SW3170702 - Harkey Creek Subdivision

I nTTa- so./
- DEhIIa,+R'fiTS� 0
Date Received Fee P ' Permit Number
Applicable Rules! ❑ Coas SW -1995 ❑ Coastal SW - 2008 2Th 11- Post Construction
(select all that apply) ❑ Non -Coastal SW HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ Met Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources P1=(-%1=1\/ED
STORMWATER MANAGEMENT PERMIT APPLICATION FORM j U t 26 2'U"67
This form mmj be photocopied far use as an original
DENR-LAND QUALITY
L GF14ERAL MORMATION STORMWATER PERMITTING
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Harkey Creek Subdivsion
2 Location of Project (street address):
4610 Old Charlotte Hwy
City: NA County:Union Zip:28110
3. Directions to project (from nearest major intersection):
From the intersection of Hwy 74 and WgIe Chapel Stouts Road (SR 1377)_proceed southwest on WesleX
Chapel Stouts Road 2.2 miles. Turn left (southeast) onto Old Charlotte Hwy1SR 1009) and proceed 2.6 miles.
Site is on the right.
4. Latitude:350 02' 19" N Longitude: -800 37 52" W of the main entrance to the project
IL PERMrr INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
tRenewals with modifications also requires SWU--102 - Renewal Application Form
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known)_________, and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* - *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System []Other
3. If this application is being submitted as the result of a previously returned application or a letter from
DEMLR requesting a state stormwater management permit application, list the stormwater project number,
if assigned, and the previous name of the project, if different than currently
Proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑LAMA Major ®Sedimentation/Erosion Control• 55.0 ac of Disturbed Area
❑NPDES Industrial Stormwater ®404/401 Permit Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? []No ®Yes
If yes, see S.L. 2012-200, Part VT http:l1portal.ncdenr.org/web/lr/rules-and-regulations
Form SWU-101 Version Oct. 31, 2013 Page 1 of 6

M. CONTACT INFORMATION
a. Print Applicant / Signing Official's name and title (specifically the developer, property owner, lessee,
designated government official, individual, etc. who owns the project
Applicant/ Organization:
Signing Official & Title:
b. Contact information for person listed in item la above:
Street Address:
City: State: Zip:
Mailing Address (if applicable):
City:
Phone: ( )
Email:-
State: Zip:
Fax:
c. Please check the appropriate box. The applicant listed above is:
❑ The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/ Organization:
Signing Official &
b. Contact information for person listed in item 2a above:
Street Address:
City: State: Zip:
Mailing Address (if applicable):
City: State: Zip:
Phone: ( 1 Fax:
Email:
3. a. (Optional) Print the name and title of another contact such as the project's construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:
Signing Official & Title:
b. Contact information for person listed in item 3a above:
Mailing Address:
City: State: Zip:
Phone: f ) Fax: ( )
Email:
4. Local jurisdiction for building permits:
Point of Contact: Phone #: ( )
Form SWU-101 Version Oct. 31, 2013 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
The storm water will be treated by 7 BNT wet ponds.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b. If cIaiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph 11- Post Construction
3. Stormwater runoff from this project drains to the Catawba River basin.
4. Total Property Area: 78.31 acres
5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: 2.52 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area+:75.79 acres
* Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal Hi h Water (NHM line or Mean High Water
(A4W line, and coastal wetlands landward from the NHW (or MIM9 line. The resultant project area is used to
calculate overall percent built upon area (B ). Non -coastal wetlands landward of the NHW (or AffiM line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 - 30.9 %
9. How many drainage areas does the project have?7 (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
B4smmfomatwn _
1 D_ =eine Area1rain_a-vAiea_-2;_;
Urania 'e?A_rea_ 3_ i'D_rai%ia
Ursine e'Area•-3 ,
;__Uia3ria T _Areal',
Receiving Stream Name
East Fork
Twelvemile
Creek
East Fork
Twelvemile
Creek
East Fork
Twelvemile
Creek
East Fork
Twelvern le
Creek
Stream Class *
C
C
C
C
Stream Index Number *
11138-2
11-138-2
11-138-2
11-138-2
Total Drainage Area (sf)
164656
156380
568893
459558
On-site Drainage Area (so
129674
156380
546279
459558
Off-site Drainage Area (sf)
34982
22614
Off-site (so
Proposed Impervious Area* s
86517
78408
274997
196096
% Impervious Area'" total
51
50
49
43
Im 'ous`";Surface,Aiea Dra_in_ a e A_r_e_a_1 DrainakeArea_
Urania 'e?A_rea_ 3_ i'D_rai%ia
" 'rA_iea_
On-site Buildings/Lots (sf)
38550
45900
191950
143100
On-site Streets (sf)
12825
23996
61677
41966
On-site Parking (sf)
28502
On-site Sidewalks (sf)
6640
8570
21370
11030
Other on-site (sf)
Future (sf)
Off-site (so
350
3700
Existing BUA*** (sf)
Total (so:
86867
78466
278697
1 196096
* Stream Class and Index Number can be determined at: littp://portal.ttcdeair.or vebfcucppsAsu/ciassifications
Form SWM -101 Version Oct, 31, 2013 Page 3 of 6

