SW6101104_Application_20121221

_ DWQ USE ONLY
Date Rem' ed
Fee aid
Permit Number
j0 I
Applicable Rul s: ❑ Coastal SW -1995 0 Coastal SW - 2008 ❑ Ph II -Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
D Other WQ Mgmt Plan:
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
L GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name- should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
TUAS Support Facility at Fort Bragg
2. Location of Project (street address):
City:Fort Bragg County:Cumbertand Zip:28310
3. Directions to project (from nearest major intersection):
The Rroiect is located off the northern side of Pratt Street approximately 1100' east of the intersection of
Pratt Street and Lewis Street in Fort Bragg NC
� m
4. Latiitude:350 09' 26" N Longitude:790 00' 54" W of the main entrance to the projdo Z
II. PERMIT INFORMATION: N
1. a. Specify whether project is (check one): ®New ❑Modification o
b.lf this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density []Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the Stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. 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): r--
❑LAMA Major ®Sedimentation/Erosion Control: 3.1 ac of Disturbed Area gg
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
n
b.lf any of these permits have already been acquired please provide the Project Name, Project/Permit Nit`mber, c
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issue date and the type of each permit:�� ~`
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III. CONTACT INFORMATION
1. a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project):
Applicant/Organization:NC National Guard
Signing Official & Title:Col. William lohnson
b.Contact information for person listed in item la above:
Street Address:4105 Reedy Creek Road
City:Raleinh State:NC Zip:27607
Mailing Address (if apphcabie):_
City: State:
Pbone: (919 )_664-6116 Fax: [phone]
Email:bill [e-mail]
c. Please check the appropriate box. The applicant listed above is:
❑ The property owner (Skip to Contact Information, item 3a)
® Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a a nd
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2, a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (Phis is the
person who owns the property that the project is located on):
Property Owner/Organizatron:Department of Defense
f
Signing Official & Title:Lee Ward, DPW - Water Management Branch
b.Contact information for person listed in item 2a above:
Street Address:Building 3-1631 Butner Road
City:Fort Bragg State:NC Zip:28310
Mailing Address (if
Phone: (910 ) 396-0321 Fax: ( l
Email:lee [e-mail]
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/ Organization:N C National Guard
Signing Official & Title:Roland Myrick
b. Contact information for person listed in item 3a above:
Mailing Address:4105 Reedy Creek Road
City:Raleigh State:NC Zipi27607

Phone: (919 ) 664-6116 Fax: (919 ) 6646V9
[e-mail]
4. Local jurisdiction for building permits: Fort Bragg
Point of Contact:Robert Fleming Phone #: [phone]
IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
The majority of the stormwater runoff will be routed through the bioretention pond and dry detention basin:
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
Approval of a Site Specific Development Plan or PUD Approval Date:
Valid Building Permit Issued Date: .
❑'Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ® Ph B - Post Construction
3. Stormwater runoff from this project drains to the
River basin.
4. Total Property Area: 6.35 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total,Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area`:6.35 acres
Tofa! yroject prey shall he calculated to exchule the follmuing the nonnal pool of innpounded structures, the area -
between the banks of streams and rivers, the area below the Normal High Water (NM) line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultantprelect area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area).X 10 = 21 %
9. How many drainage areas does the project have?l (For high density, count 1 for each propose engineered
stormwater BMP. For low density and other projects, use 1. for the whole property area)
10. Complete,the;following information for each drainage area identified in Project Information item 9. If there.
are more than four drainage areas irvthe project, attach an additional sheet with the information for each area
provided in the same format as below,
, ri

