SW8040214_Current Permit_20050209

Michael F. Easley, Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
February 9, 2005
Ms. Natasha Roberts, Vice President
Acquiport Wilmington Manager, LLC, General Partner
Acquiport Wilmington, LP
C/o Lexington Corporate Properties Trust
One Penn Plaza, Suite 4015
New York, NY 10119
Subject: Permit No. SW8 040214
Lot 3 Shipyard Commons — Verizon Wireless
Stormwater Project served by an Offsite System
New Hanover County
Dear Ms. Roberts:
The Wilmington Regional Office received a completed request to transfer the Stormwater Management
Permit for Lot 3 Shipyard Commons — Verizon Wireless on January 31, 2005. 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 040214
Modification, dated February 9, 2005, for the construction of Lot 3 Shipyard Commons - Verizon
Wireless.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
conditions and limitations as specified therein.
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 sixty (60) 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 [phone].
Sincerely,
Edward Beck
Regional Supervisor
Surface Water Protection Section
ENB/arl: S:IWQS\STORMWAT\PERMIT1040214MOD.feb05
cc: WK Dickson
Tony Roberts, New Hanover County Building Inspections
Beth E. Wetherill, New Hanover County Engineering
Linda Lewis
Wilmington Regional Office
Central Files
North Carolina Division of Water Quality 127 Cardinal Drive Extension Phone [phone] Customer Service1-877-623-6748
Wilmington Regional Office Wilmington, NC 28405,3845 FAX [phone] Internet: h2o.enr.state.nc.us 1lorthCarolina
An Equal opportunity/Affirmative Action Employer — 50% Recycled/10°% Post Consumer Paper Nat(!', 4

State Stormwater Management Systems
Permit No. SW8 040214 Modification
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
SERVED BY AN OFF -SITE STORMWATER CONTROL
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
Natasha Roberts, Acquiport Wilmington Manager, LLC, and Acquiport Wilmington, LP
Lot 3 Shipyard Commons — Verizon Wireless
New Hanover County
FOR THE
construction of impervious areas with runoff to be treated in an offsite permitted
stormwater facility, 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. The stormwater
runoff from the site will be routed to a wet detention pond operated and maintained by
Cameron Properties under the terms and conditions set forth in Permit No. SW8
000120.
This permit shall be effective from the date of issuance until rescinded, and shall be
subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. The runoff associated with this project has been approved to be discharged into
a stormwater management system permitted under Stormwater Management
Permit No. SW8 000120, as described in Section 1.7 on page 3 of this permit.
3. The built -upon area allotted to this development by Stormwater Management
Permit No. SW8 000120 is 580,786 square feet. This project proposes 522,486
square feet.
4. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
5. 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.
6. The runoff from the permitted built -upon area must be directed into the permitted
stormwater system.
Page 2of7

State Stormwater Management Systems
Permit No. SW8 040214 Modification
7. The following design elements were approved for the permitted offsite wet
detention facility under SW8 000120:
a. Drainage Area, acres: 47.3
Onsite, acres: 47.3
Offsite, acres: 0
b. Total Impervious Surfaces, ft2: 1,629,790
Lots @81 % of Lot Area, ft2: 1,372,140
Roads/Parking, ft2: 220,150
Sidewalks, ft2: 37,500
C.
Design Storm:
ill
d.
Pond Depth, feet:
7.5
e.
Permanent Pool Elevation, FMSL:
38.5
f.
Permanent Pool Surface Area, ft2:
67,700
g.
Temporary Storage Volume, W:
134,858
h.
Temporary Storage Elevation, FMSL:
40.2
I.
Controlling Orifice:
4" cp pipe
j.
Name of Receiving Stream:
Hewletts Creek
k.
Index #:
CFR 18-87-26
I.
Classification of Water Body:
"SA"
II. SCHEDULE OF COMPLIANCE
1. The offsite 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 associated with this project.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. Cameron Properties shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater management 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 outlet structure, orifice device and catch
basins and piping.
g. Access to the outlet structure must be available at all times.
Page 3 of 7

