SW8040301_CURRENT PERMIT_20191031

STORMWATER DIVISION CODING SHEET
POST-CONSTRUCTION PERMITS
PERMIT NO. SW8
DOC TYPE CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE ��
YYYYMMDD

t�
5rATEu
�P
ROY COOPER
Governor
MICHAEL S.REGAN � .
Secretary
S.DANIEL SMITH NORTH CAROLINA
Director Environmental Quality
October 31, 2019
Susan Booth Stevenson
781 Firetower Road
Swansboro, NC 28584-7730
Subject: Permit Transfer
State Stormwater Management Permit No.SW8 040301
Stevenson Toyota
Onslow County
Dear Mrs. Stevenson:
Effective August 1, 2013 the State Stormwater program has been transferred from the Division of
Water Quality (DWQ) to the Division of Energy, Mineral and Land Resources (DEMLR). All previous
references to DWQ will remain in older stormwater permits issued prior to August 1, 2013 until
they are modified. Please note that this updated permit now references DEMLR as the Division
responsible for issuance of the permit
On August 9, 2019,the Wilmington Regional Office received a request to transfer the ownership of
the state stormwater management permit for the subject project. Staff from the City of Jacksonville
inspected the project on September 26, 2019 and based on the photographs provided by the City,
the Division has determined that the offsite wet detention pond (SW8 900506,) which treats the
runoff from this parcel, is not in compliance with that permit. The SW8 900506 permit was
transferred to you on October 31, 2019. The permit documents contain an inspection report of the
compliance issues for the SW8 900506 pond. Since the SW8 040301 permit is an offsite permit,
DEMLR can transfer this permit with the understanding that the transferred permit for the wet
pond under SW8 900506 will require that the pond be maintained and restored to design condition
within 90 days of receipt of the transferred permit.
By signing the Permit Transfer Application Form,you have accepted the responsibility for
complying with the terms and conditions outlined in this permit. The Division is hereby notifying
you that the subject permit has been transferred on October 31, 2019 and is reminding you that this
permit shall be effective until it is rescinded by the Division. A copy of the following documents are
included: the transferred and updated permit; and the original offsite supplement form with the
0&M requirements for the lot; and,the permit transfer application. Please note that this
transferred,updated, and re-issued permit does not impose new or different terms; it merely
restates and clarifies some of the previous terms to provide you with a better understanding of
your obligations under the permit.
Please be aware that the project's built-upon area and stormwater controls must be built and
maintained in compliance with the permit documents and the approved plans. Maintenance of
the collection system within the project covered by this permit shall be performed in
accordance with the attached Operation and Maintenance agreement.Any modifications to this
project must be submitted to DEMLR and approved prior to construction.The issuance of this
approval does not preclude you from complying with all other applicable statutes, rules,
regulations or ordinances,which may have jurisdiction over the proposed activity, and
obtaining a permit or approval prior to construction.
A North Carolina Department of Environmental Quality I Division of Energy,Mineral and Land Resources
Wilmington Regional Office 1 127 Cardinal Drive Extension I Wilmington,North Carolina 28405
910,796.7215

c
r'y - State Stormwater Permit No. S W8 040301
Page 2 of 2
If any parts,requirements, or limitations contained in this permit are unacceptable,you have the
right to request an adjudicatory hearing by filing a written petition with the Office of Administrative
Hearings (OAH). The written petition must conform to Chapter 150B of the North Carolina General
Statutes,and must be filed with the OAH within thirty (30) days of receipt of this permit. You
should contact the OAH with all questions regarding the filing fee (if a filing fee is required) and/or
the details of the filing process at 6714 Mail Service Center, Raleigh, NC 27699-6714, or via
telephone at 919-431-3000, or visit their website at www.NCOAH.com. Unless such demands are
made this permit shall be final and binding.
If you have any questions,need additional copies of the permit or approved plans, please contact
any of the state Stormwater staff with DEMLR in the Wilmington Regional Office at [phone].
Sincerely
F.S. Daniel Smith, Director
Division of Energy, Mineral and Land Resources
Enclosures: Updated Permit
Permit Transfer Application Form
Operation&Maintenance Agreement(offsite supplement)
GDS/arl: G:\\\Stormwater\Permits&Projects\2004\040301 Offsite\2019 10 permit 040301
CC: Jason Houston, PE,Parker&Associates
Pat Donovan-Brandenburg,City of Jacksonville
Wilmington Regional Office Stormwater File

