SW8990940_CURRENT PERMIT_20240122

STORMWATER DIVISION CODING SHEET
POST-CONSTRUCTION PERMITS
PERMIT NO. SW8
DOC TYPE 2 CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE �`f o( d
YYYYMMDD

d,;.SfATpp
�y Wad
ROY COOPER
Governor
ELIZABETH S.BISER W�
Secretary
WILLIAM E.TOBY VINSON,JR NORTH CAROLINA
lnfertm Director Environmental Quality
January 22"d, 2024
Southport Property,LLC
Attn: John Clarke, Manager
5 Park PI,#409
Annapolis,Maryland 21401
Subject: Permit Renewal
Post-Construction Stormwater Management Permit No. SW8990940
Walgreens Southport
Brunswick County
Dear Mr. Clarke:
The Division of Energy, Mineral and Land Resources received a complete 8-year Permit Renewal Application for
the subject permit on January 11", 2024. The Division is hereby notifying you that permit SW8990940 has been
renewed, updated, and re-issued on January 22"d, 2024, as attached. Please be aware that the renewal and re-
issuance of this stormwater permit does not imply that the site is currently in compliance.
This permit shall be effective until December 16",2031, and does not supersede any other agency permit that
may be required. The project shall be subject to the conditions and limitations as specified therein. This permit
does not impose new or increased stormwater control requirements; it clarifies the rules and requirements of this
program to provide you with a better understanding of your obligations under this permit. Failure to comply with
these requirements will result in future compliance problems. Please note that this permit is not transferable
except after notice to and approval by the Division.
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 concerning this permit, please contact Logan Inman in the Wilmington Regional Office,
at(910) 796-7215 or [e-mail].
Sine
.N,-,William E. Toby Vinson,Jr., PE,CPM, Interim Director
Division of Energy,Mineral and Land Resources
Enclosures: Attachment C—Permitting History
copy of the Renewal Application Documents
DES/Iwi: %Stormwater\Permits&Projects\1 999\990940 HD\2024 01 permit 990940
cc: Wilmington Regional Office Stomlwater File
�D_FQ North Carolina Department of Environmental Quality I Division of Energy,Mineral and Land Resources
Wilmington Regional Offlce 1127'Cardinal Drive Extension I Wilmington,North Carolina 28405
910.796.7215

I State Stormwater Management Systems
Permit No. SW8 990940
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
POST-CONSTRUCTION STORMWATER MANAGEMENT PERMIT
HIGH DENSITY COMMERCIAL DEVELOPMENT
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
Southport Property, LLC
Walgreens - Southport
1531 North Howe Street, Southport, Brunswick County
FOR THE
operation and maintenance of six (6) sand filters in compliance with the provisions of 15A NCAC
2H .1000 effective September 1, 1995 (hereafter referred to as the "stormwater rules') and as
outlined in the application, approved stormwater management plans, supplement, calculations,
operation and maintenance agreement, recorded documents, specifications, and other
supporting data (the "approved plans and specifications") as attached and/or on file with and
approved by the Division of Energy, Mineral and Land Resources (the "Division" or "DEMLR").
The project shall be constructed, operated, and maintained in accordance with these approved
plans and specifications. The approved plans and specifications are incorporated by reference
and are enforceable part of this permit.
This permit shall be effective from the date of issuance until December 16`", 2031, and shall be
subject to the following specified conditions and limitations. 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 condition. The issuance
of this permit does not prohibit the Director from reopening and modifying the permit, revoking,
and reissuing the permit, or terminating the permit for cause as allowed by the laws, rules, and
regulations contained in Title 15A NCAC 2H.1000 and NCGS 143-215.1 et.al.
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.
Page 1 of 5