State Stormwater Management Systems
Permit No. SW8 040214 Modification
4. The permittee is responsible for keeping the collection system on the lot clear of
debris, and keeping the site stabilized in accordance with the requirements of the
NC Erosion and Sediment Control Design Manual.
5. Cameron Properties must keep records of maintenance activities and make them
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.
6. 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.
7. Cameron Properties is responsible for providing, prior to issuance of a Certificate
of Occupancy, and prior to operation of the permitted stormwater management
facility, a certification from an appropriate designer for the system installed,
certifying that the permitted facility has been installed in accordance with
Stormwater Permit No. SW8 000120, the approved plans and specifications, and
other supporting documentation. Any deviations from the approved plans and
specifications must be noted on the Certification.
8. 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.
9. This lot is limited to the amount of built -upon area indicated in the supporting
calculations and per approved plans. The project must have a built -upon area
less than or equal to the amount permitted under Stormwater Permit No. SW8
000120. Additional built -upon area will require a modification to the overall
Permit.
10. Cameron Properties must record any deed restrictions as required by their permit
and they must verify that the proposed built -upon area does not exceed the
allowable built -upon area. Once the lot transfer is complete, the built -upon area
may not be revised without approval from the permittee, and responsibility for
meeting the built -upon area limit is transferred to the individual property owner.
11. The drainage features shown as a part of the stormwater management system
on the approved plan shall not be filled in, altered, or piped by any party without
first submitting a revision to the permit and receiving approval from the Division.
12. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
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.
e. Further subdivision, acquisition or selling of the project area. The project
area is defined as all property owned by the permittee, for which
Sedimentation and Erosion Control Plan approval or a CAMA Major permit
was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
Page 4 of 7

State Stormwater Management Systems
Permit No. SW8 040214 Modification
13. The Director may determine that other revisions to the project should require a
modification to the permit.
14. The permittee shall notify the Division of any name, ownership or mailing address
changes within 30 days.
15. 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.
III. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the Director.
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. The permittee is responsible for compliance with all terms and
conditions of this permit until such time as the Division approves the permit
transfer.
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, Cameron Properties 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 permission for DENR Staff 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 9th day of February 2005.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Division of Water Quality
By Authority of the Environmental Management Commission
Page 5of7

OFFICE USE ONLY
Date Received
Fee Paid
Permit Number
it L4
sw 2 b u Akon
State of North Carolina
Department of Environmental and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
Gilbane Construction Company
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
Roger McFarland, Project Manager
3. Mailing Address for person listed in Item 2 above:
2530 Merridian Parkway, Suite 200
City: Durham State: NC Zip: 27713
Telephone Number: [phone]
4. Project Name (subdivision, facility, or establishment name — should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Jordan 2 at Shipyard Commons
5. Location of Project (street address):
3520 Converse Drive
City: Wilmington County: New Hanover
6. Directions to project (from nearest major intersection):
Project is located at the northeast corner of Shipyard Boulevard and Independence Boulevard
7. Latitude: - 340-12'
Longitude: 770-54' of project.
8. Contact person who can answer questions about the project:
Name: Mark N. Hargrove
H. PERMIT INFORMATION:
1. Specify whether project is (check one): X New
Form SWU-101 Version 3.99 Page 1 of 4
Telephone Number: [phone]
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)
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 404/401 Permit NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project.
The stormwater runoff will be treated by the existing stormwater pond that was designed and built to
treat 81 percent imperviousness of the subject site.
2. Stormwater runoff from this project drains to the Hewlett's Creek
3. Total Project Area: 17.58 acres.
4. Project Built Upon Area: 68.2 %.
How many drainage areas does the project have?
River Basin.
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach and additional sheet with the information for each area provided in the same format as below.
Basin Information
Drainage Area 1
Drainage Area 2
Receiving Stream Name
Hewlett's Creek
Receiving Stream Class
SA
Drainage Area
765,785 sf
Existing Im ervious*Area
Proposed Impervious* Area
522,486 sf
% Impervious* Area (Total
68.2%
Impervious* Surface Area
Drainage Area 1
Drainage Area 2
On -Site Buildings
68,363 sf
On -Site Streets
28,917 sf
On -Site Parking
406,167 sf
On -Site Sidewalks
19,039 sf
Other On -Site
0
Off -Site
0
Total: 522,486 sf
Total:
See attachment i for impervious calculation analysis
*Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 3.99 Page 2 of 4

