2. Stormwater runoff from this project drains to the e!! 7a p i F2A r River basin.
3. Total Project Area: . S0 acres 4. Project Built Upon Area:
5. How many drainage basins does the project have? 1
6. Complete the following information for each drainage basin. If there are more than two drainage basins
in the project, attach an additional sheet with the information for each basin provided in the same format
as below.
Basin Information =
---Draina etBasin' I' ,—'
Draina a Basin 2--- mm
Receivin Stream Name
unnanM-1ri -4
io ow c
Receiving Stream Class
S o
Drainage Basin Area
i95 SF
Existing Impervious * Area
Proposed Impervious * Area
3 2
% Impervious* Area (total)
53.007o
Impervious * Surface Area �".._
a._
•� 'Diamage Bisin 1 "
_"`t :Draina a Basin;2� a
On -site Buildings
4,p0
On -site Streets
WH
On -site Sidewalks
la 02
On -site Parkin
�f✓2 SF
Other on -site
nJ /
Off -site
NIA
Total:
Y= K K2-Sc
X=
* Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking
areas sidewalks, gravel areas, etc.
How was the off -site impervious area listed above derived? N
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
Deed restrictions and protective covenants are required to be recorded for all low density projects and all
subdivisions prior to the sale of any lot. Please see Attachment A for the specific items that must be recorded.
Form SWU-101 January 1998 Page 2 of 4
By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the items required by the permit, 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 State, and that they will be recorded prior to the sale of any lot.
V. AGENT AUTHORIZATION
If you wish to designate submittal authority to another individual or firm so that they may provide information
on your behalf, please complete this section:
Designated agent (individual or firm): Tripp Engineering, P.C.
Mailing Address: 507 Chestnut Street
City: Wilmington State: NC Zip: 28405
Phone: (9l0) 763-5100 Fax: (910) 763-5631
VI1. SUBMITTAL REQUIREMENTS
This application package will not be accepted by the Division of Water Quality unless all of the applicable
items are included with the submittal.
I. Please indicate that you have provided the following required information by signing your initials in the
space provided next to each item.
Applicant's Initials
• Original and one copy of the Stormwater Management Permit Application Form
• One copy of the applicable Supplement Form(s) for each BMP (see Attachment A)
• Permit application processing fee (see Attachment A)
• Two copies of plans and specifications including:
• Detailed narrative description of stormwater treatment/management
• Two copies of plans and specifications, including:
- Development/Project name
- Engineer and firm
- Legend
- North arrow
- Scale
- Revision number and date
- Mean high water line
- Dimensioned property/project boundary
- Location map with named streets or NCSR numbers
- Original contours, proposed contours, spot elevations
- Details of roads, parking cul-de-sacs, sidewalks, and curb and gutter
- Wetlands delineated, or a note on plans that none exist
- Existing drainage (including off -site), drainage casements, pipe sizes, runoff calculations
- Drainage basins delineated
- Vegetated buffers (where required)
VI. APPLICANT'S CERTIFICATION
1, (print or type name of person listed in General Information, item 2) Brian Smith
certify that the information included on this permit application form is correct, that the project will be
constructed in conformance with the approved plans, that the deed restrictions in accordance with Attachment A
of this form will be recorded with all required permit conditions, and that to the best of my knowledge, the
proposed project co"lies with the r9pirements of 15A NCAC 2H .1000.
Signature:
Title:
Form SWU-101 January 1998 Page 3 of 4
ATTACHMENTA
1. Deed Restriction Language
The following statement must be recorded for all low density projects and for all projects that involve the
subdivision and selling of lots or outparcels:
1. No more than square feet ofany lot, including that portion of the right-of-way between the
edge of pavement and the front lot line, shall be covered by impervious strictures including asphalt,
gravel, concrete, brick, stone, slate or similar material but not including wood decking or the
surface ofswimming pools. This covenant is intended to insure continued compliance with the
stormwater permit issued by the State of North Carolina. The covenant may not be changed or
deleted without the consent of the State.
2. No one may fill in, pipe, or alter any roadside swale except as necessary to provide a minimum
driveway crossing.
NOTE: If lot sizes vary significantly, the owner/developer must provide an attachment listing each lot
member, size and the allowable built upon area for each lot.
