SW6111206_CURRENT PERMIT_20130305

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW &,Y/
DOC TYPE
URRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
�, ,. 250,5
YYYYMMDD

wa�� ®ENR -FRO
r
, U 5 2013
NCDENR
North Carolina Department of Environment and Natural Resourceg)WQ
Division of Water Quality
Pat McCrory Charles Wakild, P.E.
Governor Director
January 30, 2013
Mr. Tommy Bradford
Ralph Huff Holdings, LLC, Elmwood Holdings, LLC
P.O. Box 8755
Fayetteville, NC 28303
Subject: Stormwater Permit No. SW6111206 Modification
Northgate NC24-87
High Density Commercial Infiltration Basin Project
Harnett County
Dear Mr. Bradford:
John E. Skvarla, III
Secretary
M ob (Ff
7r 0-MlT
The Stormwater Permitting Unit received a complete Stormwater Management Permit Application to modify
the subject project on'January 22, 2013, with additional information received January 30, 2013. Staff review of
the plans and specifications has determined that the project, as proposed, will comply with the Stormwater
Regulations set forth in Title 15A NCAC 2H.1000 and Session Law 2006-246. We are forwarding modified
Permit No. SW6111206, dated January 30, 2013, for the construction, operation and maintenance of the subject
project and the stormwater BM Ps. This modification includes revisions to the lots and additional BUA.
This permit shall be effective from the date of issuance until January 8, 2020 and shall be subject to the
conditions and limitations as specified therein, and does not supersede any other agency permit that may be
required. Please pay special attention to the conditions listed in this permit regarding the Operation and
Maintenance of the BM P(s), recordation of deed restrictions, procedures for changes of ownership,
transferring the permit, and renewing the permit. Failure to establish an adequate system for operation and
maintenance of the stormwater management system, to record deed restrictions, to follow the procedures for
transfer of the permit, or to renew the permit, will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing by filing a written petition with the Office of Administrative Hearings (OAH).
The written petition must conform to Chapter 150B of the North Carolina General Statutes. Per NCGS 143-
215(e) the petition must be filed with the OAH within thirty (30) days of receipt of this permit. You should
contact the OAH with all questions regarding the filing fee (if a filing fee is required) and/or the details of the
filing process at 6714 Mail Service Center, Raleigh, NC 27699-6714, or via telephone at 919-431-3000, or visit
their website at www.NCOAH.com. Unless such demands are made this permit shall be final and binding.
This project will be kept on file at the Fayetteville Regional Office. If you have any questions, or need additional
information concerning this matter, please contact Robert Patterson at [phone]; or
[e-mail].
Sincerely,
for Charles Wakild, P.E., Director
Wetlands and Slormwater Branch
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Location: 512 N Salisbury St Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet: www nmalerquality.org
An Equal Opportunity 4 Affirmative Aclion Employer
One
NorthCarolina
Natuhillif

Mr. Tommy Bradford
SW6111206 MOD-"Northgate NC24-87
January 30, 2013
i •
cc: SW6.1-11206 File
ec: Thomas S. Speight, Jr., PE, PLS - Larry King & Associates, RLS, PA
Mike Lawyer - Fayettevilie Regional Office
Page 2 of 2

State Stormwater Permit
Permit No. SW6111206
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY DEVELOPMENT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of
North Carolina as amended, and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
Ralph Huff Holdings, LLC, Elmwood Holdings, LLC
Northgate NC24-87
NC 24-27 and Plantation Dr. (SR2411), Cameron, Harnett County
FOR THE
construction, operation and maintenance of one infiltration basin in compliance with the
provisions of Session Law 2006-246 and 15A NCAC 2H .1000 (hereafter referred to as
the "stormwater rules') and the approved stormwater management plans and
specifications and other supporting data as attached and on file with and approved by
the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until January 8, 2020, and shall
be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1. This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. This stormwater system has been approved for the management of stormwater
runoff as described in Section 1.8 of this permit. The stormwater control has been
designed to handle the runoff from 351,527 square feet of impervious area.
3. The infiltration basin is designed, and must be maintained, to capture and
infiltrate the 10-yr, 24-hr storm event in lieu of providing a vegetated filter strip
and bypass.
4. The tract will be limited to the amount of built -upon area indicated in Section 1.8
of this permit, and as shown on the approved plans.
5. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
6. The runoff from all built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
Page 1 of 6