State Stormwater Management Systems
Permit No.SW8 040301
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
SERVED BY AN OFF-SITE STORMWATER CONTROL
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North
Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Susan Booth Stevenson
Stevenson Toyota
N. Marine Boulevard at Dixie Trail, Jacksonville, Onslow County
FOR THE
construction of impervious areas with runoff to be treated in an offsite permitted stormwater
facility, in compliance with the provisions of 15A NCAC 2H .1000 (hereafter referred to as the
"stormwaterrules') and the approved stormwater management plans and specifications and
other supporting data as attached and on file with and approved by the Division of Energy,
Mineral and Land Resources (DEMLR or Division) and considered an enforceable part of this
permit. The stormwater runoff from the site will be routed to a wet detention pond which is
permitted under Permit No. SW8 900506.
This permit shall be effective from the date of issuance until rescinded, and shall be subject to
the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater described
in the application and other supporting data.
2. The runoff associated with this project has been approved to be discharged into a
stormwater management system permitted under Stormwater Management Permit No.
SW8 900506 , the "Master Permit", which is owned and operated by Susan B. Stevenson,
the "Master Permit Holder".
3. The built-upon area allotted to this development by the Master Permit is 48,596 square
feet. This project proposes 48,596 square feet.
4. Approved plans and specifications for this project are incorporated by reference and are
enforceable parts of the permit.
5. All stormwater collection systems must be located in public or private rights-of-way,
dedicated common areas or recorded drainage easements. The final plats for the project
will be recorded showing all such required rights-of-way, common areas and easements,
in accordance with the approved plans.
6. The runoff from the permitted built-upon area associated with this project must be directed
into the permitted stormwater system.
Page 1 of 5

State Stormwater Management Systems
Permit No. SW8 040301
II. SCHEDULE OF COMPLIANCE
1. This permit is issued contingent on the Master Permit Holder having constructed,
vegetated, operated and maintained the stormwater management system approved under
the Master Permit.
2. During construction of this project, erosion shall be kept to a minimum and any eroded
areas of the system will be repaired immediately. The permittee shall restrain sediment on
the lot. The permittee shall routinely check the amount of accumulated sediment and shall
remove any accumulated sediment from the street, catch basins and piping which collect
the runoff from the lot.
3. The Master Permit Holder shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater management system functions at design
condition. The Master Permit Holder shall follow the approved Operation and Maintenance
Plan and shall perform the required maintenance at the scheduled intervals per the O&M
agreement.
4. The permittee shall maintain the project's vegetated areas and stormwater collection
system in accordance with the approved Operation and Maintenance plan, the signed
O&M agreement and the requirements of the NC Erosion and Sediment Control Design
Manual. Maintenance includes but is not limited to:
a. Semiannual scheduled inspections (every 6 months);
b. Sediment removal;
c. Mowing and revegetation of vegetated areas of the project;
d. Immediate repair of any eroded areas;
e. Debris removal and unclogging of the stormwater collection system of catch basins,
drop inlets, pipes and swales.
5. The project shall be constructed, operated and maintained in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting data
as attached and on file with the Division.
6. The permitted offsite stormwater management facility shall be certified by an appropriate
designer for the system installed, certifying that the permitted facility has been
constructed, operated and maintained in accordance with the provisions of Stormwater
Management Permit No. SW8 900506, the approved plans and specifications, and other
supporting documentation. Any deviations from the approved plans and specifications
must be noted on the Certification.
7. A copy of the approved plans and specifications shall be maintained on file by the
Permittee.
8. This lot is limited to the amount of built-upon area indicated in the supporting calculations
and per approved plans. The project must have a built-upon area less than or equal to the
amount permitted under the Master Permit. Additional built-upon area ion excess of
48,596 sf will require a modification to the Master Permit.
9. The Master Permit Holder shall have recorded any deed restrictions as required by the
Master Permit and shall have verified that the proposed built-upon area does not exceed
the maximum allowable built-upon area for the lot. The allocated built-upon area may not
be increased or decreased without prior approval from the Master Permit Holder.
10. The permittee is responsible for ensuring that the maximum built-upon area limit for the lot
is not exceeded.
11. The drainage features shown as a part of the stormwater management system on the
approved plan shall not be filled in, altered, or piped by any party without first submitting a
revision to the permit and receiving approval from the Division.
Page 2 of 5

