NCC224156_FRO Submitted_20230104

,��onville/N
4 C�i'Inp Comm°^ttY
City of Jacksonville
Erosion and Sedimentation Control Application
1. Applicant(s): A. Sydes Construction, Inc.
Address: 100 Carolina Plantations Blvd; Jacksonville, NC 28540
Phone Number: 910-455-6956
Interest in property: Owner
(owner, developer, registered agent, manager, etc.)
2. ePlan Applicant Info: (Infonnairon of the person who will be uploading documents to eplan)
First Name: Kim Last Name: Whaley
Email Address: [e-mail]
3. Owner of Property: _
(If not the applicant)
Address:Fax Number: _ Email:
4. Description of property:
a. Location of Property/Address: __Gum Branch
b. Onslow County Deed Book: 4862 Page Number: 208
C. Onslow County Map Book: 77 Page Number: 30
d. Total Acreage in Tract: _ 78.9_
e. Acreage to be Disturbed: 9.5
5. Submit the following documentation to Planning and Permitting:
a. One original fully executed Financial Responsibility/Ownership Form. (Attachment A)
b. One copy of a completed checklist along with all required information and documentation.
(Attachment B)
C. Check made out to the CITY OF JACKSONVILLE for the total amount due.
($225 for first acre plus $125 for every additional acre or portion thereof based on the
total disturbed acreage in the tract.)
d. Upload to eplan - Erosion control plan(s) along with all related details, calculations, and
documents as required on the checklist.
ace as
-L
Signature f Propebwngr or Applicant Dat

(ATTACHMENTA)
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land -disturbing activity on one or more acres as covered by the Act before this
form and an acceptable erosion and sedimentation control plan have been completed and approved by the
Land Quality Section, N.C. Department of Environment and Natural Resources. (Please type or print and, if
the question is not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.)
Part A.
1. Project Name: Southern Charm at the Vineyards_
2. Location of land -disturbing activity: Onslow County City or Township: Cit, of Jacksonville_
Highway/Street: Gum Branch Road Latitude: 34°48'.37.3" Longitude: 770 26'08.9°
3. Approximate date land -disturbing activity will commence: _
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Resdiential
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): _ _ _ 9.5
6. Amount of fee enclosed: _cS 1,350.00
The application fee of $225.00 for the first acre plus $125 for every additional acre (rounded up to the
next acre) is assessed without a ceiling amount. (Example: 6.4-acre application fee is $975).
7. Has an erosion and sediment control plan been filed? Yes ❑ No ❑✓ Enclosed 0
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity
Name: Anthony W. Sydes _ E-mail Address: _leahquinn@sydescommunities
Telephone #: [phone] Cell #: Fax #:
9. P.O. Box 7122 100 Carolina Plantations Blvd
Current Mailing Address Current Street Address
Jacksonville NC 28540 Jacksonville NC 28540
City State Zip City State Zip
10. Deed Book: 4862 Page Number: 208 __ _ (Provide a copy of the most current deed)
Part B.
1. Person(s) or firm(s) who are financially responsible for the land -disturbing activity
(Provide a comprehensive list of all responsible parties on an attached sheet):
A. Sydes Construction.. Inc._ [e-mail]
Name E-mail Address
P.O. Box 7122
Current Mailing Address
Jacksonville NC
city State Zip
100 Carolina Plantations Blvd.
Current Street Address
28540 Jacksonville
city
NC 28540
State Zip
Telephone #: [phone] Cell #: Fax #: — -

