NCC230897_FRO Submitted_20230405

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JNTY.,yo APPLICATION FOR PERMIT FOR A
File#
�'yLAND DISTURBING ACTIVITY
Under the conditions set forth bi/\.; pYLD Fee Review Fee
The New Hanover County
`' Ii �2Soil Erosion and Sedimentation Control Ordinancers�rco'tt'' Date Pd Date Pd
N&T#21166
Engineering Department
Applicant or Applicant's Agent: Norris&Tunstall Consulting Engineers, P.C./John S. Tunstall, P.E.
Mailing Address: 2602 Iron Gate Drive, Suite 102 Telephone Number: 910-343-9653 Fax Number: 910-343-9604
Wilmington, NC 28412 Email Address: [e-mail] cc: [e-mail]
Total Acres of Land Disturbance: 3.42 Purpose of Development: Carolina Bay at Autumn Hall
Description of Land Disturbance: Carolina Bay at Autumn Hall
Address of Land Disturbance 5549 Old Garden Rd. Wilm., NC Latitude:34 14' 11"N Longitude:77 51'02"W
5553 Old Garden Rd. Wilm., NC 340)14' 10" N 77°51'03"W
STATEMENT OF FINANCIAL RESPONSIBILITY
Land owner(s)of record: 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 Below)
Name: Carolina Bay Properties of Wilmington, LLC Name: Carolina Bay Properties of Wilmington,LLC
Address: 2334 S. 41st Street Address: 2334 S.41st Street
City/State: Wilmington, NC City/State: Wilmington, NC
Zip Code: 28403 Zip Code: 28403
Telephone Number: 910-332-1790 Telephone Number: 910-332-1790
Email: Rspivey©libertysenioriiving.rcom FaxNumber N/A Email: RS ive libert senorvin .com p Y@ ili
Y g FaxNumber: N/A
Location of deed(s)or instrument(s): County: New Hanover Book: 5795 page; 486-490
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-
fact, 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: 4I it 1 ZO?Z Name Ronald B.McNeill Title Manager
1(4: fJi2"�/'fi
Signature //
I, i(A allotary Public of the County of NeA ) ''T CIYWileA State of
North Carolina,hereby certify that113VSk1CI �• PR C_Nt�I` appeared personally before me this day and
being duly sworn acknowledged that the above form was uted by him.
Witness hind and TM t 's of 20
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Notary ``.* FL•L.ii,',,,-� My commission expires OS Il� ` .aq--
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SEAL _Q.•'cY�oTAq��O �2 s
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Permission to Enter on Lands ��iiti,9+Q s 18 210Joi.
I certify that I am authorized to grant aneffa ,1, a gt[t?t permission to the Erosion Control Inspector and his agents to enter on
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the land in question in connection related sto this permit application.
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Application Signature and Date Ronald B. McNeill,
, Manager
PLEASE COMPLETE ALL PORTIONS OF APPLICATION

GQUNTY-gyp APPLICATION FOR PERMIT FOR A
o� P's LAND DISTURBING ACTIVITY File#
z "�Z 9. Under the conditions set forth by
i ,AA\ p LD Fce Review Fee
,,a The New Hanover County
z u,II !d �? Soil Erosion and Sedimentation Control Ordinance
-`r'^aetst+tlavn" Date Pd Date Pd
N&T#21166
Engineering Department
Norris&Tunstall Consulting Engineers, P.C./John S.Tunstall, P.E.
Applicant or Applicant's Agent:
Mailing Address: 2602 Iron Gate Drive, Suite 102 Telephone Number: 910-343-9653 910-343-9604
P Fax Number:
Wilmington, NC 28412 Email Address: [e-mail] cc: [e-mail]
Total Acres of Land Disturbance: 3.42 Purpose of Development: Carolina Bay at Autumn Hall
Description of Land Disturbance: Carolina Bay at Autumn Hall
Address of Land Disturbance 5503:550g.551q,55�5,5533 Old Garden Rd. 34a 14' 13"iJ
Latitude: Longitude: 77 51'08"VV
5505, 5511,5521, 5529, 5539 & 5545 Old Garden Rd. 34014' 12" N 77°51' 07" N
STATEMENT OF FINANCIAL RESPONSIBILITY
Land owner(s)of record: 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 Below)
Name: Carolina Bay Properties of Wilmington Il, LLC Name: Carol na gay Properties of Wilmington ii,LLC
Address: 2334 S.41st Street Address: 2334 S. 41st Street
City/State: Wilmington, NC _City/State: Wilmington, NC
Zip Code: 28403 Zip Code: 28403
Telephone Number: 910-332-1790 Telephone Number: 910-332-1790
Email: [e-mail] FaxNumber N/A Email: RS ive seniorlivin .com P velibert° Y g FaxNumber: NIA
Location of deed(s)or instrument(s): County: New Hanover Book: RB 6167 page: 1665-1668
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-
fact, 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: .R1 l( (7_o1'LName Ronald B. McNeill _ Title_ Manager
Signature :_ i. / 7.'_ 2/�.
