19960933 Ver 1_Modifications_20080730

TfiaaqDesign
Group
4807-C Koger Blvd.
Greensboro, NC 27407
Phone [phone]
Fax [phone]
at to -b133
TRANSMITTAL LETTER
Date: July 29, 2008
To:Annette Lucas
N. C. Division of Water Quality
Wetlands/401 Certification Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
Project: Mylan Stormwater Ponds
Greensboro, NC
We Transmit:
( x ) herewith
( ) under separate cover
The Following:
Copies Date
1 July 29, 2008
1 April 15, 2008
1 July 15, 2008
1 July 15, 2008
1 July 28, 2008
kf?@29161E B
JU6 3 0 2008
DENR - WATER QUALITY
WETLANDS AND STORMWATER BRANCH
Project No.: 08-009/D
For Your:
( x) approval
( ) review & comment
( ) use
Description
Cover Letter
Storm Water Plans (to modify existing
approved plan)
Checklist
Wet Detention Basin Supplement (ponds 1 & 2)
Operation & Maintenance Agreement (ponds 1
& 2)
Remarks: If you have any questions or need additional information, please contact
me.
Copies: File
Sue Homewood
Sincerely,
By. '4.1?.. -P.4
J. Anthony Lusk, P.E.
Civil Engineer
P:\2008\Mylan Stormwater Ponds\Wdmin\07-29-08 SW plans to Raleigh DWQ.xmt.wpd
Triad'
Design
Group
ARCHITECTURE
E N G I N E E R I N G
P L A N N I N G
I N T E R I O R D E S I G N
N
PRINCIPALS:
Thomas J. Stone
Mark J. Davis. PE
ASSOCIATES:
Rodney M. Lindsey, AIA
L. Allan Hill, P.E.
Jim 0. White, AIA
0
4807-C Koger Blvd.
Greensboro, NC 27407
Telephone [phone]
Fax [phone]
www.triad-designgroup.com
July 29, 2008
Annette Lucas
N. C. Division of Water Quality
Wetlands/401 Certification Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
RE: Mylan Pharmaceuticals Storm Water Modification
Greensboro, NC
Project no: 08-009/1)
Dear Annette,
We are requesting to modify the existing, approved storm water plan for the Mylan
Pharmaceuticals site. The original approval can be found under DWQ Project
#960933. Proposed changes are shown on the accompanying plans. There will be no
wetland or stream impacts as a result of this modification.
Please feel free to contact me if you have any questions or need more information.
Sincerely,
J. Anthony Lusk, P.E.
Civil Engineer
Permit No. g Lo - C 3 3
1 (to be provided by DWQ)
v
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met. If the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Pagel Plan
Initials Sheet No.
S,ku 0t lU.l B 1. Plans (1" 50' or larger) of the entire site showing:
Design at ultimate build-out,
Off-site drainage (if applicable),
Delineated drainage basins (include Rational C coefficient per basin),
Basin dimensions,
Pretreatment system,
High flow bypass system,
Maintenance access,
Proposed drainage easement and public right of way (ROW),
Overflow device, and
Boundaries of drainage easement.
T?,t_ C, 2 • t 2. Partial plan (1" = 30' or larger) and details for the wet detention basin showing:
Outlet structure with trash rack or similar,
Maintenance access,
Permanent pool dimensions,
Forebay and main pond with hardened emergency spillway,
Basin cross-section,
Vegetation specification for planting shelf, and
Filter strip.
S(- Cz. + 3. Section view of the dry detention basin (1" = 20' or larger) showing:
Side slopes, 3:1 or lower,
Pretreatment and treatment areas, and
Inlet and outlet structures.
SqL- G1,1It, b U • 6 4. If the basin is used for sediment and erosion control during construction, clean out of the basin is specified
on the plans prior to use as a wet detention basin.
3A, L Pq L?: 5. A table of elevations, areas, incremental volumes & accumulated volumes for overall pond and for forebay,
to verify volume provided.
'V'L_ t=l •t k , C1 .113 6. A construction sequence that shows how the wet detention basin will be protected from sediment until the
entire drainage area is stabilized.
.
??L C2? caf e tt%c7. The supporting calculations.
SAIL ? 8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
9. A copy of the deed restrictions (if required).
l?L 10. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. County
soil maps are not an acceptable source of soils information.
