20150745 Ver 1_401 Application_20150901

CurrYENGINEERING®
TRANSMITTAL FORM
TO: Karen Higgins
NCDWR - 401 & Buffer Permitting Unit
512 N. Salisbury Street
Raleigh, NC 27604
919.807.6360
'1�
06(�014S
i r R
,#
E d
2015
'`=F hArTT n
SUBJECT: North Grove Subdivision - Buffer Authorization DATE: August 31, 2015
CURRY PROJECT NO: 2014 -063 SENT BY: Andy Petty
We are sending you the following items-
COPIES ITEM
1 Letter
1 Form
2 Maps
2 Letter
2 Plans
2 Calculations
2 0 &M
DESCRIPTION
Copy of Request for Additional Information
NCDENR Level Spreader Supplement Form
USGS & Soils Survey with Property Delineated
NCDENR Determination Letter
Design Plans
Design Calculations
Signed 0 &M Agreement
These are transmitted as checked below:
For Information Approved as Noted - Revise and Resubmit
As Requested Not Approved - Revise and Resubmit
For Review and Comments For Record and File
For Revision X Submittal
x For Approval For Recording
Approved For Signature, then return to:
REMARKS:
Buffer Authorization request form for impacts to an unnamed tributary subject to the Neuse River
Buffer rules Authorization for impacts to buffer to install level spreader by -pass channel and sanitary
sewer connection Both impacts are listed as "allowable" impacts.
T (919) 552 -0849 205 S.Fuquay Avenue
F (919)552 -2043 Fuquay- Varina,NC 27526
E 11 G14;
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NCD►ENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
August 14, 2015
Certified Mail
Return Receiot Reauested
7012 1640 00019605 9168
Fuller Land Development
Attn: Alex Capps
8801 Fast Park Dr.; Ste. 301
Raleigh, NC 27617
Subject: REQUEST FOR ADDITIONAL INFORMATION
North Grove Subdivision
Dear Mr. Capps:
Donald R, van der Vaart
Secretary
DWR #15 -0745
Wake County
On August 5, 2015, the Division of Water Resources (Division) received your application dated
July 24, 2015 requesting a Riparian Buffer Authorization from the Division for your project. The
Division has determined that your application is incomplete and cannot be processed. The
application is on -hold until the following information is received:
Provide the project boundary on a USGS 1:24,000 topographic map and most recent
published county soil survey. [15A NCAC 02H .0502(b)j
The application states that the Division did an on -site stream determination on May 2,
2013. The letter and maps generated from this site visit from the Division need to be
included with this application. A search of our stream determination database to try
and locate this letter did not reveal anything called North Grove Subdivision or Berkshire
at Millbrook. [15A NCAC 02B .0233(8)(b)(iv)j
Submit a Level Spreader Supplemental Form with all required items including the
stormwater calculations and length of the level spreader. Detailed drawings should also
be included on the plans for the level spreader and bypass channel. In addition, an
Operation and Maintenance Agreement that is signed and sealed by a professional
Division of Water Resources, Raleigh Regional Office, Water Quality Operations Section http: / /portal.ncdenr.org /web /wq /aps
1628 Mail Service Center, Raleigh, NC 27699 -1628 Phone: [phone]
Location: 3800 Barrett Drive, Raleigh, NC 27609 Fax: [phone]
An Equal Opportunity 1 Affirmative Action Employer — Made in part by recycled paper

o�OF WATFgOG
,ATA y
NCDENR
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
LEVEL SPREADER - VEGETATED FILTER STRIP (LS -VFS) SUPPLEMENT
This form must be completely filled out, printed, initialed, and submitted.
I.:PROJECT _INFORMATION, e °
Project name North Grove Subdivision
Contact name Andrew Petty, PE
Phone number 919 552 0849
Date August 28, 2015
Drainage area number 1
II: °DESIGN =INFORMATION
The purpose of the LS -VFS ° Buffer Rule- Diffuse Flow
Stormwater enters LS -VFS from The drainage area
Type of VFS Protected npanan buffer (slope < 5 %)
Explanation of any "Other" responses above
If Stormwater Enters the LS -VFS from the Drainage Area
Drainage area
562,795
fly
Impervious surface area
195.584
fly
Percent impervious
34.75
%
Rational C coefficient
0.35
Peak flow from the 1 in/hr storm
4.52
cfs
Time of concentration
500
min
Rainfall intensity, 10 -yr storm
7.04
in/hr
Peak flow from the 10 -yr storm
31.83
cfs
Design storm
10 -year storm
Maximum amount of flow directed to the LS -VFS
2
cfs
Is a flow bypass system going to be used?
Y
(Y or N)
Explanation of any "Other" responses above
If Stormwater Enters the LS -VFS from a BMP
Type of BMP Pick one
Peak discharge from the BMP during the design storm cfs
Peak discharge from the BMP during the 10 -year storm cfs
Maximum capacity of a 100 -foot long LS -VFS 2 cfs
Peak flow directed to the LS -VFS cfs
Is a flow bypass system going to be used? (Y or N)
Explanation of any "Other" responses above
Do not complete this section of the form.
Do not complete this section of the form.
Do not complete this section of the form.
SEP 2015 i
DFN8F - WATFk r1GSC�l1
401 R L�ClFFER f'ERMITi ItlG
Form SW401 - LS -VFS - 29June2012 - Rev. 10 page 1 of 3