7. How was the off -site impervious area listed above derived? NA
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
The following italicized deed restrictions and protective covenants are required tc be recorded for all
subdivisions, out parcels, and future development prior to the sale of any lot. If lot sizes vary significantly, a
table listing each lot number, size, and the allowable built -upon area for each lot must be provided as an
attachment.
1. The following covenants are intended to ensure ongoing compliance with state stormwater management
permit number as issued by the Division of Water Quality. These covenants may not
be changed or deleted without the consent of the State.
2. No more than square feet of any lot shall be covered by structures or impervious materials.
Impervious materials include asphalt, gravel, concrete, brick, stone, slate or similar material but not include
wood decking or the water surface of swimming pools.
3. Swales shall not be filled in, piped, or altered except as necessary to provide driveway crossings.
4. Built -upon area in excess of the permitted amount requires a state stormwater management permit
modification prior to construction.
S. All permitted runoff from the outparcels or future development shall be directed into the permitted
stormwater control system. These connections to the stormwater control system shall be performed in a
manner that maintains the integrity and performance of the system as permitted.
By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, 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. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for
each BMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for
the status and availability of these forms.
Form SW-102
Wet Detention Basin Supplement
Form SW-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 SW-108
Neuse River Basin Supplement
Form SWU-109
Innovative Best Management Practice Supplement
Form SWU-101 Version 3.99 Page 3 of 4

SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ). A
complete package includes all of the items listed below. The complete application package should be submitted to
the appropriate DWQ Regional Office.
1. Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
• Original and one copy of the Stormwater Management Permit Application Form
• One copy of the applicable Supplement Form(s) for each BUT
• Permit application processing fee of $42-0 (payable to NCDENR) ($4,000)
• 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 & date
- Mean high water line
- Dimensioned property/{project boundary
- Location map with named streets or NCSR numbers
- Original contours, proposed contours, spot elevations, finished floor elevations
- Details of roads, drainage features, collection systems, and stormwater control measures
- Wetlands delineated. or a note on plans that none exist
- Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations
- Drainage areas delineated
- Vegetated buffers (where required)
VH. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section.
Designated agent (individual or firm): W. K. Dickson & Co., Inc.
Mailing Address: 909 Market Street
City Wilmington
Phone: [phone]
State: NC
VIH- APPLICANT'S CERTIFICATION
Zip: 28401
Fax: [phone]
I, (print or type name of person listed in General Information, Item 2) Roger McFarland
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformancc with the approved plans, that the required deed restrictions and
protective covenants will be recorded, and that the proposed project complies with the requirements of 15A
NCAC 211.1000.
Signature: Date:
L
Form SWU-101 Version 3.99 Page 4 of 4