For commercial projects that have outparcels or future development, the following statements must also be
recorded:
3. The connection from the outparcel or future area into the stormwater system must be made into the
forebay such that short-circuiting of the system does not occur.
d. All built -upon area from the outparcel or future development must be directed into the permitted
stormwater control system.
5. Built -upon area in excess of the permitted amount will require a permit modification prior to
construction.
For curb outlet systems, the following statement in addition to items t and 2 above must berecorded:
6. No one may pipe, fill in or alter any designated 100 foot long grassed swale used to meet the
requirements ofNCAC 2H.1008(g).
2. Supplement Forms
The applicable supplement form(s) listed below must be submitted for each BMP specified for this project:
Form SWU-102 Wet Detention Basin Supplement
Form SWU-103
Infiltration Basin Supplement
Form SWU-104
Low Density Supplement
Form SWU-105
Curb Outlet System Supplement
Form SWU-106
Off -Site System Supplement
Form SWU-107
Underground Infiltration Trench Supplement
Form SWU-108
Neuse River Basin Nutrient Management Strategy Supplement
3. Permit Application Fees (check made payable to NCDENR and submitted to the appropriate
Regional Office)
Type of Permit
Low Density
High Density
Other
Director's Certification
General Permit
Form SWU-101 January 1998
New, Modification, or
Late Renewal
$225
$385
$225
$350
$ 50
Page 4 of 4
Timely Renewal Without
Modification
n/a
$225
n/a
n/a
n/a
If
E C E I V E
INFILTRATION POND MAINTENANCE
uu MAY 2 71998
D M'
Project Name: Perkins Family Restaurant PROJ s
Responsible Party Name: S T Group, LLC
Address: 1903 Inverness -Lane_ Wilmington, NC 28405_ Phone {9101256-4791
After every runoff producing rainfall event, or at least monthly, whichever comes first:
1. Inspect the infiltration pond (s) for erosion, trash accumulation, grass coverage,
and general condition of the facility.
2. Repair eroded areas immediately, re -seed as necessary, keep side slopes and
bottom mowed, and remove trash.
3. Check any inlet piping, swales and catch basins. Repair broken piping, reseed
swales, and remove trash.
4. Inspect the bypass/overflow structure for blockage and deterioration. Remove
blockage and repair structure to originally approved design specifications.
5. Check the depth of the pond (s) every six months. If siltation has occurred -to the
point that only 75% of the original design depth is provided, remove the excess
silt to the original depth. Do not over -excavate, as this may cause the required
water table separation to be reduced, and may affect the ability of the system to
perform as designed,.
SPECIAL REQUIREMENTS
1, W. Haan Smith agree to be responsible for
performing the maintenance items as listed above for this project. I agree to notify
NCDEM of any problems with the system or changes in the name of the project, name of
responsible p rty or dress.
Signature Date Y!/�7 e
TRIPP ENGINEERING, P.C.
19 507 Chestnut Street RECEIVE
Wilmington, North Carolina 28401
Phone: (910) 763-5100 • Fax: (910) 763-5631 APR 1998
BY: SLl)$ �i�304
OW
April 3, 1998
NCDENR
Division of Environmental Management
Water Quality..Section
127 Cardinal Drive
Wilmington, NC 28405-3845
Attn: Ms. Linda Lewis
Re: Per)kins Family Restaurant
New Hanover County, NC
TE No. 98013
Dear Linda:
Enclosed please find two (2) sets of plans, two (2) sets of sealed calculations, one
(1) signed application form including narrative, one (1) check to cover the application
fee, (1) soils report, (1) chloride test and (1) map showing chloride sample point.
Please review for approval and contact us with.any questions or comments. Thank
you.
Sincerely,
Tripp Engineering, P.C.
/ t
Phillip G. Tripp
PGT/jss
Enc.
Stormwater Narrative
April 3, 1998
Re: Perkins Family Restaurant
New Hanover County
TE 98013
Lot is to be cleared and graded for the construction of a 4,400 sf restaurant. Also included
is 28,352 sf of.asphalt parking and 1,890 sf of concrete sidewalk.
Runoff from this site is routed to an ifiltration pond. Proposed impervious area for this
site is 53.0%.
