SW4161101_CURRENT PERMIT_20161205

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
sw,/y
DOC TYPE
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
YYYYMMDD
I

Received
NOV 3 0 2016
Energy, Mineral
and Land Resources Land Quality Section
ENVIRONMENTAL QUALITY
Asheville
November 28, 2016
Mr. Bob Broadway, Manager
The Broadway Group, LLC
216 West Side Square
Huntersville, AL 35801
Subject: Stormwater Permit No. SW4161101
The Broadway Group, Foscoe, NC
Dear Mr. Broadway:
PAT MCCRORY
Gn""nr
DONALD R. VAN DER VAART
.1e¢r eG,m
TRACY DAVIS
NC Department of
Environmental Quality
Received
DEC 0 5 2016
FY
1;{ Winston-Salem
Regional Office
The Division of Energy, Mineral, and Land Resources (DELMR), received a complete Stormwater
Management Permit Application for the subject project on November February 25, 2016. 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 Section NCAC 2H.1000. We are forwarding Permit No. SW4161101,
dated November 28, 2016, for the construction, operation and maintenance of the subject project and the
stormwater system. This permit shall be effective from the date of issuance until November 27, 2024, or
until rescinded and shall be subject to the conditions and limitations as specified therein, and does not
supersede any other agency permit that may be required.
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 Asheville Regional Office. If you have any questions, or need
additional information concerning this matter, please contact Mike Randall at [phone]; or
[e-mail].
Sincerely,
for Tracy E. Davis, PE, CPM, Director
cc: SW4161101 File, Asheville Regional Office
cc: Melissa Ballard, The Broadway Group, LLC
Pete Moreau, CEI Engineering Associates, Inc.
slate of North Calolim I Envimnraental Quality I liner6ry, Mineral and land Resources
1612 Mail Service Center I Raleigh, North Carolina 27699-1612
919-807-6375

State Stormwater Permit
Permit No. SW4161101
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT QUALITY
STATE STORMWATER MANAGEMENT PERMIT
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
The Broadway Group — Foscoe North Carolina
Watauga County
FOR THE
construction, operation and maintenance of the dry detention basin 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 State and considered a part of this permit.
This permit shall be effective from the date of issuance until November 27, 2024, and shall
be subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data.
2. The dry detention basin is approved for the management of stormwater runoff as
described in the application documents and as shown on the approved plans.
3. 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.
4. The runoff from all built -upon area within the permitted drainage area of this project
must be directed into the dry detention basin.
5. The built -upon areas associated with this project shall be located at least 30 feet
landward of all perennial and intermittent surface waters.
Page 1 of 4

State Stormwater Permit
Permit No. SW4161101
II. SCHEDULE OF COMPLIANCE
During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
2. The permittee shall at all time provide the operation and maintenance necessary to
assure the dry detention basin 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 (every 6 months).
b. Sediment removal.
C. Mowing and re -vegetation of slopes and the filter strip.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans.
f. Debris removal and unclogging of all drainage structures, level spreader, filter
media, planting media, underdrains, catch basins and piping.
g. Access to the cell and outlet structure must be available at all times.
Records of maintenance activities must be kept for the dry detention basin. The
reports will indicate the date, activity, name of person performing the work and what
actions were taken.
4. The permittee shall submit an annual summary report of the maintenance and
inspection records for each of the dry detention basin. The report shall summarize
the inspection dates, results of the inspections, and the maintenance work
performed at each inspection.
5. The dry detention basin shall be constructed in accordance with the approved plans
and specifications, the conditions of this permit, and with 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 dry detention basin certifying that it 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. 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 was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
Page 2 of 4

State Stormwater Permit
Permit No. SW4161101
9. A copy of the approved plans and specifications shall be maintained on file by the
Permittee for a minimum of eight years from the date of the completion of
construction.
10. 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 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 signed by both parties; to the State,
accompanied by the supporting documentation. The approval of this request will be
considered on its merits and may or may not be approved.
2. The permittee is responsible for compliance with all permit conditions until such time
as the Division approves a request to transfer the permit.
Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the State, 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 DEQ 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 re -issuance or termination does
not stay any permit condition.
8. 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.
9. Approved plans and specifications for this project are incorporated by reference and
are enforceable parts of the permit.
Page 3 of 4

