SW7061108_CURRENT PERMIT_20061128

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW
DOC TYPE
[ CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
DOC DATE
,�,Ypll�S'
YYYYMMDD

pF W A rF9 Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
p Alan W. Klimek, P.E. Director
Division of Water Quality
November 28, 2006
Father Dan Oschwald, Pastor
Roman Catholic Diocese of Raleigh, NC
715 Nazareth St.
Raleigh, NC 27606
Subject: Stormwater Permit No. SW7061108
Annunciation Catholic Church
Redevelopment Stormwater Permit
Craven County
Dear Rev. Oschwald:
The Washington Regional Office received a complete Stormwater Management Permit
Application for Annunciation Catholic Church on November 27, 2006. 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. We are
forwarding Permit No. SW7061108 dated November 28, 2006, for the construction of
the subject project.
This permit shall be effective from the date of issuance until November 28, 2016, and
shall be subject to the conditions and limitations as specified therein. Please pay
special attention to the Operation and Maintenance requirements in this permit. Failure
to establish an adequate system for operation and maintenance of the stormwater
management system 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 upon written request within sixty (60)
days following receipt of this permit. This request must be in the form of a written
petition, conforming to Chapter 150B of the North Carolina General Statutes, and filed
with the Office of Administrative Hearings, P.O. Drawer 27447, Raleigh, NC 27611-
7447. Unless such demands are made this permit shall be final and binding.
If you have any questions, or need additional information concerning this matter, please
contact Scott Vinson, or me at [phone],
ince ly,
Al Hodge
Regional Supervisor
Surface Water Protection Section
AHlsav: C:ISTORMWATERIPERMIT1SW7061108
cc: Marc Christopher, Phillips Architecture
Jamie Byrd, PE, Transite Consulting
Craven County Building Inspections
-'Washington Regional Office
Central Files Nor`hCaro
- _ - Natural
North Carolina Division of Water Quality Washington Regional Office Phone [phone] FAX [phone] Customer Service
Internet: www. ncwateraualirv.ore 943 Washington Square Mall, Washington, NC 27889 1-877-623-6748
An Equal QpperlunitylAffirrnative Acton Employer— 50% Recycled110% Post Consumer Paper

State Stormwater Management Systems
Permit No. SW7061108
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
STATE STORMWATER MANAGEMENT PERMIT
REDEVELOPMENT
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
Roman Catholic Diocese of Raleigh, NC
Annunciation Catholic Church
Craven County
FOR THE
construction, operation and maintenance of a bioretention area in compliance with the
provisions of 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 November 28, 2016, 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 1.6 on page 3 of this permit. The stormwater controls have
been designed to handle the runoff from 59,894 square feet of impervious area.
3. The tract will be limited to. the amount of built -upon area indicated in the application,
and per approved plans.
4. 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.
5. 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 2 of 7

State Stormwater Management Systems
Permit No. SW7061108
[9
The following design criteria have been provided in the bioretention area and must be
maintained at design condition:
Drainage Area, acres:
Total Impervious Surfaces, ft2:
TSS removal efficiency:
Bioretention Depth, inches:
Temporary Ponded Depth Elevation, FMSL:
Bioretention Planting Elevation, FMSL:
Bioretention Surface Area, ft2:
Permitted Storage Volume, ft3:
Minimum Required Volume, ft3:
Receiving Stream/River Basin:
Stream Index Number:
Classification of Water Body:
Drainage Area 2
1.84
59;894
85%
12.0
23.95
22.95
3,956
5,003
4,809
East Prong Slocum Crk / Neuse
27-112-2
"C; Sw, NSW'
II. SCHEDULE OF COMPLIANCE
1. 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:
a. Semiannual scheduled inspections (at least every 6 months).
b. Sediment removal.
C. Mowin.9 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. Debns removal and unclogging of outlet structure, flow spreader, catch basins
and piping.
g. Access to the outlet structure must be available at all times.
4. Records of maintenance activities must be kept and made available upon
request to authorized personnel of DWQ. The records will indicate the date,
activity, name of person performing the work and what actions were taken.
Page 3of7