E C E I V E D
APR 071998
PROJ N U O04 IZ
�j��GQf2 pp
DIVISION OF WATER QUALITY
INFILTRATION SYSTEM INVESTIGATION
1. The minimum bore depth:
2. The type of soil:
3. The expected infiltration rate:
y46. S
Z.
42` 2
re�oh,mer�e �i:� s���s repo-t"
4. The depth to the Seasonal High Water Table:
5. Additional comments:
Signature of Regional Office Personnel:
0S if �1G
Linda Lewis, DWQ Vincent Lewis, Soil Scientist
Permit Application No. 1�(� ��2— Date 4-2Z-a43
S: \W QS\STORMWAT\FORMS\INFINVST. FOR
4r397
PGT
2
WATERSHED DATA
WATERSHED AREA
1.5 ACRES
HYDRAULIC LENGTH
400 FT
CHANGE IN HEIGHT
5 FT
RUNOFF COEF.'C'
0.25
TIME OF CONCENTR
5.00 MIN
INTENSITY 25YR
8.151N/HR
Qa= 3.06 CFS
Oa = PRE -DEVELOPED PEAK DISCHARGE
COMPUTE DEPTH OF RUNOFF
Perkins Restaurant
Infiltration Pond Routing
25-year Storm
P = 5.7 INCHES 25 yr, 6hr PRECIPITATION
CN = 87
S = (1000/CN)-10
S = 1.49
Depth (D) = (P-0.2S)^2/(12+0.8S)
D = 4.23 IN - 24yr, 6hr RUNOFF DEPTH
SET VOLUME AND COMPUTE TIME TO PEAK
Tp = 1(43.5)(D)(Area)1 / Op
Tp = 33.70 MINUTES
CALCULATE Ks AND b
SET NORMAL ELEVATION AT = 44.00 feet
SURFACE AREA AT N.E. = 3,204 sq ft
AFTER DEVELOPMENT
WATERSHED AREA
1.5 ACRES
HYDRAULIC LENGTH
400 FT
CHANGE IN HEIGHT
5 FT
RUNOFF COEF.'C'
0.67
TIME OF CONCENTR
5.00 MIN
INTENSITY 25 YR
8.151N/HR
Qp= 8.19 CFS
Op = POST -DEVELOPED PEAK DISCHARGE
a sim. l
tij 1jk a
Q
�1P6REG�,.���`�
"4
1 (-f4.
111i64•o3•95
•_�
SYORMWATER
D E C E I V E
APR 071998 D
S
Z
CONTOUR
INCR
ACCUM
CONTOUR
AREA
VOL
VOL
STAGE
In S
In Z
Z est
(sq ft)
(cu ft)
ICU ft)
(ft)
(R)
44.0
3,533
0
0
0
0
0
0
45.0
4.695
4,114
4,114
1.0
8.3222
0
1.01
46.0
5,928
5,312
9,426
2.0
9.1512
0.6931
1.95
47.0
7,236
6,582
16,008
3.0
9.6808
1.0986
2.97
48.0
8,614
7,925
23,933
4.0
10.0630
1.3863
4.08
Regression Output:
=_> Ks - 4042
b - 1.26
X Coefficient 8.30
PROJ N 5WSSO4(Z-
4W7
PGT
CHAINSAW METHOD FOR
RISER BARREL ROUTING
STORM DATA
as =
3.06 cis
Op =
8.19 cfs
Tp =
33.7 min
dT =
4 min
BASIN DATA
Ks =
4042
b=
1.26
Zo -
44.0 ft
Normal ureter elev =
44.0 ft
Box Weir Length = 0 it
Cw= 3.0
Zcr = 0.0 it
Dd = 0 in
Cd = 0.6
Zi = 0.0 It
Perkins Restaurant
Infiltration Pond Routing
25-year Storm
Pk Outflow = CDO cis
Pk Stage = 47.97 it
Maximum Storage = 23104.09 cu It
Control Holes:
State Orifice: Dia = 0.00 in
Inv= 44.0 It
Time
Inflow
Storage
Stage
Outflow
W Riser
Barrel
Orifice
City Weir
(min)
(cfs)
ICU ft)
(it)
(cfs)
(cfs)
(cfs)
(cfs)
(cfs)
0
0.0
0
44.00
0
0
0
0
0.00
4
0.3
0
44.00
0
0.00
0
0
0.00
8
1.1
68
4404
0.00
0.00
0.0
COD
0.00
12
2.3
328
44.14
0.00
0.00
0.0
0.00
0.00
16
3.8
882
44.30
0.00
0.00
0.0