State Slormwater Management Systems
Permit No. SW8 990940
2. A series of six (6) sand filters has been approved for the management of stormwater
runoff as described in Section 1.6 of this permit. Each sand filter has been designed to
handle the runoff from a maximum amount of built-upon area as follows: #1 @ 12,200
square feet; #2 @ 2,614 square feet; #3 @ 10,020 square feet; #4 @ 1,742 square feet,
#5 @ 10,890 square feet; #6 @ 1,742 square feet.
3. The stormwater control has been designed to handle the runoff from 39,208 square feet
of impervious area.
4. The tract will be limited to the amount of built-upon area indicated in this permit, and per
approved plans. The built-upon area for the future development is limited to 0 square
feet.
5. All stormwater collection and treatment systems must be located in either dedicated
common areas or recorded easements. The final plats for the project will be recorded
showing all such required easements, in accordance with the approved plans.
6. The runoff from all built-upon area within the permitted drainage area of this project must
be directed into the permitted stormwater control system.
7. The following design criteria have been permitted for the sand filter and must be
provided and maintained at design condition:
Drainage Area, acres: 1.11
Onsite, ft2: 48,351
Offsite, ft': 0
Total Impervious Surfaces, ft2: 38,821
Design Storm, inches: 1
Sand Filter#: 1 2 3 4 5 6
Sand Depth, inches: 18" 181, 18" 18" 18" 18"
Invert Elevation, FMSL: 19.5 19.95 21.25 19.75 19.5 20.25
Drainage Area, ft2: 12,200 2,614 10,020 1,742 10,890 1,742
Total Impervious Surfaces, ft2: 12,200 2,614 10,020 1,742 10?8901,742
Offsite Area entering Filter, ft2: None, per Engineer
Required Surface Area, ft': 202 43 166 29 180 29
Provided Surface Area, ft': 224 64 192 32 192 32
Required Storage Volume, ft3: 302 65 248 43 270 43
Provided Storage Volume, ft': 336 96 288 48 288 48
Top of Weir Elevation, FMSL:21 21.45 22.75 21.25 21 21.75
Controlling Orifice, pipe: 61,cp 6"T 6"cp 6"cp 6"cp 6"tp
Receiving Stream/River Basin: Price Creek/Cape Fear River
Stream Index Number: 18-88-3
Classification of Water Body: "SC SW'
II. SCHEDULE OF COMPLIANCE
1. The stormwater management system shall be constructed in its entirety, operational for
its intended use prior to the construction of any built-upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of the
system will be repaired immediately.
Page 2 of 5

State Stormwater Management Systems
Permit No. SW8 990940
3. The permittee shall at all times provide the operation and maintenance necessary to
assure the permitted stormwater system functions at the design condition. The approved
Operation and Maintenance Plan must be followed in its entirety and maintenance must
occur at the scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Debris removal and unclogging of the filter media, orifice devices, catch basins,
and piping.
d. Access to the sediment chamber and sand filter must be available at all times.
4. Records of maintenance activities must be kept and made available upon request to
authorized personnel of DEMLR. The records will indicate the date, activity, name of
person performing the work and what actions were taken.
5. The facilities shall be constructed, operated, and maintained in accordance with the
provisions of this permit, the approved plans and specifications, and the supporting
documents attached to this permit and on file with the Division.
6. Upon completion of construction, prior to issuance of a Certificate of Occupancy, and
prior to operation of this permitted facility, the permittee shall cause a certification from
an appropriate designer for the system installed to be submitted, certifying that the
permitted facility has been installed in accordance with this permit, the approved plans
and specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A modification
may be required for those deviations.
7. Access to the stormwater facilities shall be maintained via appropriate recorded
easements at all times.
8. The permittee is responsible for verifying that the proposed built-upon area for the entire
project does not exceed the allowable built-upon area.
9. No person or entity, including the permittee, shall alter any component shown in the
approved plans and specifications. Prior to the construction of any modification to the
approved plans, the permittee shall submit to the Director, and shall have received
approval for modified plans, specifications, and calculations including, but not limited to,
those listed below. For changes to the project or SCM that impact the certifications, a
new or updated certification(s), as applicable, will be required and a copy must be
submitted to the appropriate DEQ regional office upon completion of the modification.
a. Any modification to the approved plans and specifications, regardless of size
including the SCM(s), BUA, details, etc.
b. Redesign or addition to the approved amount of BUA or to the drainage area.
c. Further development, subdivision, acquisition, lease or sale of any, all or part of the
project and/or property area as reported in the approved plans and specifications.
d. Altering, modifying, removing, relocating, redirecting, regrading, or resizing of any
component of the approved SCM(s), the stormwater collection system and/or
vegetative conveyance shown on the approved plan.
e. The construction of any allocated future BUA.
f. The construction of any permeable pavement, #57 stone area, public trails, or
landscaping material to be considered a permeable surface that were not included in
the approved plans and specifications.
g. Other modifications as determined by the Director.
Page 3 of 5

