HomeMy WebLinkAboutSW6091006_Application_201001084jctI I
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Datg Received
qe Paid
Permit Number
11
S
S bD q
State of North Carolina
Department of Environment 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):
Directorate of Public Works
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
Mr. Craig Lantz, Water Management Branch Chief
3. Mailing Address for person listed in item 2 above:
2175 Reilly Road Stop A
City:Fort Bragg State:NC Zip:28310
Phone: (910 ) 396.2301 Fax: (910 ) 432.6908
Email:.jennings.c.1a.ntz@us.army.mil
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Fort Bragg Indoor Firing Range
5. Location of Project (street address):
Stabo Loop Rd
City:Fort Bragg County:NC Zip:28310
6. Directions to project (from nearest major intersection):
From All American Expressway, go South on Reily St. for approximately 2 mi., turn right onto Yadkin Rd at
approximately .5 miles, turn left onto Stabo Loop, project is on the left at a distance of 1000'.
7. Latitude:35° 06' 29.66" N Longitude:79' 00' 28.57" W of project
8. Contact person who can answer questions about the project:
Name:Bryan M. Dick Telephone Number: (919 ) 854-6252
Email:bryan.dick@aecom.com
II. PERMIT INFORMATION:
I. Specify whether project is (check one):
4
❑Renewal ❑Modification
Form SWU-101 Version 09.25.08 Page] of4
2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit numberNA and its issue date (if known)NA
3. Specify the type of project (check one):
❑Low Density ®High Density ❑Redevelop ❑General Permit ❑Universal SMP ❑Other
4. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ®Sedimentation/Erosion Control ❑404/401 Permit ❑NPDES Industrial Stormwater
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.
Stormwater will be collected and treated via an infiltration basin. The basin is sized to 2.5X the required
treatment volume and 1 /2 the Ksat value from the soils report in order to eliminate the need for bypass and level
spreader devices.
2. Stormwater runoff from this project drains to the Cape Fear River basin.
3. Total Property Area: 2.99 acres 4. Total Coastal Wetlands Area: 0 acres
5. Total Property Area (3) — Total Coastal Wetlands Area (4) = Total Project Area**: 2.99 acres
6. (Total Impervious Area / Total Project Area) X 100 = Project Built Upon Area (BUA): 34 %
7. How many drainage areas does the project have? 1
8. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
For high density projects, complete the table with one drainage area for each engineered stormwater device.
Receiving Stream Name
Persimmon Creek
Stream Class & Index No.
Class C (18-31-24-5-3)
Total Drainage Area (sf)
70825
On -site Drainage Area (sf)
70825
Off -site Drainage Area (sf)
0
Existing Impervious* Area (sf) 2425
Proposed Impervious*Area (sf) 37428
% Impervious* Area (total) 56%
Im erviqus Surface Area 'Dramage Area 1 9 `Drama e Area 2
p _ ...,.�_.< . ,..._, ..k .. k..,_. g.,
, E....
On -site Buildings (sf) 25342
On -site Streets (sf) 0
On -site Parking (sf) 6205
On -site Sidewalks (sf) 7092
Other on -site (sf) 1214
Off -site (sf) 0
Total (sf): 39853
* 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 09.25.08 Page 2 of
**Total project area shall be calculated to exclude Coastal Wetlands from use when calculating the built upon area
percentage calculation. This is the area used to calculate overall percent project built upon area (BUA).
9. How was the off -site impervious area listed above derived? NA
Projects in Union County: Contact the DWQ Central Office staff to check to see if you project is located
within a Threatened & Endangered Species watershed that may be subject to more stringent stormwater
requirements.
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
One of the following property restrictions and protective covenants are required to be recorded for all
subdivisions, outparcels 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.
Forms can be downloaded from http://h2o.enr.state.nc.us/su/bml2 forms.htm - deed restrictions.
Form DRPC-1
High Density Commercial Subdivisions
Form DRPC-2
High Density Developments with Outparcels
Form DRPC-3
High Density Residential Subdivisions
Form DRPC-4
Low Density Commercial Subdivisions
Form DRPC-5
Low Density Residential Subdivisions
Form DRPC-6
Low Density Residential Subdivisions with Curb Outlets
By your signature below, you certify that the recorded property restrictions and protective covenants for this
project shall include all the applicable items required in the above form, 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 NC DWQ, 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 Permitting Unit at (919) 807-6300 for the status and
availability of these forms. Forms can be downloaded from http://h2o.enr.state.nc.us/su/bml2 forms.htm.