LS -VFS Design
Forebay surface area
610
sq ft Forebay is adequately sized
Depth of forebay at stormwater entry point
36
in
Depth of forebay at stonnwater exit point
12
in Depth is appropnate
Feet of level lip needed per cfs
50
fucfs
Computed minimum length of the level lip needed
100
ft
Length of level lip provided
100
ft
Width of VFS
50
ft
Elevation at downslope base of level lip
29825
fmsl
Elevation at the end of the VFS that is farthest from the LS
29675
fmsl
Slope (from level lip to the end of the VFS)
3.00
%
Are any draws present in the VFS?
N
(Y or N) OK
Is there a collector swale at the end of the VFS?
N
(Y or N)
Bypass System Design (if applicable)
Is a bypass system provided?
Y
(Y or N)
Is there an engineered flow splitting device?
Y
(Y or N) Please provide plan details of flow splitter & supporting talcs.
Dimensions of the channel (see diagram below):
M
300
ft
B
400
ft
W
1600
ft
y (flow depth for 10 -year storm)
100
ft
freeboard (during the 10 -year storm)
100
ft
Peak velocity in the channel during the 10 -yr storm
461
ft/sec
Channel lining material
Rip -rap
Does the bypass discharge through a wetland?
N
(Y or N)
Does the channel enter the stream at an angle?
Y
(Y or N)
Explanation of any "Other" responses above
r_
A.
na
i
\V'
1 fieebovtl iilulinv the I Q -v1 stonul
v (CllUlllg the 10- }'1 stollll) l
----- -- - - -�
B i
Form SW 401 - LS -VFS - 2gJune2012 - Rev.10 page 2 of 3

1IIL" REQUIRED ITEMS'CHECKLIST _ . _ ° _ . _ .. _ _ _ .. _ ° • °_ . .. _ _ . ��
EDIT Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to indicate the
following design requirements have been met If the applicant has designated an agent, the agent may initial below. If a requirement has not been
met, attach justification.
Requried Item:
1. Plans (1" - 50' or larger) of the entire site showing:
- Design at ultimate build -out,
Off -site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Forebay (if applicable),
High flow bypass system,
Maintenance access,
Proposed drainage easement and public right of way (ROW), and
Boundaries of drainage easement
2. Plan details (1" = 30' or larger) for the level spreader showing:
- Forebay (if applicable),
High flow bypass system,
One foot topo lines between the level lip and top of stream bank,
Proposed drainage easement, and
Design at ultimate build -out.
3. Section view of the level spreader (1" = 20' or larger) showing:
- Underdrain system (if applicable),
Level lip,
Upslope channel, and
Downslope filter fabric.
4. Plan details of the flow splitting device and supporting calculations (if applicable).
5. A construction sequence that shows how the level spreader will be protected from
sediment until the entire drainage area is stabilized.
6. If a non - engineered VFS is being used, then provide a photograph of the VFS showing
that no draws are present.
7. The supporting calculations.
8. A copy of the signed and notarized operation and maintenance (0 &M) agreement.
Rp //
ZZ
F
3 823
/�'' FW Isi � P�g !✓
In' ials Page or plan sheet number and any notes:
Photograph not avaliable. Buffer is heavily vegetated within f oodplain
Form SW401 - LS -VFS - 29June2012 - Rev.10 page 3 of 3

jolso-)45,
su99ORT DpDDI'ENTS
R D E--:' C, �1:2 0 W 19
SEP 1 2015
QENrc - t�fA7ER!- ;E50LRC1nS
401 & BUFFER PERMITTING
6NGINEERING�

AW�
LOMA
4 Op
ircIDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Pat McCroy Thomas A. Reeder John E. Skvaiia, III
Governor Acting Director Secretary
July 2, 2013
Nil
GENE
JUL Steven Ball U 11 8 ?91;, ..
Soil & Environmental Consultants, PA
11010 Raven Ridge Rd I ky Sad g i nudat Ce!rsust +r�ls, i:u
Raleigh, NC 27614
Subject: Surface Water Determination Letter
NBRRO #13 -150
Wake County
Determination Type:
Buffer Call Isolated or EIP Call
® Neuse (15A NCAC 2B .0233)
El Tar-Pamlico (15A NCAC 26 .0259) El Ephemeral /Intermittent/Perennial Determination
❑ Isolated Wetland Determination
❑ Jordan (15A NCAC 2B .0267)
Project Name: 2121 Paces Forest Dr Raleigh
Location/Directions: Subject property is a partially undeveloped tract located at intersection of
Millbrook and Lead Mine Roads in Raleigh
Subject Stream: UT to Mine Creek
Determination Date: May 2, 2013 Staff: Martin Richmond
Feature E/UP* Not Subject Subject Start@ Stop@ I Soil USGS
Survey Topo
I A X I I I X
*F/I/P = Ephemeral /Intermittent/Perennial
Explanation: The feature(s) listed above has or have been located on the Soil Survey of Wake County, North
Carolina or the most recent copy of the USGS Topographic map at a 1:24,000 scale. Each feature that is checked
"Not Subject" has been determined not to be a stream or is not present on the property. Features that are checked
"Subject" have been located on the property and possess characteristics that qualify it to be a stream. There maybe
other streams located on your property that do not show up on the maps referenced above but still may be
considered jurisdictional according to the US Army Corps of Engineers and/or to the Division of Water Quality.
N,,°��e ttCaro i a
ova M'7J?
North Carolina Division of Water Quality Raleigh Regional Office Surface Water Protection Phone [phone] Customer Service
Internet www.ncwaterquality.org 1628 Mail Service Center Raleigh, NC 27699 -1628 FAX [phone]
An Equal Opportunity /Affirmative Action Employer-50% Recycied/10% Post Consumer Paper

2121 Paces Forest Dr Raleigh
Wake County
July 2, 2013
Page 2 of 2
This on -site determination shall expire five (5) years from the date of this letter. Landowners or affected parties that
dispute a determination made by the DWQ or Delegated Local Authority may request a determination by the
Director. An appeal request must be made within sixty (60) days of date of this letter or from the date the affected
party (including downstream and/or adjacent owners) is notified of this letter. A request for a determination by the
Director shall be referred to the Director in writing c/o Karen Higgins, DWQ WeBSCaPe Unit, 1650 Mail Service
Center, Raleigh, NC 27699.
This determination is final and binding unless, as detailed above, you ask for a hearing or appeal within sixty (60)
days.
The owner /future owners should notify the Division of Water Quality (including any other Local, State, and Federal
Agencies) of this decision concerning any future correspondences regarding the subject property (stated above). This
project may require a Section 404/401 Permit for the proposed activity. Any inquiries should be directed to the
Division of Water Quality (Central Office) at (919)-807 -6300, and the US Army Corp of Engineers (Raleigh
Regulatory Field Office) at (919) - 554 -4884.
If you have questions regarding this determination, please feel free to contact Martin Richmond at (919) 791 -4200.
R se pectfully,
Ii 1
Danny Smi
Regional Supervisor
cc: RRO /SWP File Copy

Topographic Quadrangle
Project Mgr.: Berkshire at Millbrook
513 Wake Co, NC
5cale:
I' = 2,000'
Raleigh West Quadrangle
5/1/13
Soil & Environmental PA
11010 Raven Ridge Rd.-
(919) 846 -5900 • (919) 846 -9467
Web Page: www.SandEC.com

Project No. Figure 2 -NRC5
12O79.W I Soli 5urvey map
Project Mgr.: Berkshire at Millbrook
55 Wake Co, NC
Scale:
I'= 1,320'
Wake Co 55
5/1/13 Sheet 38
Soil & Environmental Consultants, PA
11010 Raven Ridge Rd.- Raleigh, NC 27614
[phone] • (919) 846 -9467
Web Page: www.SandEC.com