State Stormwater Permit
Permit No. SW6111206
The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
The following design criteria have been permitted for the infiltration basin and
must be provided and maintained at design condition:
a.
b.
C.
d.
e.
f.
h.
i.
1�
k.
I.
m
n.
Drainage Area, Acres:
Onsite, ft :
Offsite, ft2.
Total Impervioug Surfaces, ft2:
Onsite, ft :
Offsite, ft2:
Design Storm, inches:
Bottom Elevation, FMS�:
Bottom Surface Area, ft
Bypass Weir Elevation, FMSy
Permitted Storage Volume, ft
Type of Soil:
Expected Infiltration Rate, inlhr:
Seasonal High Water Table, FMSL
Time to Draw Down, hours:
Receiving Stream/River Basin:
Stream Index Number:
Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
11.4
496,593
0
351,527
351,527
0
1.0
338.00
9,039
340.78
93,695
Candor
8.23
331.84
23
UT to Muddy Creek 1 Cape Fear
18-23-26
„C,P
The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater system functions at optimum
efficiency. The approved Operation and Maintenance Plan must be followed in
its entirety and maintenance must occur at the scheduled intervals including, but
not limited to:
4
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of bypass structure, infiltration media, flow
spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all times.
Records of maintenance activities must be kept for each permitted BMP. The
reports will indicate the date, activity, name of person performing the work and
what actions were taken.
5. The permittee shall submit to the Division of Water Quality an annual summary
report of the maintenance and inspection records for -each BMP. The report
shall summarize the inspection dates, results of the. inspections, and the
maintenance work performed at each inspection. ,
Page 2 of 6

State Stormwater Permit
Permit No. SW6111206
6. The stormwater treatment system shall be constructed in accordance with the
approved plans and specifications, the conditions of this permit, and with other
supporting data.
7. If the stormwater system was used as an Erosion Control device, it must be
restored to design condition prior to operation as a stormwater treatment device,
and prior to occupancy of the facility.
8. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A
modification may be required for those deviations.
9. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
10. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project
area. The project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
12. A copy of the approved plans and specifications shall be maintained on file by
the Permittee for a minimum of ten years from the date of the completion of
construction.
13. The Director may notify the permittee when the permitted site does not meet one
or more of the minimum requirements of the permit. Within the time frame
specified in the notice, the permittee shall submit a written time schedule to the
Director for modifying the site to meet minimum requirements. The permittee
shall provide copies of revised plans and certification in writing to the Director
that the changes have been made. "
III. GENERAL CONDITIONS
This permit is not transferable to any person or entity except after notice to and
approval by the Director. In the event of a change of ownership, or a name
change, the permittee must submit a completed Name/Ownership Change form
to the Division of Water Quality, signed by both parties, and accompanied by the
appropriate documentation as listed on page 2 of the form. The approval of this
request will be considered on its merits and may or may not be approved.
Page 3 of 6

State Stormwater Permit 1
Permit No. SW6111206
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
6. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
7. The permit issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and reissuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
controls must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2006-
246, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et. al.
11. The permittee shall notify the Division in writing of any name, ownership or
mailing address changes at least 30 days prior to making such changes.
12. The permittee shall submit a renewal request with all required forms and
documentation at least 180 days prior to the expiration date of this permit.
Permit issued this the 30th day of January, 2013.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
;e4p',6� 1
fir Charles Wakild, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Page 4 of 6

4. State Stormwater Permit
Permit No. SW6111206
Northgate NC24-87
Stormwater Permit No. SW6111206
Harnett County
Designer's Certification
I, , as a duly registered in the
State of North Carolina, having been authorized to observe (periodically/ weekly/ full
time) the construction of the project,
(Project)
for (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 5 of 6

State Stormwater Permit y
Permit No. SW6111206
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The bypass structure weir'elevation is per the approved plan.
6. The bypass structure is located per the approved plans.
7. A Trash Rack is provided on the bypass structure.
8. All slopes are grassed with permanent vegetation.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. All required design depths are provided.
13. All required parts of the system are provided.
14. The required system dimensions are provided per the approved plans.
Please submit this Designer's Certification to: Fayetteville Regional Office
Surface Water Protection
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
Cc: Harnett County Building
Inspections
Page 6 of 6

y•1 IF
Slate Stormwater Permit
Permit No. SW6111206
Northgate
Harnett County
Designer's Certification
I, �aMA( r. ,S ? , _H-A_efas a duly registered AguG1-�ercR in the
State of North Carolina, having been authorized to observe (periodically/ weekly/ full
time) the construction of the project,
North -gate Development
for RhLetk rr _(Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
'� p��{GwJ�JLx CirR7. �p/cw,or�a .',jp44r.1,^W
AFL, 5 •foRA war#k AI+w1409"r F'Aw. �wip b�Ln+�S
I�A�crts UsPT,rRt,,p �.r Pu^jA, Lo-r r Ski, +.,r- -;W "3 LS'
I�+��O I.�T C �-MP�a✓ia� +►�&+f7 ,s'ristLc, C1j^p..+Gfd , AAA.+.,rQL6r Sr�rrpL AJG'�
Hare �Q ,v rn a&v.s�e P4ft— i-r Cu*-.LW sl'.' q& /1 p SEAL
Signature `":n�o
Registration Number _,/V t AG, 2 z3,._
Date _ -. mil_ 7�l-13
Certification Requirements:
`i i, it li ll llf ll fl ff�
GAR04/,
S��.�
2023
ti•. FNGIN���U��
S.'SeF�,... JWoo,N�RIR
��Lt��
`lrll ll li 111 ii1 ��
EC 1 7 2012
- d a1ALI ry
d,. a
Page I'd 2