State Stormwater Management Systems
Permit No. SW8 990940
III. GENERAL CONDITIONS
1. CORRECTIVE ACTIONS REQUIRED. If the facilities fail to perform satisfactorily, the
permittee shall take immediate corrective actions. This includes actions required by this
Division and the stormwater rules such as the construction of additional or replacement
on-site stormwater systems. These additional or replacement measures shall receive a
permit from the Division prior to construction.
2. PERMIT RENEWAL. A permit renewal request must be submitted at least 180 days
prior to the expiration date of this permit. The renewal request must include the
appropriate application, documentation and the processing fee as outlined in Title 15A
NCAC 02H.1045(3).
3. CHANGES TO THE PROJECT NAME, PERMITTEE NAME OR CONTACT
INFORMATION. The permittee shall submit a completed Permit Information Update
Application Form to the Division within 30 days to making any one of these changes.
4. TRANSFER. This permit is not transferable to any person or entity except after notice to
and approval by the Director. Neither the sale of the project and/or property, in whole or
in part, nor the conveyance of common area to a third party constitutes an approved
transfer of the permit.
a. TRANSFER REQUEST. The transfer request must include the appropriate
application, documentation and the processing fee as outlined in 15A NCAC
02H.1045(2). This request must be submitted within 90 days of the permit holder
meeting one or more of the following:
i. A natural person who is deceased;
ii. A partnership, limited liability corporation, corporation, or any other business
association that has been dissolved,
iii. A person or entity who has been lawfully and finally divested of title to the
property on which the permitted activity is occurring or will occur through
foreclosure, bankruptcy, or other legal proceeding.
iv. A person or entity who has sold the property, in whole or in part, on which the
permitted activity is occurring or will occur.
V. The assignment of declarant rights to another individual or entity;
vi. 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);
b. TRANSFER INSPECTION. Prior to transfer of the permit, a file review and site
inspection will be conducted by Division personnel to ensure the permit conditions
have been met and that the project and the on-site stormwater system complies with
the permit conditions. Records of maintenance activities performed to date may be
requested. Projects not in compliance with the permit will not be transferred until all
permit and/or general statute conditions are met.
5. COMPLIANCE. The permittee is responsible for compliance with the terms and
conditions of this permit until the Division approves the transfer request.
a. APPROVED PLANS AND SPECIFICATIONS. A copy of this permit, approved
plans, application, supplement, operation and maintenance agreement, all applicable
recorded documents, and specifications shall be maintained on file by the permittee
at all times.
b. DIVISION ACCESS. The permittee grants Division Staff permission to enter the
property during normal business hours to inspect all components of the permitted
project.
Page 4 of 5

State Stormwater Management Systems
Permit No. SW8 990940
c. ENFORCEMENT. Any individual or entity found to be in noncompliance with the
provisions of a stormwater management permit or the requirements of the
stormwater rules is subject to enforcement procedures as set forth in NCGS 143
Article 21.
d. ANNUAL CERTIFICATION. The permittee shall electronically submit to the Division
an annual certification completed by either the permittee or their designee confirming
the project's conformance with permit conditions.
e. OBTAINING COMPLIANCE. 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 modified plans and certification in writing to the
Director that the changes have been made.
f. OTHER PERMITS. The issuance of this permit does not preclude the permittee from
complying with and obtaining any other permits or approvals that are required for this
development to take place, as required by any statutes, rules, regulations, or
ordinances, which may be imposed by any other Local, State or Federal government
agency having jurisdiction. Any activities undertaken at this site that cause a water
quality violation or undertaken prior to receipt of the necessary permits or approvals
to do so are considered violations of NCGS 143-215.1, and subject to enforcement
procedures pursuant to NCGS 143-215.6.
Permit renewed, updated, and reissued this the 22nd day of January 2024.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
William E. Toby Vinson, Jr., PE, CPM, Interim Director
Division of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW8 990940
Page 5 of 5