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4
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MAP TITLE
9
O
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FIT,
� SAN
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N
PIN. OMS10301 000
Property Description, PROP CORN: RSTONE
Real Estate ID: 0089804
REALTY INCOME TRUST INC
Map Name: 078612
Heated Area 98352
Owner. OCEAN MILLBROOK LLC
Site Address: 2121 PACES FOREST CT
Mailing Address 1: ATLANTIC & PACIFIC
City: Raleigh
COmPAN1ES
Township. HOUSE CREEK
Mailing Address 2 1025 KANE CONCOURSE
Year Built 1886
0 205 410 620 Feel
STE 215
Total Sale Price ST,b10,ODO
I 1 1
Maiing Address 3: BAY HARBOR ISIANDS FL
Sale Date OM212012
1 inch = [DO feet
3315421!8
Type and Use GardenApar'rnents
Deed Book 14673
Design Stytc Conventional
Deed Page: 0687
Land Class: APARTMENT
Feed Date: 03102/2012
Old Parcel Number 378 -
Decded Acreage: 21.71
0!s eHtmer
Assessed Budding Value: $3,940,256
Maps makes omq anon to produce and pabUh
Assessed Lard Value: 5936,000
the moat cunem and accunte inkMmarlon poaslote.
local Assessed Value: $4,878,256
However, the maps am pmduced rbr Wwwo ton pwposse.
Bilbng Class, CORPORATE LISTING
and am NOT arnveys. No warranties expressed w impked
ors p akd br Ns data theretn. Rai uae,wlte NRrpmtation.
/rilre* ro 0
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-'!NORTH GROVE BOUNDARY -
ADDED BY CURRY
ENGINEERING 8/28/15
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CALCULATIONS & ANAYLSIS
AL �•
3 823 _
WiiSt
CurLr ENGINEERING

CALCULATIONS & ANALYSIS
Storm Sewer Composite C Values
�NG/NFF�
EST. Q 10
\�Ty CAR&/

Protect Data Revisions
Protect 2014-063 No Date Description
Project Name North Grove
Date I 8/28/2015
7-11-P A!
NN,
W "aft
067
OR
D r
Open Space
0 15
SF Residential 0 50
Impervious
102
0 26
0 09
103
0 17
0 16
104
0 07
OK
105
0 07
0 95
106
0 05
OK
107
0 10
0 95
108
0 08
OK
109
0 01
0 68
110
0 02
OK
ill
005
0 42
112
0 05
OK
113
007
038
114
0 09
OK
115
0 13
004
116
0 25
008
117
0 18
006
118
053
119
0 77
120
0 15
121
0 10
122
5 14
2 62
123
3 27
0 52
124
0 08
125
0 14
009
126
0 23
0 12
127
0 26
128
025
129
0 35
Storm Sewer System
x
'F
1mr pervious ',Wooded',, Rqsidentiall,• ,, d
, -
-Z,
Area lac)Area(acl 04c
0,17
001
007
007
005
010
008
001
0 02
0 05
0 05
007
009
0 09
0 17
0.12
006
0.04
1 66
021
008
005
005 042
017 056
0 03 0.12
004 0 06
0.32 054
074 1.80
0 11
026
025
035
10TO(L P?,"`fW'Pr kffA To !9�40(01' = le.""
Table 1 - Value of Runnoff Cociffictents
067
C Value
020
Open Space
0 15
SF Residential 0 50
Impervious
0 95
MF Residential 0 65
Woodlands
010
Open
0 95
OK
Open
005 042
017 056
0 03 0.12
004 0 06
0.32 054
074 1.80
0 11
026
025
035
10TO(L P?,"`fW'Pr kffA To !9�40(01' = le.""
bigh�ffla atue J ,
067
OK
020
OK
0.95
OK
0 95
OK
0.95
OK
0 95
OK
0 95
OK
0 95
OK
0 95
OK
0 95
OK
0 95
OK
0 95
OK
0 95
OK
070
OK
0 69
OK
0 68
OK
051
OK
044
OK
0 42
OK
034
OK
044
OK
038
OK
0 95
OK
044
OK
0 13
OK
0.50
OK
0 50
OK
0 50
OK

