SW5190702_Application_20190711

N V 5 CALYX
ENGINEERS+ CONSULTANTS
July 11, 2019
Annette Lucas, PE
® UNf
NC Division of Energy, Mineral and Land Resources
Stormwater Program
JUL 1 2011
512 N. Salisbury Street
Raleigh, NC 27699
DENR-LAND OLIALITY
STORMWER PERP,1,1T lNO
RE: North Carolina Department of Military and Veteran Affairs (NCDMVA)
Raleigh State Veterans Home
Annette,
Please find enclosed the application package for the stormwater drainage and treatment system for the
proposed Raleigh State Veterans Home. The NCDMVA is proposing to construct a new 120-bed State
Veteran's Home located on approximately 18 acres at the northeast quadrant of the intersection of
NC54 (Chapel Hill Road) and Edwards Mill Road. The building will consist of a single story with a total
square footage of approximately 110,000 SF. The project will be partially funded through the State
Veterans Home Construction Grant Program of the US Department of Veterans Affairs.
Because the nursing home is a State and Federally funded project on State property, it is not required to
go through the City of Raleigh's Site Plan Approval process. However the City disagrees with this
interpretation so the attorneys for both groups are discussing. In the meantime the project must meet
certain dates in order to obtain the federal grant. Therefore, we would like to begin the permitting
process for the stormwater system. The project is located on approximately 18 acres of a much larger
parcel totaling 119.35 acres (PIN 0784132319). At this time the NC Department of Administration
(NCDOA) has stated that they do not intend on subdividing the property. However, depending on the
outcome with the City of Raleigh, it may be forced to subdivide. Our design is based on a subdivided
property. Because the ownership is still unknown at this time, the attached application has not been
signed by anyone at NCDMVA or NCDOA. We are hoping that we can begin the review process while
ownership continues to develop. Regardless, the parcel will be owned by a State agency. Our intentions
is to provide a signed application before approval is issued for the project.
Please let me know if you have any questions, comments or concerns. You can contact me at (919) 858-
1888 or [e-mail]. If I am unavailable, please contact Caleb Robinson in my office at
[phone] or [e-mail].
Thank you for your time and assistance,
;hael AI(en, PE
,ject Ma ager
6750 Tryon Road, Cary NC 27518 1919.836.4800
CAMengineers.com I NV5.com

DEMLR USE ONLY
Date Received
Fee Paid
Permit Number
?-010A
I C r73 1$
5 t 0 -7 02—
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) F1 Non -Coastal SW- HQW/ORW Waters F1 iTniversal Stormwater Managomont Plan
❑ Other WQ Mgmt Plan:
State of North Carolina R E 0 " 1,
Department of Environment and Natural Resources JUL 11
Division of Energy, Mineral and Land Resources
l3ENR-1.ANi? OUALITY
STORMWATER MANAGEMENT PERMIT APPLICATION FC3RMWER KHRiiVII- i-IN
This fonn 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.):
NC Department of Military and Veteran Affairs: RaleiLyh State Veteran's Home
2. Location of Project (street address):
5900 Chapel Hill Road
City:Raleigh County: Wake
3. Directions to project (from nearest major intersection):
Zip:27607
The project will bo located at tho intorsoction of Edwards Mill Road and Chapel I Iill Road
4. Latitude:35° 47 22" N Longitude:78° 43' 31" W of the main entrance to the project.
II. PERMIT 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 N/A , its issue date (if known) N/A 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, N/A and the previous name of the project, if different than currently
proposed, N/A
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: 14.00 ac of Disturbed Area
❑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:Sedimentation and Erosion Control currently under review.
5. Is the project located within 5 miles of a public airport? ®No ❑Yes
If yes, see S.L. 2012-200, Part VI: http://12ortal.ncdenr.org/web/lr/rules-and-regulations
rpm
Form SWU-101 Version Oct. 31, 2013 Page 1 of 6