State Stormwater Permit
Permit No. SW6111206
/I. The drainage area to the system contains approximately the permitted
acreage.
/2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
'/3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
✓4. All roof drains are located such that the runoff is directed into the system.
A. The bypass structure weir elevation is per the approved plan.
1/6. The bypass structure is located per the approved plans.
v 7. A Trash Rack is provided on the bypass structure.
•/8. All slopes are grassed with permanent vegetation.
✓9. Vegetated slopes are no steeper than 11.
,/10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
�11. The permitted amounts of surface area and/or volume have been
provided.
�2. All required design depths are provided.
13. All required parts of the system are provided.
____LA4. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
` Page 2 of 2

W; .
ENGINEERING a SURVEYING o DESIGNING DRAFTING
Larry King & Associates R.L.S., P.A.
Post Office Box 53787 •1333 Morganton Road, Suite 201
Fayetteville, forth Carolina 28305
[phone] • Fax: [phone]
www.LKandA.com
December 17, 2012
Mike Randall. PE
Wetlands and Stormwater Branch
NCDENR
512 North Salisbury St.
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Stormwater permit No. SW6111206
Northgate
High Density Commercial Infiltration Basin
Harnett County
Dear Mr. Randall:
I have attached the Designer's Certification for Northgate in Harnett County
Stormwater permit No. SW6111206.
All stormwater on site is captured in drainage ponds as designed for 100 yr. storm.
Infrastructure have been constructed substantially as planned. When'the proposed
new division of lot 5 into three lots and lot 6 is developed into site plans. We shall
update permit as required.
I appreciate your help on our project.
Sincerely,
Thomas S. Sp ig t, PE, PL5
Larry King &Associates R. L. S., P. A.
Cc: Elmwood Holdings, LLC, Ralph Huff, "pommy Bradford
DEC Y 7 2012
041

N
DINQ;iJSE`ONLY:
ceived Fee Paid
13 A r 4 r._,.. C
Perrnit Number
I 12_CID Alr�'
Applicable Rules.' ❑ Coastal SW -1995 ❑ Coastal SW - 2008 PTh 11- Post Construction
(select all that apply) ❑ Nan -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ MMt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This forfn Wray be photocopied for use as an original
1. 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.):
Northgate NC24-87
2. Location of Project (street address):
' City:Cameron County:Harnett Zip:28326
3. Directions to project (from nearest major intersection):
Commencing at the intersection of 24-87 and PIantation Dr. (SR2411), Site is located on Southerly side of
NC24-87
4. Latitude:350 15' 40" N Longitude:79° 02' 14" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): []New ®Modification ❑ Renewal w/ Modificationi
tRenewats with nzodif cations also requires 5WU-102 — Reneu aI Application Form
b.If this application is being submitted as the result of a modification to an existing permit, List the existing
permit numberSW6111206 , its issue date (if known)lanuary 9, 2012 , and the status of
construction: ❑Nat Started ®Partially Completed* ❑ Completed* "provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑brains to an Offsite Stormwater Systern ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state storrnwater management permit application, list the stormwater project number, if
assigned, na and the previous name of the project, if different than currently
proposed, na
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 ❑Sedimentation/Erosion Control: _
❑NPDES Industrial Stormwater 71404/401 Permit: Proposed Impacts
ac of Disturbed Area
b.1f any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit: North watQ e Project ID Harne- 2012-039 Approved Nov 15, 2011
Is the project located within 5 miles of a public airport?
If yes, see S.L. 2012-200, Part VI: htg2A,
i[,• 9 .,
. � 201.]
Form SWU-101 Version 06Aug2012
Page 1 of 6
s