State Stormwater Management Systems
Permit No. SW8 040301
12. The permittee shall submit to the Director and shall have received approval for revised
plans, specifications, and calculations prior to construction, for any modification to the
approved plans, including, but not limited to, those listed below:
a. Any revision to the approved plans, regardless of size.
b. Redesign or addition to the approved amount of built-upon area.
c. Further subdivision, acquisition or sale of the project area, in whole or in part.
d. Any revisions to the runoff collection and conveyance system shown on the approved
plan.
e. The construction of any areas of#57 stone or permeable pavement for BUA credit.
f. Any other revision as determined by the Director.
13. The Director may notify the permittee when the permitted site does not meet one or more
of the minimum requirements of the permit. Within the time frame specified in the notice,
the permittee shall submit a written time schedule to the Director for modifying the site to
meet minimum requirements. The permittee shall provide copies of revised plans and
certification in writing to the Director that the changes have been made.
III. GENERAL CONDITIONS
1. Any individual or entity found to be in noncompliance with the provisions of this stormwater
management permit or the requirements of the Stormwater rules is subject to enforcement
procedures as set forth in NCGS 143 Article 21.
2. The permittee shall submit a completed "Permit Information Update Application Form"
(available on the Division website) to the Division within 30 days to making any one or
more of the following changes:
a. A name change of the current permittee;
b. A name change of the project;
c. A mailing address change of the permittee;
3. This permit is not transferable to any person or entity except after notice to and approval
by the Director. The permittee shall submit a completed and signed "Permit Transfer
Application Form" (available on the Division website) accompanied by the required fee and
supporting documentation as listed on the form, to the Division at least 60 days prior to
any one or more of the following events:
a. The sale or conveyance of the project area in whole or in part;
b. The assignment or conveyance of declarant rights to another individual or entity;
c. The sale or conveyance of the common areas to a Homeowner's or Property Owner's
Association, subject to the requirements of NCGS 143-214.7(c2),
d. Dissolution of the partnership, corporate, or LLC entity, subject to NCGS 55-14-05 or
NCGS 57D-6-07 and 08;
e. Bankruptcy;
f. Foreclosure, subject to the requirements of Session Law 2013-121,
4. The permittee is responsible for compliance with all permit conditions until such time as
the Division approves the transfer request. Neither the sale of the project, in whole or in
part, nor the conveyance of common area to a third party constitutes an approved transfer
of the stormwater permit.
5. The permit issued shall continue in force and effect until the permittee files a request with
the Division for a permit modification, transfer, renewal, or rescission; however, these
actions do not stay any permit conditions.
6. The issuance of this permit does not preclude the Permittee from complying with any and
all statutes, rules, regulations, or ordinances which may be imposed by other government
agencies (local, state, and federal) which have jurisdiction.
7. The permittee grants permission for DEQ Staff to enter the property during normal
business hours for the purpose of inspecting all components of the permitted project.
Page 3 of 5