Form SW401-Wet Detention Basin-Rev.4 Part III. Required Items Checklist, Page 1 of 1
• Permit No.
(to be provided by DWQ)
i
1
NCDENR °
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information.
Project name
Contact person
Phone number
Date
Drainage area number
A' 4L..h4 Lush
(.336) 2- 6t - $L$ Z
II. DESIGN INFORMATION
Site Characteristics
Drainage area ft2
Impervious area ft2
% impervious %
Design rainfall depth l,p in
Storage Volume: Non-SR Waters
Minimum volume required Zk. 347 ft3
Volume provided 6-7)(2-5 ft3
Storage Volume: SR Waters
1-yr, 24-hr runoff depth in
Pre-development 1-yr, 24-hr runoff ft3
Post-development 1-yr, 24-hr runoff ft3
Minimum volume required ft3
Volume provided ft3
Peak Flow Calculations
1-yr, 24-hr rainfall depth in
Rational C, pre-development (unitless)
Rational C, post-development p, g (unitless)
Rainfall intensity: 1-yr, 24-hr storm in/hr
Pre-development 1-yr, 24-hr peak flow ft3/sec
Post-development 1-yr, 24-hr peak flow 1. 20 ft3/sec
Pre/Post 1-yr, 24-hr peak flow control ft3/sec
Basin Elevations
Basin bottom elevation 14 $,p ft
Sediment cleanout elevation -t?t9, p ft
Bottom of shelf elevation 1St • S ft
Permanent pool elevation •15Z• p ft
SHWT elevation ft
Top of shelf elevation -752.S7 ft
Temporary pool elevation -ZSy, p ft
Form SW401-Wet Detention Basin-Rev.4 Parts 1. & II. Design Summary, Page 1 of 2
Permit No
(to be provided by DWQ)
IL DESIGN INFORMATION
Volume and Surface Area Calculations
i SA/DA ratio 2.5 (unitless)
Surface area at the bottom of shelf 23, 005 fts
Volume at the bottom of shelf Gi&G(o ft3
Permanent pool, surface area required ?3 5 5o ftZ
+
Permanent pool, surface area provided 32 000 ft2
Permanent pool volume -2 387- ft3
Average depth for SA/DA tables 3 ft
Surface area at the top of shelf ZI.95FS ftz
Volume at the top of shelf (gp ft3
Forebay volume 2$p ft3
Forebay % of permanent pool volume j2 A4
Temporary pool, surface area provided
_5ft2
_ 35 I2
Drawdown Calculations
Treatment volume drawdown time 2.57 days
Treatment volume discharge rate 0.5( ft3/s
Pre-development 1-yr, 24-hr discharge ft3/s
Post-development 1-yr, 24-hr discharge ft3/s
Additional Information
Diameter of orifice 42) .. y in
Design TSS removal gs %
Basin side slopes 3 :1
Vegetated shelf slope to :1
Vegetated shelf width ? p ft
Length of flowpath to width ratio 2, 3 :1
Length to width ratio 2. 3 :1
Trash rack for overflow & orifice? (Y or N)
Freeboard provided 2 ft
Vegetated filter provided? V (Y or N)
Recorded drainage easement provided? 'Y (Y or N)
Capures all runoff at ultimate build-out? Y (Y or N)
Drain mechanism for maintenance or emergencies z) - g" prewAs <16 le Dtcmcnt S?eA"yJ ?t
Form SW401-Wet Detention Basin-Rev.4 Parts I. & II. Design Summary, Page 2 of 2
Permit No. t0 ' ° 0, 3 3
(to be provided by DWQ)
Please complete the yellow shaded items.
of wATF9
v? 7
=AUMV -0
NCDENR ril
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part III) must be printed, filled out and submitted along with all of the required information.