State Stormwater Permit
Permit No. SW4161101
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 21-1.1000, 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 281' day of November, 2016.
Director Division of Energy, Mineral, and Land Resources
Page 4 of 4

State Stormwater Permit
Permit No. SW4161101
The Broadway Group — Foscoe North Carolina
Watauga 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 Name)
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.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
cc: NCDEQ-DEMLR Asheville Regional Office
Page 1 of 1

DEM LR USE ONLY
Date Received
Fee Paid
Pe mit
rV7
Applicable ples: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post ClonstYuction
R&ceWQApply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
NOV 3 0 2016
State of North Carolina
Department of Environment and Natural Resources
Land Quality Section Division of Energy, Mineral and Land Resources
Asheville STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This forth may be photocopied for use as an original
I. GENERAL INFORMATION QLi`.7tie
1. Project Name (subdivision, facility, or establishment name - should be consistent with project We on plans,
specifications, letters, operation and maintenance agreements, etc.):
- r
2. Location of Project (street address): .�y C 0J%
8973 NC-105 %Er
City:Foscoe County:Watauea Zip:28607 `a
3. Directions to project (from nearest major intersection): Q
260' West of Church Road NCSR 1559 south side of NC-105.
5 miles east of NC-184. n
4. Latitude:36° 9' 26" N Longitude:81 ° 46' 18" W — of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification ❑ Renewal w/ Modificationt
tRenewnls znith modifications also requires SWU-102 - Reneeual Application Form
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) and the status of
construction: ❑Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Low Density ®High Density ❑Drains to an Offsite Stormwater System ❑Other
3. If this application is being submitted as the result of a previously returned application or a letter from
DEMLR requesting a state stormwater management permit application, list the stormwater project number,
if assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
❑CAMA Major
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 2.1 ac of Disturbed Area
❑404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? ®No ❑Yes
If ycs, see S.L. 2012-200, Part VI: http:///oortal.ncdenr.org/web/Ir/rules-and-regulations
FormSWU-101 Version Oct. 31,2013 Page Iof6

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: The Broadway Group, LLC
Signing Official & Title: Bob Broadway,fEe fKe,,,x_ L¢
b. Contact information for person listed in item 1 a above:
Street Address: 216 West Side Sgaure
City: Huntsville State: AL Zip: 35801
Mailing Address (if applicable): P.O. Box 18968
City: Huntsville
Phone: (256 ) 533-7287
Email:[e-mail]
State: AL Zip: 35804
Fax: (256 ) 533-7236
c. Please check the appropriate box. The applicant listed above is:
® The property owner (Skip to Contact Information, item 3a)
❑ Lessee* (Attach a copy of the lease agreement and complete Contact Information, item 2a and 2b below)
❑ Purchaser* (Attach a copy of the pending sales agreement and complete Contact Information, item 2a and
2b below)
❑ Developer* (Complete Contact Information, item 2a and 2b below.)
2. a. Print Property Owner's name and title below, if you are the lessee, purchaser or developer. (Phis is the
person who owns the property that the project is located on):
Property Owner/Organization-
Signing Official & Title:
b.Contact information for person listed in item 2a above:
Street Address:
City: State: Zip:
Mailing Address (if applicable):
City: State: Zip:
Phone: ( ) 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: The Broadway Group, LLC
Signing Official & Title: Melissa Ballard, Due Diligence Coordinator
b.Contact information for person listed in item 3a above:
Mailing Address: 216 West Side Square
City: Huntsville State: AI_ Zip: 35801
Phone: (256 ) 533-7287
Email: me][e-mail]
Fax: (256 ) 533-7236
4. Local jurisdiction for building permits: Watauga County Planning & Inspections
Point of Contact: Joe Furman Phone #i: (828 ) 265-8043
Form S WU-101 Version Oct. 31, 2013 Page 2 of 6

