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Home My WebLink AboutSW3170606 - Randy Marion Chevrolet of StatesvilleSTATESVILLE, NC IREDELL County Mr. Donald. L. Munday, P.E., Piedmont Design Associates, P.A RANDY MARION CHEVROLET OF STATESVILLE &Pa STATESVILLE, NC IREDELL County ��r Mr. Donald. L. Munday, P.E., Piedmont Design Associates, P.A. NC®GN Ft Application Type of application:1 New Permit Only complete application packages will be accepted and reviewed. A complete package includes all of the items in the checklist below. Add any comments, and indicate the page or plan sheet number where the following information can be found. Please indicate that you have provided the following required information by initialing in the space provided next to each item. Part I: Submittal Checklist Item Notes / Comments Initials 1 Original and one copy of this application form (all worksheets) and the permit JCw application fee For applications submitted to the DEMLR regular permitting program, the fee is $505 payable to NCDENR. For Express Review, click on the link below for information and fee schedule. Contact the appropriate regional office Express Review Coordinator to schedule the required pre -application meeting. Click here for Express Permitting info 2 A USGS map identifying the site location. If the receiving stream is reported as Jew-- Cw_class classSA or the receiving stream drains to and is within 1/2 mile of SA waters, then include the 1/2 mile radius on the map. 3 A copy of the most current property deed. JCw 4 Two copies of additional calculations (as needed). Sealed, signed and dated. JCw 5 Two sets of sealed, signed, & dated full-sized plans of the entire site at a JCw readable scale, including. a. Project name, engineer and firm, revision number and dates. JCw b. Location map with street names and SR numbers, legend, north arrow, JCw_ scale. c. Dimensioned property/project boundary with bearings & distances. JCw d. The boundaries of all surface waters, regulatory flood zones, and protected JCw riparian buffers or a note on the plans that none exist e The boundaries of all vegetated or protected riparian buffers. JCw f Site layout showing all built -upon areas, drainage features, stormwater JCw collection systems (inlets, outlets, swales, pipe elevations, slopes and diameters), and SCMs at ultimate build -out g Existing contours, proposed contours, spot elevations, and finished floor JCw elevations. h. Existing drainage (including off-site), drainage easements, pipe sizes, runoff JCw calculations. i Drainage area boundaries (included in the main set of plans, not as a JCw separate document) I Existing and proposed maintenance access routes, utility easements, JCw drainage easements, public rights-of-way etc k. A construction sequence that shows how the SCMs will be protected from JCw sediment until the entire drainage area is stabilized. 6 Two sets of sealed, signed, & dated full-sized plan details of each SCM (or JCw typical if appropriate) in both plan view and cross-section at a scale of 1" = 30' or larger, including a. Dimensions, side slopes, length to width ialios and elevations will) a JCw benchmark for clean-out if appropriate STORM -EZ 6/7/2017 Version 1 4 Application Page 1 of 6 � HCl STATESVILLE, NC IREDELL County Mr. Donald. L Munday, RE , Piedmont Design Associates, P.A b. All applicable conveyance devices, including. bypass structure, JCW pretreatment area, flow distribution device, underdrains, outlet device, outlet dissipater and level spreader. c. A table of elevations, incremental volumes and accumulated volumes (if - - JCW applicable). d. Specifications for applicable materials, such as planting media, aggregate, JCW sod, underdrains, outlet devices, etc. STORM -EZ 6/7/2017 Version 1.4 Application Page 2 of 6 STATESVILLE, NC IREDELL County Mr. Donald. L. Munday, P.E., Piedmont Design Associates, P.A. 7 Two sealed, signed, & dated planting plans for each SCM (or typical) at a scale JCW of 1" = 20' or larger, as applicable, including a. The locations of each species and a planting detail. JCW b. A table summarizing the size, spacing and total quantity of each plant JCW species that should be used c. The source nursery for the plants. TBD d. A one-time fertilizer specification to establish plants if necessary JCW 8 A soils report based on field evaluation indicating the SHWT elevations within N/A the footprints of the proposed SCM(s). Provide a map of the boring locations With the existing elevations and boring logs. For infiltration SCMs, the report shall include the soil type, infiltration rate and method for determining the infiltration rate Sods information shall be signed and sealed by a licensed soil 9 A copy of the signed and notarized operation and maintenance (O & M) JCW agreement. 