State Stormwater Management Systems
Permit No. SV 7061108
5. The facilities shall be constructed as shown on the approved plans. This permit shall
become voidable unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other supporting
data.
6. 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.
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. Access to the stormwater facilities shall be maintained via appropriate easements at
all times.
9. 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
soug ht.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
10. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
11. 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.
12. 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 pfans and certification in writing to the Director that the changes have been
made.
13. This permit shall be effective from the date of issuance until November 28, 2016.
Application for permit renewal shall be submitted 180 days prior to the expiration date
of this permit and must be accompanied by the processing fee.
Page 4 of 7

State Stormwater Management Systems
Permit No. SV 7061108
III. GENERAL CONDITIONS
This permit is not transferable 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
formal permit transfer request to the Division of Water Quality, accompanied by a
completed name/ownership change form, documentation from the parties involved,
and other supporting materials as may be appropriate. The approval of this request
will be considered on its merits and may or may not be approved. The permittee is
responsible for compliance with all permit conditions until such time as the Division
approves the transfer request.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
8. Approved plans and specifications for this project are incorporated by reference and
are enforceable parts of the permit.
9. The permittee shall notify the Division any name, ownership or mailing address
changes within 30 days.
Permit issued this the 281h day of November, 2006.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
t� for
Alan W. Klimek, P.E., Director
Division of Water Quality
By Authority of the Environmental Management Commission
Permit No. SW7061108
Page 5 of 7

State Stormwater Management Systems
Permit No. SV 7061108
Annunciation Catholic Church
Stormwater Permit No. SW7061108
Craven 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 6 of 7

State Stormwater Management Systems '
Permit No. SV 7061108
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 outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Trash rack is provided on the outlet/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. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf, and a
forebay.
15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Regional Office
Craven County Building Inspections
Page 7 of 7

..
- �, � �, � _ h_ • ��° �, ,�r -.�-0FEICE=_USEON[.Y :�.. � - ��,. AS
Date Received
Fee Paid
Permit Number
State of North Carolina �.
RECEUVLED Department of Environment and Natural Resources
Nov — 9 Zoos
Division of Water Quality
Q�14
)_
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
DWQ-WARD This form may be photocopied for use as an original
I. GENERAL INFORMATION
1. Applicants name (specify the name of the corporation, individual, etc. who owns the project):
ZoN�A GA7NcltG bEoc ec.— of R,A.LFt NG
2. Print Owner/Signing Official's name and title (person legally responsible for facility and compliance):
'D,&\t4 Q5cHyALD -- PP&Iog�
3. Mailing Address for person listed in item 2 above:
11S LAAZARETt 4ST _
city: R AFL f_�t &++ State: r.1 G zip: 2�t Co d
Telephone Number: ( C1(9 ) 92 l — 110 0
4. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
I' titIJUNGt�TtO CATHoL4G CHuR-C�i
5. Location of Project (street address):
24(o a BAST Mki hl S-r.
City: H P-1\1 a L DC.ic. , W G 2? 5 3 2 County: C;KA Ve-t�
6. Directions to project (from nearest major intersection):
_PRW FC-T IG UPCPAJeD 61- DAE, WTERSr--GTtoN of F--c66T
MAIN ST. WS AD) AND GUMMIN_GHAM DR
7. Latitude: 3 4, 52 Longitude:
`I(o.54 25
8. Contact person who can answer questions about the project:
Name: Mj-� ?:G G tA?,I STO PH F_ R Telephone Number:
P iLLIPS RCNIT�YU R�
II. PERMIT INFORMATION:
1. Specify whether project is (check one): ✓ New Renewal
of project
sle -- lVO
Modification
Form SWU-101 Version 3.99 Page 1 of 4