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stonmwater runoff will be treated.
Runoff from proposed building and parking areas will be collected with a series of catch basins and
routed to a dry detention basin at the south end of the site for treatment.
2. a. If claiming vested rights, identify the supporting documents provided and the date they were approved:
❑ Approval of a Site Specific Development Plan or PUD Approval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW - 1995 ❑ Ph II - Post Construction
3. Stormwater runoff from this project drains to the Watauga River basin.
4. Total Property Area: 2.16 acres 5. Total Coastal Wetlands Area: 0.0 acres
6. Total Surface Water Area: 0.0 acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area*: 2.16 acres
* Total project area shall be calculated to exclude the following the norrrral pool of impmmded structures, fhe area
betzoeen the banks of streams and rivers, the area belora the Normal High Water (NHW) line or Mean High Water
(MFIW) tine, and coastal Wetlands landeoard front the NHW (or MHM line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal euetlands landtuard of the NFIW (or MHW) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 56 9
9. How many drainage areas does the project have? 1 (For high density, count I for each proposed engineered
stornnvater BMP. For loud density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drainage Area 1
Drainage Area _
Drainage Area _
Drainage Area _
Receiving Stream Name
Watauga River
Stream Class *
B; Tr; HQW
Stream Index Number *
8-(1)
Total Drainage Area (so
104,790
On -site Drainage Area (so
94,072
Off -site Drainage Area (so
10,718
Proposed Impervious Area** (so
55,517
Impervious Area* total
53.0%
Impervious— Surface Area
Draina e Area 1.
Draina e Area
Draina e Area
Draina e Area _
On -site Buildings/Lots (so
10,906
On -site Streets (so
7,846
On -site Parking (so
31,622
On -site Sidewalks (so
2,035
Other on -site (so
0
Future (sf)
0
Off -site (so
3,108
Existing BUA*** (so
0
Total (so:
55,517
" Stream Class and Index Number can be determined at: htty.//portaLncdenr.or eoeb/zi)(Vps/esu/classiFications
** Intpervious area is defined as file built upon area including, but not limited to, buildings, roads, parking areas,
sidcvvalks, gravel areas, etc.
*** Report only that annunt of existing BUA tlutt will rennin after development. Do not report any existing BUA that
is to be removed and which will be replaced by neiv BUA.
Form SWU-101 Version Oct. 31, 2013 Page 3 of 6

11. How was the off -site impervious area listed above determined? Provide documentation. Topographic Survey
- Ron Kirkland Land Surveying dated 3-17-16
Proiects in Union County: Contact DEMLR Central Office staff to check if the project is located within a Threatened &
Fndangered Species irntershed that may be subject to more stringent stormu,ater requirements as per 15.4 A'CAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http://portal.ncdetir.org/web/wq/ws/su/bmp-manual.
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Energy, Mineral and
Land Resources (DEMLR). A complete package includes all of the items listed below. A detailed application
instruction sheet and BMP checklists are available from
ham://portal.ncdenr.org/web/wq/ws/su/statesw/forms does. The complete application package should be
submitted to the appropriate DEMLR Office. (The appropriate office may be found by locating project on the
interactive online map at http://portal.ncdenr.org/web/wq/ws/su/maps.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from hfp://12ortal.ncdenr.org/web/wq/ws/su/statesw/forms does.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants_
Form. (if required as per Part VII belor))
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
ham://www.envhelp.org/pages/onestol2express.html for information on the Express program
and the associated fees. Contact the appropriate regional office Express Permit Coordinator for
additional information and to schedule the required application meeting.)
5. A detailed narrative (one to two pages) describing the stormwater treatment/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 1h mile of the site boundary, include the 1/2
mile radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
Form SWU-101 Version Oct.31, 2013 Page of