1
I, `G daota1y Public offtl e County of a, OVEN State of
North Carolina,hereby certify that e r i l appeared personally before me this day and
being duly sworn acknowledged that the above� form was executed by him.
Witness hand.�ind notary se 1 this- t +ityi j(klal
20
Notary _ ( (/t ELL.W�� ins My commission expires_ J tit3 px22--
.� G� �ssio� .S'0�� 111
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SEAL :N. , Y N•:U
T. \-)Cj
•
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Permission to Enter on Land �',ti-9•'•5.16.••:� .� `
I certify that I am authorized to grant and'tkolyritiVFftgVnt permission to the Erosion Control Inspector and his agents to enter on
the land in question in connection related to this permit application.
Application Signature and Date Ronald B. McNeil, Manager
PLEASE COMPLETE ALL PORTIONS OF APPLICATION

G°UNTY.ivo APPLICATION FOR PERMIT FOR A
a``� �'s LAND DISTURBING ACTIVITY File#
0
4 o�`� ` Under the conditions set forth by LD Fee Review Fee
3,, '. , ' w I The New Hanover County
Z s ii ,a
Soil Erosion and Sedimentation Control Ordinance
•e�1eirs„cv�tl' Date Pd Dale Pd
N&T#21166
Engineering Department
Norris&Tunstall Consulting Engineers, P.C.I John S. Tunstall, P.E.
Applicant or Applicant's Agent:
Mailing Address: 2602 Iron Gate Drive, Suite 102 Telephone Number: 910-343-9653 Fax Number: 910-343-9604
Wilmington, NC 28412 Email Address: [e-mail] cc: [e-mail]
Total Acres of Land Disturbance: 3.42 Purpose of Development: Carolina Bay at Autumn Hall
Description of Land Disturbance: Carolina Bay at Autumn Hall
e
Address of Land Disturbance 5537 Old Garden Rd. Wilm., NC Latitude:34 14'13"N Longitude:77 51'06"W
5543 Old Garden Rd. Wilm., NC 34°14' 12"N 774751' 03"W
STATEMENT OF FINANCIAL RESPONSIBILITY
Land owner(s)of record: 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 Below)
Name: Carolina Bay Properties of Wilmington III,LLC Name: Carolina Bey Properties or Wilmington III,LLC
Address: 2334 S.41st Street Address: 2334 S.41st Street
City/State: Wilmington,NC City/State: Wilmington, NC
Zip Code: 28403 Zip Code: 28403
Telephone Number: 910-332-1790 Telephone Number: 910-332-1790
Email: RSpivey@Iibertyseniorliving,com FaxNumber N/A Email: [e-mail] N/A
g FaxNumber:
Location of deed(s)or instrument(s): County: New Hanover Book: RB 6271 page: 565-567
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-
fact, 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: l II ) LU L s, /j Name Ronald B. McNeill Title Manager
Signature ,:t&<7 /�z?
•
I, %� a Notary Public of the County of (\ WJ WArip vtr State of
North Carolina,hereby certify that d n. al cAiti I( appeared personally before me this day and
being duly sworn acknowledged that the above form was ''cu,t``ed by him.
Witness y Ilnd and not s �l, this m da�of lAA ve- ,20 22
�l U k 7LZ u t r 911 / DD,,
Notary � iry/ �ii� My commission expires (�,] �U .9—. .
SEAL 4 4V rcv/V!.2
il.Vi .00"'yV:v
'aUB�-�G r�-i.-
Permission to Enter on Land , 7.
'a''I yv os te-fk,t".
I certify that I am authorized to grant an ' 'd AIE% i`permission to the Erosion Control Inspector and his agents to enter on
the land inquestion in connection related to this permit
p�rmit application.