0.00
0.00
20
5.3
1787
44.52
0.00
0.00
0.0
0.00
0.00
24
6.6
3054
44.80
0.00
0.00
0.0
0.00
0.00
28
7.6
4644
45.12
0.00
0.00
0.0
0.00
0.00
32
8.1
6475
45.45
0.00
0.00
0.0
0.00
0.00
36
8.1
8428
45.79
0.00
0.00
0.0
0.00
0.00
40
7.5
10371
46.11
0.00
0.00
0.0
0.00
0.00
44
6.5
12173
46.39
0.00
0.00
0.0
0.00
0.00
48
5.6
13736
46.63
0.00
0.00
0.0
0.00
0.00
52
4.8
15075
46.83
0.00
0.00
0.0
0.00
0.01)
56
4.1
16223
47.00
ODD
0.00
0.0
0.00
0.00
60
3.5
17207
47.14
0.00
0.00
0.0
0.00
0.00
64
3.0
18050
47.26
0.00
0.00
0.0
0.00
0.00
fib
2.6
18773
47.37
0.00
0.00
0.0
0.00
0.00
72
2.2
19392
47.46
0.00
0.00
0.0
0.00
0.00
76
1.9
19923
47.53
0.00
0.00
0.0
0.00
0.00
80
1.6
20378
47.59
0.00
0.00
0.0
0.00
0.00
84
1.4
20768
47.65
0.00
0.00
0.0
0.00
0.00
68
1.2
21102
47.69
0.00
0.00
0.0
0.00
0.00
92
1.0
21388
47.73
0.00
0.00
0.0
0.00
0.00
96
0.9
21633
47.77
0.00
0.00
0.0
0.00
O.OD
100
0.8
21844
47.80
0.00
0.00
0.0
0.00
0.00
104
0.6
22024
47.82
0.00
0.00
0.0
0.00
0.00
108
0.6
22178
47.84
0.00
0.00
0.0
0.00
0.00
112
0.5
22311
47.86
0.00
0.00
0.0
0.00
O.OD
116
0.4
22424
47.88
ODD
ODD
0.0
0.00
0.00
120
0.3
22521
47.89
0.00
0.00
0.0
0.00
0.00
124
0.3
22605
47.90
0.00
0.00
0.0
0.00
0.00
128
0.3
22676
47.91
0.00
0.00
0.0
0.00
0.00
132
0.2
22737
47.92
0.00
0.0D
0.0
0.00
0.00
136
0.2
22790
47.93
0.00
0.00
0.0
0.00
0.00
140
0.2
22835
47.93
0.00
0.00
0.0
0.00
0.00
98013
4/.iRJ7
Perldns Restaurant
98013
PGT
Infiltration Pond Routing
25-year Storm
144
0.1
22873
47.94
0.00
0.00
0.0
0.00
0.00
148
0.1
22906
47.94
0.00
0.00
0.0
0.00
0.00
152
0.1
229M
47.95
0.00
0.00
0.0
0.00
0.00
156
0.1
22958
47.95
0.00
0.00
0.0
0.00
0.00
160
0.1
22980
47.95
0.00
0.00
0.0
0.00
0.00
164
0.1
22998
47.95
0.00
0.00
0.0
0.00
0.00
168
0.1
23013
47.96
0.00
0.00
0.0
0.00
0.00
172
0.0
23026
47.96
0.00
0,00
0.0
0.00
0.00
176
0.0
23037
47.96
0.00
0,00
0.0
0.00
0.00
180
0.0
23047
47.96
0.00
0,00
0.0
0.00
0.00
184
0.0
23055
47.96
0.00
0,00
0.0
0.00
0.00
188
0.0
23062
47.96
GOD
0.00
0.0
0.00
0.00
192
0.0
23068
47.96
0.00
0,00
0.0
0.00
0.00
196
0.0
23073
47.96
0.00
0.00
0.0
0.00
0.00
200
0.0
23078
47.97
0.00
0.00
0.0
0.00
0.00
204
0.0
23081
47.97
0.00
0.00
0.0
0.00
0.00
me
0.0
23085
47.97
0.00
0.00
0.0
0.00
0.00
212
0.0
23088
47.97
0.00
0.00
0.0
0.00
obo
216
0.0
23090
47.97
0.00
0,00
0.0
0.00
0.00
220
0.0
23092
47.97
0.00
0.00
0.0
0.00
0.00
224
0.0
23094
47.97
0.00
0.00
0.0
0.00
0.00
228
0.0
23095
47.97
0.00
0.00
0.0
0.00
0.00
232
0.0
23097
47.97
0.00
0.00
0.0
0.00
0.00
236
0.0
23098
47.97
0.00
0.00
0.0
0.00
0.00
240
0.0
23099
47.97
0.00
0.00
0.0
0.00
0.00
244
0,0
23099
47.97
000