State Stormwater Management Systems
Permit No.SW8 040301
8. The permit may be modified, revoked and reissued or terminated for cause. The filing of a
request for a permit modification, revocation and reissuance or termination does not stay
any permit condition.
Permit updated, transferred and reissued this the 315t day of October 2019.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
F. S. Waniel Smith, Wector
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Page 4 of

State Stormwater Management Systems
Permit No. SW8 040301
Stevenson Toyota
Stormwater Permit No. SW8 040301
Onslow County
Designer's Certification
I, as a duly registered in the
State of North Carolina, having been authorized to observe (periodically/weekly/full time) the
construction of the project,
(Project)
for (Project Owner) hereby state that, to the best of
my abilities, due care and diligence was used in the observation of the project construction such
that the construction was observed to be built within substantial compliance and intent of the
approved plans and specifications.
Noted deviations from approved plans and specifications:
SEAL
Signature
Registration Number
Date
Certification Requirements:
1. The drainage area to the system contains approximately the permitted acreage.
2. The drainage area to the system contains no more than the permitted amount of
built-upon area.
3. All the built-upon area associated with this project is graded such that the runoff
drains to the system.
4. The project is stabilized with permanent vegetation or other erosion control
material.
5. Vegetated slopes are no steeper than 3:1.
6. The inlet from this project into the approved offsite system is located per the
approved plans and does not cause short-circuiting of the system.
cc: NCDEQ-DEMLR Regional Office
Onslow County Building Inspections
Page 5 of 5

UL-MLK UJt UNLY
at Re Ived Fee Paid EPejrMtNumber
obSW 0ii
NC DEQ Division of Energy, Mineral and Land Resources
STATE STORMWATER:
PERMIT TRANSFER APPLICATION FORM
Pursuant to 15A NCAC 02H.1045 and otherapplicable statues as reference within
Only complete applications packages will be accepted and reviewed. This form and the required items(with
original signatures) must be sent to the appropriate DEMLR Regional Office, which can be determined by locating
the project on the interactive online map at:http://deo.nc.govicontact/regional-offices.
After this application is accepted, DEMLR will conduct a compliance inspection and report any deficiencies to the
current permittee and/or the proposed permittee. Per the state stormwater rules and the state stormwater permit
conditions, the permit shall not be transferred until:
1. the current permittee resolves all non-compliance issues identified in the inspection report;
2. the current permittee negotiates a resolution with the proposed permittee (in writing and signed by both
entities. The negotiated resolution must identify the necessary actions, the responsible party(ies), and the
timelines to correct the deficiencies. The site must either be found in compliance or a copy of the
negotiated resolution must be submitted prior to the transfer of the permit.);or
3. in the case where a transfer falls under G.S. 143-214.7(c2) (see also SL 2011-256), the proposed
permittee resolves all non-compliance issues upon acquiring the permit.
Signature requirements for the named signing official(for current and proposed permittee) must meet the following:
• Corporation-a principal executive officer of at least the level of vice-president;
• Limited Liability Company(LLC) -the designated manager, (Documentation from the NC Secretary of
State or other official documentation must be provided that states the titles and positions held by the
person who signed the application (pursuant to 02H.1040) that shows they have legal authority to sign for
the LLC)
• Municipality-a ranking official or duly authorized employee;
• Partnership or limited partnership-the general partner,
• Sole proprietor,
• The signature of the consultant or other agent shall be accepted on this permit transfer application only if
accompanied by a letter of authorization signed by one of the signatories noted in a-e above, as
applicable.
A. GENERAL INFORMATION
1. State Stormwater Permit Number: SW8 -040301
2. Project name: Stevenson Toyota
Is this an updated project name from the current permit? ❑Yes ® No
3. Reason for the permit transfer request:
Transfer of Ownership
EN'
AUG 0 9 2099 ;; I
Stormwater Permit Transfer Application Form Page 1 of 7 April 27, 2018