10 A copy of the proposed deed restrictions protecting the SCMs and limiting the JCW built -upon area so that it does not exceed the capacity of the SCM(s) or the high density threshold (as applicable) NCDENR Deed Restriction Forms 11 For corporations and limited liability corporations (LLC). Documentation from the JCW NC Secretary of State or other official documentation, which supports the titles and positions held by the persons listed in the Contact Information section. The corporation or LLC must be listed as an active corporation in good standing with the NC Secretary of State, otherwise the application will be returned. NC Dept of the Secretary of State 12 A copy of the lease agreement or pending sales agreement if applicable. N/A STORM -EZ 6/7/2017 Version 1 4 Application Page 3 of 6 0,6 Q" I 't, -C� I- ff: STATESVILLE, NC IREDELL County Mr. Donald. L. Munday, P.E., Piedmont Design Associates, P.A. Part If: General Project and Applicant Information Project Name: RANDY MARION CHEVROLET OF STATESVILLE Date: 10 -May -17 Project Street Address: 615 GAITHER ROAD_ Lat: 35.806875 City: STATESVILLE Zip: 28677 Long. -80.882814 Directions to Project FROM 1-40 (EXIT 151) TURNERSBURG HWY. (SR -21), go North 150', Turn County. IREDELL (from nearest intersection) left (WEST) ON Gaither Road (2148 LF) to Driveway Entrance NON -COASTAL Project Applicant: Randy Marion Chevrolet of Statesville, LLC (Identify the corporation, organization, property owner, designated government official, etc. which owns the project.) Owner/ Signing Offical's Name: Title: Address: City. State: Zip: Phone Fax: Email. Randall L. Marion Member Manager PO Box 1559 Mooresville NC 28115-1559 704-659-7037 704-230-1302 ebroach rand marion.com Status of applicant:1 Developer Complete contact information for property owner below. River Basin: Yadkin Receiving Stream(s)- Morrison Creek Stream Class(es): C Surface Water Area (ac). 10.99 Coastal wetland area (ac): N/A Total property area (ac)- 33.99 Total project area (ac). 8.79 Goals/characteristics YES Volume Matching (LID) NO Drains to an offsite stormwater system NO Low Density NO Within 575' of Saltwater ORW YES High Density -YES Within 5 miles of a public airport summarize how the stormwater runoff will be treated: Part III: Permit Information Status of construction INot Started Other permits needed YES Sedimentation & erosion control NO404 Permit / 401 Certification NO I CAMA Major Permit NO Isolated Wetlands Permit NO Threatened & Endangered Species NO NPDES Industrial Stormwater Permit If an application for this project has been previously returned, provide the original project number and previous name of the project None Provide the permit type, number and issue date for any permits that have already been obtained for this If claiming vested rights, then identify (and attach) the supporting documents and approval dates NO Approval of a site-specific development plan or PUD Approval date: NO Valid building permit Issue date. NO Other Date Not Slaited Point of Contact I Phone number STORM -EZ 6/7/2017 Version 1 4 Application Page 4 of 6 STATESVILLE, NC IREDELL County Mr. Donald. L. Munday, P.E., Piedmont Design Associates, P.A. Part IV: Additional Contact Information Property Owner/Organization. Howard Family Investments #1, LLC Signing Official & Title- Linda H. Howard Street address: 403 Deauville Rd City, State, Zip Statesville, NC 28677 Phone number(s): 704-873-9094 Email (Optional) Additional Person / Orgu Signing Official Street a City, St; Phone nur (Note: Person/Organization noted above may be contacted for additional project information if applicant cannot be reached.) Part V: Consultant Information Complete this section if you wish to designate authority to another Individual or firm so that they may provide Information on your behalf for this project (such as addressing requests for additional information). Consultant: Firm: Street address. City, State, Zip - Phone number(s): Email Mr. Donald. L. Munday, P.E. Piedmont Design Associates, P.A. 125 East Plaza Drive, Suite 101 Mooresville, NC 704-664-7888 dmundavCcDpdapa com STORM -EZ 6/7/2017 Version 1.4 Application Page 5 of 6 STATESVILLE, NC IREDELL County Mr. Donald. L. Munday, P.E , Piedmont Design Associates, P.A. Part VI: Property Owner Authorization I, (the Property Owner listed above), Dawn Properties, LLC , certify that I own the property identified in this permit application and thus give permission to (the Applicant), Randy Marron Chevrolet of Statesville, LLC to develop the project as currently proposed. A copy of the lease agreement or pending property sales contract has been provided with this submittal, which indicates the party responsible for the operation and