SW6211205_Application Form_20230201

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/contacUregiooal-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: SW6211205
2. Current Permit Holder's Company Name/Organization: McNair Mill, LLC
3. Signing Official's Name: Charles C. Morris
4. Signing Official's Title: Manager
5. Mailing Address: 85 Cherry Hill Drive
City: Pinehurst State: NC ZIP: 28374
6. Street Address (if different):
City:
7. Phone: [phone]
Email: char►escmorrisCaD-gmail.com
State: ZIP:
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):
Providing BUA allocations for residential subdivision designated as "future development" on
original permit
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.:
1. Two hard copies (with original signatures) and one electronic copy of this completed form.
2. Two hard copies and one electronic copy of the revised plan sheets (must be a revision of the
originally approved plan sheets).
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.
4. If applicable, the appropriate Express review fee.
Stormwater Permit Form 7. Minor Modification Page I of L, 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:C. Scott Brown, PE
Consulting Firm: 4D Site Solutions, Inc.
Mailing Address:409 Chicago Drive — Suite 112
City: Fayetteville State:NC Zip:28306
Phone: [phone] Fax: [phone]
Email::sbrown(c)4dsitesolutions.com
2. [OPTIONAL] If you would like to designate another person to answer questions about the project:
Name & Title:
Organization:
Mailing Address:
City: State: Zip:
Phone:
Email: :
D. CERTIFICATION OF PERMITTEE
Charles C. Morris MaRker McNair Mill ILL
have authorized the mi
Fax: ( )
the current permittee, certify that I
modifications listed in Section A and shown in the attached revised plan sheets. I further
attest that this inf6rmXjon is accurate and complete to the best of my knowledge.
Signature:
Date: / Z /� /LZ
I, .J e Pf er 4 1`1a tic,a Notary Public for the State of
County of ro F do hereby certify that CG.0 ale; E per. s
personally appeared before me this the 12 day of 20 Z2 , and
acknowledge the due execution of the forgoing instrument. Witness my hand and official seal,
Jeffery Markham
Notary Public
(Notary Seal) Moore County, NC
My commission expires t . tot S
Notary Signature 44",
My commission expires
Stormwater Permit Form 7: Minor Modification Page 2 of 2 Oct 6, 2017