Form SW401-Low Density
Form SW401-Curb Outlet System
Form SW401-Off-Site System
Form SW401-Wet Detention Basin
Form SW401-Infiltration Basin
Form SW401-Infiltration Trench
Form SW401-Bioretention Cell
Form SW401-Level Spreader
Form SW401-Wetland
Form SW401-Grassed Swale
Form SW401-Sand Filter
Form SW401-Permeable Pavement
Form SW401-Cistern
Low Density Supplement
Curb Outlet System Supplement
Off -Site System Supplement
Wet Detention Basin Supplement
Infiltration Basin Supplement
Underground Infiltration Trench Supplement
Bioretention Cell Supplement
Level Spreader/Filter Strip/Restored Riparian Buffer Supplement
Constructed Wetland Supplement
Grassed Swale Supplement
Sand Filter Supplement
Permeable Pavement Supplement
Cistern Supplement
Form SWU-101 Version 09.25.08 Page 3 of 4
VI. SUBMITTAL REQUI UB4ENTS
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 Office. (Appropriate office may be found by locating project on the interactive online
map at http://h2o.enr.state.nc.us/su/msi maps.htm)
1. Please indicate that you have provided the following required information by initialing in the space
provided next to each item.
Initials
• Original and one copy of the Stormwater Management Permit Application Form S�
• Original and one copy of the Deed Restrictions & Protective Covenants Form (if N,1A
required as per Part IV above)
• Original of the applicable Supplement Form(s) and O&M agreement(s) for each BMP -5 e; _
• Permit application processing fee of $505 (Express: $4,000 for HD, $2,000 for LD)
payable to NCDENR -5
• Calculations & detailed narrative description of stormwater treatment/management
• Copy of any applicable soils report
• Two copies of plans and specifications (sealed, signed & dated), 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)
VIL AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf (such as additional information requests), please complete this section. (ex. designing engineer or firm)
Designated agent (individual or firm): Bryan Dick- AECOM
Mailing Address:701 Corporate Center Dr.
City: Raeleigh State: NC Zip: 27670
Phone: ( 919 ) 854-6252 Fax: (919 ) 854-6259
Email:bryan.dick@aecom.com
VIIL APPLICANTS CERTIFICATION
I, (print or type name ofperson listed in General lnformabon, item 2) Mr. Craig Lantz
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 conformance 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 2H .1000.„
Date:
Form SV U-101 Version 09.25.08 Page 5 of 4
DWQ USE ONLY
Date Received Fee Paid Permit Number
State of North Carolina
Department of Environment 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):
Directorate of Public Works
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
Mr. Craig Lantz Water Management Branch Chief
3. Mailing Address for person listed in item 2 above:
.2175 Reilly Road Stop A
City:Fort Bragg State:NC Zip:28310
Phone: (910 ) 396.2301 Fax: (910 ) 432.6908
Email:iennin;j;,s.c.lantz@us.army.mil
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Fort Bragg Indoor Firing Range
5. Location of Project (street address):
Stabo Loop Rd
City:Fort BrajYg County:NC Zip:28310
6. Directions to project (from nearest major intersection):
From All American Expressway, o South on Reily St. for approximately 2 mi., turn right onto Yadkin Rd at
aapproximately .5 miles turn left onto Stabo Loop project is on the left at a distance of 1000'
7. Latitude:351 06' 29.66" N Longitude:79° 00' 28.57" W of project
ro'ect
8. Contact person who can answer questions about the project:
Name:Bryan M. Dick PH Telephone Number:: (919 ) 854-6252
Email:baan.dick@aecom.com
H. PERMIT INFORMATION:
Form SWU-101 Version 09.25.08 Page 1 of
1. Specify whether project is (check one): ®New ❑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 numberNA and its issue date (if known)NA
3. Specify the type of project (check one):
❑Low Density ®High Density ❑Redevelop ❑General Permit ❑Universal SMP ❑Other
4. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major ®Sedimentation/Erosion Control ❑404/401 Permit ❑NPDES Industrial Stormwater
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.
Stormwater will be collected and treated via an infiltration basin. The basin is sized to 2 5X the required
treatment volume and 1/2 the Ksat value from the soils report in order to eliminate the need for bypass and level
spreader devices.
2.
3.
5.
6.
7.
8.
Stormwater runoff from this project drains to the Cape Fear River basin.
Total Property Area: 2.99acres 4. Total Coastal Wetlands Area: 0 acres
Total Property Area (3) - Total Coastal Wetlands Area (4) = Total Project Area**: 2.99 acres
(Total Impervious Area / Total Project Area) X 100 = Project Built Upon Area (BUA): 34%
How many drainage areas does the project have? 1
Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
For high density projects, com lete the table with one drainage area for each en ineered stormwater device.
