SW1221002_Application Form_20231208

Basin Information Drainage Area 1 Drainage Area 2 Drainage Area 3 Drainage Area
Receiving Stream Name Unnamed Unnamed Unnamed
Tribuary of Tribuary of Tribuary of
Cane Creek Cane Creek Cane Creek
Stream Class * C C C
Stream Index Number* 6-57-(9) 6-57-(9) 6-57-(9)
Total Drainage Area(sf) 243790 57250 46475
On-site Drainage Area(sf) 243790 57250 46475
Off-site Drainage Area(sf) 0 0 0
Proposed Impervious Area**(sf) 215541 11900 36850
% Impervious Area**(total) 88.41 20.79 79.29
Impervious**Surface Area Drainage Area 1 Drainage Area 2 I Drainage Area 3 Drainage Area
On-site Buildings/Lots(sf) 22463 - -
On-site Streets (sf) 1299 - -
On-site Parking (sf) - - 33250
On-site Sidewalks (sf) - - -
Other on-site (sf) 10080 - 3600
Future(sf) - - -
Off-site (sf) - - -
Existing BUA***(sf) 181699 11900 -
Total (sf): 215541 11900 i 36850
* Stream Class and Index Number can be determined at: http://portal.ncdenr.org/web/wq/ps/csu/classifications
** Impervious area is defined as the built upon area including, but not limited to, buildings, roads,parking areas,
sidewalks,gravel areas, etc.
***Report only that amount 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 new BUA.
11. How was the off-site impervious area listed above determined?Provide documentation.N/A
Projects in Union County: Contact DEMLR Central Office staff to check if the project is located within a Threatened&
Endangered Species watershed that may be subject to more stringent stormwater requirements as per 15A 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://portal.ncdenr.org/web/wq/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy,Mineral and
Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
http://portal.ncdenr.org/web/wq/ws/su/statesw/forms_docs. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map at http://portal.ncdenr.org/web/wq/ws/su/maps.)
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://portal.ncdenr.org/web/wq/ws/su/statesw/forms docs.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions&Protective Covenants
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.
Form SWU-101 Version Oct. 31,2013 Page 4 of 7