Line 118 Retrofit - Piedmont Natural Gas - 18-147 Line 118 Stormwater submittal 1

STORMWATER PERMIT APPLICATION
PIEDMONT NATURAL GAS COMPANY
LINE 118 Retrofit
Waxhaw, NC
SAPA Project # 18-147
Owner:
Piedmont natural Gas Company
4720 Piedmont Row Drive
Charlotte, NC 28210
Designed By:
,`t►i 111111%,
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SEAL Cyr'
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U-'00V stimmell601 N. TRADE STREET, SUITE 200
WINSTON-SALEM, NC 27101
www.stimmelpa.com 336.723.1067
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LAND PLANNING
May, 2019

Table of Contents
Stormwater Permit Application
Narrative
Soils Information
Flood Map
Owner /Easement Exhibits
Vicinity Map - See Plans
Topo Map — See Plans
Site Plan — See Plans

DEMLR USE ONLY
Date Received Fee Paid Permit Number
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ Mgmt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This fonu pray 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.):
Line 118 Retrofit
2. Location of Project (street address):
799 Waxhaw -Indian Trails Rd.
City: Waxhaw County:Union Zip:28173
3. Directions to project (from nearest major intersection):
200' north of intersection Waxhaz-Indian Trail Rd and Will Pl ler Rd.
4. Latitude:340 59' 15" N Longitude:80° 4T 16" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modifications
tRenenmis with modifications also requires SWU-102 - Renernal Application Fonn
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 El 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):
❑CAMA Major
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 2.94 ac of Disturbed Area
❑404/401 Permit: Proposed Impacts
b.lf any of these permits have already been acquired please provide the Project Name, Project/Permit
Number, issue date and the type of each permit:NCDEO Sediment/Erosion Control, Union-2019-070
5. Is the project located within 5 miles of a public airport? ®No ❑Yes
If yes, see S.L. 2012-200, Part VI: httpllp ortal.ncdenr.orglwebllrlrules-and-regulations
Farm SWU-l01 Version Oct. 31, 2013 Page I of

III. CONTACT INFORMATION
1. 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: Piedmont Natural Gas Company
Signing Official & Title: Oluwasanu Odugbesan
b.Contact information for person listed in item 1a above:
Street Address:4720 Piedmont Row Dr.
City:Charlotte State:NC Zip:28213
Mailing Address (if applicable):
City: State: Zip:
Phone:.(704 ) 731-4246 _ Fax:
Email:sanu.odugbesan®duke-energy.com _
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 Iessee, purchaser or developer. (This is the
person who owns the property that the project is located on):
Property Owner/Organization:lercy Gill Davis and Shirleycan N. Davis
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Address:5823 Will PIvler Rd.
City: Waxhaw State:NC Zip:28173
Mailing Address (i f applicable):
City: State: Zip:
Phone: { 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:Dann ester, Stimmel Associates P.A.
Signing Official & Title:
b.Contact information for person listed in item 3a above:
Mailing Address:601 N. Trade St. Suite 200
City:Winston-Salem State:NC Zip:27101
Phone:.[phone] ) 1113
Email:[e-mail]
4. Local jurisdiction for building permits:
Point of Contact: Phone #:
Form SWU-101 Version Oct. 31, 2013 Page 2 of
Fax:

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
no bml2 using #57 washed stone with geotextile fabric
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 Il - Post Construction
3. Stormwater runoff from this project drains to the Catawba River basin.
4. Total Property Area: 2.707 acres 5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area+:2.701 acres
" Total project area shall be calculated to exclude the follorving: the normal pool of impounded stntctures, the area
between the banks of streams and rivers, the area bdozv the Nonuai Hi Water (NHW) line or Menu High Water
(MHW) Iine, and coastal ivetlands Iandrvard front the NHW (or MHW) line. The resultant ro' t area is used to
calculate overall percent built upon area (BUA). Non -coastal rvetlatds Iandward of the NHW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 =1.89 %
9. How many drainage areas does the project have?l (For high densihj, count I for each proposed engineered
stonurvater BMP. For lory densihj and other projects, use I 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
Drainage Area _
Draina&2 Area _
Drainage Area
Receiving Stream Name
Twelvemile
creek
Stream Class
C
Stream Index Number *
1I-138-2
Total Drainage Area (so
102,466
On -site Drainage Area (so
101,016
Off -site Drainage Area (so
1,450
Proposed Impervious Area
s
1,904
% Im ervious Area** total
1.89%
-Impervious" Surface Area
Drainage Area
Drainage Area _
Drainage Area _
Draina a Area _
On -site Buildings/Lots (so
On -site Streets (so
1,789
On -site Parking (so
On -site Sidewalks (so
Other on -site (so
31.5
Future (so
83.5
Off -site (so
Existing BUA*** (so
Total (so:
1,904
* Stream Class and hides Number can be detenuined at: ltt rtal.ttcdetir.or veb v s csu classi cations
** Impervious area is defrnned as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version Oct. 31, 2013 Page 3 of 6