Basin Information
Drainage Area 1
Drainage Area 2.
Receiving Stream Name
Persimmon Creek
Stream Class & Index No.
Class C (18-31-24-5-3)
Total Drainage Area (so
70825
On -site Drainage Area (so
70825
Off -site Drainage Area (so
0
Existing Impervious* Area (so
2425
Proposed Impervious*Area (so
37428
% Impervious* Area (total)
56%
Impervious* Surface Area
Drainage Area 1
Drainage Area 2
On -site Buildings (so
25342
On -site Streets (so
0
On -site Parking (so
6205
On -site Sidewalks (so
7092
Other on -site (so
1214
Off -site (so
0
Total (so:
39853
Form SWU-101 Version 09.25.08 Page 2 of 4
Total (sf):
* Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
**Total project area shall be calculated to exclude Coastal Wetlands from use when calculating the built upon area
percentage calculation. This is the area used to calculate overall percent project built upon area (BUA).
9. How was the off -site impervious area listed above derived? NA
Projects in Union County: Contact the DWQ Central Office staff to check to see ifyou project is located
within a Threatened & Endangered Species watershed that may be subject to more stringent stormwater
requirements.
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
One of the following property restrictions and protective covenants are required to be recorded for all
subdivisions, outparcels 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.
Forms can be downloaded from htty://h2o.enr.state.nc us/su/bmp forms htm - deed restrictions.
Form DRPC-1
High Density Commercial Subdivisions
Form DRPC-2
High Density Developments with Outparcels
Form DRPC-3
High Density Residential Subdivisions
Form DRPC-4
Low Density Commercial Subdivisions
Form DRPC-5
Low Density Residential Subdivisions
Form DRPC-6"
Low Density Residential Subdivisions with Curb Outlets
By your signature below, you certify that the recorded property restrictions and protective covenants for this
project shall include all the applicable items required in the above form, 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
p 1= cannot be changed or deleted without concurrence from the NC DWQ 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 Permitting Unit at (919) 807-6300 for the status and
availability of these forms. Forms can be downloaded from 1-ittu:/Ji2o.enr.state.nc.us/su/bml2 forms htm:
Form SW401-Low Density
Form SW401-Curb Outlet System
Form SW401-Off-Site System
Form SW401-Wet Detention Basin
Form SW401-Infiltration Basin
Form SW401-Infiltration Trench
Form SW401-Bioretention Cell
Form SW401-Level Spreader
Form SW401-Wetland
Form SW401-Grassed Swale
Form SW401-8and Filter
Form SW401-Permeable Pavement
Low Density Supplement
Curb Outlet System Supplement
Off -Site System Supplement
Wet Detention Basin Supplement
Infiltration Basin Supplement
Underground Infiltration Trench Supplement
Bioretention Cell Supplement
Level Spreader/Filter Strip/Restored Riparian Buffer Supplement
Constructed Wetland Supplement
Grassed Swale Supplement
Sand Filter Supplement
Permeable Pavement Supplement
Form SWU-101 Version 09.25.08 Page 3 of 4
VI. 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 Office. (Appropriate office maybe found by locating project on the
interactive online map at http:/ih2o.em•.slzte.nc.usisu!nnsi maps.htm)
1. Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
Inn 'als
• Original and one copy of the Stormwater Management Permit Application Form
• Original and one copy of the Deed Restrictions & Protective Covenants Form (if — Q
required as per Part IV above)
• Original of the applicable Supplement Form(s) and O&M agreement(s) for each BMP
• Permit application processing fee of $505 (Express: $4,000 for HD, $2,000 for LD)
payable to NCDENR _ 1511,40,
• Calculations & detailed narrative description of stormwater treatment/management
• Copy of any applicable soils report
• Two copies of plans and specifications (sealed, signed & dated), 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)
VII. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf (such as additional information requests), please complete this section. (ex. designing engineer or firm)
Designated agent (individual or firm): Bryan Dick- AECOM
Mailing Address:701 Corporate Center Dr.
City: Raeleigh State: NC Zip: 27670
Phone: ( 919 ) 854-6252 Fax: j919 ) 854-6259
Email:bryan.dick@aecom.com
VIII. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in General Inforniation, item 2) Mr. Craig Lantz
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 conformance 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 2H ANk
Signature:
Form SWU-1,61 Version 09.25.08 / Page 5 of 4
Date: _