0.00
0.0
0.00
0.00
248
0.0
23100
47.97
0.00
0.00
0.0
0.00
0.00
252
0.0
23101
47.97
0.00
0.00
0.0
0.00
0.00
256
0.0
23101
47.97
0.00
0.00
0.0
0.00
0.00
260
0.0
23102
47.97
0.00
0.00
0.0
0.00
0.00
264
0.0
23102
47.97
0.00
D.00
0.0
0.00
0.00
268
0.0
23102
4T97
0.00
0.00
0.0
0.00
O.DD
272
0.0
23103
47.97
0.00
0.00
0.0
0.00
0.00
276
0.0
23103
47.97
0.00
0.00
0.0
0.00
0.00
280
0.0
23103
47.97
0.00
0.00
0.0
0.00
0.00
284
0.0
23103
47.97
0.00
ODO
0.0
0.00
0.00
288
0.0
23103
47.97
O.00
0.00
0.0
0.00
0.00
292
0.0
23104
47.97
0.00
0.00
0.0
0.00
0.00
296
0.0
23104
47.97
0.00
0.00
0.0
0.00
0.00
300
0.0
23104
47.97
0.00
0.00
0.0
0.00
0.00
3D4
0.0
23104
47.97
0.00
0.00
0.0
0.00
0.00
308
0.0
23104
47.97
0.00
0.00
0.0
0.00
0.00
312
0.0
23104
47.97
0.00
0.00
0.0
0.00
0.00
316
0.0
23104
47.97
0.00
0.00
0.0
0.00
0.00
320
0.0
23104
47.97
0.00
0.00
0.0
0.00
0.00
324
0.0
23104
47.97
0.00
0.00
0.0
0.00
0.00
A NPR 04 '98 15:46 FP. L V ENGINEERING 910 791 1338 TO 76356.31 P.03i05
EASTERN SOILS LIMITED
Post Office Box 10161
Wilmington, North Carolina 28405
TeVFn: (910) 686MM
Cen"rg Environmental ScientWs
March 3, 1998
t ` l
Mr. Carter Hubard, Project Manager n E C E I V E D
Law Engineering and Environmental Services, Inc. lu u(
5710 oleander Drive, site I10 APR 0 71998
Wilmington, North Carolina 28403
E
PROJN W S Z
SUBJECT. Soil Evaluation for Proposed Stormwater Pond
Perkins Restaurant Site, Market Street and Gordon Road
LEES Project No. 31000-8-0953, Task 800
Eastern Soils Project No. 98-110
Dear Mr. Hubard:
At your request, we visited the subject site on February 19, 1998 for the puppose of
evaluating soil conditions in area of the proposed stormwater pond (stormwater
infiltration basin). The purpose of the field work was to identify the soil type in the area
of the pond, estimate the depth to the seasonal high water table (SHWT), and estimate the
permeability rate of the soil.
The approximate pond location was found in the field from taped measurements and
referring to a site plan that you provided. Four hand auger borings were made to a depth
of about 84 inches. Their locations are depicted with respect to geotechnical boring B-3
on the accompanying sketch. The soil characteristics were observed and the depth to free
water was measured. In addition, the depth to the water table was measured in an existing
geotechmcal boring (B-3), which was open at the time of the site visit. Soil permeability
was estimated using published data (Soil Survey of New Hanover County, Norrh Carolina,
USDA-SCS, 1977) and our observations of the soil.