p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xll" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate
(Infiltration Devices submitted to WiRO: Schedule a site visit far DEMLR to verifij the SHWT prior
to submittal, [phone].)
10. A copy of the most current property deed. Deed book: Page No:
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item la, 2a, and/or 3a per 15A NCAC 21-1.1003(e).
The corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
http:/ /www.secretary.state.nc.us/Corporations/CSearch.aspx
VIL DEED RESTRICTIONS AND PROTECTIVE COVENANTS
PL��J
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table listing each lot number, lot size, and the allowable built -upon area must be provided
as an attachment to the completed and notarized deed restriction form. The appropriate deed restrictions and
protective covenants forms can be downloaded from http://portal.ncdenr.orglweb/Ir/state-stormwater-
forms does. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMLR, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer: Pete Moreau
Consulting Firm: CEI Engineering Associates, Inc.
Mailing Address: 2025 Centre Point Blvd., Suite 210
City: Mendota Heights State: MN Zip: 55120
Phone: (651 ) 452-8960
Email:[e-mail]
Fax: (651 ) 452-1149
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been 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 type name of person
listed in Contact lnfomuation, items to) with (print or type naive of organization listed in
Contact Infonmation, item la) to develop the project as currently proposed. A copy of
the lease agreement or pending property sales contract has been provided with the submittal, which indicates the
party responsible for the operation and maintenance of the stormwater system.
Form SWU-101 Version Oct. 31, 2013 Page 5 of6

As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR immediately and
submit a completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater
treatment facility without a valid permit. I understand that the operation of a stormwater treatment facility
without a valid permit is a violation of NC General Statue 143-215.1 and may result in appropriate enforcement
action including the assessment of civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature:
1, a Notary Public for the State of County of
do hereby certify that
before me this _ day of
personally appeared
and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission
X. APPLICANT'S CERTIFICATION
1, (print or type nacre ofperson listen in Contact Information, item 1a) -Th0 f3r't �'va Ld..
certify that the information included on this permit application form is, to the bes of my knov�ledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 2H .1000 and any other applicable state stormwater requirements.
Date: I 1 I
a Notary Public for the State of kal,Aya— . County of
Sov\ do hereby certify that-0-0bZr'V- (VI. 0Z)( 0,4 W0.,u personally appeared
before me this'Aa day of NOV,t.WIbQX a.otln , and acknowledge the due execution of the application for
a stormwater permit, Witness my hand and official seal, �1/r'YC. t� IXtKkAti.ot
SSF D
�� : •R`�ssioq `99 i
LU
••off. F+.o••• � i
S TAV—
SEAL
My commission expires 3� I5111
Form S WU-101 Version Oct. 31, 2013 Page 6 of 6

Project Name
Project Location
The Broadway Group - Foscoe NC
8973 NC-105
maintenance recoras snaii oe Kept on me rouowing twins). i nis maintenance record snap oe Kept in a iog in a Known sei
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 pollutant removal efficiency of the BMP(s).
The BMP(s) on this project include (check all that apply & corres onding O&M tables wi
Bioretention Cell Quantity:77 Location(s):
Dry Detention Basin Quantity:
Grassed Swale Quantity:
Green Roof Quantity:
Infiltration Basin Quantity:
Infiltration Trench Quantity:
Level SpreaderNFS Quantity:
Permeable Pavement Quantity:
Proprietary System Quantity:
Rainwater Harvesting Quantity:
Sand Filter Quantity:
Stormwater Wetland Quantity:
Wet Detention Basin Quantity:
Disconnected Impervious Area Present:
User Defined BMP Present:
1
Location
Location
Location
Location
Location
Location
Location
Location
Location
Location
Location
Location
Location
Location
No
No
ISouth end of site. I
I acknowledge and agree by my signature below that I am responsible for the performance of the maintenance procedures listed
for each BMP above, and attached O&M tables. I agree to notify NCDENR of any problems with the system or prior to any
changes to the system or responsible party.
* Responsible Party:
Title & Organization:
Street address:
City, state, zip:
Phone number(s):
Email:
Signature:
Owner
The Broadway Group, LLC
216 West Side Square
Huntsville, AL, 36801
256-633-7287
[e-mail]
Date: 111a a i It,
I, M ELIG5A Z. T Z%R-o a Notary Public for the State of or 11 01,:a,rna_.
County of M0.1;Son do hearby certify that -i�b qq+ rA - 13vro01c1 U' n AJ-
personally appeared before me this a a "a day of W04t nX6'✓, a O I to and
acknowledge the due execution of the Operations and
�Maintenance Agreement .
Witness my hand and official seal, %V A Q ✓Y12- ^� 6' 3W➢01t.� �tullu/�
tv F' p
Received
0 �p A4?Y+4 NOV 3 0 2016
--
F'UF3,rj 2 `.-_ Land Quality Section
Asheville
STOSWZ My commission expires 31ISi 1- i STATE P �`%
Version 1.4-o3101ivra7Nd.
11/17/2016
Page 1 of 5

