SW6240205_Application Form_20240223

DEMLR USE ONLY
Date Received Fee Paid Permit Number
Applicable Rules: E Coastal SW-1995 E Coastal SW-2008 ❑Ph II-Post Construction
(select all that apply) ❑ Non-Coastal SW-HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ Mgmt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. 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.):
HOKE COUNTY HIGH SCHOOL REPLACEMENT
2. Location of Project(street address):
505 S BETHEL RD
City:RAEFORD County:HOKE Zip:28376
3. Directions to project(from nearest major intersection):
4. Latitude:34°58'25" N Longitude:79°14'01"W of the main entrance to the project.
II. PERMIT INFORMATION:
1.a.Specify whether project is(check one): New ['Modification ❑ Renewal w/ Modificationt
tRenewals with modifications also requires SWU-102-Renewal Application Form
b.If 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
DEMLR 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):
❑CAMA Major ®Sedimentation/Erosion Control:18.94 ac of Disturbed Area
❑NPDES Industrial Stormwater 0404/401 Permit:Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name,Project/Permit Number,
issue date and the type of each permit:Name-Hoke County High School Improvements,Number-Hoke-
2023-029,Date-5/8/23,E≻Number-Hoke-2024-029,Date-11/30/2023,E≻
5. Is the project located within 5 miles of a public airport? No ❑Yes
If yes,see S.L.2012-200,Part VI:http://portal.ncdenr.org/web/lr/rules-and-regulations
Form SWU-101 Version Oct.31,2013 Page 1 of 6

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:HOKE COUNTY BOARD OF EDUCATION
Signing Official&Title:KENNETH SPELLS-SUPERINTENDENT
b.Contact information for person listed in item la above:
Street Address:310 WOOLEY ST
City:RAEFORD State:NC Zip:28376
Mailing Address (if applicable):
City: State: Zip:
Phone: (910 ) 875-2416 Fax: ( )
Email:[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 and
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. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:HOKE COUNTY BOARD OF EDUCATION
Signing Official&Title:KENNETH SPELLS-SUPERINTENDENT
b.Contact information for person listed in item 2a above:
Street Address:310 WOOLEY ST
City:RAEFORD State:NC Zip:28376
Mailing Address (if applicable):
City: State: Zip:
Phone: (910 ) 875-2416 Fax: ( )
Email:[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:
Signing Official&Title:
b.Contact information for person listed in item 3a above:
Mailing Address:
City: State: Zip:
Phone: ( ) Fax: ( )
Email:
4. Local jurisdiction for building permits: City of Raeford
Point of Contact:Felecia Locklear Phone#: f910 ) 875-5031 ext.302
Form SWU-101 Version Oct. 31,2013 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below,briefly summarize how the stormwater runoff will be treated.
Runoff from a portion of the building and parking area will flow to 2 bioretention basins. Runoff from other
portions of the building and parking areas will drain towards existing structures. The bioretention basins
will be constructed after the area draining to them has been stabilized.Note: Property area=Limit of
Construction(LOC).Scool is on three parcel totaling 59.78 acres,much of which will not be disturbed.
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:
n Valid Building Permit Issued Date:
n Other: Date:
b.If claiming vested rights,identify the regulation(s)the project has been designed in accordance with:
❑ Coastal SW-1995 ❑ Ph II-Post Construction
3. Stormwater runoff from this project drains to the LUMBER River basin.
4. Total Property Area:18.52(LOC) 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+:18.52(LOC) acres
+ Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water(NI-ITN) line or Mean High Water
(MI-ITN)line, and coastal wetlands landward from the NHW(or MHW)line. The resultant project 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 100 =57
9. How many drainage areas does the project have?3 (For high density, count 1 for each proposed 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 in the project,attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information ] Drainage Area 1 Drainage Area 2 Drainage Area 3 Drainage Area
Receiving Stream Name TONEYS CREEK TONEYS CREEK TONEYS CREEK
Stream Class * C;Sw C;Sw C;Sw
Stream Index Number* 14-10-1.2 14-10-1.2 14-10-1.2
Total Drainage Area(sf) 130,244 146797.2 529689.6
On-site Drainage Area(sf) 130,244 146797.2 529689.6
Off-site Drainage Area(sf) 0 0 0
Proposed Impervious Area**(sf) 40,511 91,912 329,314
% Impervious Area**(total) 31 63 62
Impervious*Surface Area Drainage Area 1 Drainage Area 2 Drainage Area 3 Drainage Area
On-site Buildings/Lots (sf) 21085 0 67696
On-site Streets (sf) 0 0 0
On-site Parking (sf) 19426 54886 261,618
On-site Sidewalks (sf) 0 0 0
Other on-site (sf) 0 37026 0
Future(sf) 0 0 0
Off-site (sf) 0 0 0
Existing BUA***(sf) 0 0 0
Total (sf): 40,511 91912 329314
* 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.
Form SWU-101 Version Oct. 31,2013 Page 3 of 6

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 NCA C 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. KSL
2. Original and one copy of the signed and notarized Deed Restrictions&Protective Covenants KS L
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed,signed and dated) and O&M KSL
agreement(s)for each BMP.
4. Permit application processing fee of$505 payable to NCDENR. (For an Express review,refer to KSL
http://www.envhelp.org/pages/onestopexpress.html 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.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management for KSL
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the KSL
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(one copy). KSL
8. Two sets of plans folded to 8.5" x 14" (sealed,signed,&dated),including: KSL
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).
Form SWU-101 Version Oct. 31,2013 Page 4 of 6