B. PERSON(S) WHO HAVE SIGNED THIS FORM (select only one response below)
❑ 1. Both the current and proposed permittees
❑ 2. Only the current permittee of a condominium or planned community (skip Part F& G).
In accordance with G.S. 143-214.7(c2) (see also SL 2011-256), this type of transfer is allowed only
when all of the following items can be truthfully checked:
❑ Any common areas related to the operation and maintenance of the stormwater management
system have been conveyed to the unit owners' association or owners' association in
accordance with the declaration;
❑ The declarant has conveyed at least fifty percent (50%) of the units or lots to owners other than
a declarant(provide documentation per submittal requirements below);
❑ The stormwater management system is in compliance with the stormwater permit.
NOTE: If subdivision was built prior to 1999, the Declarant's Attorney can make a determination that
the elements of the Planned Community Act (see §47F) have been met by the Declarant for the
subdivision. If the Declarant chooses to use this type of transfer, the determination must be in
writing, signed by the attorney, and submitted to DEMLR with this form.
(� 3. Only the proposed permittee (skip Part D below).
In accordance with G.S. 143-214.7(c5) (see also SL 2013-121), this type of transfer is allowed only
when all of the following items can be truthfully checked:
❑ a. The proposed permittee is either (select one of the following):
❑ The successor-owner who holds title to the property on which the permitted activity is
occurring or will occur;
❑ The successor-owner who is the sole claimant of the right to engage in the permitted
activity.
© b. The current permittee is (select at least one of the following, but all that apply):
❑ A natural person who is deceased.
❑ A partnership, Limited Liability Corporation, corporation, or any other business
association that has been dissolved
❑ A person who has been lawfully and finally divested of title to the property on which the
permitted activity is occurring or will occur.
© A person who has sold the property on which the permitted activity is occurring or will
occur.
❑ Other(please explain):
❑ c. The proposed permittee agrees to the following requirements (all must be selected):
❑ There will be no substantial change in the permitted activity.
❑ The permit holder shall comply with all terms and conditions of the permit until such
time as the permit is transferred.
❑ The successor-owner shall comply with all terms and conditions of the permit once the
permit has been transferred.
ECE0'V
AUG 0 9 2019
BYr—__--_--
Stormwater Permit Transfer Application Form Page 2 of 7 April 27, 2018

C. SUBMITTAL REQUIREMENTS
Please mark"Y"to confirm the items are included with this form. Please mark 'W"if previously provided. If not
applicable or not available, please mark N/A.:
1. A processing fee of five hundred and five dollars ($505.00) per G.S. 143-215.3D(e)(2).
2. Two hard copies (with original signatures) and one electronic copy of this completed form and the
required items.
3. For proposed permittees that are corporations or LLC's, documentation from the NC Secretary of
State demonstrating that the proposed permittee is a legal and viable entity able to conduct
business in North Carolina.
4. If Part B, Items 1 or 3 of this form is selected, the signed and notarized
applicable O&M agreement(s)from the proposed permittee, as required by the permit.
5. Legal documentation that the property has transferred to the proposed permittee (such as a
recorded deed for the property, uncompleted development and/or common areas) or legal
documentation demonstrating that the proposed permittee is the sole claimant of the right to
engage in the permitted activity.
6. If required by the permit and if the project has been built, a signed, sealed and dated certification
document from a licensed professional stating that the stormwater management system has been
inspected and that it has been built and maintained in accordance with the approved plans.
7. A copy of the recorded covenants and deed restrictions, if required by the permit. If the project has
been built, documentation that the maximum allowed per lot built-upon area or the maximum
allowed total built-upon area has not been exceeded. If the project has not been built, the new
owner shall provide a signed agreement to submit final recorded deed restrictions and protective
covenants.
8. If transferring under G.S. 143-214.7(c2) (i.e., Part B, Item 2 of this form is selected),
documentation verifying that 50% or more of the lots have been conveyed to individuals (not
builders). Copies of the deeds of conveyance or a chart listing the lot number, lot address,
owner's name, conveyance date and deed book and page number are acceptable.
9. If transferring under G.S. 143-214.7(c5) (i.e., Part B, Item 3 of this form is selected), provide legal
documentation supporting the dissolution of the corporation or documentation supporting the
current permittee was lawfully and finally divested of title of the property.
10. A copy of the lease agreement if the proposed permittee is the lessee.
11. A copy of the pending sales agreement if the proposed permittee is the purchaser.
12. A copy of the development agreement if the proposed permittee is the developer.
A4G 0 9 2019 '
i;
Stormwater Permit Transfer Application Form Page 3 of 7 April 27, 2018