Basin Information
Draina e Area 1
Drainage Area 2
Drainage Area 3
Drainage Area 4
Receiving Stream Name
Tank Creek
Tank Creek
Tank Creek
Tank Creek
Stream Class *
C
C
C
C
Stream Index Number *
18-23-27
18-23-27
18-23-57
18-23-27
Total Drainage Area (so
127195
12096
17680
128879
On -site Drainage Area (so
118314
12096
17680
128879
Off -site Drainage Area (sf)
8881
0
0
0
Proposed Impervious Area** s
66216✓
206 ✓
9703
856
% Impervious Area** total
52.1
1.7
54.9
0.7
Impervious- Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area 3
Drainage Area 4
On -site Buildings/Lots (so
12225
0
0
0
On -site Streets (so
37330
0
9703
0
On -site Parking (so
9937
0
0
0
On -site Sidewalks (so
2499
206
0
0
Other on -site (so
225
0
0
0
Future (so
0
0
0
0
Off -site (sf)
4000
0
0
0
Existing BUA*** (so
0 .
0
0
856
Total (so:
66216
206
9703
856
Stream Class and Index Number can be determined at: http:/At2o.enr.state.netts/bites/reports7reportsWB.html
Lnpervious area is defined as :he built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
**"Report only that anwunt of existing BUA that will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by net, BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. Estimated from
Projects in Union Comity: Contest DIVA Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that mqv be subject to more stringent storrmvater requirements as per NCAC 02B .0600
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http://h2o.enr.state.nc.us/su b/ mp forms.htm.
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. A detailed application instruction sheet and BMP
checklists are available from httl2://h2o.enr.state.nc.us/su/bmp forms.htm. The complete application
package should be submitted to the appropriate DWQ Office. (The appropriate office may be found by locating
project on the interactive online map at ht h2oenr.state.nc.us/su/msi maps.htm.)
Please indicate that the following required information have been provided by initialing in the space provided for
each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions for
each submitted application package from http://l12o.enr.state.nc.us/su/bmp forms.htm.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. ' a
N 2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants I A
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http://www.envhelp.ory/12ages/onestopexpress.htrnl for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
FormSWU-101 Version07July2009 Page4of7

ms,consultants, Inc.
engineers, architects, planners
336 B Carthage Street
Sanford, NC 27330
[phone]
FAX: [phone]
www.msconsultants.com
BIORETENTION POND CALCULATIONS
Runoff Volume using Simple Method (Section 3.3)
Rainfall Depth
Drainage Area =
127195 SF
Drainage Area =
2.92 Ac
Impervious Area =
66216 SF
Impervious Fraction (IA) =
0.52
Runoff Coefficient (Rv) =
0.52
Rainfall Depth to control =
1 "
Volume =
5496 cf
Pre/Post Development Differece e-- Co^+rn tled
1yr 24 hr Rainfall Depth =
3.11 "
Predev Drainage Area =
127195 sf
Predev Impervious Area =
0
Impervious Fraction =
0
Predev Rv =
0.05
Volume =
15445 cf
Project Name :
TUAS
Project Number.
64-12810
Project Location :
Fort Bragg, NC
Designed by:
NSR
Date :
2-Aug-10
= Drainage Area / Impervious Area
=0.05+(0.9'IA)
= 3630' Depth' Rv' Area
In, Dr, Pe:i l-ton Ab•�d
= Drainage Area / Impervious Area
=0.05+(0.9'IA)
= 3630 ' Depth ' ( Rv post - Rv pre) ' Area

5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/ project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required). S AV+' pacvideri
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xll" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHWT prior
to submittal, [phone])
10. A copy of the most current property deed. Deed book: fx 10, Page No: n 4 ^ 0.
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC r\ 4q
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per NCAC 2H.1003(e), The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http://www.secretaEy.state.nc.us/Corporations/­`CSearch.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
hqp://portal.ncdenr.org/web/wq/ws/su statesw/forms does. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, 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.

VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer:William (Bill) W. Dreitzler, P.E.
Consulting Firm: ms consultants inc
Mailing Address:500 Jackson Street
City:Roanoke Rapids
Phone: (252 ) 519-2135
Email:bdreitzier®msconsultants.com
State:NC Zip:27870
Fax: (252 ) 519-2137
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) Department of Defense (Lee Ward) , certify that.I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item la) Col. William Johnson with (print or type name of organization listed in
Contact Information, item la) NC National Guard to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves thew company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise 1 will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
a Notary Public for the State of County of
do hereby certify that
personally appeared
before me this _ day of and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
ion expires My commiss

X. APPLICANTS CERTIFICATION
1, (print cm type name of person listed in Contact Inf'onnation, item 1a) Coln William lohnsoin, NC National Guaid
certify that the information included on this permit application form is, to the best of my knowledge, Icorrect 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 the
applicable storJm�w�ter rules r rr 15A NCAC 2H .1000, SL 2006-246 (Ph. 11- Post Construction)) or SL 2g00088-211.
Signahire: tit/✓ \� /i�yy Date:O?f4 ioxd/o
rA<I IT, M "(A,, J a Notary Public for the State of 064-nAOAmf, a4 " County of
W 0, K do hereby certify that W A ,-.m F . J oti so personally appeared
before me this a7Kday of OcTOE& Zo k o and acknowledge th dr cy a ut on he application for.
it stormwater permit. Witness my hand and official seal,
SEAL
My commission expires 31 SU j I zo I