Project name
Contact person
Phone number
Date
Drainage area number
(3U) 2.115- $ZFSZ
V,j l5, Z6d$
11. DESIGN INFORMATION
Site Characteristics
Drainage area )10 ft2
Impervious area 2
2 ft
1714
% impervious %
Sg
Design rainfall depth - p in
Storage Volume: Non-SR Waters
Minimum volume required Z(FS 211 ft3
Volume provided ft3
Storage Volume: SR Waters
1-yr, 24-hr runoff depth in
Pre-development 1-yr, 24-hr runoff - - ft3
Post-development 1-yr, 24-hr runoff ft3
Minimum volume required ft3
Volume provided ft3
Peak Flow Calculations
1-yr, 24-hr rainfall depth .. 17- in
Rational C, pre-development (unitless)
Rational C, post-development O . &,47 (unitless)
Rainfall intensity: 1-yr, 24-hr storm I ( in/hr
L
L11
Pre-development 1-yr, 24-hr peak flow _
-
ft3/sec
Post-development 1-yr, 24-hr peak flow ft3/sec
Pre/Post 1-yr, 24-hr peak flow control ft3/sec
Basin Elevations
Basin bottom elevation - 7 5-f ft
Sediment cleanout elevation X357 ft
Bottom of shelf elevation 167.5 ft
Permanent pool elevation ?13g ft
SHWT elevation ft
Top of shelf elevation 3?s , 5, 5 ft
Temporary pool elevation -7 L4Ci ft
?04_? 71-
Form SW401-Wet Detention Basin-Rev.4 Parts I. & II. Design Summary, Page 1 of 2
t
Permit No.
(to be provided by DWQ)
IL DESIGN INFORMATION
Volume and Surface Area Calculations
SA/DA ratio 2.33 (unitless)
Surface area at the bottom of shelf 4.3l ftZ
j o1
Volume at the bottom of shelf ,
ZSg , 629 ft3
Permanent pool, surface area required Lo?? ftz
J
Permanent pool, surface area provided I I
p p ftZ
Permanent pool volume 3i qq ft3
Average depth for SA/DA tables 3 ft
Surface area at the top of shelf ?Z( S CFc ftZ
Volume at the top of shelf
3
p !o ft
Forebay volume (oZ? 3iz ft3
Forebay % of permanent pool volume 21 S %
Temporary pool, surface area provided lit 4 ffZ
Drawdown Calculations
Treatment volume drawdown time 3,$ days
Treatment volume discharge rate '1 O ft3/s
Pre-development 1-yr, 24-hr discharge ft3/s
Post-development 1-yr, 24-hr discharge ft3/s
Additional Information
Diameter of orifice ( _Z?- (o in
Design TSS removal _R5 %
Basin side slopes 3 :1
Vegetated shelf slope I:1
Vegetated shelf width ?p ft
Length of flowpath to width ratio
Length to width ratio
Trash rack for overflow & orifice? (Y or N)
Freeboard provided Z ft
Vegetated filter provided? (Y or N)
Recorded drainage easement provided? (Y or N)
Capures all runoff at ultimate build-out? (Y or N)
Drain mechanism for maintenance or emergencies N-r-kM
Form SW401-Wet Detention Basin-Rev.4 Parts I. & II. Design Summary, Page 2 of 2
Permit Number: ` (.# -DR 33

(to be provided by DWQ)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
-RoY"? 1
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
The wet detention basin system is defined as the wet detention basin,
pretreatment including forebays and the vegetated filter if one is provided.
This system (check one):
? does Y does not
This system (check one):
? does fA does not
incorporate a vegetated filter at the outlet.
incorporate pretreatment other than a forebay.
Important maintenance procedures:
Immediately after the wet detention basin is established, the plants on the
vegetated shelf and perimeter of the basin should be watered twice weekly if
needed, until the plants become established (commonly six weeks).
No portion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
If the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected once a month and
within 24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a
Coastal County). Records of operation and maintenance should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element: Potential problem: How I will remediate the problem:
The entire BMP Trash/ debris is resent. Remove the trash/ debris.
The perimeter of the wet Areas of bare soil and/or Regrade the soil if necessary to
detention basin erosive gullies have formed. remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
Vegetation is too short or too Maintain vegetation at a height of
long. approximately six inches.
Form SW401-Wet Detention Basin O&M-Rev.3
Page 1 of 4
Permit Number:
(to be provided by DWQ)
?. Drainage Area Number:
BMP element: Potential problem: How I will remediate the problem:
The inlet device: pipe or The pipe is clogged. Unclog the pipe. Dispose of the
swale sediment off-site.
The pipe is cracked or Replace the pipe.
otherwise damaged.