The soils mapped in the area of the proposed restaurant by USDA-SCS soil scientists are
from the Kureb series (Kr). These soils are excessively well drained sands with a SHWT
found deeper than 72 inches. Typically, they have a surface laver of dark gray sand that is
about 3 inches thick. The subsurface soil to a depth of about 23 inches is light gray sand.
The underlying soil is brownish yellow sand in the upper part and pale brown sand in the
MPR 04 '98 15:47 FR LPM ENGINEERING 91C 791 1338 TO 7635631 P.04:05
w
Mr. Carter Hubard
Page 2
lower part. Dark brown bands and dark reddish brown lumps of sand are found between
depths of 26 and 51 inches. Baymeade (Be) soils are often found as inclusions in Kureb
map units. These soils are also sandy , but have a SHWT found at depths between 48 and
60 inches below the ground surface. They also have a sandy loam to loamy sand Bt
horizon.
The soils observed on the site resembled the Kureb series in texture and color in the upper
portion of the profiles. The soil material underlying the surface and subsurface soil layers
was brownish yellow or yellowish brown to pale brown sand to a depth of about 0 inches
in borings HA-1 and HA-2 and 65 inches in borings HA-3 and HA4. Below those depths
the soil was a light gray to gray sand. Free water was encountered in the borings at the
depth of the color change, or about 70 inches and 65 inches, respectively. The deeper
depth to free water was associated with a higher landscape position. Creotechnical boring
B-3 was located near the highest position on the landscape (estimated). Free water was
measured at a depth of 70 inches at the time of the site visit in boring B-3. The recent
record breaking rainfall amounts have undoubtedly pushed the water table to the
shallowest depths that can be expected.
According to SCS data presented in the soil survey report for New Hanover County, the
permeability of the Kureb soils is 6.0 to 20 LThr throughout the 89 inch soil profile
described. It is our opinion that the soils on the subject site haae a permeability on the
lower end of that range. We would suggest using a permeability of no greater than 6.0
irift for drawdown estimates.
If we can be of further assistance or if you have any questions about this report please
contact us.
Sincerely,
W.R. (Bill) Dunlop, Jr., LSS
NC Licensed Soil Scientist #1095
Attachment
EASTERN SOILS LIMITED P.O. Box 10161 Wilmington, NC 23405
MAR 24 '90 15:47 FR LAW ENGINEERING 910 791 1336 TO 7635E31 P.05/05
** TOTAL P9GE.C5 **
OXFORD
Laboratories
Inc.
Analytical and Consulting Chemists
1316 South Fifth Street
2 Wilmington, N.C. 28401
(910)763-9793
DATE RECEIVE 08-22-96 Fax (910)343.9688
DATE REPORTS 08-27-96
96W9 93
PAGE 1 OF
PHILLIP TRIPP P.E.
211 NORTH 5TH ST.
WILMINGTON, NC 28401
ATTENTION: PHILLIP TRIPP
SAMPLE DESCRIPTION: STORMWATER
P.O. #
1. TRIBUTARY TO HOWES CREEK 08-22-96
Chloride, as Cl, PPM
RESULTS
1
24
ROGER C. OXFORD, CHEMIST
/W �/'IT�r
1
rr _
R PR p
• i •. r.
OXFORD LABORATORIES, INC.
LABORATORYN.P.D.E.S. #75
AWALYTICAL AN3D
COlfSULTINiG CHEMISTS'
1316 SOUTH FIFTH S T.
WILIAHIGTOIt. N.C. 28401
(910)763.9793
CLIENT: i PjPY� gj61r- D!4 Q,�.
DATE: ZII'/z t`I• 5TH a
ADDRESS:
FAS.(910)343.9688
COLLECTED BY: wwa tom. TQ,A-, P. E.
P.O. q:
COUNTY: tw Arlo�i�
PHDtJE: ��• (o�j•
AiiENTION: H,L I G,pp
FAX: q10 3 (a3t
TYPE OF SA.IdPLE: wares ryorF Htac, 64*s K
DEM RC sw0 SOIL WW MW DW OTHER
SAMPLE ID:
TRIBV A fD oW 's ` ,�
BOTTLE
tl0.