2. If this application is being submitte as the result of a renewal or modification to an existing permit, list the
existing permit number W and its issue date (if known)___ _ .
3. Specify the type of project (check one):
Low Density High Density ✓ Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
_CAMA Major ✓ Sedimentation/Erosion Control _404/401 Permit _NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Sen C-EIVED
t1-877-623-6748.
III. PROJECT INFORMATION
NOV. z 7 2006
DWQ
1. In the space provided below, summarize how stormwater will be treated. Also att.?Tycw narrative
(one to two pages) describing stormwater management for the project .
1W Vi6s2. 12 aDEP- W1LL Be TR -«n BY A, �15'x 22.5'
p�IO&F-TeQT%ON SAc5014, IN, W7 . 'FL>WCTF WILL Be TRr--A.- aD Br
A- CQOJBOaAT4Dt_DF CgE9LA%40 FLOW Agp F.QW-THRDU&H
R1 PA'F'okw•S-
2. Stormwater runoff from this project drains to the River basin.
3. Total Project Area: 10 o % acres 4. Project Built Upon Area: 33, i y
5. How many drainage areas does the project have?a__
6. Complete the following information for each drainage area. If there are more than two drainage areas in.the
project, attach an additional sheet with the information for each area provided in the same format as below.
"2 M
Basin Information: _
...;
k , ram. Drainage Area 1�
�r�.n�_..
L Drainage Area Z.
��.,,.
Receiving Stream Name
�r 5T pRM4&
Receiving Stream Class
S
Drainage Area
0 % 1(0 AeC-
Existing Impervious* Area
0.11 ACC,
1,25 A&
Proposed Impervious*Area
O. I 1 Ac,
1. 37 ►4G
% Impervious* Area (total)
(o .1-S
4 . 14 (� v
Sa
lmMaus rurface Area
pen
Mon
eDrairia e ArealAVEDrainage
P rea 2
-site Buildings
4 6-18. 5 SF
iy5 4 .5 S F
On -site Streets
—
Cl 1 013. 3 S
On -site Parking
—
Z, 90 5l , D SF
On -site Sidewalks
28 , b S F
110 1. 1 S f
Other on -site
Off -site
Total: 4101,u SF 0, 11 A
Total: 54644 SF 1'.3`i �G
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 3.99 Page 2 of 4

. 2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number and its issue date (if known)
3. Specify the type of project (check one):
Low Density High Density Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
CAMA Major _Sed im e ntation /Erosion Control �404/401 Permit NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project,
2. Stormwater runoff from this project drains to the
3. Total Project Area:
acres
5. How many drainage areas does the project have?
River basin.
4. Project Built Upon Area: %
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
Basin Inforrna[ion =*� =
Drariia e AreaX �
g .3a.
•;
D'rairi e A'rdar-
�
Receiving Stream Name
EAST P MNG SLO U C ,�
C-Wr PSG SLOv,-um GK
Receiving Stream Class
Drainage Area
0, 2 `j k G
y{ C.
Existing Impervious* Area
O . D Ae,
C.
Proposed Impervious`Area
O . p AG
D, 26 i,G
% Impervious* Area (total)
33.33 %
603. 41 °lo
:. _
Impervious Surface Area,
,•_Drainage Area 3 ,f
Drainage Area' .y, i� .'.g
On -site Buildings
3 5 3 2 .-1 S F"
261. I S F
On -site Streets
—
On -site Parking
—
7A tq q 6 S F
On -site Sidewalks
3 4 2- S SF
3 2 6 6. S S F
Other on -site
Off -site
—
Total: 3926.2 SF ().09
Total: 1144('6SF 4, 2.6 AC
Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 3.99 Page 2 of 4