Attachment 1
Impervious Surface Analysis for Jordan 2 at Shipyard Commons
The subject property was made-up of existing lots 3,4,5, 12 and a portion of Converse
Road io create a new Lot 3 which was approved by the City of Wilmington SRB.
Existing Lot Imerviousness allowance:
Area (so 81% or Fixed
Existing Lot 3 86,901 70,390
Portion of Lot 3 proposed to be conveyed to Lot 2
(18,519)
(15,000)
Existing Lot 4
101,930
82,563
Existing Lot 5
79,279
64,216
Existing Lot 12
430,373
348,602
Portion of Existing Lot 13 to be added to RIW
8,755
7,092
Street RM
107,622
Roadway Impervious Surface
59,780
Sidewalk Impervious Surface
15,466
Total:
796,341
633,108
Acres:
18.28
14.53
Proposed Lot Imerviousness allowance:
Area (so 81% Actual
Proposed Lot 3 * 765,785 620,286 522,486
Acres: 17.58 11.99
Proposed New Street RIW 59,710
Roadway Impervious Surface 33,193
Sidewalk Impervious Surface 7,142
Total: 825,513 562,833
* Proposed Lot 3 is composed of previously proposed Lots 3, 4, 5 and 12 and portions of the
previously proposed street R/Ws, LESS the area of Lot 3 to be conveyed to Lot 2 and the
revised proposed street R/Ws.

Permit No. 5W �� Z
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Ouality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
OFF -SITE SYSTEM SUPPLEMENT
FOR DEVELOPMENT DRAINING TO PERMITTED OFF -SITE TREATMENT SYSTEMS
This form may be photocopies for use as an original
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
off -site system supplement for each off -site stormwater treatment system, appropriate supplement forms for any
on -site stormwater treatment systems, and plans and specifications showing all stormwater conveyances and
drainage details for the project.
I. PROJECT INFORMATION
Project Name: Jordan 2 at Shipyard Commons
Contact Person: Tony Garcia
Is all drainage from the project directed to the off -site system? (circle one): Yes No
II. OFF -SITE SYSTEM INFORMATION (please complete the following information for the off -site
system that will treat runoff from your project):
Permit No.: SW8 040214
Project Name: Jordan 2 at Shipyard Commons
Type of System (wet pond, infiltration basin, etc.): Wet Pond
Lot No. (if part of a subdivision): Lots 3, 4, 5, and 12
How much built upon area draining to the permitted treatment system has been allocated to this project? 81%
III. REQUIRED ITEMS CHECKLIST
Prior to issuing an off -site permit, verification of the following information must be provided. Initial in the space
provided to indicate that the following requirements have been met and supporting documentation is attached. If
the applicant has designated an agent in the Stormwater Management Permit Application Form, the agent may
initial below. If a requirement has not been met, attach justification.
Applicants Initials
Aw W a. Deed restrictions limiting the built -upon area on the site have been recorded.
Awl� b. Engineers certification for the existing off -site system has been submitted to DWQ.
mod c. There are no outstanding Notices of Violation for the off -site system.
YAw0- d. Off -site system is in compliance with the issued permit.
Form SWU-106 Ver 3.99 Page 1 of 2

IV. STORMWATER COLLECTION SYSTEM MAINTENANCE REQUIREMENTS
Mowing will be accomplished as needed according to the season. Grass height will not exceed six inches
at any time.
2. Accumulated sediment and trash will be removed from the collection system as necessary. Swales and
ditches will be reseeded or sodded following sediment removal.
3. Eroded areas of swales and ditches will be repaired and reseeded. Swales and ditches will be revegetated
as needed based on monthly inspections.
4. The collection system, including catch basins, curb cuts, velocity reduction devices, and piping will be
inspected monthly or after every significant runoff producing rainfall event. Trash and debris will be
cleared away from grates, curb cuts, velocity reduction devices, and piping.
5. The collection system may not be altered in any way without prior approval from NCDENR Division of
Water Quality.
I acknowledge and agree by my signature below that I am responsible for maintaining the stormwater collection
system in accordance with the five maintenance procedures listed above. I agree to notify DWQ of any problems
with the system or prior to any changes to the system or responsible party.
Print Name and Title: Tony Garcia, Area Director — Northeast Verizon Wireless
Address: 100 Southgate Parkway, 2nd Floor Morristown, NJ 07960
Phone: [phone] Date: 7/9/4
Signature:
Note. The legally responsible party should not be a homeowners association unless more than 50% of the lots
have been sold and a resident of the subdivision has been named the president.
I, 20 /a07G 5. �Z��• n a Notary Public for the State of / to ri'k rot,-4 f ,*7ccr
County of nrni 2 , do hereby certify that ornj rjaj4 .
personally appeared before me this day of and
acknowledge the due execution of the foregoing infiltration basiA maintenance requirements. Witness my hand
and official seal,
-'i
SEAL
q 'a
-yg e
��hi•�i iel rs�
My commission expires qZ-F—A
Form SWU-106 Ver 3.99 Page 2 of 2