Attachment C-Permitting History
W algreens-Southport
Permit No.SW8 990940
Approval Permit Action BM4S Date version Description of the Changes Modified Plan Sheets
12/16/1999 Original 1.0 construction,operation and maintenance of 7 sand filters in compliance with
Approval the provisions of 15A NCAC 2H.1000.#I @ 12,200 ft';42 @2,614 ft';43
a 1 020 ft';#4 a 1,742 ft2;#5 @10,890 ft';#6 a 1,742 ft';and#7 @871 ft'.
7/24/2009 Renewal 2.0 expired 12/16/2023
Removed a sand filter.(6)sand filters has been approved for the management
2/112015 Plan Revision 2 l of stormwater runoff.Each sand filter has been designed to handle the runoff
from a maximum amount of built-upon area as follows:#1 @ 12,200 square
feet;#2 @ 2,614 square feet;#3 @ 10,020 square feet;#4 @ 1,742 square
feet;#5 a 10,890 square feet;#6 @ 1,742 square feet
2/112015 Transfer 2.2 ownership transfer from Ross-Civello Development Inc.to Southport Property,LLC
1/222024 Renewal 3.0 Expires 12/162031
Page 1 of 1

SAND FILTERS OPERATION AND MAINTENANCE AGREEMENT
1. After every runoff producing rainfall event and at least monthly inspect the system
for trash accumulation and general condition.
2. At least once a year each filter must be inspected after a rainfall event to determine if
the filter bed is passing the runoff within 24 hours.
3. The following maintenance operations must be performed when storms of
approximately one inch are not passing through the filter within-, 24 hours.
a. The first two or three inches of discolored sand must be removed from the sand
filter and replaced with new sand. Note that the removal sand shall be dewatered,
if necessary, and the land filled.
b. The sediment chamber shall be pumped and cleaned. It is also likely that the
sediment removed will need to be dewatered prior to landfill disposed.
I acknowledge and agree by my signature below that I am responsible for the
performance of the above maintenance procedures. I agree to notify D WQ of any
problems with the system or changes in the name of the project, responsible party, or
address. 1qq! -Ao %S
Print name: Ross-Civello Devgdopment_ Jelly ( 1 rGiEWiYtI CL 4",'1 FCIq¢.K.a
Address: 2522 S. Tri-Center Blvd. Durham. NC 27713 at\CNtx6 Ifla �p STEVEHSottt( mD�IWo(�
Phone: [phone]
Title: Dire DirecQ ofPlannine on truction
Signature.-
Date: �'/ o `1 g Z O 15-
1, /a%iMM/ I-FCA."egl a Notary Public for the State of /la gi,y GA/i c LiNA,
County of do hereby certify that `/
personally appeared before me on this day of •S7/c/727 A zr � 19�,
and acknowledge the due execution of the forgoing infiltration system maintenance
requirements. Witness my hand and official seal,
¢ SL�Lj* V •'sz=
M co fission expires //- /�/-Z liO�;s, FJo
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NDWEEK NESMRRmmYgbn .
. C

DEMLR USE ONLY
Dat Re ived Fee Paid IPermit Number
l a = I swsl Lfyoylqo
STATE STORMWATER:
PERMIT INFORMATION UPDATE APPLICATION FORM
There is NO FEE for updating project name or permittee information.
This form is to only to be used by the current permittee to notify the Division of:
1)changes to the Point of Contact(signing official) for the current permittee (LLC, Corporation, HOA or POA);
2) changes to the mailing address, phone number or email address of the current permittee;
3) changes to the name of the project; and
4) changes to the legal corporate name as documented by a Name Change or Merger filed with the NCSOS.
A. NEW PERMIT INFORMATION
State Stormwater Permit Number: SW8990940
Are you updating(check all that apply): If so, please provide the updated information:
❑ Project name
❑ Corporation Name' BAN 1 1 2024
❑ Permit Contact Name2,3
❑ Permit Contact Title
x❑ Mailing AddresS3 5 Park PI#409, Annapolis, MD 21401
x❑ Phone number 301-518-7400
x❑ Email address clarkemgmtCg live.com
Provide documentation such as a Name Change/Merger filed with the NCSOS.
s Provide supporting documentation such as NCSOS filing. The permit contact's position must be in accordance
with 15A NCAC 02H .1040(1).
3 If more than one point of contact or mailing address is being changed, please attach a separate sheet.
B. CERTIFICATION OF PERMITTEE
I, Jack (John) Clarke , the current permittee, hereby notify DEMLR that I am making the
changes as listed in Section A a ve. I further attest that this application for an update to the permit information currently
on file is accurate and co pi o the m knowledge.
Sign /�Date:
I, , a Notary Public for the State of V�`n l d
County of , doorhereby certify that Z
personally appeared before me this the O day of 20_L, and acknowledge the due
execution of the forgoing instrument. Witness my hand and official seal,
ANI BACOT EDWMDS
(Notary Seal) NOTARY PUBLIC STATE OF MARYLAND
My Commsion E FeIxu&y 24,2M
Notary Signature
My commission expires to,;-
Stormwater Permit Information Update Form Page 1 of 1 May 11, 2017