Application Signature and Date Ronald B. McNeill, Manager
PLEASE COMPLETE ALL PORTIONS OF APPLICATION

This application must be sealed by the notary and accompanied by 4 sets of plans, the fee, calculations, dimensions, temporary and
permanent seeding specifications, a maintenance plan for erosion control measures and seeding, and narrative statements as called for by
the ordinance. The following list specifies the minimum requirements.
SEDIMENTS AND EROSION CONTROL PLAN COMPONENTS
1. Name,address of the designer,phone number,fax number and email address.
2. Vicinity map. Address assigned by County Planning or the City of Wilmington.
3.Copy of deed(s)for the property.
4.Latitude and Longitude of Project.
5.DXF File.(On Disk)
6. Existing&Proposed topography.
7. Area to be disturbed(shown as construction limits on the plan with a legend. Include off site work).
8. Proposed site improvements(structures,roads,parking areas,lots,easements,etc.)
9. Construction Sequence.
10.Temporary sediment control measures(locations,dimensions,details and calculations).
11.Graveled construction entrance(dimensions and cross section details).
12.Proposed storm water network(swales,culverts,inlet and outlet structures,etc.with grades,elevations,details,
drainage calculations with velocities)and energy dissipater dimensions.
13. Permanent erosion controls(locations,dimensions,details and calculations)
14.Permanent&temporary seeding specifications(seedbed preparation,soil amendments,seeding rates&schedule).
15. Sediment and erosion control material specifications.
16. General notes.
17.Wetlands,C.A.M.A. areas, 100-year floodplain,575' HQW,and Conservation Overlay Districts must be shown on the
plan if applicable.
18.Maintenance plan for all erosion control measures&stabilization methods.
19.Tree protection approval from the City of Wilmington or New Hanover County Planning for subdivisions or New
Hanover County Zoning for Commercial Projects.
NARRATIVE STATEMENT COMPONENTS
1. Name and address of owner and of the financially responsible person,phone number,fax number&email address.
2. Sealed notarized financial responsibility form with a North Carolina agent and individual's name/signature.
3. Purpose of land disturbing activity.
4. Storm water run off calculations and explanation of the method of determination.
5. Construction sequence and schedule(flow chart if available).
6. Re-vegetation specifications(preparation,seed type and rates;fertilizer,lime and mulch rates and schedule)
The New Hanover County Erosion and Sedimentation Control Ordinance requires that all persons disturbing more than one (1) acre of
land must obtain approval of a soil erosion control plan and be issued a permit prior to the commencement of said land disturbing activity.
Before an application package is considered complete, this application must be completed and submitted along with the fees, plans, the
calculations, dimensions and the narrative to this office. The plans and narrative will be submitted to New Hanover County Soil
Conservation Service and State Stormwater. Plans must be submitted by the applicant to the New Hanover County Planning Department
for Conservation Overlay Review and subdivision tree approval. Commercial tree approval requires submittal to New Hanover County
Zoning. Projects within the City of Wilmington require City tree approval. Commencement of a land disturbing activity under the
jurisdiction of this Act prior to the approval of an erosion and sedimentation control plan is a violation of the Act.The Act further states
that the application package must be filed a minimum of thirty(30)days prior to the activity and the approving authority must approve the
submitted plan within thirty (30) days of receipt. Failure of the approving authority to approve or disapprove the submitted plan within
the thirty(30)day period will be deemed approval of the plan.Additional information may be requested after the 30 day period in order to
meet requirements of the ordinance.
No activity should proceed on site without the issuance of a land disturbing activity unless the approving authority fails to notify the
applicant (usually the engineer) within the 30 day submittal period. If an environmental document is required, the application will be
deemed incomplete until the document is available for review by the County. In this case, the applicant will be notified that the 30 day
time limit for a review of the plan shall not begin until a complete environmental document is available for review. Revisions or
amendments to existing plans must be submitted for review 15 days prior to any site changes. Until such time as the revision is approved
by the County, the land disturbing activity shall not proceed. Any previously permitted site that requires additional work no matter
what size,must submit an amended erosion control plan for approval prior to any changes on site. All land disturbing activity
on a tract since 1988 is cumulative towards the one acre threshold and requires a permit. NO work should begin on site without a
preconstruction erosion control conference.