'Report only that amount of existing BUA that will rentain after development. Do not report any existing BUA that
is to be rentoved and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation.
Proiects in Union County: Contact DEMLR Central Office staff to check if the project is located within a Threatened
Endangered Species watershed that may be subject to more stringent stormwater requirements 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 htW:/112ortal,ncdenr.org/­web/wq/wslsuZbmi2-manual.
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
h ortaLng-d,�nr.org/webiwo/ws/su/`statg!sw/­forms do�-5. 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://p2rtaI; nac a .or ebjwyAlws/su/maps.)
Please indicate that the following required information have been rovided by initialin 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
Iitt ortal_ncdenr.org/web/wq/ws/sufstatesw/forms flocs.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form. _
I 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
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
http://www.envheII2.org/pam/­onestol2express.html 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.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/management for
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the l: z
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.
c. 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.
j. 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

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 Iogs. 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 verifij the SHIM' prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 7216 Page No: 498
11. For corporations and limited Iiability 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 1a, 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.
http://www.secretary_.state.nc.us/Corporations/CSearch.aspx
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 Iisting each Iot number, Iot 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 http-apnrt;fl.ncdenr.orfz webllrlskate-
stormwater-forms dncs. 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 holders) 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 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:Neal Tucker
Consulting Firm: Stimmel Associates P.A.
Mailing Address:601 N. Trade St. Suite 200
City: Winston-Salem StateN Zip:2710I
Phone: (336 ) 723-1067 Fax: j
Email: [e-mail]
IX. PROPERTY OWNER AUTHORIZATION (if Contact Imnforinatmon, item 2 has been filled out, complete this
section)
1, (print or hjpe name of person listed in Contact Immfonuation, item 2a) . certify that I
own the property identified in this permit application, and thus give permission to (print or hjpe nnante of person
listed in Contact Innfon nations, items 1a) with (print or hjpe nanne of organization listed in
Contact hnfomnation, itemu 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 SWU-101 Version Oct. 31, 2013 Page 5 of

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 DEMLR
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.I 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.
Signature: Date:
a Notary Public for the State of _. . County of
do hereby certify that
before me this _ day of
personally appeared
. and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
X. APPLICANT'S CERTIFICATION
i, (print or hjpe uante of person listed in Contact Infor►nation, item Ia) Oluwasanu Odugbesan
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. lop—N
Date: C. e� () 1
a Notary Public for the State of McJa e" , County of
do hereby certify that 0. l cA w o Zi&t-u DtS personally appeared
before me this day of 4O 19 , and ackn dge h exec 'on of the application for
a stormwater permit. Witness my hand and official seal,
Tracy R Landrum
NOTARY PUBLIC
MECKLEid3URG COUNTY, N.C.
My Commtssion Expires 05-07-2023
SEAL
My commission expiresyl(e 0-4- a JL-3
Form S WU-101 Version Oct. 31, 2013 Page 6 of 6

Piedmont Natural Gas Company
LINE 118
Stormwater Narrative
Project Description
The purpose of this project is to build a new gas receiver and future launcher for
PNG Line 118. The receiver site is on the east side of Waxhaw-Indian Trail Road
(SR 1008) in Waxhaw, NC. The receiver site will consist of a new paved driveway
to the site totaling 1,789 sq. ft. The receiver site will be 40,370 sq. ft. of 6" of #57
washed stone with a geotextile fabric underlayment that will not count as BUA. The
new driveway and a few concrete pads & piers for the png equipment will bring the
total impervious area for the project to 1,904 sq. ft.
Adjacent Property
Property adjacent to the sites are agriculture or wooded.
Best Management Practices
There are no SCMs proposed for the site.
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LAND PLANNING

BK 7216 PG 0499
FILED
UNION COUNTY, NC
CRYSTAL D. GILLIARD
REGISTER OF DEEDS
FILED Aug 15, 2018
AT 12:14 pm
BOOK 07216
START PAGE 0499
END PAGE 0500
INSTRUMENT # 23028
EXCISE TAX (None)
AH
NORTH CAROLINA GENERAL WARRANTY DEED
Excise Tax: S.00
Parcel Identifier No. 06-075-021 & 06-075-022 Verified by County on the day of
20 — —'
By:
Mall/Box to: Perry, Bundy, Plyler & Long, LLP
This instrument was prepared by: Perry, Bundy, Plyler & Long, LLP (NO TITLE SEARCH REQUESTED OR PERFORMED)
Brief description for the Index: 2 tracts Davis
THIS DEED made this _ day of August, 2018, by and between
GRANTOR
Jerry Gill Davis and wife, Shirley Jean H. Davis
Mailine Address:
5823 Will Plyler Rd.
Waxhaw, NC 28173
GRANTEE
Jerry Gill Davis and wife, Shirley Jean H. Davis
Mailing Address:
5823 Will Plyler Rd.
Waxhaw, NC 28173
Enter in appropriate block for each party: name, address, and, if appropriate, character of entity, e.g. corporation or partnership
The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include
singular, plural, masculine, feminine or neuter as required by context.
WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has
and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated
in the Town of Sandy Ridge Township, Union County, North Carolina and more particularly described as
follows:
FIRST TRACT: BEING that certain tract of land containing 19.132 acres, more or less and designated as
Tract C on a map entitled "Boundary Survey & Division of the Estate of Lee Bell Davis" by Broome
Associates dated August 7, 1992 through September 8, 1992 and recorded in Plat Cabinet D, File 303 in
the office of the Register of Deeds of Union County, North Carolina to which reference is hereby made
for a more particular description.
NC GENERAL. WARP ANTY DEED.I

