SW6100704_CURRENT PERMIT_20100824

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO,
SW�J1i'�f
DOC TYPE
CURRENT PERMIT
APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATEJ`D��o�`
f
YYYYMMDD
I

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Colleen H. Sullins
Governor Director
August 24, 2010
Pine Needles Country Club, Inc.
Attn: Kelly Miller, President
PO Box 88
Southern Pines, NC 28387
Subject: Stormwater Management Permit SW6,100704
Pine Needles Country Club
High Density Project
Moore County
Dear Mr. Miller:
Dee Freeman
Secretary
The Fayetteville Regional Office of the Division of Water Quality received a complete Stormwater
Management Permit Application for the Pine Needles Country Club project on July 27, 2010. 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 2I-1 .1000. Therefore, we are forwarding herewith
Stormwater Management Permit S W6100704 dated August 24, 2010 for the construction of the subject
prof ect.
This permit shall be effective from the date of issuance until August 23, 2020 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 thirty (30) calendar 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 2761 1-7447. 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 Mike
Lawyer or myself at [phone].
Sincerely,
Belinda S. Henson
Regional Supervisor
Surface Water Protection Section
13SH: ML/ml
cc: Tom Goodwin, PE-Flobbs, Upchurch & Associates, P.A. (via e-mail)
Brent Lockamy, PE, Town Engineer -Town of Southern Pines Planning Department (via e-mail)
FRO -Surface Water Protection
DWQ Central Files
Location: 225 Green Street, Suite 714, Fayetteville, North Carolina 28301
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748
Internet: vxnv.nevatercualitv.oro
Nne
orthCaroli na
Naturally
An Equal Opportunity 1 Affirmative Action Employer

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
Pine Needles Country Club, Inc. - Kellt, Miller
Pine Needles Country Club
Moore Counly
FOR THE
construction, operation and maintenance of two bio-retention areas in compliance with the provisions of
15A NCAC 214 A000 (hereafter referred to as the "stortnwnler 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 August 23, 2020 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 stormwater systems have been approved for the management of stormwater runoff as
described in Section 1.6 of this permit. The stormwater controls have been designed to handle the
runoff from a total of 22,416 square feet of new built -upon area.
3. The tract will be limited to the amount of built -upon area indicated in Section 1.6 of this permit
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.
The runoff from all built -upon areas within the permitted drainage areas of this project must be
directed into the permitted stormwater control systems.
6. The following design criteria has been provided in the bio-retention areas and must be
maintained at design condition:

Bioretention Area 1
a. Drainage Area, ft2:
b. Total Impervious Surfaces, ft'
C. TSS removal efficiency:
d. Bioretention Depth, inches:
e. Temporary Ponded Depth Elevation, FMSL:
Bioretention Bottom Elevation, FMSL:
f. Bioretention Surface Area, It2:
g. Permitted Storage Volume, ft3:
Minimum Required Volume, ft3:
h. Receiving Stream/River Basin:
i. Stream Index Number:
j. Classification of Water Body:
Bioretention Area 2
a. Drainage Area, ft2:
b. Total Impervious Surfaces, 1-12:
C. TSS removal efficiency:
d. Bioretention Depth, inches:
e. Temporary Ponded Depth Elevation, FMSL:
Bioretention Bottom Elevation, FMSL:
f Bioretention Surface Area, ft'`:
g. Permitted Storage Volume, ft3:
Minimum Required Volume, ft3:
h. Receiving Stream/River Basin:
i. Stream Index Number:
j. Classification of Water Body:
IL SCHEDULE OF COMPLIANCE
25.199
16,072
85"/0
12
450.00
445.67
3,503
3,035
1,310
McDeeds Creek/Cape Fear
18-23-11-4
"WS-111;HQW: a "
9,771
6.344
m
12
451.80
447.47
1,355
1,072
517.0
McDeeds Creek/Cape Fear
18-23-11-4
"WS-III;HQW: cr "
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.
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 (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 outlet structure, (low 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.
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.
If the stormwater system was used as an Erosion Control device, it must be restored to design
conditions 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.
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 Erosion and
Sedimentation 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.
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 notily 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.
13. This permit shall be effective from the date of issuance until August 23, 2020. 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.
M. 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.
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.
The issuance of this permit does not preclude the Penmittee 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.
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.
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.
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
thirty (30) calendar days.
Permit issued this the twenty-fourth day of August 2010.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission
Stormwater Management Permit SW6100704

Pine Needles Country Club Page 1 of 2
Stormwater Management Permit SR'6100704
Moore Countv
Designer's Certification
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 a part of this Certification.
Noted deviations from approved plans and specification:
SEAL
Signature
Registration Number
Date

..Certification Requirements:
Page 2 of 2
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 runolI'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