D. CURRENT PERMITTEE INFORMATION AND CERTIFICATION Please be sure to provide Email.
1. Current Permit Holder's Company Name/Organization:
2. Signing Official's Name:
3. Signing Official's Title:
4. Mailing Address:
City: State: -ZIP :
5. Street Address:
City: State: ZIP :
6. Phone: (_) Email:
I, the current permittee, am submitting this application for a
transfer of ownership for the above listed stormwater permit under the General Statute and Session Law identified
on Page 1 of this application. I hereby notify DEMLR of the sale or other legal transfer of the property/project
and/or the stormwater system associated with this permit. I have provided a copy of the following documents to
the proposed permittee named in this application form: (select all that apply)
❑ the most recent permit;
❑ the designer's certification for each SCM;
❑ any recorded deed restrictions, covenants, common areas, drainage easements or plats;
❑ the approved plans and/or approved as-built plans;
❑ the approved operation and maintenance agreement;
❑ past maintenance records from the previous permittee(where required);
❑ a copy of the most recent inspection report,
I further attest that this application and request for a permit transfer is accurate and complete to the best of my
knowledge.1 attest that I have provided all of the required items per the law to transfer this permit. I understand
that if all required parts of this request are not completed or if all required supporting information and attachments
listed above are not included, this request package will be returned as incomplete 1 assign all rights and
obligations as permittee to the proposed permittee named below. I understand that this request to transfer the
permit may not be approved by the DEMLR unless and until the facility is in compliance with the permit.
Signature: Date:
I, a Notary Public for the State of
County of , do hereby certify
that personally appeared before me
this the day of 20 , and acknowledge the due
execution of the forgoing instrument. Witness my hand and official seal,
(Notary Seal)
17CEIVE ,,
Notary Signature: t! AUG 0 9 2019
My commission expires oy
Stormwater Permit Transfer Application Form Page 4 of 7 April 27, 2018

E. PROPOSED PERMITTEE INFORMATION
1. The proposed permittee is the:
® Property owner(Also complete Part F.)
❑ Home Owners Association (HOA), Property Owners Association (POA),or Unit Owner Association
(UOA) (Also complete Part F.)
❑ Lessee -Attach a copy of the lease agreement. Both the lessee and the property owner will appear on
the permit as co-permittees. If the lease is terminated, responsibility for the permit reverts to the property
owner. (Also complete Parts F&G.)
❑ Purchaser-Attach a copy of the pending sales agreement. The permit will require submission of a copy
of the recorded deed after the purchase has taken place. If the purchase agreement is cancelled the
permit reverts to the property owner. (Also complete Parts F& G.)
❑ Developer-Attach a copy of the development agreement. Both the developer and the property owner
will appear on the permit as co-permittees. If the development agreement is terminated, responsibility for
the permit reverts to the property owner. (Also complete Parts F&G.)
2. Proposed permittee name (check one of the following and provide the name):
❑ Corporation, LLC, Partnership, Municipality name:
❑ HOA/ POA/UOAname:
® Sole Proprietor
3. Proposed permittee contact information:
Please be sure to provide Email.
a. Signing Official's Name: Susan Booth Stevenson
b. Signing Official's Title: Property Owner
c. Mailing Address: 781 W. Firetower Road
City: Swansboro State: NC ZIP : 28584-7730
d. Street Address:
City: State: ZIP
e. Phone: (_) Email:
4. If there is a Management Entity that manages the property for an HOA, POA or UOA, please provide:
Please be sure to provide Email.
a. Management Company or Business name:
b. Contact Name: Title:
c. Mailing Address:
d. City: State ZIP:
e. Phone: (_), Email:
" AUG 0 9 2M
Stormwater Permit Transfer Application Form Page 5 of 7 April 27,2018 i