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:Ral h lluff Holdings LLC Elmwood Holdings LLC
Signing Official & Title:Tornmv Bradford hannerANNEWY
b. Contact information for person listed in tem 1a above:
Street Address:2919 Breezewood Avenue Suite 400
City:Fayetteville State:NC Zip:28303
Mailing Address (if applicrible):PO Box 8755
City: Favettev isle
Phone: (910 ) 486-4864
Email:
State:NC
Fax:
Zip:28303
485-0463
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 Con tact-lnformaLion, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. ('Phis is the
person who owns the property that the project is Iocated on):
Property Ovmer/Organization:
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if spph
City:
Phone: ( 1
Email:
State:
Zi p:
State: Zip:
Fax: {
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 itvrn 3a above:
Mailing Address:
City: State: Zip:
Phone: f �Fax: ( i
Email:
4. Local jurisdiction for building permits: Harnett County
Point of Contact:lay Sikes Phone #: [phone]
Form SWU-101 Version 06Aug2012 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, hjLefl,y summarize how the Stormwater runoff will be treated.
Stormwater from site will be discharged into a infiltration pond. Water seeps back into soil on site. There
is no outside discharge,
2. a. If claiming vested rights, identify the supporting docurnents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Dater
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW -1995 ❑ Ph fi -- Post Construction
3. Stormwater runoff from this project drains to the Cape Fear - _ River basin.
4. Total Property Area:11.88 acres 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':11.88 acres
Total project area shall be calculated to exclude the follmving$- the norrual pool of impounded strictures, the area
between the banks of streams and rivers, the area Motu the Normal High Water (NHVI>) lime or Mean High Water
(MHW) line, and coastal wetlands landioard from the NHW (or MHVV) line. The resultant project area is used to
calculate overall percent built upon area (8 UA). Nan -coastal wetlands Landward of the NHW (or MHW) lute pray
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 70.79 %
9. How many drainage areas does the project have?l (Tor high densihj, count i for each proposed engineered
stor-11170ater BMP. For lore density and other projects, rise 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 pro}ect, attach an additional sheet with the information for each area
provided in the same format as below.
.:Basin>Inforinaisoir. :... -.. ,. , ;;
.Draina eArea �
; Diaiiia e Area?_,
:Draicaa�e Area _
;Draina"e Arrea._
Receiving Stream Name
Unnamed Trib to
Muddy
Creek
Stream Class *
C
Stream Index Number*
18-23-26
Total Drainage Area (sf)
496592.5
On -site Drainage Area (so
496592.5
Off -site Drainage Area (so
0
Proposed Impervious Area" s
351527
Im ervious Area** (total)
70.79
lm ervious" Surface"Area
Draina e'Area - �
Draina e Area`'"
Drama e'Area
Drama e Area _
On -site Buildings/Lots (so
55214
On -site Streets (so
41108.37
On -site Parking (so
147091.7
On -site Sidewalks (so
7244
Other on -site (so
840
Future (SO
100029
Off -site (SO
Existing BUA*** (so
Total (so--
351527
* Stream Class and Index Number can be detennined at., litiv, portal.iicde?li-.oig.Aveblzvq&FLcst(Iclassiflcatiotis
Form SWU-101 Version 06Aug2012 Page 3 of 6

rtrt hrappervious area is defined as the built upon area including, but not liwiled to, buildings, roads, parking areas,
sidervalks, gravel areas, etc.
Report only that amount of existing 8L A that will remain after drvelopment. Do not report any existing Ili IA flint
is to be removed and rulrich will be replaced by new BUA.
11. I-Iow was the off -site impervious area listed above determined? Provide documentation. N/A
Protects in Union County: Contact DWQ Central Ojjrce staff to check if the project is located within a Threatened &
Endangered Species watershed that pray be ,subject to more stringent stormmvater requirements as per 15A AICAC 028.0600,
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 h"://t)ortal.ncdeiir.orv/web/wci/ws/su / bmu-manual.
V1. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from h"://portal,ncdenr.or /g web/wq/ws/su/statesw/forms dots. The complete
application package should be submitted to the appropriate DWQ Office. (The appropriate office may be
found by locating project on the interactive online map at http:/ /portal.ncdenr org/-,veb/wq/ws/su/ma}_s.)
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 htip://pc)rtal.ncdenT,org/iti,eb/wq/ws/stifstatesw/fornis does.
Initials
1. Original and one copy of the Storm water Management Permit Application Form. !
2. Original and une copy of the signed and notarized Dced Restrictions & Protective Covenants 1
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
littp://www.envllelp,org/pages/onestopexpress.htnll 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
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
receiving stream drains to class SA waters within 1/2 mile of the site boundary, include the'/z
mile radius on the map.
T 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 NI-11Y line of tidal
waters, and any coastal wetlands landward of the MHYV 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 06Aug2012 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 `l�►� ��►�
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 determilung the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verifij the SHl'VT prior
to submittal, [phone].)
10, A copy of the most current property deed. Deed book: Page No: +y
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC A
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 21-1.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the INC
Secretary of State, otherwise the application will be returned.
http_/ /www.secretary.state.nc.us/Corl2oratioitis/CSearcli.asl2x
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
],or 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 notarised deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from
hn://portal.ncdenr.org/web/wg/ws/su/statesw/fornis 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 Iisted
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 DWQ, 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:Thomas S. Speight, Ir., Ph,l'hS
Consulting Firm: Larry King & Associates, RLS, PA
Mailing Address:1333 Morganton Road
City:Favetteville, NC _- _ - _-- ----_---_------- - - State:NTC Zip:28305
Phone: [phone] Fax: (910 ) 483-4052
Ernail:tqL)[e-mail]
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has bee;i filled out, complete this
section)
1, (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 hype name of person
Iisted in Contact Information, item 1a) with (print or type name of organization listed in
Contact Information, item Ia) to develop the project as currently proposed. A copy of
the Iease 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 06Aug2012 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 DWQ Stormwater permit reverts back to
me, the property owner. As the property owner, it is my responsibility to notify DWQ 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 3-215.1 and may result in appropriate enforcement action including
the assessment of civil es of up to $25, 0 per day, pursuant to NCGS 143-215.6.
Signature: Date: / s 20 r3
I� t { ,tL f !L{� f L L` l_, -Ur 1� .
CLIYY bC' I CLX\J do hereby certify that
before me this Ito day of JAr
N,o�ar Public for the State of C
i d m rack
an lyr ledge the due execti
a stormwater permit. Witness my hand and official seal,
'�'`G�EE N++1f�i,��''
24 Pp,Y r
z 0V O
r G
O
1111r11110%
SEAL
My commission expires t �-' m - / .T"
County of
personally appeared
,n of the application for
o sL�
X. APPLICANT'S CERTIFICATION
I, (print or hfpe name of person listed in Contact Information, item 1a)
certify that the information included on this permit application form is, to the tiest o owledge, correct and
that the project will be constructed in conformance with the approved plans, th&t th iced deed restrictions
and protective covenants will b
applicable stormwaterek19 under 15A
that the proposed project complies with the requirements of the
? i .1D00 and any other applicable state stormwater requirements.
Date:
4 54"_
I, r. 1ai'i'1Q 1'G£�'_ �� L-r rea Nota I'ublic for the State of N C_ County of
�Lft1gbpr&,u( do hereby certify that I,., Br'0rj�d personally appeared
before me this _k, day of b anus v e' ge the clue exec 'on of the -application for
a stormwater permit. Witness my hand and
official seal,
('J
SEAL
My commission expires
Form SWU-101 Version 06Aug2012 Page 6 of 6