Project Drainage Areas — Additional Sheet
Basin Information
Drainage Area 5
Drainage Area 7
Receiving Stream Name
East Fork
East Fork
Twelevemile
Twelevemile
Creek
Creek
Stream Class
C
C
Stream index Number
11-138-2
11-138-2
Total Drainage Area (sf)
414255
463914
On-site Drainage Area (sf)
364265
463914
Off-site Drainage Area (sf)
49990
Proposed Impervious Area (sf)
134291
221559
% impervious Area
34
47
impervious Surface Area
On-site Building/Lots (sf) 85050 142250
On-site Streets (sf) 36741 63559
On-site Parking (sf)
On-site Sidewalks (sf) 12500 15750
Other on-site (sf)
Future (sf)
Off-site (so 6000
Existing BUA (sf)
Total (sf) 140291 221559
Drainage Area 8
East Fork
Twelevemile
Creek
C
11-138-2
96267
86684
9583
29115
30
18900
7835
2380
9583
38698

Impervious area is defined as the built upon area including, but not linrited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc,
"'Report only that aniount of existing BUA that will remain after development Do not report any existing BUA that
is to be removed and which will be replaced'by new BUA
11 How was the off-site impervious area listed above deternuned? Provide documentation_ Aerial Photo
C ditm6
Pro 'ects in Union Countr Contact DE,IILR Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requir•enients as per 15A .NCAC 02B .0600
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http-//1ortal iicdenr.org/web/--wq/-wsZsu/­bmp-manua.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
httL?://portal ncdenr org/web/wgLws/su/statesw/formsdocs. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map at http:/ /portal ncdenr org/web/wq/ti,s/sui maps.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from lith//portal ncdenr org/%,%'eb/wq/ivvs/su/statesw/forms docs_
Initials
1. Original and one copy of the Stormwater Management Permit Application Form
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed signed and dated) and O&M
h BMP
agreements) for eac
4. Permit application processing fee of 5505 payable to NCDENR. (For an Express review, refer to
http //www.envhelp.org/­12aggsLonestopexpress.htrrd for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting_)
A detailed (one to two describing the stormwater treatment/ma_nagementfor
5. narrative pages)
the project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6 A USGS map identifying the site location. If the receiving stream is reported as class SA or theme.
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/ Project name.
b. Engineer and firm.
e. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g_ Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/ project boundary with bearings & distances.
1. Site Layout with all BUA identified and dimensioned
k. Existing contours, proposed contours, spot elevations, finished floor elevations
1. Details of roads, drainage features, collection systems, and stormwater control measures.
Form SWU-101 Version Oct. 31; 2013 Page 4 of 6

m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans
n. Existing drainage (including off-site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required)
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"x11" copy of the MRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate
(Infiltration Devices submitted to WiRO: Schedule a site visit for DEMLR to venfij the SHWT prior
to submittal, [phone].) �
10. A copy of the most current property deed. Deed book:4*9� Page No.
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 2H.1003(e).
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.
htt wtvw.secreta .state.nc.us Cor orations CSearch.as x
VII. DEED' RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from littp //moi til.ncdenr.org/hveb/lrlstate-stormwater-
torms docs. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the Iand, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMLR, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer: Teffrey P Schmitt
Consulting Firm: Kenney Design Group PA
Mailing Address: 1226 Parsons Trail
City. Denver State: NC Zip: 28037
Phone [phone] Fax:
Email: ischmitt®kenneydesign.com
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or hjpe name of person listed in Contact Information, Item 2a) certify that I
own the property identified in this permit application, and thus give permission to (print or hype nanie of person
listed in Contact Inforiiiation, item 1a) with (print or type name of organization listed in
Contact Information, item 1a) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWV-101 Version Oct. 31; 2013 Page 5 of 6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
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 notify DENnR immediately and
submit a completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater
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 Statue 143-215.1 and may result in appropriate enforcement
action including the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
HARKEY CREEK (CHARLOTTE) ASLI VIII, LLC, a Delaware limited liability company
By: Avanti Strategic Land Investors VIII, "L.P., a Delaware limited liability limited partnership, its sole Member
By: APG ASLI VIII GP, LLC, a Delaware limited liability company, its sole General Partner'
By: Avanti Properties Group III, L.L.L.P., a Delaware limited liability limited partnership, its Managing Member
By: APG III GP, LLC, a Florida limited liability company, its sole General Partner
By: Avanti Manest"orpbration, a Florida corporation, its sole Manager
Andrew DublQVice President,
923 N. Pennsylvania Ave., Winter Party Florida 32789
407-6284488, Email• adubilWavantiaroo.com
I,7YcxYri9—+ . 0) 0 Ct;t3e s , a Notary Public for the state of Florida, County of (range, do hereby certify that Andrew
Dubill personally appeared before me this 218t day of July 2017, and acknowledge the due execution of the application for a
stormweter permiL n n I --
Witness my hand and official seal, _}�;( !(/V Y 1 r / UaUi&XA/ My commission expires May 28, 2019
Notary Pub@c Stets Of Florida
Janet R Morales
%qlMy Comm%sM FF 223166
up fu F,xpirost36l1a/2o1a -
X APPLICANTS C1I<LTIFICATION
I, (print or We name of person listed in Contact Information, item la)
certify that the information included on this permit application 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 restrictions
and protective covenants, will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 2H.1000 and any other applicable state stormwater requirements.
Signature: Date:
a Notary Public for the State of I . County of
. do hereby 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,
SEAL
My commission expires
US2008 12194243 1
Form SWU-101 Version Oct 31, 2013 Page 6 of 6