DWQ USG ONLY
Date Received
Fee Paid
Permit Number
7-2 /a
SeS
1S4✓ a
Applicable Rules: ❑ Coastal SW - 1995 ❑ Coastal SW - 2008 ❑ I'll 11 - Post Construction
(Select all that apply) ❑ Non -Coastal SW- I-IQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ %i >mt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopier) fi)r use as an original
L 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.):
Pine Needles Country Club
2. Location of Project (street address):
City:Southern Pines County:
3. Directions to project (from nearest major intersection):
Zip:28387
From the Intersection of U.S. Flwy 1 and Midland Road, go west northwest along Midland Road for 0.5 miles,
turn right on Ridge Road, project is on the left.
4. Latitude:35* 11' 46" N Longitude:-79' 23' 34" W of the main entrance to the project.
IL PERMIT INFORMATION:
1.a.Specify whether project is (check one): ®New ❑Modification
I). 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 DWQ
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
®Sedimentation/Erosion Control: 3.6 ac of Disturbed Area
❑NPDES Industrial Stormwater ❑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:
FormSWU-101 Version07Jun2010 Page I of

III. CONTACT INFORMATION
L 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:Pine Needles Country Club
Signing Official & Title:Kelly Miller
b.Contact information for person listed in item la above:
Street Address:P.O. Box 88
City:Southern Pines
Mailing Address (ifapphcahle):
City:
Phone: (910 ) 692-7111
Email:
State:NC Zip:28387
Late: Zip:
Fax: ( )
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, (This is the
person who owns the property that the project is located on):
Property Owner/Organization:Pine Needles Country Club
Signing Official & Title:Kelly Miller
b.Contact information for person listed in item 2a above:
Street Address:P.O. Box 88
City:Southern Pines
Mailing Address (if applicable):
Phone: (910 ) 692-7111
State:NC Zip:28387
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 item 3a above:
Mailing Address:
City: Stat
Phone: ( ) Fax:
Email:
Form SWU-101 Version 07Jun2010 Page 2 of 7

4. Local jurisdiction for building permits: Town of Southern Pines
Point of ContactBrent Lockamy
Phone #: (910 ) 692-1983
IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
Stormwater run-off will be treated with two (2) bioretention basins
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 lI - Post Construction
3. Stormwater runoff from this project drains to the
4. Total Property Area: 10.62 acres
River basin.
5. Total Coastal Wetlands Area: acres
6. Total Surface Water Area: acres
7. Total Property Area (4) - Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area':10.62 acres
Total project area shall be calculated to exclude the folloming the normal pool of impounded structures, the area
between the banks of stremus and rivers, the area behno the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal zoetlauds laudzoard from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BLIA). Nan -coastal toetlmids lanndurard of the NHYV (or MHW) line ❑nay
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 21.66 %
9. How many drainage areas does the project have?7 (For high densihj, count 1 for each proposed engineered
stormroater BMP. For hnv density and other projects, use 1 for the whole properly/ 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.
Form SWU-101 Version 07Jun2010 Page 3 of 7

Basin Information
Drainage Area 1
Drainage Area _
Drainage Area
'Drainage Area
Receiving Stream Name
McDeeds Creek
Stream Class *
WSIII;HQW:©
Stream Index Number *
18-23-11-4
Total Drainage Area (sf)
34,970
On -site Drainage Area (sf)
34,970
Off -site Drainage Area (sf)
0
Pro osed Im ervious t\rea** s
22,116
o Impervious Area** total
64.1
Impervious** Surface Area
Draina e Area 1
Draina a Area
Draina a Area _
Draina a Area _
On -site Buildings/Lots (sf)
8,964
On -site Streets (so
0
On -site Parking (so
60,838
On -site Sidewalks (sf)
8,650
Other on -site (so
0
Future (sf)
0
Off -site (sf)
0
Existing BUA*** (so
21,616
Total (st):
100,068
Stream Class and Index Number can be determined at: hftp//portal.ncdeur.nr*/ucb/oq/ps/c<u/cln>erficntir,ns
Imr{{rervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sn7m,alks, gravel areas, etc.
Report only that mnount If existing BUA that Will remain after development. Do not report any existing BUA that
is to be removed and which will be replaced by nezo BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. Computer
See Map DA-5 in calculation book
Projects in Union County: Contact D4VQ Central O#ice staff to check if the project is located within a Threatened &
Endangered Species watershed that miry be suhject to more stringent stortwater requirements as per NCAC 02B .0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http //portil ncdenr org/web/wq/ws/su/bap-manual.
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. A detailed application instruction sheet and BMP
checklists are available fromhttp//portlncLienrorg/web/w(IZ",s/su/stilesw/forms does. 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/web/wq/ws/su/maps.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http //portal ncdenr org/aveb/aeai/ays/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 Nln-
Form. (if required as per Part Vll 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://%%,%vw.ciivhelp.org/pages/oiiestoLiexpress.litiii] 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.)
Form SWU-101 Version 07Jun2010 Page 4 of 7