. ?. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number and its issue date (if known)
3. Specify the type of project (check one):
Low Density High Density Redevelop General Permit Other
4, Additional Project Requirements (check applicable blanks):
CAMA Major _Sedimentation/Erosion Control 404/401 Permit �NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748,
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project.
2. Stormwater runoff from this project drains to the River basin.
3. Total Project Area: acres 4. Project Built Upon Area: %
5. How many drainage areas does the project have?
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
=Basin Information' �- 1�Y
t
`�l 'Dra�riage Area Y $xy
�.
9qi,_ „ Drainage:Area
_
Receiving Stream Name
EASY p & 6Lc)GQ M Gc
SAS P G SLOGUm Cif
Receiving Stream Class
Drainage Area
Q ,1 x A c
8. 50 k&
Existing Impervious` Area
O . 4-2 G
Q ,' o AG
Proposed lmpervious*Area
Q , tit kc,
d , 2.o AG
% Impervious* Area (total)
51a, 3 3 %
40 , 01D °
lin ervious� Surface Area
p
�� < " :Drainage°Area �'$ v
it Hama e°Area:2,�
On -site Buildings
S j S l .-I S F
3bl b ,S S
On -site Streets
3 4 65. 5 SF
5, 35. 6 S F
On -site Parking
"� Cf (p(o , Z S
—
On -site Sidewalks
Z , g S�
Z 13, 3 SF
Other on -site
—
-
Off -site
Total: 0,'4'i Ac
Total: 83b�.�lSF 0, 2 �4G
" Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
8
8
Form SWU-141 Version 3.99 Page 2 of 4

..2. If this application is being submitted as the result of a renewal or modification to an existing permit, list the
existing permit number and its issue date (if known)
3. Specify the type of project (check one):
Low Density High Density Redevelop General Permit Other
4. Additional Project Requirements (check applicable blanks):
�CAMA Major Sedimentation/Erosion Control 404/401 Permit �NPDES Stormwater
Information on required state permits can be obtained by contacting the Customer Service Center at
1-877-623-6748.
III. PROJECT INFORMATION
1. In the space provided below, summarize how stormwater will be treated. Also attach a detailed narrative
(one to two pages) describing stormwater management for the project.
2. Stormwater runoff from this project drains to the River basin.
3. Total Project Area: acres 4. Project Built Upon Area: %
5. How many drainage areas does the project have?
6. Complete the following information for each drainage area. If there are more than two drainage areas in the
project, attach an additional sheet with the information for each area provided in the same format as below.
>Bas�n Ir formation ,
y fiDrainaee Area.1'j: 5` r:,
5-1 ' Drainae A greal'
Receiving Stream Name
Ppww& GLocu M CR
EAST PRONG sLocum GR
Receiving Stream Class
Drainage Area
3 , +-{ 5 P-.rl
C,
Existing Impervious* Area
0. Q A r,
O, o O A r—
Proposed Impervious*Area
1.1)o Ar,
d . O D A C.
% Impervious* Area (total)
2 Q1, q q °%
D , 00 b/0
Im envious*Surface Area s`
��" Drama e P:reaX
Drairia e Area2'0'
_ rir T
On -site Buildings
�'� �! , y
0.00 A c
On -site Streets
5065.S SF
On -site Parking
E (0 1 65.9 SF
On -site Sidewalks
rJ g 4
Other on -site
( I s �=
Off -site
Total: g33cf0,35F 1.00 �
Total: ©, ov I�
fi Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
Form SWU-101 Version 3.99 Page 2 of 4

7. How was the off -site impervious area listed above derived? /A
IV. DEED RESTRICTIONS AND PROTECTIVE COVENANTS -w Nl,6r
The following italicized deed restrictions and protective covenants are required to be recorded for all
subdivisions, outparcels and future development prior to the sale of any lot. If lot sizes vary significantly, a table
listing each lot number, size and the allowable built -upon area for each lot must be provided as an attachment.
The following covenants are intended to ensure ongoing compliance with state stormwater management permit number
as issued by the Division of Water Quality. These covenants may not be
changed or deleted without the consent of the State.
No more than square feet of any lot shall be covered by structures or impervious materials.
Impervious materials include asphalt, gravel, concrete, brick, stone, slate or similar material but do not include wood
decking or the water surface of swimming pools.
3. Swales shall not be filled in, piped, or altered except as necessary to provide driveway crossings.
4. Built -upon area in excess of the permitted amount requires a state storrnwater management permit modification prior to
construction.
5. All permitted runoff from outparcels or future development shall be directed into the permitted stormwater control
system, These connections to the storm water control system shall be performed in a manner that maintains the integrity
and performance of the system as permitted.
By your signature below, you certify that the recorded deed restrictions and protective covenants for this project
shall include all the applicable items required above, 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 State, and that they will be recorded prior to the sale of any lot.
V. SUPPLEMENT FORMS
The applicable state stormwater management permit supplement form(s) listed below must be submitted for each
BMP specified for this project. Contact the Stormwater and General Permits Unit at [phone] for the status
and availability of these forms.
Form SWU-102
Wet Detention Basin Supplement
Form SWU-103
Infiltration Basin Supplement
Form SWU-104
Low Density Supplement
Form SWU-105
Curb Outlet System Supplement
Form SWU-106
Off -Site System Supplement
Form SWU-107
Underground Infiltration Trench Supplement
Form SWU-108
Neuse River Basin Supplement
Form SWU-109
Innovative Best Management Practice Supplement
Form SWU-101 Version 3.99 Page 3 of 4