High Density Residential Subdivisions
Deed Restrictions & Protective Covenances
In accordance with Title 15 NCAC 2H.1000 and S.L. 2006-246, the Stormwater Management Regulations,
deed restrictions and protective covenants are required for High Density Residential Subdivisions where
lots will be subdivided and sold and runoff will be treated in an engineered stormwater control facility. Deed
restrictions and protective covenants are necessary to ensure that the development maintains a "built -upon"
area consistent with the design criteria used to size the stormwater control facility.
I, Andrew Dubill, acknowledge, affirm and agree by my signature below, that I will cause the following deed
restrictions and covenants to be recorded prior to the sale of any lot:
The following covenants are intended to ensure ongoing compliance with State Stormwater
Management Permit Number , as issued by the Division of Energy, Mineral and
Land Resources under the Stormwater Management Regulations.
2. The State of North Carolina is made a beneficiary of these covenants to the extent necessary to
maintain compliance with the stormwater management permit.
3. These covenants are to run with the land and be binding on all persons and parties claiming under
them.
4. The covenants pertaining to stormwater may not be altered or rescinded without the express written
consent of the State of North Carolina, Division of Energy, Mineral and Land Resources.
5. Alteration of the drainage as shown on the approved plan may not take place without the concurrence
of the Division of Energy, Mineral and Land Resources.
6. The maximum built -upon area per lot, in square feet, is as listed below:
Lot # BUA Lot # BUA Lot # BUA Lot # BUA
1-175 2700 sf 176-260 2300 sf
This allotted amount includes any built -upon area constructed within the lot property boundaries, and
that portion of the right-of-way between the front lot line and the edge of the pavement. Built upon area
includes, but is not limited to, structures, asphalt, concrete, gravel, brick, stone, slate, coquina and
parking areas, but does not include raised, open wood decking, or the water surface of swimming
pools.
7. Each lot will maintain a 30** foot wide vegetated buffer between all impervious areas and surface
waters
**50 foot for projects located in the 20 coastal counties.
8. All runoff from the built -upon areas on the lot must drain into the permitted system. This may be
accomplished through a variety of means including roof drain gutters which drain to the street, grading
the lot to drain toward the street, or grading perimeter swa/es to collect the lot runoff and directing them
into a component of the stormwater collection system Lots that will naturally drain into the system are
not required to provide these additional measures.
Fonn DRPC-3 Rev.2 05Nov2009 Page 1 of 2

J i .
High Density Residential Subdivisions
Deed Restrictions & Protective Covenances
HARKEY CREEK (CHARLOTTE) ASLI VIII LLC, a Delaware limited liability company
By: Avanti Strategic Land Investors VIII, L.L.L.P .
By: APG ASLI VIII, LLC
By: Avanti Properties. Group III, L.L.L.P.
By: APG III GP, LLC
By: Avanti Management -C
Signature: I Date• , /-J./
Andrew Dubill, Vice President r
1, of g,�o��(�C�� ��Gr�,' , a Notary Public in the
State of
do hereby certify that
County of
rsonally appeared
before me this the =5 day of 20jl_, and acknowledge
the due execution of the foregoing instrument. Witness my hand and official seal,
Sidn.ature
My Commission expires 0�
Form DRPC-3 Rev.2 05Nov2009 Page 2 of 2
SEAL
LNotary Public State of Flonda
Janet R.Morales
Expires My OS/28 2 Tg X3166