Permit No. 51A/t III x o JQ
(to be provided by DWQ)
Ao�oF wa TFg4G
Z STORMWATER MANAGEMENT PERMIT APPLICATION FORM
A -c
MC®ENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part 111) must be printed, filled out and submitted along with all of the required information.
1- PROJECTJNFORl�fA710N 4 r ,_ r s
Project Name Norttgate High? vay 87-24"(1400 Btock Cameron, NC',
Cenfact Person Thomas $. Spei ht, Jr., PE
PhaneNumher 910 483 4300 .., .",.., ,...... ._....................................................
Date Jan. 9, 2013
Drainage Area Number na
Site Characteristics
Drainage area
496,592,50
112
Impervious area
351,527 00
f�
Percent impervious
70.79
%
Design rainfall depth
1.00
in
Peak Flow Calculations
1-yr, 24-hr rainfall depth
3.20 `- °:
in
1-yr, 24-hr intensity
0.13 .:::
infhr
Pro-developmenl1-yr,24-hrdischarge
0.29
ft3lsec
Post -development 1-yr, 24-hr discharge
`' 1.13...
" n3lsec
Pre(Posl 1-yr, 24-hr peak flow control
0.84
W/sec
Storage Volume: Non -SA Waters
Minimum design volume required
28,433.50
:. ft3
Design volume provided
93,695.00
ft3 OK for non -SA waters
Storage Volume: SA Waters
RQ��'',,
1.5' runoff volume
rya
O
��� • S S • '�
1��ti9
Pre -development 1-yr, 24-hr runof volumo
ft
r OFF
Post -development 1-yr, 24-hr runoff volume
Minimum required volume
n3
= SEAL p1
Volume provided
n3
"r 2023 ! ji -
= '• ; z
Soils Report Summary;,�y•'•
" "
FN EF�'ti �=
,oti�.,GII�,,.��,
Soil type
candor
��
Infiltration rate
8.23
initlr
��qs,S,
,��""""
SHWT elevation
331.84
fmsI
Basin Design Parameters
Drawdown time
0.93
days OK
Basin side slopes
3.00
:1 OK
Basin bottom elevation
338.00
fmsl OK
Storage elevalion
340.78
fmsl
Storage Surface Area
25,695.00
o2
Top elevation
343.00
fmsl
Basin Bottom Dimensions
Basin length
470.00
it
Basin width
24.00..:::
ft
Bottom Surface Area
9,039.00
n�
Form SW401-Infiltration Basin-Rev,5 11Apr2011 Pans I, $ II, Design Summary, Page 1 cf 2