. VI. 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. The complete application package should be
submitted to the appropriate DWQ Regional Office.
Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
Initials
• Original and one copy of the Stormwater Management Permit Application Form J B
• One copy of the applicable Supplement Form(s) for each BMP 8
• Permit application processing fee of $420 (payable to NCDENR) W/A1
• Detailed narrative description of stormwater treatment/management JB
• Two copies of plans and specifications, including: J B
Development/Project name
Engineer and firm
-Legend
North arrow
Scale
- Revision number & date
- Mean high water line
Dimensioned property/project boundary
Location map with named streets or NCSR numbers
Original contours, proposed contours, spot elevations, finished floor elevations
- Details of roads, drainage features, collection systems, and stormwater control measures
- Wetlands delineated, or a note on plans that none exist
- Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations
- Drainage areas delineated
- Vegetated buffers (where required)
VII. AGENT AUTHORIZATION
If you wish to designate authority to another individual or firm so that they may provide information on your
behalf, please complete this section. P��1 rr
Designated agent (individual j or firm).LJ>R I LL i P RIH 4 TEG�"U
Mailing Address: tlD [�!�VAAo DR., SIE, 600 _
City: 4�G GG t �j N State: �,J G Zip: 2 e
Phone: ( 1 _� �...._.. ) ��. `" tC� 10 Fax:
VIII. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in General Information, item 2)
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 15A
NCAC 2H .10
Signature: Date:
Farm SWU-101 Version 3.99 Page 4 of 4

