SW4240203_Application Form_20240515

IV. PROJECT INFORMATION
1. In the space provided below,briefly summarize how the stormwater runoff will be treated.
The site infrastructure(streets and water main was installed in 2008-2009 and has ribbon payment streets
with side ditches. The intersection in the middle of the site is flat and has no piping. No piping other than
driveway pipes is expected during the home building phase of construction. Stormwater will be treated
using vegetated conveyance and infiltration to the maximum extent practical.
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:6-17-08
❑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 II-Post Construction
3. Stormwater runoff from this project drains to the Roanoke River basin.
4. Total Property Area:16.569 acres 5. Total Coastal Wetlands Area:0 acres
6. Total Surface Water Area:0.039 acres
7. Total Property Area(4)-Total Coastal Wetlands Area(5)-Total Surface Water Area(6)=Total Project
Area*:16.529 acres
+ Total project area shall be calculated to exclude the followin : the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water(NHW)line or Mean High Water
(MHW)line,and coastal wetlands landward from the NHW(or MHi4 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 =13.7 %
9. How many drainage areas does the project have?1 (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.
Form SWU-101 Version Oct.31,2013 Page 3 of 7

Basin Information Drainage Area 1 Drainage Area_ Drainage Area_ Drainage Area_
Receiving Stream Name Trick-Urn Creek
Stream Class * C
Stream Index Number* 22-25-5-1
Total Drainage Area (sf) 720023
On-site Drainage Area(sf) 720023
Off-site Drainage Area(sf) 0
Proposed Impervious Area**(sf) 110050
% Impervious Area**(total) 15.3
Impervious**Surface Area Drainage Area 1 Drainage Area_ Drainage Area_ Drainage Area_
On-site Buildings/Lots (sf) 71400
On-site Streets (sf) 38650
On-site Parking (sf) 0
On-site Sidewalks (sf) 0
Other on-site (sf) 0
Future(sf) 0
Off-site (sf) 0
Existing BUA*** (sf) 0
Total (sf): 110050
* Stream Class and Index Number can be determined at: http://pnrtal.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 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/suibmp-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/state.sw/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.naienr.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. AG
2. Original and one copy of the signed and notarized Deed Restrictions&Protective Covenants AC'
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M AC
agreement(s)for each BMP.
4. Permit application processing fee of$505 payable to NCDENR. (For an Express review,refer to AC/
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.)
Form SWU-101 Version Oct. 31,2013 Page 4 of 7