Permit No.
(to be provided by DWO)
Additional Information
Maximum runoff to each inlet to the basin?
Aa,:
ac-in
Maximum of 2 acre -inches allowed
Length of vegetative filter for overflow
40.00
ft
OK
Distance 10 St[UGtUre
:20.M':. �.`:7 :'ft
OK
Distance from surface waters
500.00
ft
OK
Distance from water supply well(s)
It
OK
Separation from impervious soil layer
10,317'l.'::'.:It
-7-
OK
Naturally occuifing soil above shyA
ft
CK
Bottom covered with 4-in of clean sand?
y
(Y or N)
OK
Proposed drainage easement provided?
y
(Y or N)
OK
Capures all runoff at u lim ale build -out?
Y,
(Y Of N)
OK
Bypass provided for larger storms?
na
(Y or N)
OK
Prelreatment device provided
y
Form 5W4DI-infiltrationBasin-Rev.5 llAprMl
Paris 1. & 4. Design Summary, Page 2 of 2

'• High Density Commercial Subdivisions
Deed Restrictions & Protective Convenances
In accordance with Title 15 NCAC 2H.1000 and S.L. 2006-246, the Management Regulations, deed
restrictions and protective covenants are required for High Density Commercial 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, _Tommy Bradford , 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 within the project known as Northgate Highway 87-24 (1400 Block Cameron
Rd.
1. The following covenants are intended to ensure ongoing compliance with State Stormwater
Management Permit Number _SW6111206 , as issued by the Division of
Water Quality 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 Water Quality.
5. Alteration of the drainage as shown on the approved plan may not take place without the
concurrence of the Division of Water Quality.
6. The maximum built -upon area per lot, in square feet, is as listed below
Lot # 1 BUA 43,142 sq ft, Lot # 2 BUA 38,950 Lot # 3 BUA 48,120sq ft, Lot #4 BUA 94, 545sq
ft, Lot# 5A 31,189 sq ft, Lot 5B BUA 33106 sq ft, Lot 5C BUA 32,234sq ft,
Lot 6 29, 853sq ft
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. 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 swales 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.
8. The owner of each lot, whose ownership is not retained by the permittee, is required to submit a
separate stormwater permit application to the Division of Water Quality and receive a permit
prior to construction.
9. The project and 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.
Form DRPC-1 Rev.2 05Nov2009 Page 1 of 2

Hiah Densitv Commercial Subdivisions
Deed st4etie otective Convenances
Signature:
a Notary Public in the
State of 0 County of l.4Lrftherlctnef
do hereby certify that bf1��'Yl� F�ZLclfaw4 personally appeared
before me this the (o day of 1.4 a 20 13 , and acknowledge
the` dux-c— cution of the foregoing instrument. Witness my hand and official seal,
SEAL
Iture b� \�� V'REE v
ommission expires
=Q
� Pv�v Qom:
Q L%
J�rrrr
Form DRPC-1 Rev.2 .05Nov2009 Page 2 of 2

Permit Number: ;W6 1 I J 2-04
(to be provided by D Il'Q)
Drainage Area Number: /
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the
infiltration basin.
— Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
— No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
— The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basin is established, it will be inspected once a quarter and within
24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately:
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
a licable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Form SW401-Infiltration Basin O&M-Rev.3 Page 1 of 3

BMP element:
The forebay
The main treatment area
The embankment
The outlet device
The receiving water
Potential problem:
Sediment has accumulated
and reduced the depth to 75%
of the original design depth.
Erosion has occurred or
riprap is displaced.
Weeds are present.
A visible layer of sediment
has accumulated.
Water is standing more than
5 days after a storm event.
Weeds and noxious plants are
growing in the main
treatment area.
Shrubs or trees have started
to grow on the embankment.
An annual inspection by an
appropriate professional
shows that the embankment
needs repair.
Clogging has occurred
The outlet device is damaged
Erosion or other signs of
damage have occurred at the
outlet.
How 1 will remediate the problem:
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Remove the weeds, preferably by
hand. If pesticides are used, wipe
them on the plants rather than
spraying.
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP. Replace any media that
was removed in the process.
Revegetate disturbed areas
immediately.
Replace the top few inches of filter
media and see if this corrects the
standing water problem. if so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Remove the plants by hand or by
wiping them with pesticide (do not
spray).
Remove shrubs or trees
immediately.
Make all needed repairs.
Clean out the outlet device. Dispose
of the sediment off -site.
Repair or replace the outlet device.
Contact the NC Division of Water
Quality 401 Oversight Unit of 919-
733-178b.
Form SW401-Infiltration Basin O&M-Rev.3 Page 2 of 3

Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that i am responsible for the
performance of the maintenance procedures listed above. 1 agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:North aatHighway 87-24, 1400 Block , Cameron, NC 28326
BMP drainage area number:
Print name: 1 ��'' �S L 6AAL . �i
'f itle: MG _01
Address: 91 `j j1� "� Q 2-0�
Phone.
Sign;
Date
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the subdivision has been named the president.
I,y_a L a Notary Public for the State of
V I C , County of curnbertar-uaL , do hereby certify that
h6o- s BYacl1 G -6( personally appeared before me this %
day of�O_nUa)2a13 and acknowledge the due execution of the
f-orgoing infiltration basin maintenance requirements. Witness my hand and official seal,
SEAL
My commission expires 5 _ID_ 4 ^
Form 5W401-Infiltration Basin O&M-Rev3 Page 3 of 3

r
• Permit No.
(to be provided by DWQ)
a�oF warERoG
��. STORMWATER MANAGEMENT PERMIT APPLICATION FORM
¢ S
NCDENR 401 CERTIFICATION APPLICATION FORM
INFILTRATION BASIN SUPPLEMENT
This form must be filled out, printed and submitted.
The Required items Checklist (Part fit) must be printed, filled out and submitted along with all of the required information.
Project Name 'Northgate'Hwy 87-24 .(:1400 Block Cameron; NC)
Contact Person Thomas'S. Speight, Jr., PE
Phone Number 910 4.83 4300,
Date 1218I2011
Drainage Area Number na
II:',-DES1WINF0RMATI0N'� � s� :' ,rs .era ' .. � .�14 � =t e, �:
�..=A e.r�?%.a:;..� �as3e;A .�49.� t't' ' %F ';,4 i.. ; i.� .ur
Site Characteristics
Drainage area 456,508.00 ft2
Impervious area 269,200.00 ft2
Percent impervious 58.97 %
Design rainfall depth 1.00 in
Peals Flow Calculations
1-yr, 24-hr rainfall depth
.:13.20
in
1-yr. 24-hr intensity
0.13
inihr
Pre -development 1-yr, 24-hr discharge
0.29
ft'lsec
Post -development 1-yr, 24-hi discharge
1.13
ft'/sec
Pre/Post 1-yr, 24-hr peak flow control
0.84
ft'Isec
Storage Volume: Non -SA Waters
Minimum design volume required
22,092.00
ft'
Design volume provided
93,695.00
ft'
Storage Volume: SA Waters
1.5" runoff volume
ft'
Pre -development 1-yr, 24-hr runoff volume
ft'
Post -development 1-yr, 24-hr runoff volume
fi3
Minimum required volume
ft3
Volume provided
ft3
Soils Report Summary
Soil type -candor .
Infiltration rate 8.23 inlhr
SHWT elevation " 331,84 fmsl
Basin Design Parameters
Drawdown time
0.63
days
Basin side slopes
3.00
:1
Basin bottom elevation
338.00
fmsl
Storage elevation
340.60
fmsl
Storage Surface Area
25;039.00
ft2
Top elevation
' 343.00
fmsl
Basin Bottom Dimensions
Basin length
470.00 . '
ft
Basin width
24.00
ft
Bottom Surface Area
9,039.00
ft2
OK for non -SA waters
OK
OK
OK
Form SW401-Infiltration Basin-Rev.5 11Apr2011 Parts I. & I$. Design Summary, Page 1 o1 2

Permit No.
(to be provided by DWQ)
Additional Information
Maximum runoff to each inlet to the basin?
;-~ na
ac-in
Maximum of 2 acre -inches allowed
Length of vegetative filter for overflow
-40.00
ft
OK
Distance to structure
20.00 ....
; ft
OK
Distance from surface waters
500.00
It
OK
Distance from water supply well(s)
I . . . 300.00
ft
OK
Separation from impervious soil layer
'.10.31
ft
OK
Naturally occuring soil above shwt
10.31
ft
OK
Bottom covered with 4-in of clean sand?
y
(Y or N)
OK
Proposed drainage easement provided?
''y
(Y or N)
OK
Capures all runoff at ultimate build -out?
y
(Y or N)
OK
Bypass provided for larger storms?
' na -,
(Y or N)
OK
Pretreatment device provided
y
Form SW401-Infiltration Basin-Rev.S 11Apr2911 Parts I, & II. Design Summary, Page 2 of 2