All I av
RDENR
North Carolina Department of Environment and Natural Resources
Request for Express Permit Review
FILL-IN all information below and CHECK required Permit(s), Fax or email this completed form along with a narrative
and vicinity mara of the project location to the appropriate One -Stop Coordinator:
• Fayetteville or Raleigh Region -David Lee 919-791-4203, davidlee@ncmaiLnet eEGERVED
• Mooresville & Asheville Region -Patrick Grogan 704-663.3772 or Patrick -grogan @ncmail.net
• Washington Region -Lyn Hardison 252-946-9215 or 1 [e-mail] a
• Wilmington Region -Cameron Weaver 910-350.2004 or [e-mail] NOV - 9 2006
Project application received after 12 noon will be stamped in the following work day.
DVIMMAM
APPLICANT NameROVAAt4 GA,TtkoL[G DIOCESE ee RALiEl&b, h40
Company —
Address _11 fiL S . CitylState RA�LEIG NC: Zip 2_1 Co D
Phone IR Z1 ~ 91D i7ax92(- 5 Email --
PROJECT SYSTEMS) TRIBUTARY TO r6C-_Lo+,4SURFACE WATER CLASSIFICATION G 4aL 5 V�
PROJECT Name C -k RGN CountyGR^Y E N
PROJECT LOCATION (ADDRESS;' 2.t4& B EAST MRtiJ STKEET , 4AA\! E; ODIC , QC 26 5'32
Company T'RANSt e C49 A6UkA I N.G l
Address 1300 PADDOGi_ DR. 'T G� - 10 CitylState PA LEI&B a t,1 C_ Zip 2"l(44q
Phone(( ql1- 14rij Fax(atQ) @13- :240 q_ Emai1JBYR-D@tRA �r CONSQLT�k,G. COM
State or National Environmental Policy Act (SEPA, NEPA) - FA or EIS Required ❑Yes No
❑ STREAM ORIGIN Determination: of Stream calls; Stream Name F:K-_,T pROt-16, 5LO&U M CAR•
0 STORMWATER []Low Density ❑ High Density -Detention Pond
❑ Low Density -Curb & Gutter ® High Density -Infiltration
WETLANDS MUST BE ADDRESSED BELOW
❑ High Density -Other
❑ Off Site
El COASTAL ❑ Excavation & Fill ❑ Bridges & Culverts ❑ Structures Information
MANAGEMENT ❑x Upland Development ❑ Marina Development ❑ Urban Waterfront
( �L �A -3s31
® LAND QUALITY 0 Erosion and Sedimentation Control Plan with 3 • I acres to be disturbed.($ 00 00 (for DENR use))
0
WETLANDS {401r Check all that apol *00T W vv H +ts kv-F- ,
Wetlands on Site ❑ Yes 0 No I
Wetlands Delineation has been completed: ❑ Yes © No 1
US ALOE Approval of Delineation completed: ❑ Yes © No
404 Application in Process wl US ACOE: ❑ Yes ® No 1
401 Application required: []Yes Z No If YES, ❑ Regular
Perennial, Blue line stream, etc on site R yes ❑ No
DF C0t'lS-C9'aGT10N
Isolated wetland on Property ❑ Yes 0 No
Suffer Impacts: 0 No ❑ YES: acre(s)
Permit Received from US ACOE ❑ Yes 0 No
❑ Express
The legislation allows additional fees, not to exceed 50% of the original Express Review permit application fee, to be
charged for subsequent reviews due to the insufficiency of the permit applications.
For DENR use only
Fee Split for multiple permits: .3 I? vv ) Total Fee Amount $ '4oG)n
SUBMITTAL
DATES
Fee
SUBMITTAL
DATES
Fee
CAMA
LOS
4l - v b L
CD C v
SW HD; LID)
32-00-rF)
401:
Stream Deter,,

f
Refer to this list of items to make sure all necessary documents are part
of the SW application package
A complete package (for Express submittals) includes all of the items listed below.
Initial blank spaces for completion
J� Original and one copy of the Stormwater Management Permit Application Form
N One copy of the applicable Supplement Form(s) for each BMP
Permit application processing fee
J B Detailed narrative description of stormwater treatment/management
J Two copies of plans and specifications, including:
$ - Development/Project name
$_- Engineer and firm
B - Legend
8 - North arrow
Ja - scale
Revision number & date
��- Mean high water line
E � V
NOV - 9 2006
DWQ-WAR®
J B - Dimensioned property/project boundary Cgou N VA RY ON LT, W0 D t M E N 5 10 N5)
J8 - Location map with named streets or NCSR numbers
J $ - Original contours, proposed contours, spot elevations, finished floor elevations
J g - Details of roads, drainage features, collection systems, and stormwater control
measures
J.B - Wetlands delineated, or a note on plans that none exist
J B -Existing drainage (including off -site), drainage easements, pipe sizes, runoff
calculations
Drainage areas delineated
- Vegetated buffers (where required)
Note: High density project include soil report