I
DATE
COLLECTED
TIME
COLLECTED
�-WAm
ANALYSIS
�oR S
PRE
H2304
VP.TIVF:S
W-L
J t9.0H HNO3 P(Pl!=11ry+C SNH2 OTri
NOTE: MAXIMUM HOLDING TIME AND LAB SCHEDULE FOR THE FOLLOWING
48 HRS BOD5 TUES AND THURS 8:00.4:30
48 HRSTH
MBAS, O.PO4 URS. 8:00.4:30 ED 8:0012:00
30 HRS FOR T. COLIFORI4 (M01.1-THURS 8:00.2.00l
5 HRS. FOR F. COLIFORM MON.-THUUS. 8:00 2:00
OTHEM llpP OTED RMULA.R SCH U N.-FRI.
LAB US NLY
D ItI WATER WITH ICE CHILLED TO 4 C: YES: N0�-
47F1-p—'
D IN HOLDING TIPAE: YES: NO:CEIVED: TIPAE RECEIVED^D: = REJECTED: BY:LERELIUESTED: YES:TS:
I NTCOtvIMENTS:
L
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BAA 37
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5 4� A
-'39 (WRIGH]ISVILLE 247 47 30"
SALE
,ALE 4 )00
20X
5000 61-0c, 'DOO FEE
Ivs CONTOUR INTERVAL 5 FEET
28 DATUM IS MEAN SEA LEVEL
DEPTH, CURVES AND SOUNDING IN FEET —DATUM IS MEAN LOW WATER
-L-1. RA.I;F "I TiOF is "fri
MAGNETIC NORTH
NTER OF SHEET
OL;AD:
THIS MAP COMPLIES WITH NATIONAL MAP ACCURACY STANDARDS
FOR SALE BY U.S,GEOLOGICAL SURVEY, WASHINGTON. D.C. 20242
A FOLDER DESCRIBING TOPOGRAPHIC MAPS AND SYMBOLS IS AVAILABLE ON REQUEST
3
0
TE 98013
3NGINEERING d FAGUnES APPLICATION FOR PERM17 FOR A
LAND -DISTURBING ACTIVITY lie \
t _
UNDER THE CONDITICNS SET -FORTH BY
-I uer
THE NEW HANOVER COUNTY ree per_
SCIL EROSION AND SEDIMENTATION CONTROL ORDINANCE
Date
Applicant: S T GrouD, LLC
Applicant's Agent: S T Group, LLC
Address: 1903 Inverness Lane Address: 1903 Inverness Lane
Wilmington, NC 28415
Telephone Number: (910) 256-4791
Wilmington, NC 28405
Telephone Number: (910) 256-4791
Total Acres of Land Disturbance: 1.5 acres Purpese of Development: Comm sal
Location and Description of Land Disturbance:
Aporox. 400 if South from the intersection of US Hwv 17 andgR 90ap
Land owner(s) of Record
STATEMENT OF FINANCIAL RESPONSIBILITY
Person or firm(s) financially responsible for the
land -disturbing activity. If not a North Carolina
resident you must have a N.C. agent (List 2-zloty)
Name: t.7 p
W`L'n_ 1 PS Name: S T Group, Ld,C
Address: Towles Road Address: 1903 Inverness ranp
Wilmington NC 28409 Wilmington, NC 28405
Telephone Number: (910) 350-0002 Telephone Number: (910) 256-4791
Location of deed(s) or instrument(s): County New Hanover Book Pag
e
The above information is true and correct to the best of my knowledge and belief and was provided by me while under oath.
(This form must be signed by the financially responsible person if an individual and by an officer, director, partner, attorney-in-
fac:, or other person of authority to execute instruments for the financially responsible person if not an individual.) I agree to
provide corrected information should there be any change in the information provided herein.
Date: 03,/31/98
Name (Type or P t) Brian QWAh
Tate: 14anaging Ntnter g
Si nature:
Carolina, hereb certify the
ing duly
S �T�Ai►
_ , a Notary Public of the County of I�r �p`Rr State of North
�� 9mth that the above form was executed by him. appeared personally before me this day and be -
Witness my h,#pd and notarial
Notary
day of March , 19 98
04
My commission expires