Permit No
(to be provided by DWQ)
Jill: .REQUIRED =ITEMS: CHECKLI5T:���, „€s �� . i,;� t •.- ; �:` r
Please indicate the page or plan sheet numbers where the supporting documentation can be found. An incomplete submittal package will
result in a request for additional information. This will delay final review and approval of the project. Initial in the space provided to
indicate the following design requirements have been met, if the applicant has designated an agent, the agent may initial below. If a
requirement has not been met, attach justification.
Page/ Plan
Initials Sheet No.
—7s1 I oc. %4
1. Plans (1" - 50' or larger) of the entire site showing:
3 of
Design at ultimate build -out,
- Off -site drainage (it applicable),
Nt„*s
Delineated drainage basins (include Rational C coefficient per basin),
Basin dimensions,
lfia�►4 PL-A4
Pretreatment system,
- Nigh flow bypass system, Ak-p%
Maintenance access,
h�`�'F'
- Proposed drainage easement and public right of way (ROW),
�,,F ►a
Overflow device, and %-►etirl
y C.4, pwr
Boundaries of drainage easement.
to .*(4-
2. Partial plan (1" = 30' or larger) and details for the infiltration basin showing:
90'.4
- Bypass structure,
Maintenance access,
Basin bottom dimensions,
Basin cross-section with benchmark for sediment cleanout.
Flow distribution detail for inflow,
Vegetated filter, and
Pretreatment device.
T I4 •F� 3. Section view of the infiltration basin (1" = 20' or larger) showing:
- Pretreatment and treatment areas, and
- Inlet and outlet structures.
�.� &,"GJ 4. A table of elevations, areas, incremental volumes & accumulated volumes to verify the volume provided.
90-1 N
5. A soils report that is based upon an actual field investigation, soil borings, and infiltration tests. The
results of the soils report must be verified in the field by DWQ, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information.
•�Ff4-
6. A construction sequence that shows how the infitlration basin will be protected from sediment until the
entire drainage area is stabilized.
7. The supporting calculations.
8. A copy of the signed and notarized operation and maintenance (0&M) agreement.
9. A copy of the deed restrictions (if required).
Form SW401-Infiltration Basin-Rev.4 Page 1 of 1 Part 111, Required Items Checklist, Page 1 of 1

Permit Number:
(to be provided by DWQ)
Drainage Area Number:
Infiltration Basin Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
— The drainage area will be carefully managed to reduce the sediment load to the
infiltration basin.
Immediately after the infiltration basin is established, the vegetation will be
watered twice weekly if needed until the plants become established (commonly
six weeks).
— No portion of the infiltration basin will be fertilized after the initial fertilization
that is required to establish the vegetation.
— The vegetation in and around the basin will be maintained at a height of
approximately six inches.
After the infiltration basin is established, it will be inspected once a quarter and within
24 hours after every storm event greater than 1.0 inches (or 1.5 inches if in a Coastal -
County). Records of operation and maintenance will be kept in a known set location
and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall
be repaired immediately.
BMP element:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
infiltration basin.
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide lime and a
one-time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
UncIog the pipe. Dispose of the
swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe,
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Form SW401-Infiltration Basin O&M-Rev.3 Page 1 of 3

BMP element:
The forebay
The main treatment area
The embankment
The outlet device
The receiving water
Potential problem: _
Sediment has accumulated
and reduced the depth to 75%
of the original design depth.
Erosion has occurred or
riprap is displaced.
Weeds are present.
A visible layer of sediment
has accumulated.
Water is standing more than
5 days after a storm event.
Weeds and noxious plants are
growing in the main
treatment area.
Shrubs or trees have started
to grow on the embankment.
An annual inspection by an�
appropriate professional
shows that the embankment
needs repair.
Clogging has occurred.
The outlet device is damages
Erosion or other signs of
damage have occurred at the
outlet.
How I will remediate th_problem:
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosionTeroblems.
Remove the weeds, preferably by
hand. If pesticides are used, wipe
them on the plants rather than
spraying. _
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP. Replace any media that
was removed in the process.
Revegetate disturbed areas
immediately.
Replace the top few inches of filter
media and see if this corrects the
standing water problem. If so,
revegetate immediately. If not,
consult an appropriate professional
for a more extensive repair.
Remove the plants by hand or by
wiping them with pesticide (do not
Remove shrubs or trees
immediately.
Make all needed repairs.
Clean out the outlet device. Dispose
of the sediment off -site.
Repair or replace the outlet device,
Contact the NC Division of Water
Quality 401 Oversight Unit at 919-
733-1786.
Form SW401-infiltration Basin O&M-Rev.3 Page 2 of 3

. � r
Permit Number:
(to be provided by DWQ)
I acknowledge and agree by my signature below that I am responsible for the
performance of the maintenance procedures listed above. I agree to notify DWQ of any
problems with the system or prior to any changes to the system or responsible party.
Project name:Northgate Highway 87-24 , 1400 Block, Cameron NC 28326 _
BMP drainage area number:
Print name -Ralph Huff
Title: President, Ralph Huff Holdings, LLC T
Addr
Phon
Signi
Date
Note: The legally responsible party should not be a homeowners association unless more than 50% of
the lots have been sold and a resident of the cnh {iiric;nn ha., been ......,ed Yr
th^" csiucnt.
I, S N F'QR t 5 9 t- ( C� M+ S , a Notary Public for the State of
N G , County of Ctk)-/I 6ffk NAt0 , do hereby certify that �
C] a 4 k P�1 R -} tC rF 11:7 personally appeared before me this 9
day of OK Alt 6E/? 0611 , and acknowledge the due execution of the
forgoing infiltration basin maintenance requirements. Witness my hand and official seal,
�,ti��tit�ttrii
S SUG 'T
CO 01ARy.
z_
e� 0,
AND%
SEAL
My commission expires r t8 7 �P_ 0 r �
Form SW401-Infiltration Basin O&M-Rev.3
Page 3 of 3