A74LA..
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., secretary
i
WATER QUALITY SECTION fan W. l:limek, P.E., Director
COASTAL STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
1. Stormwater Management Permit Number SW 8040 214
2. Permit Holder's name Cello Partnership d/b/a Verizon Wireless
3. Signing official's name: Joseph Greco Title: Staff Vice President -Finance
(person legally responsible for permit)
4. Mailing address: 100 Southgate Parkway, 2nd Floor City Morristown
State NJ Zip Code: 07960 Phone:[phone] Fax: [phone]
(Area Code and Number) (Area Code and Number)
II. NEW OWNER / PROJECT I ADDRESS INFORMATION
1. This request is for: (please check all that apply)
X a. Change in ownership of the property/company (Please complete Items
#2, #3, and #4 below)
b. Name change of project (Please complete Item #5 below)
P. Mailing address change. (Please complete Item #4 below)
d. Other (please explain):
2. New owner's name to be put on permit: Acguiport Wilmington, L.P.
3. New owner's signing official's name and title: Natasha Roberts
Vice President
(Title)
4. New Mailing Address: c/o Lexington Corporate Properties Trust, One Penn Plaza,
Suite 4015 City: New York State NY ZipCode 10119
Phone: [phone] FAX [phone]
(Area Code and Number) (Area Code and Number)
5. New Project Name to be placed on permit: N/a
Page 1 of 2
Wilmington Regional Office ,
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 One
�1,
111�aro�111a
Phone: [phone] / FAX [phone] / Internet: h2o.enr.state.nc.us
An Equal Opportunity/Affirmative Action Employer-50% Recycled/10% Post Consumer Paper%�r+�`��
C699038 f�

0?04v214
PERMIT NAME/OWNERSHIP CHANGE FORM
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION OF
WATER QUALITY UNLESS ALL OF THE APPLICABLE ITEMS LISTED BELOW ARE
INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed form.
2. Legal documentation of the transfer of ownership.
3. A copy of the recorded deed restrictions, if required by the permit.
4. The engineer's certification, if required by the permit.
5. A signed Operation and Maintenance plan, if a system that requires maintenance
will change ownership.
6. Maintenance records.
CERTIFICATION MUST BE COMPLETED AND SIGNED BY BOTH THE CURRENT
PERMIT HOLDER AND THE NEW APPLICANT IN THE CASE�F A CHANGE OF
OWNERSHIP.
FOR NAME CHANGES, COMPLETE AND SIGN ONLY THE CURRENT PERMITTEE'S
CERTIFICATION.
Current Permittee's Certification:
1, sct, Grec-o attest that this application for a
name/ownership change has been reviewed and is accurate and complete to the best of
my knowledge. I understand that if all required parts of this application are not completed
and that if all required supporting information and attachments are not included, this
application pa age will be returned as incomplete.
Signature:rpm Date: / Z 2 3 0
New jAppli nt'sdtfi tication: (Must be completed for all transfers of ownership)
1, qtq "44—+-5 , attest that this application for an ownership
change has been reviewed and is accurate and complete to the best of my knowledge. 1
understand that if all required parts of this application are not completed and that if all
required sup orting informa 'on and attachme is a e not included, this appplication Mckage
wil! be retur tl incom le14
eQ-�
Signature: Date: Ta-s 9��`q
p.t.
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS, SHOULD BE SENT TO THE FOLLOWING 84:
ADDRESS:
North Carolina Department of Environment and
Division of Water Quality
127 Cardinal Drive Extension
Wilmington, NC 28405
ATTN: Linda Lewis
Page 2 of 2
RECEIVED
JAN 3 1 2005
BY:
Natural Resources