F. PROPOSED PERMITTEE CERTIFICATION
I, Susan Booth Stevenson , hereby notify the DEMLR that I have acquired through sale, lease,
development agreement, or other legal transfer, the project/property covered by the stormwater management
permit and/or the responsibility for constructing and/or operating and maintaining the permitted stormwater
management system. I acknowledge and attest that I have received a copy of: (select all that apply):
❑ the most recent permit;
❑ the designers certification for each SCM;
❑ any recorded deed restrictions, covenants, common areas, drainage easements or plats;
❑ the approved plans and/or approved as-built plans;
❑ the approved operation and maintenance agreement;
❑ past maintenance records from the previous permittee(where required);
❑ a copy of the most recent inspection report;
® Check here if the proposed permittee agrees to be the entity responsible for addressing any compliance
issues outlined in the Compliance Inspection Report. If checked, the proposed permittee must provide a
written document statement, with a plan of action and schedule"addressed to this office stating that they will
bring the project into compliance upon receipt of the transferred permit. This written plan of action and
schedule'must be received by the Division before the Division will transfer the permit.
I have reviewed the permit, approved plans and other documents listed above, and I acknowledge that I will
comply with the terms and conditions of the permit. 1 will construct the project's built-upon area as shown on the
approved plans; and I will{construct}, operate and maintain the approved stormwater management system
pursuant to the requirements
,listed in the permit and in the operation and maintenance agreement.
Signat w/' "--t L r5iztT�W� Date: ti — ) 1 — 19
I, Iv l(VO(- Cf4? '}" T�(U.fYlYY10YA , a Notary Public for the State of�IyV �E'1 e nnl`t(' i I i
County of rennin k) do hereby certify that IY3 Yl d'�cx u I Q�/Q Y��})
personally appeared before me this the I }�day of ,20i�-, and
acknowledge the due execution of the forgoing instrument Witness hand and official seal,
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My commission expires = Ons low
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a° AUG 0 9 2019
Stormwater Permit Transfer Application Form Page 6 of 7 ApH127,2018

G. PROPERTY OWNER INFORMATION AND CERTIFICATION
Fill out this section only if the property owner is different from the proposed permittee. The permit will revert to
the property owner if the purchase agreement, development agreement or lease expires or is terminated.
Company Name/Organization:
Signing Official's Printed Name:
Signing Official's Title:
Mailing Address:
City: State: —ZIP :
Phone: (_) Email:
I, hereby certify that I currently own the property identified in
this permit transfer document and acknowledge that the Proposed Permittee listed in Part F will be purchasing the
property, developing the property on my behalf, and/or leasing the property from me. A copy of the purchase
agreement, development agreement or the lease agreement, which names the party responsible for the
construction and/or operation and maintenance of the stormwater system, has been provided with the permit
transfer request.
I agree to notify DEMLR within 30 days if there are any changes to the purchase, developer or lease agreements
and will submit the applicable completed and signed Permit Information Update Form, or Permit Transfer
Application Form to address these changes.As the legal property owner, I acknowledge, understand, and agree
by my signature below, that the permit will revert to me and I will be responsible for complying with the DEMLR
Stormwater permit if the property purchase, lease or developer agreementicontract is cancelled or defaults. I
understand that any individual or entity found to be in noncompliance with the provisions of the stormwater
management permit or the stormwater rules, is subject to enforcement action as set forth in NC General Statute
(NCGS) 143,Article 21.
Signature of the property owner
1, mond a Notary Public for the State of
County of Dn:6nl,� , do hereby certify that
5un= E=ffi ne personally appeared before me this the ( tM—day of
20�, and acknowledge the due execution of the forgoing instrument. Witness
my hra and official seal,
(Notary Seal) tS t ID tFI&
Z.
�O
? Notary Public * =
Notary Signature�ffl = Onslow
County =
My commission expires
y''o rH CAPO�\ \
'CE0 IV`E,
AUG 09 2019
w:
BY:-- - -----
Stormwater Permit Transfer Application Form Page 7 of 7 April 27,2018