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' DEMUR USE ONLY
i Date a ived Fee Paid Permit Number
I '4 to0 5>O o
NC DEQ Division of Energy, Mineral and Land Resources
STATE STORMWATER:
PERMIT RENEWAL APPLICATION FORM
In accordance with 15A NCAC 2H.1045(3), the current permit holder shall renew their high density permit 180 days
prior to its expiration. Renewed permits are valid for a period of 8 years pe essipa Law 2QQ11 398(SB 781)
Section 60.(c). This application form is for permit renewals only. Et�� 1�u �
A. PROJECT INFORMATION
JAN 11 2024 I
1. BY, State
Stormwater Permit Number: S W $ 0110''pp014 D {—
2 ��a...��i'>`eM� SOu.."C�.-PD'(' \ Project
name:
3.
J
S 31 N � �oL,,)e �'t Project
street address: o r
City: County: PifLly�SLJ �L�C ZIP :
4. i_ What, if
any, changes have been made to the project as permitted? 5_" �j` lcT 7 W a.5
C�r+Ol3G0 . A-lo 0 ,,0.`` ,i lJCDI=N a `I' 2-111 �201s
If the project has chang d from the original lapproved plans, please complete SWU-101 for a Major
Modification or Minor Modification Application form available at: https://deg.nc.gov/about/divisionsienergy-
mineral-land-resources/energy-mineral-land-ru les/stormwater-program/post-construction.
B. PERMITTEE INFORMATION
If changes to the permittee or project name have been made, please complete either the Permit Update form
or the Permit Transfer form available at. https://deg.nc.gov/about/divisions/energv-mineral-land-
resources/energv-mineral-land-rules/stormwater-program/post-construction. State Stormwater Permits do not
automatically transfer with the sale of the property. 1
1. Current Permit Holder's Company Name/Organization: w crT L L
2. Signing Official's Name: a�n L6 C. AGk )ti C 10.
3. Signing Official's Title: M O.VVP_ a c-
4. Mailing Address: g Po-C� Q HDc\
Y City: Cy\n a7 p l 1, < State: (y ZIP : Z 1 42) 1
5. Street Address: o
City: S° State: ZIP :
6. Phone: (30 LQail: c to-+"Ke- U'C , G o YvL
EGEO lv/ E
JAN 1 12024
BY:
Stormwater Permit Renewal Form Page 1 of 3 May 11,2018

C. SUBMITTAL REQUIREMENTS
Submit the application package to the appropriate DEMLR Regional Office (Coastal, SA Waters) or DEMLR
Central Office (Urbanizing Areas Ph 2, USMP, Non-Coastal HQW/ORW). Only applications packages that
include all required items listed below will be accepted and reviewed.
Initial each,item below to indicate that the required information is provided in the application package:
F75p.Dv
1. A permit application processing fee of%&J-08 payable to NCDEQ.
= 2. One original signed hard copy and one electronic copy of this completed form. The signing official
named on this application to represent the current permittee must meet one of the following:
a. Corporation—a principle executive officer of at least the level of vice-president;
b. Limited Liability Company (LLC)—a manager or company official as those terms are defined
in G.S. 57D"North Carolina Limited Liability Company Act;"
c. Public Entity—a principal executive officer, ranking official, or other duly authorized employee;
d. Partnership or limited partnership—the general partner;
e. Sole proprietor, or
f. Letter of authorization signed by one of the signatories noted in a—e above authorizing the
signature of another entity.
tvfi 3. One hard copy and one electronic copy of recorded documents required by the original permit that
have not yet been received by DEMLR, including: deed restrictions, protective covenants,
condominium/planned community declaration and easements. If the project has been built, include
documentation that the maximum BUA per lot or maximum total BUA has not been exceeded. If
the project has not been built, include a signed agreement that the final recorded deed restrictions
and protective covenants will be submitted at a later date.
4. 0&j4 Agreements, Please select one:
[L] I have a copy of the current recorded O&M Agreement for all SCMs, and I will continue to
keep this on file with the permit; or
❑ I do not have a copy of the current recorded O&M Agreement for all SCMs and am
requesting a copy be sent to me. I agree to keep this on file with the permit.
A5. D�e ' ner Certifications, Please select one:
v� A copy of the certification(s)confirming that the project was built in accordance with the
approved plans have been previously provided to the Division; or
❑ A copy of the certification(s) confirming that the project was built in accordance with the
approved plans are enclosed; or
❑ The project has not yet been built.
NA6. [IF APPLICABLE] If the project has been built, one original hard copy and one electronic copy of a
signed, sealed, and dated letter from a licensed professional stating that the SCMs have been
inspected, and that they have been built and maintained in accordance with the permit.
7. [IF APPLICABLE]When the permittee is a corporation or a limited liability corporation (LLC):
Provide one hard copy and one electronic copy of documentation from the NC Secretary of State,
or other official documentation, which supports the titles and positions held by the persons listed in
Section C.2 per 15A NCAC 2H. 1043(3)(b).
httns:llwww.sosnc.00vlonline serviceslsearchlbv trrittel Burrsiines��sA/Registration
ELGECI �J E
JAN 1 1 2024 _
BY:
Stormwater Permit Renewal Application Form Page 2 of 3 May 11,2018