CALCULATIONS & ANALYSIS
Catch Basin DA Map
E N G INFO\
oI
EST. Q
10

T (9191 552 -0649 205 a Fuquay Avenue NORTH GROVE SUBDIVISION
F (9 19) 552 -2043 Fuquay- Verina, NC 21526
Curr CATCH BASIN DA EXHIBIT
ENGINEERING - NC IIC. N0. P -0799
FT

CALCULATIONS & ANALYSIS
By -Pass Ditch Calculation
EST. Q 10
o �2�

Project Data Revisions
Project # 2014 -063 No Date Description
Project Name North Grove
Date I 8/28/2015
Level Spreader By -Pass Channel
Peak Discharge Calculation (10 Year Design)
Drainage Area = 12.92 ac
04 'f2) sPn1 tip to l
C=
0.35
110=
7.04 in /hr
A=
1292 ac
010 =
31.83 cfs
Determine Ditch Flow Depth (d) and Velocity (v1 - Check for Permanent Conditions
Apply Manning's Equation. V= 1.49/n * R213 *S 112, O =AN
Ditch Characteristics•
n = 0 035 Rip -Rap Lined
Base Width (BI = 4.00 ft
M = 3
Ditch Slope IS) = 2.00% K.
Permissible Max Velocity IVpI = 5 00 fps
Apply the Following Analysis to Determine Actual "d" and "V"
d =
flow depth =
0.99 ft
Area (A) =
B *d + M *d2 =
6.90
Perimeter (P) =
b + 2d *(M2 +1).5 =
1026
R =
A/P =
0.67
VpR =
V Permiss * R =
336
V =
Flow Velocity =
4 61 fps
0 =
design flow =
31.83 cfs check 0 OK
Check Ditch Velocity for Lining.
VP = 5.00 fps Vactual<Vallow, No Perm. Lining Needed
Vactual = 461 fps
Determine Permanent Liner
Recalculate with Liner.
Liner Material =
n=
Base Width IBI =
M=
Ditch Slope IS) _
T allow (Td) _
Apply the Following Analysis to Deb
d = flow depth =
Area (A) = B *d + M *d2 =
Perimeter (P) = b + 2d *(M2 +11.5 =
R= A/P=
V = Flow Velocity =
Q = design flow =
None
0
4.00 ft
3
2.00%
0.00
?rmine Actual "d" and "V"
0.00 ft
0.00
4.00
0 00
#DIV /01 fps
#DIV /0! cfs check Q: #DIV /01
Tshear stress = Shear stress =
g *d *s
g = density of water =
62.4 lb /ft3
d = flow depth =
0.00 ft
S = channel slope =
2.00%
Tshear stress = Shear Stress =
0.00
Compare Tshear stress to Td:
T allow (Td)
000
Tshear stress =
0.00
Tshear stress < Td => OK
Summary
Permanent Ditch Liner = None

CALCULATIONS & ANALYSIS
Level Spreader Discharge Pipe
E N G lIVe
EST. Q 10

Channel Report
Hydraflow Express Extension for AutodeskO AutoCADO Civil 31DO by Autodesk, Inc
Friday, Aug 28 2015
Level Spreader
Discharge Pipe
Circular
Highlighted
Diameter (ft)
= 1.00
Depth (ft)
= 0.45
Q (cfs)
= 2.000
Area (sqft)
= 0.34
Invert Elev (ft)
= 297.00
Velocity (ft/s)
= 5.80
Slope ( %)
= 1.80
Wetted Perim (ft)
= 1.47
N -Value
= 0.013
Crit Depth, Yc (ft)
= 0.61
Top Width (ft)
= 1.00
Calculations
EGL (ft)
= 0.97
Compute by:
Known Q
Known Q (cfs)
= 2.00
UCE &11 b(q% Cf 14 Ovt 'r
L-3
4 'n t3't- MS5
Elev (ft) Section
29900
Reach (ft)
Depth (ft)
2.00
1.50
1.00
050
M
-0.50
3