Permit No. SW
y4v 601
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
OFF-SITE SYSTEM SUPPLEMENT
FOR DEVELOPMENT DRAINING TO PERMITTED OFF-SrrE TREATMENT SYSTEMS
This form may be photocopied for use as an original
DWO Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, an
off-site system supplement for each off-site stormwater treatment system, appropriate supplement forms for
any on-site stormwater treatment systems; and plans and specifications showing all stormwater conveyances
and drainage details for the project.
I. PROJECT INFORMATION
Project Name : "S Fe✓cn s a 1 o In - S�ie��®d�� �ro n er f!Ps
Contact Person: ec,,-C aL-Phone Number: (9/0 1343-9ooZ
Is all drainage from the project directed to the off-site system? (circle one): es No
H. OFF-SITE SYSTEM INFORMATION (please complete the following information for the off-site
system that will treat runoff from your project):
Pernut No. 0 D D 5�
Project Name: 6fe✓e�s,s U n a a_4 Ap Q o
Type of System(wet pond, infiltration basin, etc.): t �� ✓•��l
Lot No. (if part of a subdivision): ---
How much built up n area draining to the permitted treatment system has been allocated to this
project? a r 5,9
III. REQUIRED ITEMS CHECKLIST
Prior to issuing an off-site pem-dt, verification of the following information must be provided. Initial in the
space provided to indicate that the following requirements have been met and supporting documentation is
.attached. If the applicant has designated an agent in the Stormwater Management Permit Application Form,
he agent may initial below. If a requirement has not been met, attach justification.
Form SWU-106 Ver 3.99 Page I of 2

'App?ricaiits Initials
(To th_- rcco.dec a. Deed restrictions limiting the built-upon area on the site have been recorded.
r, b. Engineers certification for the existing off-site system has been submitted to DWQ.
j(Z. c. There are no outstanding Notices of Violation for the off-site system.
µ,2. d. Off-site system is in compliance with the issued permit.
IV. STORMWATER COLLECTION SYSTEM MAINTENANCE REQUIREMENTS
1. Mowing will be accomplished as needed according to the season. Grass height will not exceed six inches
at any time.
2. Accumulated sediment and trash will be removed from the collection system as necessary. Swales and
ditches will be reseeded or sodded following sediment removal.
3. Eroded areas of swales and ditches will be repaired and reseeded. Swales and ditches will be revegetated
as needed based on monthly inspections.
4. The collection system, including catch basins, curb cuts, velocity reduction devices, and piping, will be
inspected monthly or after every significant runoff producing rainfall event. Trash and debris will be
cleared away from grates, curb cuts, velocity reduction devices, and piping.
5. The collection system may not be altered in any way without prior approval from NCDENR Division of
Water Quality.
I acknowledge and agree by my signature below that I am responsible for maintaining the stormwater
collection system in accordance with the five 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.
Print Name and Title: O. Sfe✓es.sor lnw,, ,,7 er-
Address: — c Zoa
Phone: — Date: 3,h1Q�
Signature: ZV/
Note: The legal 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.
1, Lt n/U t7 LU /C i/71/32 LGL ,a Notary Public for the State of 1)0 K.T* Gge6blJ4,County of
P2 N do hereby certify that S H rJ S'T£✓F N S o N personally appeared before me this
s-t day of 960 and acknowledge the due execution of the forgoing infiltration
basin maintenance requirements. Witness my hand and official seal,
SEAL My commission expires'/ Zoo '
Form SWU-106 Rev 3.99 Page 2 of 2