NCC231374_FRO Submitted_20230510

APPLICATION FOR PERMIT FOR
A LAND DISTURBING ACTIVITY File#
Under the conditions set forth
by The New Hanover County LD Fee Review Fee
Soil Erosion and Sedimentation Control Ordinance
Date Pd Date Pd
Engineering Department
Applicant or Applicant's Agent: Covenant Senior Housing,LLC(Keith Walker)
Mailing Address: PO Box 2400 Telephone Number: 252-s04-3996
P Fax Number:
Beaufort,NC 28516 Email Address: [e-mail]
Total Acres of Land Disturbance: 7.5 Purpose of Development: Senior Housing
Description of Land Disturbance: Clearing,grading,and pipe for construction of a senior multi-family development.
Address of Land Disturbance 3118 Alex Trask Drive,Castle Hayne,NC Latitude:34° 17'53"N Longitude:77°54'42"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: Covenant Senior Housing,LLC(Keith Walker) Name: Covenant Senior Housing,LLC(Keith Walker)
Address: PO Box 2400 Address: PO Box 2400
City/State: Beaufort,NC
City/State: Beaufort,NC
Zip Code: 28516
Zip Code: 28516
Telephone Number: 252-504-3996
Telephone Number: 252-504-3996
Email: [e-mail] FaxNumber Email: [e-mail]`@ FaxNumber:
Location of deed(s)or instrument(s): County: New Hanover Book: 5723 Page: 920
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: ----)LIL J Li ( Name Keith Walker Title Owner
Signature
a Notary Public of the County of c/7/c're f E T State of
North Carolina,hereby certify that ./(F_i T7/_ .i k/4 7 appeared personally before me this day and
being duly sworn a'knowledged that the above form was e�x,cuted by him.
Witness m�_.'a ati�4` . , -; ,this �/'" .ay of -It(C. Y ,20,2 I
Notary , ' �t(,a/4 KOST My commission expires T --/ 7 (:.?
,C iy
�,SEAL �1ARY ti
Permission to Enter on Land '%/ II
I certify that I am authorized to grant' ��p4ant permission to the Erosion Control Inspector and his agents to enter on
the land in question in connection related to th' ermit application.
f � (
Application Signature and Date _J1l/ y ��_
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 sitework).
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 ofdetermination.
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.

E
AST CAROLINA COMMUNITY DEVELOPMENT, INC.
FIRST CITIZENS BANK &TRUST CO
OPERATING ACCOUNT 18498
P 0 BOX 2400
BEAUFORT, NC 28516
66-30/531
PAY TO THE 7/6/2021
ORDER OF New Hanover County
*2,600.00
Two Thousand Six Hundred and 00/100************************ **,k*.k:k *******,,**„**#,,*******w**************** ***********
DOLLARS
New Hanover County r.
230 Government Center Dr
Suite 160
Wilmington, NC 28403
MEMO:
Sediment Erosion-Control Permit
AUTHORIZED SIGNATURE
'
EAST CAROLINA COMMUNITY DEVELOPMENT, INC. -OPERATING ACCOUNT
New Hanover County
Type Reference 7/6/2021
Date021 Billy Rfer Sediment Erosion Original Amt. Balance Due Discount Payment
2,600.00 2,600.00 2,600.00
Check Amount 2,600.00
FCB -operating-9802 Sediment Erosion Control Permit
2,600.00
C 0 ii;j