OPERATION & MAINTENANCE AGREEMENT
CurLrENGINEERING

e
Permit Number:
(to be provided by DWQ)
Drainage Area Number: ____ __ -
! , ..... - Level Spreader
Operation and Maintenance Agreement 4
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
lint% arit maintenance procedures:
le_diately after the filter strip is established, any newly planted tion
w watered twice weekly if needed until the plants becomes " lislied,
Comm six weeks .
Once a ye filter strip will be reseeded to- niairitan nse.growth of
vegetation
Stable grouncicove be maintained in the ,d' J ge area to reduce the
sediment load to the v;e tion.
- Two to three times a ye I" filter s ill. be mowed and•the clippings
harvested to promote the,grow , ek vegetation with optimum pollutant
removal efficiency. Turf grass,'' _. f-be cut shorter than 3 to 5 inches and
may be allowed to grow. as ' as 12 iii epending:on aesthetic requirements
(NIPC,1993). Forested', ' r strips do not r' e this type of maintenance.
- Once a year, the;so' .: ill be aerated if necessary: -
- Once a year, so will be tested and lime will be a' Jf necessary.
After the.filte- ip is established, it will be inspected quarterly an in 24 hours
after eve orin event greater than 1.0 inch (or 1.5 inches if in a-Coast ounty);
Reco f operation and maintenance will be kept in a known set locatiowa "ill.be
,able upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element: Potential problem: How I "will remediate the tiroblerri:
The entire filter strip Trash/ debris is present. Remove the trash/ debris.
system _
The flow splitter device The flow splitter device is Unclog the conveyance and dispose
(if applicable) clogged. of any sediment off -site.
The flow sputter device is Make any necessary repairs or
damaged. replace if damage is too large for
repair.
Form SWU401 -Level Spreader, Filter Strip, Restored Riparian Buffer O &M -Rev.3 Page 1 of 3

BMP element:
The swale and the level
lip
The bypass channel
filter strip
The receiving water
Potential problem
The Swale is clogged with
sediment.
The level lip is cracked,
settled, undercut, eroded or
otherwise damaged.
There is erosion around the
end of the level spreader that
shows stormwater has
bypassed it
Trees or shrubs have begun
to grow on the swale or just
downslope of the level lip.
Areas of bare soil and /or
erosive gullies have formed.
Turf reinforcement is
damaged or ripap is rolling
downhill.
Grass is too short or too long
(if applicable).
Areas of bare soil and /or
erosive gullies have formed.
Se ent is building up on
the fill in.
Plants are
diseased or
Nuisance vegetation is
choking out desirable species.
Erosion or other signs of
damage have occurred at the
outlet.
How I will remediate the problem:
Remove the sediment and dispose
of it off -site.
Repair or replace lip.
Regrade the soil to create a berm
that is higher than the level lip, and
then plant a ground cover and
water until it is established. Provide
lime and a one -time fertilizer
application
Remove them.
Regrade the soil if necessary to
remove the gully, and then
reestablish proper erosion control.
Study the site to see if a larger
bypass channel is needed (enlarge if
necessary). After this, reestablish
the erosion control material.
Maintain grass at a height of
approximately three to six
Regrade the soil if neces to
remove the gully, rein plant a
ground cover ater until it is
establishe rovide lime and a
one-ti erh izer application
ve the sediment and
•cstabilize the soil with vegetation if
necessary. Provide lime and a one-
time fertilizer application.
Provide additional irrigation and
fertilizer as needed.
eternune the source of the
p� m: soils, hydrology, disease,
etc. dy the problem and
replace pla Provide a one -time
fertilizer applic n.
Remove vegetation and if
possible. If pesticide is do not
allow it to get into the receive
water.
Contact the NC Division of Water
Quality local Regional Office, or the
401 Oversight Unit at 919- 733 -1786.
Form SWU401 -Level Spreader, Filter Strip, Restored Riparian Buffer O &M -Rev.3 Page 2 of 3

Permit Number: __
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the 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.
Project name:North.Grove Subdivision
BMP drainage areanumber:I
Print name:Jim Anderson
Title:President
Address:88b I Fast. PArk.Drive; .RaleipkNG 2761 -7
Rhone:919.4177.6657
S i dhtul`e:
Date:- 3�. /a�IS
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, Luau) 5 Mc�os , a Notary Public for the State of
hby'A ► N -011ra , County of WQkt , do hereby certify that
Srn Rh{ itso►1_ -_ personally appeared before me this 315
day of ALU ust , aO15 , and acknowledge the due execution of the
forgoing filter strip, riparian buffer, and / /or level spreader maintenance requirements.
Witness my hand and official seal, (4ual l _B NUVIV
L_ AUREN B MATAS
NOTARY PUBLIC
WAKE COUNTY, NC
by Co Wduion Expires 8.10 -2019
SEAL
My commission expires lho 4019
Form SWU401 -Level Spreader, Filter Strip, Restored Riparian Buffer O &M -Rev.3 Page 3 of 3