SW3180401_Application Form_20221201

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://deg.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: SW3180401
2. Current Permit Holder's Company Name/Organization: Pulte Home Company, LLC
3. Signing Official's Name: Jeremy Huntsman
4. Signing Official's Title: Director of Land Development
5. Mailing Address: 11121 Carmel Commons Blvd., Suite 450
City: Charlotte State: NC ZIP: 28226
6. Street Address (if different): : Same as Above
City: State: ZIP:
7. Phone: [phone] Email: jeremy.huntsman(a�pultegroup.com
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 the Sand Filter design to include 1 ft deep stone on top of sand filter media.
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: Matthew R. Reiking
Consulting Firm:_ ESP Associates, Inc.
Mailing Address: 3475 Lakemont Blvd.
City: Fort Mill State: SC Zip: 29708
Phone: [phone] Fax: [phone]
Email: mreiking(a)espassociates.com
[OPTIONAL] If you would like to designate another person to answer questions about the project:
Name & Title:Jessica MarSr
Organization: Pulte Home Company, LLC
Mailing Address: 11121 Carmel Commons Blvd., Suite 450
City:Charlotte State:NC Zip:28226
Phone: [phone] Fax: ( )
Email: :Jessica.Marsh(a-)puftegroup.com
D. CERTIFICATION OF PERMITTEE
I, Jeremy Huntsman, 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 the best
of my knowledge.
Signature:
I, 2C)— a Notary Public for the State of eCVr)kYrl�
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personally appeared before me is the 22- day of �ao.M 20_Z, and
acknowledge the due execution of the forgoing instrument. Witness my hand and official seal,
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Stormwater Permit Form 7: Minor Modification Page 2 of 2 Oct 6, 2017