1 '
D. PERMITTEE'S CERTIFICATION —
I, .To)nv� �TacK� C'(a J�t Y , the person legally responsible for the permit, certify that I have
a copy of the Permit and O&M Agreement on site(or I will obtain a copy and it will be kept on site), that I am
responsible for the performance of the maintenance procedures, and the site has been and will be maintained
according to the O&M Agreement and approved plans. I agree to notify DEMLR of any problems with the SCMs
or built-upon area and to submit the proper forms to modify or transfer the permit prior to any changes to the
project, SCMs, or ownership. All information provided on this permit renewal application is, to the best of my
knowledge, correct and co
Signa Date:
NOTARIZAT ON:
1, - a Notary Public for the State of
County of j4 dQ I , do hereby certify
that personally appeared before me
this the SZ day of 20 , and acknowledge the due
execution of the forgoing instrument ditness my hand and official seal,
ANN BACOT EDWARDS
NOTARY PUBLIC STATE OF MARYLA.ND
(Notary Seal) W COMM 0A EVM FdXLWy 24,202t
Notary Signature: �d
My commission expires
ECEU Uri' E
IAN 1 11111
BY:
Stormwater Permit Renewal Application Form Page 3 of 3 May 11,2018

i ,
8312CreedmoorRoad Raleigh,NC27613
COMMERCIAL 919.848.6121 Phone [phone] Fax
SITE DESIGN www . csitedesign . coIn
August 18, 2009
Kerr Drug—Southport
Stormwater Permit No. SW8 990940
Brunswick County
Designer's Certification
1, W. Brian Burchett as a duly registered engineer in the State of North Carolina, have been
authorized to observe the as-build construction of the project, Kerr Drug @ Southport, NC for
Ross-Civello Development, Inc. hereby state that, to the best of my abilities, due care and diligence
was used in the observation of the project as-built construction such that the project was observed to
be built within substantial compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
•`•`� (H CARO��''%
ESS%O`N
o y
24501
9 GINErPi U?j
,��gllll<tttt•�,
04
Signature: SEAL
Registration Number:
Date: O2� Sad
6,40
AUG 2 5 2009
BY'--�_____

Kerr Drug—Southport,NC—Designer's Certification
August 18,2009
Page 2 of 2
Certification Requirements:
-A 1. The drainage area to the system contains approximately the permitted acreage.
__/12, The drainage area to the system contains no more that the permitted amount of built-upon
area.
3. All the built-upon area associated with the project is graded such that the runoff drains to
the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The sand filter elevations are per the approved plan.
6. The sand filter is located per the approved plans.
7. The inlets are located per the approved plans and do not cause short-circuiting of the
system.
8. The permitted amounts of surface area and /or volume have been provided.
9. Required drawdown devices are correctly sized and located per the approved plans.
10. All permitted design depths are provided.
11. All required parts of the system are provided such as the sedimentation chamber and the
sand filter chamber.
12. The permitted dimensions of the system are provided, per the approved plan.
cc: NCDENR— DWQ Regional Office
Inspector, Brunswick County Building Inspections