HomeMy WebLinkAboutSW3171201_Application Form_20180419DEMLR USE ONLY
Date Received
Fee Paid
Permit Number
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
IL(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Village at Granite Ouarry - Phase 1
2. Location of Project (street address):
3040 Faith Road
City:Salisbur County:Rowan Zip:28146
3. Directions to project (from nearest major intersection):
the property is located between exits 71 and 74 off 1-85 on the west side of Faith Road NCDOT S.R.1006
4. Latitude:350 36' 23.8896" N Longitude:80° 2753.6832" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
tRenez gals 2oith modifications also requires SWM -102 — Renewal Application Forni
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, Iist 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: 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 VI: http:Zl2ortal.ncdenr.org/web/lr/rules-and-regulations
Foirn SWU-101 Version Oct. 31, 2013 Page 1 of
N. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
_ .... g— e dry
The stormwater runoff is collected into storm,,,,,,,
clrian e systems that
release into stormwater BMPs. Thre,,
detention sand filters and one wet pond.
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 claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the
4. Total Property Area: 107.9 acres
River basin.
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area': 107.9 acres
+ Total project area shall be calculated to exclude the following: the normal pool of incppounded stncctures, the area
betzveen the banks of streams and rivers, the area belozo the Normal Hi h Water (NHW) line or Mean High Water
(MHM line, and coastal wetlands landward fronz the NHW (or MHVO line, The resultant project area rs used to
calculate overall percent br.tilt upon area (BUA). Norz-coastal zoetlarads landzvard of the NHW (or MHW) li)ze niay
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 =16.41 %
9. How many drainage areas does the project have?4 (For high densihj, corcnt 1 for each proposed engineered
stornavater BMP. For lozo densihj and other projects, use 1 for the whole properhj 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.
Basin Information
Drainage Area 1.
_
Drainage Area 2
Drainage Area 3
Drainage Area 4
ReceivingStream Name
Crane Creek
Crane Creek
Crane Creek
Crane Creek
Stream Class *
C
C
C
C
Stream Index Number *
12-115-(2)
12-115-(2)
12-115-(2)
12-115-(2)
Total Drainage Area (so
217,800
370,260
980,100
174,240
On-site Drainage Area (so
217,800
370,260
980,100
174,240
Off-site Drainage Area (so
0
0
0
0
Proposed Impervious Area** s
96,765
156,337
459,843
58,440
% Impervious Area total
44,43
42.22
46.92
33.54
Impervious" Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area 3
Drainage Area 4
On-site Buildings/Lots (sf)
64,885
103,293
205,895
47,208
On-site Streets (sf)
24,180
40,444
92,208
8,382
On-site Parking (sf)
0
0
0
0
On-site Sidewalks (so
7,700
12,660
34,810
2,850
Other on-site (sf)
0
0
50,700
0
Future (so
0
0
76,230
0
Off-site (so
0
0
0
0
Existing BUA*** (sf)
0
0
0
0
Total (so:
96,765
156,337
459,843 1
58,440
Stream Class and Index Number can be determined at: ht : ortal.ncdenr.oiweb zv s csu classi 'cations
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version Oct. 3 L, 2013 Page 3 of 6
a,
p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify RI
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 NRCS 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 verifuj the SHW prior
to submittal, (910) 796-7378.)
10. A copy of the most current property deed. Deed book 1297 Page No: 258 RJ
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC RJ
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item 1a, 2a, and/or 3a per 15A NCAC 2H.1003(e).
The corporation or LLC must be Iisted as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
hgp:/lwww.secretarv.state.nc.us/Coyporations/CSearch.asi2x
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 htt ortal.ncdenr.or web lx state-
stormwater-forms 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 land, 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 Iot.
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:Uy V. Nguyen, PE
Consulting Firm: DPR Associates
Mailing Address:420 Hawthorne Lane
City:Charlotte
Phone: 704 332.1204
Email:hngLtyen@dl2rassociates.net
State:NC Zip:28204
Fax: (704 332-1210
UC. PROPERTY OWNER AUTHORIZATION (if Contact Information, iteni 2 has been filled ottt, cotrtplete this
section)
I, (print or hjpe name of person listed in Contact Inforn ation, item 2a) David Hensler certify that I
own the property identified in this permit application, and thus give permission to (print or type pante of person
listed in Contact Information, item 1a) David Hensley with (print or hjpe name of organization listed in
Contact Information, item Ta) LGI Honies NC, LLC 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.
Forms SWU-101 Version Oct. 31, 2013 Page 5 of 6