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:NC Department of Military and Veterans Affairs
Signing Official & Title:Martin Falls, Assistant Secretary
b. Contact information for person listed in item 1a above:
Street Address:413 N. Salisbury Street
City:Raleigh State:NC Zip:27603
Mailing Address (if applicable):
City: State: Zip:
Phone: (984 ) 204-2980 Fax: (984 ) 2048343
Email:[e-mail]. ,zov
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:NC Department of Administration (State Property Office)
Signing Official & Title:Tim Walton, Director
b. Contact information for person listed in item 2a above:
Street Address:116 W. Jones Street, Room 4055
City:Raleigh State:NC Zip:27603-8003
Mailing Address (if applicable):
City: State: Zip:
Phone: (919 ) 807-4660 Fax: ( )
Email: [e-mail]
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: CALYX Engineers and Consultants
Signing Official & Title: Michael Allen, Project Manager
b. Contact information for person listed in item 3a above:
Mailing Address:6750 Tryon Road
City:Cary
Phone: (919 ) 858-1888
Email:[e-mail]
State:NC
Fax:
Zip:27518
4. Local jurisdiction for building permits: State Construction Office
Point of Contact:Latif Kaid Director Phone #: [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.
Runoff will collect in storm structures and connect to an underground sand filler and detentiort systei n.
The sand filter is designed to treat the first flush for 85 % TSS and reduce the nitrogen export. The detention
system will store runoff for the 1-year 24-hour storm event.
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. Stoimwater tuuoff from this project drains to the Neuse River basin.
4. Total Property Area: '18.4
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+:18.4 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 High Water (NHV0 line or Mean High Water
(MHA) line, and coastal wetlands landward from the NHW (or MHi line. The resultant project area is used to
calculate overall percent built upon area (B UA). Non -coastal wetlands landward of the NHW (or MHA) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 33.4
9. How many drainage areas does the project have?2 (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.
Basin Information
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
Receiving Stream Name
Stream Class
Stream Index Number
Total Drainage Area (so
180,138
236,169
On -site Drainage Area (sf)
180,138
236,169
Off -site Drainage Area (sf)
Proposed Impervious Area** s
107,956
148,392
% Impervious Area** total
60
63
Impervious— Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
On -site Buildings/Lots (so
48,645
69,000
On -site Streets (so
On -site Parking (so
40,447
58,635
On -site Sidewalks (so
18,864
20,757
Other on -site (so
Future (so
Off -site (sf)
Existing BUA*** (so
Total (so:
107,956
148,392
* Stream Class and Index Number can be determined at: http. portal.ncdenr.orghoeb/wq&s/esu/classi 'cations
Im ervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
***Report only that amount 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 B UA.
Form SWU-101 Version Oct. 31, 2013 Page 3 of 6

11. How was the off -site impervious area listed above determined? Provide documentation. N/A
Proiegts in Union Connly: Contact DEMLR Central Office staffto check if the project i.r 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 maii'tlenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from httv: / / vortal.ncdenr.orL,/web / wa /ws/su/bmD-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
http://portal.ncdenr.org/web/wq/ws/su/statesw/forms does. 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/ws/su/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 http://portal.ncdenr.org/web/wq/ws/su/statesw/forms
does.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
MA
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
N/A
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M
MA
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
MA
hgp://www.envhelp.org/pages/onestopexl2ress.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/managementfor
MA
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 the MA
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). MA
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including: MA
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.
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).
Form SWU-101 Version Oct. 31, 2013 Page 4 of 6

p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify MA
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"xll" 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 SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: 002672 Page No: 00073 MA
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC N/A
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 21-1.1003(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.
ht!p://www.secretaly.state.nc.us/Corporations/CSearch.asl?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 http://portal.ncdenr.org/web/Ir/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 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:Michael Allen
Consulting Firm: CALYX Engineers and Consultants
Mailing Address:6750 Tryon Road
City:Cary
Phone: (919 ) 858-1888
Email:[e-mail]
State:NC
Fax:
Zip:27518
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type 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 hjpe name of person
listed in Contact Information, 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 SWU-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 DEMLR immediately and
subiuiL a courpleled Name/Owiteiship Change Fuiut wiLltut 30 days; oLhei wise I will be opeidbitg a stoiutwalei
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.
Signature: Date:
I, a Notary Public for the State of 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,
My commission expires
X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, item. 1a)
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 21-1.1000 and any other applicable state stormwater requirements.
Signature: Da
I,
a Notary Public for the State of
do hereby certify that
County of
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
Form SWU-101 Version Oct. 31, 2013 Page 6 of 6

CALYX`
ENGINEERS + CONSULTANTS
LETTER OF TRANSMITTAL
To: NC Division of Energy, Mineral and Land
Resources
512 N. Salisbury Street
Raleigh, NC 27699
Re: NC DMVA Raleigh Veterans Home
State Stormwater Submittal
I am sending you the following item(s):
6750 Tryon Road
Cary, NC 27518
P: 919.836.4800
F: 919.851.1918
CAMengineers.com
Date: July 10, 2019
** HAND DELIVER **
Job No.: 2018062.00
COPIES
DATE
NO.
DESCRIPTION
2
Stormwater Mgmt Permit Application
1
BMP Supplement and O&M
2
Sets of plans
1
Geotechnical Report
1
Copy of property deed
1
Set of stormwater calculations (includes USGS map)
These are transmitted as checked below:
❑ As requested
❑ For approval
® For review and comment
❑ For your use
❑ For Signatures
❑�
Remarks:
Please contact me at [e-mail] or [phone] if you have any questions,
comments or concerns.
Copy to:
File
Signed: Will Mowery