Permit No.
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
BIORETENTION BASIN SUPPLEMENT
D)KQ Stormwater Mana ment Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, a bioretention
area supplement for each proposed system, sealed design calculations, soils report and 2 sets of plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name :
Contact Person:
Phone Number:
For projects with multiple basins, specify which basin this worksheet applies to: bA #:Z.
(musr match the DA # on the appllcarion)
II. DESIGN INFORMATION -Attach supporting calculations/documentation. Provide a written soils report based
on actual field investigations conducted by a qualified individual.. The soils report should include informational
references to the County soils maps when available. All elevations shall be in feet mean sea level (fms]).
Scon t
Soils Report Summary WE W I L L T-012W !��
In -Situ Soil Type nklS pA�•T.& ot~L (t-1-06
In -Situ Soil Infiltration Rate . in./hr. (the most restrictive soil layer) •S,D Y�u,R A'Rt�•
SHWT Elevation ft. (Seasonal High Water Table elevation
NO E,lt PENCE. tar WATEtt TA6L 1W 6-
must Soil Texture ,� _ must e a sandy loam, loamy son , or aam texture)t
Planting Soil Infiltration RateE 02 in./hr. (estimate
Basin Design Parameters
Drainage Area
�6O IS9. 4 sq.ft, (on -site and off -site drainage to the basin)
Impervious Area
59 G 11 .2 sq.ft. (on -site and off --site drainage to the basin)
Design Storm
I inch (1.5 inch event for SA waters, 1 inch event for others)
Design Volume
L( 2)0 a c.f. (storage volume required)
Inlet Velocity
DrawdownTime•3
— fps
hours(3'}�12"�+}{1•Q1 �� = 35,3 FIRS
Basin Dimensions
Basin Size 1 -15 • ft. x 2 2.50 ft. = 39 5 6.2 sq. ft. (surface area at basin bottom)
Basin Volume Provided 5 003 c.f.
(400 STSKS/Ac - MiWIMGtM) 3gS6.� ,O�iOS
Minimum # of plantings. stems (1000 stems per acre of bioreterttion area) y I $ 6 b
Total #of plantings provided 40 Trees 10 Shrubs 3 0 (must be a"t least 3 shrubs for each tree)
Basin Elevations
Temporary Pool Elevation 23.9S ' frnsl (elevation of the bypass/outlet structure)
Planting Elevation �2 - 1Y fmsl (elevation of the ground surface bottom)
Bottom Elevation 20 - 45 fmsl (elevation of the bottom of the planting media)
Page 1 of 3

10 9-
'=^ Permit No. W r7 00
(to be provided by DWQ)
RECE[1VE:[) State of North Carolina
Department of Environment and Natural Resources
NOV y 9 2006 Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
0vvQ-WAR0
BIORETENTION BASIN SUPPLEMENT
DWQ Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a stormwater management permit application, a bioretention
area supplement for each proposed system, sealed design calculations, soils report and 2 sets of plans and specifications
showing all stormwater conveyances and system details.
I. PROJECT INFORMATION
Project Name :
Contact Person:
Rx. _ {
Phone Number: (_9_1E) 8-13 - Z- Z
For projects with multiple basins, specify which basin this worksheet applies to; T)t, *-2
(must match the DA # on the application)
II. DESIGN INFORMATION -Attach supporting calculations/documentation. Provide a written soils report based
on actual field investigations conducted by a qualified individual. The soils report should include informational
references to the County soils maps when available. All elevations shall be in feet mean sea level (fmsl).
Soils Report Summary `
In -Situ Soil Type C- vtv
In -Situ Soil Infiltration Rate C1• X— R in./hr. (the most restrictive soil layer)
SHWT Elevation ft. (Seasonal High Water Table elevation) �9r,tA- .jam
-f No E,11I7trNCE OF WA-tF-P TAB1_E Its B-3.
Planting Soil Texture SAt� D`( L DAM (must be a sandv loans, loamy sand, or loam texture) f
Planting Soil Infiltration Rate 1, 02. in./hr. (estimated) �r w,C.*ol;.d. �'�'hc�►-j'
Basin Design Parameters
Drainage Area
Impervious Area
Design Storm
Design Volume
Inlet Velocity
Drawdown Time
Basin Dimensions
Basin Size
Basin Volume Provided
Minimum # of plantings
Total #of plantings provided
Basin Elevations
Temporary Pool Elevation
Planting Elevation
Bottom Elevation
Iap ISO. 4 sq.ft. (on -site and off -site drainage to the basin)
5Gl 6�7 •2 sq.ft. (on -site and off -site drainage to the basin)
inch (1.5 inch event for SA waters, I inch event for others)
Li (609 c.f. (storage volume required)
35.3 hours (3 �� C�I14 R� = 3S.3 li R5
115 - b3 ft. x 2 2.50 ft, = 3 9 5 b . 2 sq. ft. (surface area at basin bottom).
5 OQ_3 _.. c.f.
(kpo STEAs/ptc _ MINI KatA)
31 stems (1000 .items per acre of bioretention area) 43 5 fa b
4 D Trees 10 Shrubs 30 (nnist be at least 3 shrubs for each tree)
Z 3 - 9S fmsl (elevation of the bypass/outlet structure)
22 . 015 fmsl (elevation of the ground surface bottom)
20.95 fmsl (elevation of the bottom of the planting media)
Page I of 3