r Dry Detention Pond Maintenance Requirements
Important maintenance procedures:
- The drainage area will be managed to reduce the sediment load to the dry extended detention basin.
- Immediately after the dry extended detention basin is established, the vegetation will be watered twice weekly if needed
until the plants become established (commonly six weeks).
- No portion of the dry extended detention pond will be fertilized after the first 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.
- If cracks, seepage, or woody vegetation is present, consult a dam safety expert for a dam inspection.
The measuring device used to determine the sediment elevation shall be such that it will give an accurate depth reading and not
readily penetrate into accumulated sediments.
After the dry detention basin is established, it will be inspected quarterly. Inspection activities shall be performed as follows and
any problems identified will be remediated immediately per the table below.
BMP element:
Potential problem:
How to remediate the problem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the BMP
Areas of bare soil and/or
Regrade the soil if necessary to remove the gully, and then plant a
erosive gullies have formed.
ground cover and water until it is established. Provide lime and a one-
time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of approximately six inches.
long.
The inlet device
The pipe is clogged.
Unclog the pipe. Dispose of the sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged.
Erosion is occurring in the
Regrade the swale if necessary to smooth it over and provide erosion
swale.
control devices such as reinforced turf matting or riprap to avoid future
problems with erosion.
Stone verge is clogged or
Remove sediment and replace with clean stone.
covered in sediment (if
applicable).
The forebay
Trash/debris is present.
Remove the trash/debris.
Erosion has occurred or
Provide additional erosion protection such as reinforced turf matting or
riprap is displaced.
riprap if needed to prevent future erosion problems.
Weeds are present.
Remove the weeds, preferably by hand. If pesticides are used, wipe
them on the plants rather than spraying.
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Version 1.4 O&M Manual Page 3 of 5

I : Dry Detention Pond Maintenance Requirements (continued) I
BMP element:
Potential problem:
How to remediate the problem:
The main treatment area
Sediment has accumulated
Search for the source of the sediment and remedy the problem if
and reduced the depth to 75%
possible. Remove the sediment and dispose of it in a location where it
of the original design depth
will not cause impacts to streams or the BMP. Revegetate disturbed
(per pond design data sheet)
areas immediately with sod (preferred) or seed protected with securely
staked erosion mat.
Water is standing more than
Check outlet structure for clogging. If it is a design issue, consult an
5 days after a storm event.
appropriate professional.
Weeds and noxious plants
Remove the plants by hand or by wiping them with pesticide (do not
are growing in the main
spray).
treatment area.
The embankment
Shrubs or trees have started
Remove shrubs or trees immediately.
to grow on the embankment.
Grass cover is unhealthy or
Restore the health of the grass cover — consult a professional if
eroding.
necessary.
Signs of seepage on the
Consult a professional.
downstream face.
Evidence of muskrat or
Use traps to remove muskrats and consult a professional to remove
beaver activity is present.
beavers.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair.
The outlet device
Clogging has occurred.
Clean out the outlet device. Dispose of the sediment off -site.
The outlet device is damaged
Repair or replace the outlet device.
The receiving water
Erosion or other signs of
Contact the local NC Department of Environment and Natural
damage have occurred at the
Resources Regional Office.
outlet.
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1 15 Dry Detention Pond Design Summary I
Dry Pond Diagram
DRY POND ID FOREBAY MAIN POND
Temporary Pool El: Temporary Pool El: 3011.5
Clean Out Depth: 0 Clean Out Depth: 2.6
Pretreatment Yes Sediment Storage El: Sediment Storage El: 3008.9
Has Veg. Filter No Bottom Elevation: Bottom Elevation: 3008.5
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Version 1.4 O&M Manual Page 5 of 5