Erosion is occurring in the Regrade the swale if necessary to
swale. smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay Sediment has accumulated to Search for the source of the
a depth greater than the sediment and remedy the problem if
original design depth for possible. Remove the sediment and
sediment storage. dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred. Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present. Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than s ra in g.
The vegetated shelf Best professional practices Prune according to best professional
show that pruning is needed practices
to maintain optimal plant
health.
Plants are dead, diseased or Determine the source of the
dying. problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Weeds are present. Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The main treatment area Sediment has accumulated to Search for the source of the
a depth greater than the sediment and remedy the problem if
original design sediment possible. Remove the sediment and
storage depth. dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over Consult a professional to remove
50% of the area. and control the algal growth.
Cattails, phragmites or other Remove the plants by wiping them
invasive plants cover 50% of with pesticide (do not spray).
the basin surface.
Form SW401-Wet Detention Basin O&M-Rev.3 Page 2 of 4

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element: Potential problem: How I will remediate the problem:
The embankment Shrubs have started to grow Remove shrubs immediately.
on the embankment.
Evidence of muskrat or Use traps to remove muskrats and
beaver activity is present. consult a professional to remove
beavers.
A tree has started to grow on Consult a dam safety specialist to
the embankment. remove the tree.
An annual inspection by an Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device Clogging has occurred. Clean out the outlet device. Dispose
of the sediment off-site.
The outlet device is damaged Repair or replace the outlet device.
The receiving water Erosion or other signs of Contact the local NC Division of
damage have occurred at the Water Quality Regional Office, or
outlet. the 401 Oversight Unit at 919-733-
1786.
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads -7,_ feet in the main pond, the
sediment shall be removed.
When the permanent pool depth reads 3 feet in the forebay, the sediment
shall be removed.
BASIN DIAGRAM
ill in the blanks)
Permanent Pool Elevation '1$y
Sediment Removal
Bottom
-14 Pe anen Pool
----------------- Volume Sediment Removal Elevation -1149 Volume
i l4g -ft Min. --------------------------------------------- - ----Wr
Sediment Bottom Elevation 1 1-ft Storage Sedime?
FOREBAY
Form SW401-Wet Detention Basin O&M-Rev.3
MAIN POND
Page 3 of 4
Storage
• Permit Number:
L (to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the 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.
Project name: IrY 11gy-, ??atmat 2?{icr.(s, the-.
BMP drainage area number:
Print name:
o 'sr.2 R, T .'o w
Title: n ,c r --' Z 'L 67,1C
Address: '-Z p 5 7 yF.9 L 7,/.4 /-' IC S I D S6 ? N C 17?1O.1 c-X Phone:-
Signature:
?5
Date: o Z,/dt 4/o k
Note: The legally 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.
a Notary Public for the State of
, do hereby certify that
?". , County of qaj=j
ci?czn? personally appeared before me this
day of _ q , and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,
JAN A. Sp0?
aOTARy??
GI?? UBL%G Z.V
?Rp CpV
SEAL
My commission expires i yi zn2ll , __'L 6 1 l
Form SW401-Wet Detention Basin O&M-Rev.3 Page 4 of 4
Permit Number: Q L# -DR 33

(to be provided by DWQ)
Drainage Area Number:
Wet Detention Basin Operation and Maintenance Agreement
Po,j Z-
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
The wet detention basin system is defined as the wet detention basin,
pretreatment including forebays and the vegetated filter if one is provided.
This system (check one):
? does N does not
This system (check one):
? does ® does not
incorporate a vegetated filter at the outlet.
incorporate pretreatment other than a forebay.
Important maintenance procedures:
- Immediately after the wet detention basin is established, the plants on the
vegetated shelf and perimeter of the basin should be watered twice weekly if
needed, until the plants become established (commonly six weeks).
- No portion of the wet detention pond should be fertilized after the first initial
fertilization that is required to establish the plants on the vegetated shelf.
- Stable groundcover should be maintained in the drainage area to reduce the
sediment load to the wet detention basin.
- If the basin must be drained for an emergency or to perform maintenance, the
flushing of sediment through the emergency drain should be minimized to the
maximum extent practical.
- Once a year, a dam safety expert should inspect the embankment.