BK 7216 PG 0500
SECOND TRACT: BEING that certain tract of land containing 15.0 acres, more or less and designated as
Tract D on a map entitled "Boundary Survey & Division of the Estate of Lee Bell Davis" by Broome
Associates dated August 7, 1992 through September 9, 1992 and recorded in Plat Cabinet D, File 304 in
the office of the Register of Deeds of Union County, North Carolina to which reference is hereby made
for a more particular description.
The purpose of this deed is to convey the property described herein to the Grantees as husband and wife
as tenants by the entirety.
The property hereinabove described was acquired by Grantor by instrument recorded in Book 629, Page 441.
A map showing the above described property is recorded in Plat Cabinet D, Files 303 & 304.
All or a portion of the property herein conveyed _ includes or _X_ does not include the primary residence of a Grantor.
TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee
in fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in
fee simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against
the lawful claims of all persons whomsoever, other than the following exceptions:
Rights of way and easements for roads and utilities that border or cross the property, both recorded and visible.
IN WITNESS WHEREOF, the Grantor has duly executed the foregoing as of the day and year first above written.
S
(SEAL)
Je Gill D is
+l Dct,L , (SEAL)
Shirley Jean U. Davis
STATE OF NC
COUNTY OF UNION
1, M i rand H on eft Notary Public of the County and State aforesaid,
certify, that Jerry Gill Davis and Shirley Jean H. Davis personally appeared before me this day and
acknowledged the due execution of the foregoing instrument for the purposes therein expressed. Witness
my hand and Notarial stamp or seal this day of �U- ' 2018.
.I� wo (SEAL)
My Comm. Expires: 03' 2-3' 22 Notary Public
NC GENERAL WARRANTY DEED.I 1°UBLvG
^Gj0 _�.

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Hydrologic Soil Group —Union County, North Carolina
Line 118 Retrofit
Hydrologic Soil Group
Map unit symbol
Map unit name
Rating
Acres in AOI
Percent of AOI
BdB2
Badin channery silty
C
5.2
37.6%
clay loam, 2 to 8
percent slopes,
moderately eroded
TbB2
Tarrus gravelly silty clay
B
8.6
62.4%
loam, 2 to 8 percent
slopes, moderately
eroded
Totals for Area of Interest
13.7
100.0%
Description
Hydrologic soil groups are based on estimates of runoff potential. Soils are
assigned to one of four groups according to the rate of water infiltration when the
soils are not protected by vegetation, are thoroughly wet, and receive
precipitation from long -duration storms.
The soils in the United States are assigned to four groups (A, B, C, and D) and
three dual classes (A/D, B/D, and C/D). The groups are defined as follows:
Group A. Soils having a high infiltration rate (low runoff potential) when
thoroughly wet. These consist mainly of deep, well drained to excessively
drained sands or gravelly sands. These soils have a high rate of water
transmission.
Group B. Soils having a moderate infiltration rate when thoroughly wet. These
consist chiefly of moderately deep or deep, moderately well drained or well
drained soils that have moderately fine texture to moderately coarse texture.
These soils have a moderate rate of water transmission.
Group C. Soils having a slow infiltration rate when thoroughly wet. These consist
chiefly of soils having a layer that impedes the downward movement of water or
soils of moderately fine texture or fine texture. These soils have a slow rate of
water transmission.
Group D. Soils having a very slow infiltration rate (high runoff potential) when
thoroughly wet. These consist chiefly of clays that have a high shrink -swell
potential, soils that have a high water table, soils that have a claypan or clay
layer at or near the surface, and soils that are shallow over nearly impervious
material. These soils have a very slow rate of water transmission.
If a soil is assigned to a dual hydrologic group (A/D, B/D, or C/D), the first letter is
for drained areas and the second is for undrained areas. Only the soils that in
their natural condition are in group D are assigned to dual classes.
USDA Natural Resources Web Soil Survey 5/8/2019
Conservation Service National Cooperative Soil Survey Page 3 of 4