maintenance of the stormwater system. As the legal property owner, I acknowledge, understand and agree by my signature below, that if my designated agent (listed as the Applicant above) dissolves his/her company or cancels/defaults on his/her lease agreement or pending sale, responsibility for compliance with the DEMLR stormwater permit reverts back to me, the property owner As the property owner, it is my responsibility to contact DEMLR immediately and submit a completed Name/Ownership Change Form within 30 days; otherwise, I will be oeprating a stormater treatment facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid permit is a violation of NC General Statute 143- 215.1 and may �ulCln a ropriate enforcement action including the assessment of civil penalties up to $25,000 per day, pursuant to NCGS 143-215.6 / Signature: T Date' • �a' -7 I, ,eh e,60'A 0 : FivS�- a Notary Public fq the State of A) G County of P L� -e/i , do Nearby certify that_ rmrla /l L • Q l—i'hr , personally appeared before me thi day of -,J 11-0 U1 `7 , and acknowledge the due execution of thea lic tion for a�tormWater pedmit Witness my hand and official seal, =REBECCAJOSTLICrth Carok Aay 4, 2018 Seal commission expires � /'7"/d G / F Part VII: Applicants Certification I, (the Applicant listed above), Randy Marion Chevrolet of Statesville, LLC , certify that the information included on this permit applicant form is, to the best of my knowledge, correct and that the project will be constructed in conformance with the approved plans, that the required deed restrictusron and protective covenants will be recorded, and that the proposed project complies with the requirements of icable state stormwater rules and requirements. / 1 Signature: I Date a Notary Publicfo the St to of G County of C /C ti°i do hTrby certify that hQ11C A // L J/!,a r/ dl personally appeared before me thi day of t)///7'e -20� , and acknowledge the due execution oft application fo st1 water permit. Witness my hand and official seal, ( iUiY REBECCA J FROST NOTARY PUBLIC hFecklenburg County, North CarOno My Commission Expires May 4, 2018 commission expires Seal 5'bk? STORM -EZ 6/7/2017 Version 1 4 Application Page 6 of 6 STATESVILLE, NC IREDELL County Mr Donald L. Munday, P.E., Piedmont Design Associates, P A Part VI: Property Owner Authorization I, (the Property Owner listed above), Howard Family Investments #1, LLC , certify that I own the property identified in this permit application and thus give permission to (the Applicant), Randy Marion Chevrolet of Statesville, LLC to develop the project as currently proposed A copy of the lease agreement or pending property sales contract has been provided with this submittal, which indicates the party responsible for the operation and maintenance of the stormwater system As the legal property owner, I acknowledge, understand and agree by my signature below, that if my designated agent (listed as the Applicant above) dissolves his/her company or cancels/defaults on his/her lease agreement or pending sale, responsibility for compliance with the DEMLR stormwater permit reverts back to me, the property owner As the property owner, it is my responsibility to contact DEMLR immediately and submit a completed Name/Ownership Change Form within 30 days; otherwise, I will be oeprating a stormater treatment facility without a valid permit I understand that the operation of a stormwater treatment facility without a valid permit is a violation of NC General Statute 143- 215.1 and may result in appropriate enforcement action including the assessment of civil penalties up to $25,000 per day, pursuant to NCGS 143-2156 Date. Signature la� �C� a Notary Public for the State of G County of ,4 do hearby certify that .44 4s anak= personally appeared before me this day of , _;t and acknowledge the due execution of tqp, to for a stormwater permit. Witness my hand and official seal, My commission expires M a2'� .Pi --7/ Seal Part VII: Applicant's Certification I, (the Applicant listed above), Randy Marion Chevrolet of Statesville, LLC , certify that the information included on this permit applicant form is, to the best of my knowledge, correct and that the project will be constructed in conformance with the approved plans, that the required deed restrictusion and protective covenants will be recorded, and that the proposed project complies with the requirements of the applicable state stormwater rules and requirements Signature I, , a Notary Public for the State of County of do hearby certify that personally appeared before me this day of and acknowledge the due execution of the application for a stormwater permit. Witness my hand and official seal, My commission expires Seal Date. STORM -EZ 61712017 Version 1 4 Application Page 6 of 6