t
2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
the designated North Carolina Agent:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City
State Zip
Telephone #: Cell #: Fax #:
(b) If the Financially Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name. If the Financially Responsible
Party is a Corporation, give name and street address of the Registered Agent:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City
Telephone #: _ Cell #: _ Fax #:
State Zip
The above information is true and correct to the best of my knowledge and belief and was provided by me
under oath (This form must be signed by the Financially Responsible Person if an individual or his attorney -in -
fact, or if not an individual, by an officer, director, partner, or registered agent with the authority to execute
instruments for the Financially Responsible Person). I agree to provide corrected information should there be
any change in the information provided herein.
Anthonv W. Svdes President
Signature
Title or Authority
Date
I, ,a Notary Public of the County ff�
State of North Carolina, hereby certify that U� tu• appeared personally
before me this day and being duly sworn acknowledged that tfie above foem was exec4ed by him.
Witness my hand and no%C) jIl seal, this day of , 20
N
h/ — My commission expires
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(ATTACHMENT B)
EROSION and SEDIMENTATION CONTROL PLAN PRELIMINARY REVIEW CHECKLIST
The following items shall be incorporated with respect to specific site conditions, in an erosion & sedimentation control plan:
NPDES_ _Construction Stormwater General Permit NCGO10000
Designation on the plans where the 7 or 14 day ground stabilization requirements apply per Section 11.B.2 of the permit.
—� Design of basins with one acre or more of drainage area for surface withdrawal as per Section ILBA of the permit.
LOCATION INFORMATION
Project location & labeled vicinity map (roads, streets, landmarks)
North arrow and scale
Identify River Basin.
i4 Provide a copy of site located on applicable USGS quadrangle
and NRCS Soils maps If it is in a River Basin with Riparian Buffer
requirements.
GENERAL SITE FEATURES {plan elements)
✓ Property lines & ownership ID for adjoining properties
�- Existing contours (topographic lines)
Proposed contours
✓ Limits of disturbed area (provide acreage total, delineate limits,
and label). Be sure to include all access to measures, lots that will
be disturbed, and utilities that may extend offsite.
Planned and existing building locations and elevations
i/ Planned & existing road locations & elevations, including
temporary access roads
✓ Lot and/or building numbers
V Hydrogeologic features: rock outcrops, seeps, springs, wetland
and their limits, streams, lakes, ponds, dams, etc. (include all
required local or state buffer zones and any DWQ Riparian Buffer
determinations)
✓ Easements and drainageways, particularly required for offsite
affected areas. Include copies of any recorded easements and/or
agreements with adjoining property owners.
Profiles of streets, utilities, ditch lines, etc.
—F17' Stockpiled topsoil or subsoil locations
If the same person conducts the land -disturbing activity & any
related borrow or waste activity, the related borrow or waste
activity shall constitute part of the land -disturbing activity unless
the borrow or waste activity is regulated under the Mining Act of
1971, or is a landfill regulated by the Division of Waste
Management. If the land -disturbing activity and any related
borrow or waste activity are not conducted by the same person,
they shall be considered separate land -disturbing activities and
must be permitted either through the Sedimentation Pollution
Control Act as a one -use borrow site or through the Mining Act.
Location and details associated with any onsite stone crushing or
other processing of material excavated. If the affected area
associated with excavation, processing, stockpiles and transport
of such materials will comprise 1 or more acres, and materials will
be leaving the development tract, a mining permit will be required.
Required Army Corps 404 permit and Water Quality 401
j oEsss certification (e.g. stream disturbances over 150 linear feet)
EROSION & SEDIMENT CONTROL MEASURES (on plan
_L,' Legend (provide appropriate symbols for all measures and
reference them to the construction details)
Location of temporary measures
✓ Location of permanent measures
✓ Construction drawings and details for
temporary and permanent measures. Show measures to scale on
plan and include proposed contours where necessary. Ensure
design storage requirements are maintained through all phases of
construction.
Maintenance requirements for measures
1/ Contact person responsible for maintenance
SITE DRAINAGE FEATURES
Existing and planned drainage patterns (include off -site areas that
drain through project and address temporary and permanent
conveyance of stormwater over graded slopes)
Method used to determine acreage of land being disturbed and
drainage areas to all proposed measures (e.g. delineation map)
Size, pipe material and location of culverts and sewers
✓ Soil information: type, special characteristics
✓ Soil information below culvert storm outlets
_ // Name and classification of receiving water course or name of
municipal operator (only where stormwater discharges are to
occur)
STORMWATER CALCULATIONS
IVI �A Pre -construction runoff calculations for each outlet from the site (at
peak discharge points). Be sure to provide all supporting data for
the computation methods used (rainfall data for required storm
events, time of concentration/storm duration, and runoff
coefficients).
Design calculations for peak discharges of runoff (including the
construction phase & the final runoff coefficients for the site)
✓ Design calcs for culverts and storm sewers (include HW, TW and
outlet velocities)
Discharge and velocity calculations for open channel and ditch
✓ flows (easement & rights -of -way)
Design talcs for cross sections and method of stabilization for
existing and planned channels (include temporary linings). Include
/ appropriate permissible velocity andlor shear stress data.
Design caics and construction details for energy dissipaters below
culvert and storm sewer outlets (include stone/material specs &
apron dimensions). Avoid discharges on fill slopes.
l/ Design talcs and dimension of sediment basins (note current
surface area and dewatering standards as well as diversion of
runoff to the basins). Be sure that all surface drains, including
ditches and berms, will have positive drainage to the basins.
VEGETATIVE STABILIZATION
Area & acreage to be stabilized with vegetation
Method of soil preparation
✓ Seed type & rates (temporary & permanent)
Fertilizer type and rates
Mulch type and rates (include mulch anchoring methods to be
used)
NOTE: Plan should include provisions for groundcover in accordance with
NPDES Construction Stormwater General Permit NCGO10000
and permanent groundcover for all disturbed areas within 15
working days or 90 calendar days (whichever is shorter) following
completion of construction or development.
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
✓ Completed, signed & notarized FR/O Form
✓ Accurate application fee payable to CITY OF JACKSONVILLE
The application fee of $225.00 for the first acre plus $125 for every
additional acre (rounded up to the next acre) is assessed without a
✓ ceiling amount (Example: a 6.4-acre application fee is $975).
Certificate of assumed name, if the owner is a partnership
✓ Name of Registered Agent (if applicable)
✓ Copy of the most current Deed for the site. Please make sure the
deed(s) and ownership information are consistent between the
plan sheets, local records and this form.
Provide latitude & longitude (in decimal degrees) at the project
entrance.
NOTE: For the Express Permitting Option, inquire at the local Regional
Office for availability.
NARRATIVE AND CONSTRUCTION SEQUENCE
Narrative describing the nature & purpose of the construction
activity
(/ Construction sequence related to erosion and sediment control
(including installation of critical measures prior to the initiation of
the land -disturbing activity & removal of measures after areas they
serve are permanently stabilized). Address all phases of
construction and necessary practices associated with temporary
stream bypasses and/or crossings.
Iv r'r Bid specifications related only to erosion control
rev. 12182012