III. REQUIRED ITEMS CHECKLIST
Initial in the space provided to indicate that the following design requirements have been met and supporting
documentation is attached. If a requirement has not been met, attach written Justification. An incomplete submittal
package will result in a request for additional information and will substantially delay final review and approval of the
project.
Applicants Initials
J B a. No vertical sand bed is proposed.
JB b. The bioretention area is at least 40 feet by 15 feet.
Jg c. Sheet flow is provided at the inlet.
g d. A grass buffer strip is provided at the inlet.
e. Seasonal High Water table depth is at least 2 feet below the planting elevation surface.
B f. Pending depth of 6-12" is provided.
JAJ/i� g. In -situ soils have a minimum hydraulic conductivity of 0.52 inches per hour.
g h. An in-depth soils report is provided.
C} $ i. The planting soil has a minimum hydraulic conductivity of 0.52 inches per hour and the type is noted
on plans.
j. The planting soil meets minimum -soil specifications per the latest version of the NCDENR Stormwater
pp Best Management Practices Manual.
JP k. The ponded area will draw down in less than 5 days. (calculations attached)
1. A planting plan and schedule with species and densities is provided on the plans.
Jm. Mulch layer and depth is specified on plans.
t n. Plan and section details for the bioretention area are provided. (including dimensions and elevations)
o. Plan details for the inlet and outlet are provided.
J B p. An operation and maintenance agreement signed and notarized by the responsible party is provided.
This system (check one) ✓ does does not incorporate the use of an under -drain.
IV. BIORETENTION BASIN OPERATION AND MAINTENANCE AGREEMENT
Maintenance activities shall be performed as follows:
1. Inspect the bioretention area system for soil and mulch erosion, vegetated cover, and general condition after every
significant runoff producing rainfall event and at least monthly. Remove trash as needed.
2. Repair eroded areas immediately, re -seed and re -mulch as necessary to maintain good vegetative and mulch cover.
Page 2of3

3. Remove accumulated sediment and old mulch as needed to maintain good infiltration. Replace, or add additional
mulch as needed. Removal of the old mulch layer before applying the new layer is recommended every 2 to 3 years.
4. Prune trees and shrubs and remove debris on an annual basis. Grassed vegetation should not exceed 6 inches in height.
5. Treat all diseased trees and shrubs whenever needed. Remove and replace all dead and diseased vegetation considered
beyond treatment every 6 months.
6. Replace support stakes yearly (in the Spring). Replace deficient stakes or wires whenever needed.
7, Soil testing shall be conducted annually to determine pH and any accumulation of toxins in the planting media. Lime
or other alkaline substances shall be applied as recommended per the soil test and toxic soils shall be removed,
disposed of properly and replaced with new planting media.
8. All components of the bioretention area system shall be maintained in good working order.
1 acknowledge and agree by my signature below that 1 am responsible for the performance of the eight 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.
Print name: DaG!'k
Title: , ?Pc� T OR
Address: 2 4 (v e—AVO M 6,
Phone: (Z 5 Z) LA 4 -1 — 2.1 t 2-
Signature: _
Date: r
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, i D6eeza, ` -TL" 1 GE , a Notary Public for the State of AlCM46 Ch&Oz/nCLI
County of CP.Arle/1 do hereby certify that Fxthek %are D shw,41A-
personally appeared before me this day of ND dear, here 7 , Q oo& , and acknowledge the due execution
of the forgoing bioretention basin maintenance requirements. Witness my hand and official seal,o�L�C(tA
..........
SUS
=; 9'• psi B LAG : c;
SEAL
My commission expires /42l o� ODD
Page 3 of 3