After the wet detention pond is established, it should be inspected once a month and
within 24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a
Coastal County). Records of operation and maintenance should be kept in a known set
location and must be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element: Potential problem: How I will remediate the problem:
The entire BMP Trash/ debris is resent. Remove the trash/ debris.
The perimeter of the wet Areas of bare soil and/or Regrade the soil if necessary to
detention basin erosive gullies have formed. remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
Vegetation is too short or too Maintain vegetation at a height of
long, a roximatel six inches.
Form SW401-Wet Detention Basin O&M-Rev.3
Page 1 of 4
Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element: Potential problem: How I will remediate the problem:
The inlet device: pipe or The pipe is clogged. Unclog the pipe. Dispose of the
swale sediment off-site.
The pipe is cracked or Replace the pipe.
otherwise damaged.
Erosion is occurring in the Regrade the swale if necessary to
swale. smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
The forebay Sediment has accumulated to Search for the source of the
a depth greater than the sediment and remedy the problem if
original design depth for possible. Remove the sediment and
sediment storage. dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred. Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Weeds are present. Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The vegetated shelf Best professional practices Prune according to best professional
show that pruning is needed practices
to maintain optimal plant
health.
Plants are dead, diseased or Determine the source of the
dying. problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Weeds are present. Remove the weeds, preferably by
hand. If pesticide is used, wipe it on
the plants rather than spraying.
The main treatment area Sediment has accumulated to Search for the source of the
a depth greater than the sediment and remedy the problem if
original design sediment possible. Remove the sediment and
storage depth. dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Algal growth covers over Consult a professional to remove
50% of the area. and control the algal growth.
Cattails, phragmites or other Remove the plants by wiping them
invasive plants cover 50% of with pesticide (do not spray).
the basin surface.
Form SW401-Wet Detention Basin O&M-Rev.3 Page 2 of 4
Permit Number:
(to be provided by DWQ)
Drainage Area Number:
BMP element: Potential problem: How I will remediate the problem:
The embankment Shrubs have started to grow Remove shrubs immediately.
on the embankment.
Evidence of muskrat or Use traps to remove muskrats and
beaver activity is present. consult a professional to remove
beavers.
A tree has started to grow on Consult a dam safety specialist to
the embankment. remove the tree.
An annual inspection by an Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device Clogging has occurred. Clean out the outlet device. Dispose
of the sediment off-site.
The outlet device is damaged Repair or replace the outlet device.
The receiving water Erosion or other signs of Contact the local NC Division of
damage have occurred at the Water Quality Regional Office, or
outlet. the 401 Oversight Unit at 919-733-
1786.
The measuring device used to determine the sediment elevation shall be such
that it will give an accurate depth reading and not readily penetrate into
accumulated sediments.
When the permanent pool depth reads 3 feet in the main pond, the
sediment shall be removed.
When the permanent pool depth reads 3 feet in the forebay, the sediment
shall be removed.
BASIN DIAGRAM
ill in the blanks)
Permanent Pool Elevation 13$
Sediment Removal
Bottom Elevati
X35 ? Pe anen?
------------------ Volume
'13'1 -ft Min.
Sediment
Storage
FOREBAY
Pool
-- Sediment Removal Elevation 73$ ............ Volume
Bottom Elevation ` *3 1-ft n.
Sediment
Storage
MAIN POND
Form SW401-Wet Detention Basin O&M-Rev.3 Page 3 of 4
Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the 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.
Project name:: lcaa, kac mgtpVbm(5, InV. •
BMP drainage area number:
Print name:7- z- s 4gz M o ,,,
Title: 1) ;VjFC7o.Z r_? IC Address: _z F 5 ti, Nv rife maxE,ts .t'u /_',Srf?n,s6<.cc five- .Z7Ya6
Phone: 33,;; yi- 73oa
Signature: _?2 Z 111?
Date: o/.r y fG
Note: The legally responsible party should not be a homeowners aisociation unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
a Notary Public for the State of
_.o ® County of +t , do hereby certify that
L 'C personally appeared before me this
day of ?, and acknowledge the due execution of the
forgoing wet detention basin maintenance requirements. Witness my hand and official
seal,
QJA N A SpOr
XXOTA
13 L?G v
`.ORD COV ,
SEAL
My commission expiresO( e", 114, C-7,16s/
Form SW401-Wet Detention Basin O&M-Rev.3
Page 4 of 4