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
> Alan W. Klimek, P.E.,Director
.� Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
WATER QUALITY SECTION
COASTAL STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION:
1. Stormwater Management Permit Number: SW8 040214
2. Permit Holder's Name: Gilbane Construction Company
3. Signing Official's Name: Roger McFarland Title: Project Manager
(person legally responsible for permit)
4. Mailing Address: 2530 Meridian Parkway, Suite 200_ City: Durham
State: NC Zip Code: 27713 Phone: [phone] Fax:[phone]
II.
2.
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4.
5.
NEW OWNER / PROJECT / ADDRESS INFORMATION
This request is for: (please check all that apply)
Change in ownership of the property/company (Please complete Items #2,
#3, and #4 below)
Name Change of project (Please complete Item #5 below)
Mailing address change (Please complete Item #4 below)
Other (Please explain):
New owner's name to be put on permit:
New owner's signing official's name and title: 'Tp N-
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bctc-444- N64
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(person legally responsible for permit)
New Mailing Address: 00 .Sov f Aw City: 40,et&':S-Jslwn/
State: /V-5- Zip Code: (oO Phone:"-6 6-776 � Fax: 973-6sb- 77 67
New Project Name to be placed on permit:
N. C. Division of Water Quality 127 Cardinal Drive Extension [phone]
Wilmington Regional Office Wilmington, NC 28405 [phone] Fax
Customer Service
1 800 623-7748

PERMIT NAME/OWNERSHIP CHANGE FORM
THIS APPLICATION PACKAGE WILL NOT BE ACCEPTED BY THE DIVISION OF
WATER QUALITY UNLESS ALL OF THE APPLICABLE ITEMS LISTED BELOW
ARE INCLUDED WITH THE SUBMITTAL.
REQUIRED ITEMS:
1. This completed form.
2. Legal documentation of the transfer of ownership.
3. A copy of the recorded deed restrictions, if required by the permit.
4. The engineer's certification, if required by the permit.
5. A signed Operation and Maintenance plan, if a system that requires maintenance will
change ownership.
6. Maintenance records.
CERTIFICATION MUST BE COMPLETED AND SIGNED BY BOTH THE CURRENT
PERMIT HOLDER AND THE NEW APPLICANT IN THE CASE OF A CHANGE OF
OWNERSHIP.
FOR NAME CHANGES, COMPLETE AND SIGN ONLY THE CURRENT
PERMITTEE'S CERTIFICATION.
Current Permittee's Certification:
I, &4E1L L. WA(Z 00 , attest that this application for a name/ownership
change has been Yeviewed and is accurate and complete to the best of my knowledge. I
understand that if all required parts of this applicathon are not completed and that if all required
supporting information and attachments are not included, this application package will be
returned as incomplete.
Signature: hft( Date:
New ApplicalA Certification: (Must be completed for all transfers of ownership)
I, -roW 64KC.4' 1- , attest that this application for an ownership change
has been feviewed and is accurate and complete to the best of my knowledge. I understand that if
all required parts of this application are not completed and that if all required supporting
information and attachments are not included, this application package will be returned as
incomplete.
Signature:
THE COMPLET APPLICATION PACKAGE, INCLUDING ALL SUPPORTING
INFORMATION AND MATERIALS, SHOULD BE SENT TO THE FOLLOWING
ADDRESS:
North Carolina Department of Environment and Natural Resources
Division of Water Quality
127 Cardinal Drive Extension
Wilmington, NC 28405
ATTN: Laurie Munn