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'/2 mile of the site boundary, include the'h
mile radius on the map.
7. Sealed, signed and dated calculations.
8. "1'wo sets of plans folded to S.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 MFIW (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.
I. 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).
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"x11" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule o site visit for DWQ to verify the SHWT prior
FAF
to submittal, [phone].) 01
10. A copy of the most current property deed. Deed book: MB 1,2,3 Page No: 45,31,60 �J eel ( 5
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 NCAC 2H.1003(e). The
corporation or LLC must be listed as an active corporation in good standing with the NC
Secretary of State, otherwise the application will be returned.
htt2 //www secretarestate nc us/Corporations/CSearch.aspx
VII. DEED RESTRICTIONS AND PROTECTIVE COVENANTS
For all subdivisions, outparcels, and future development, the appropriate property restrictions and protective
covenants are required to be recorded prior to the sale of any lot. If lot sizes vary significantly or the proposed
BUA allocations vary, a table 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
httr portil ncdenr ory/web/wq/rvs/su/statesw/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 DWQ and that they will be recorded prior to the sale of any lot.
Form SWU-101 Version 07Jun2010 Page 5 of7

Vill. 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 EngineecThomas K. Goodwin PE
Consulting Firm: Hobbs Upchurch and Associates P.A.
Mailing Address:P.O. Box 1737
City:Southern Pines State:NC Zip:28388
Phone: (910 ) 692-5616
F.mail:tgoodwin@hobbsupchurch corn
Fax: (910 ) 692-7342
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
1, (print or h/pe name (t person listed in Contact Information, item 2a) Kelhr Miller , certify that I
own the property identified in this permit application, and thus give permission to (print or type ramie of person
listed in Contact Information, item In) with (print or type name of organization listed in
Contact Information, 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.
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 rmit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of C it.
Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of enaltiess oof tt000'25,000 per day, pursuant to NCGS 143-215.6. Signature. / G �n� Date: / %
AIlQ
1, &A1c:I2A 60/ 68 l INJ a Notary Public for the State of � County of
AA6L)& C do hereby certify that_J�FLV t� - Klt /( personally appeared
before me this 14 day of --�UlL�J 90t6,1 nd a knowledge the execution of the application for
a stormwater permit. Witness my hand and official seal,
SANDRA COOPERMAN
NOTARY PUBLIC
MOORE COUNTY, NC
SEAL
bty commission expires 12,2—b r
Form S W U-101 Version 07Jun2010 Page 6 of 7

X. APPLICANT'S CERTIFICATION
1, (print or type name of person listed in Contact Information, item 1a)
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be c structed in conformance with the approved plans, that the required deed restrictions
and protective covens will be recorded, and that the proposed project complies with the requirements of the
applicable storm r es onmay[].Ar 1 2H .1000, SL 2006-246 (Ph. II - Post Construction) or SSL 2008-211.
Sienature: / J / Date: / �! ` Ll
t <54 I�JCJXA COO &Ajt HW , a �Notary Public for the State of / V County of
&1067� E , do hereby certify that KFi� - GLII l DER personally appeared
before me this day of Sup :2010, and a nowlledge the e execution of the application for
a stormwater permit. Witness my hand and official seal, �Lfs� LC d��lib�� L�
SANDRA COOPERMAN
NOTARY PUBUC
MOORE COUNTY, NC
SEAL
My commission expires
FormSWU-101 Version071un2010 Page 7of7

Town of 188
0
outhern Ines
rµ, orth Carolina
/ The Mid South Resort
Internationally Recognized for Program Excellence
Kelley Miller
P.O. Box 88
Southern Pines, NC 28387
910-692-7111
Public Works Department
140 Memorial Park Court
August 18, 2010
Southern Pines, NC 28387
®ENR-FRO-
AUG 2 0 2010
Re: Approval with Modifications: ®WQ
Pine Needles Country Club — CGA Headquarters (TSPE tf 216)
McDeeds Creek, Cape Fear River Basin, WS-III, HQW
Covered under 5/70 Provision: No, Under 24% (need NCDENR approval)
Project Location: Financially Responsible Owner/Developer:
150 Ridge Rd. Kelley Miller
Southern Pincs, NC 28387 P.O. Box 88
Lat: 35' 11' 44" N Southern Pines, NC 28387
Long: 79' 23' 35" W 910-692-7111
Plans Received: 8-12-10'
Dear Mr. Miller:
Sw.bt00%D�
/Sit.-eiOh 8/Zy�O
Our review of the above referenced erosion control plan has been completed. The plan submitted has been found
acceptable with modification and subject to the following stipulations:
1. This is not a stormwater.discharge permit approval. If you receive comments from DENR concerning
the slromwater permit, and the plans change, you. will have to make anew full submittal as stated in note
P2. Provide a copy of approved stormwater plans and calculations along with a copy of the permit when
issued.
2. Provide plans for final signature. PW will require 3 full size sets, 1 scaled -half size set, and a PDF copy of
signed/sealed plans.
3. Indicate tree protection location on plans.
4. ,. Provide a note stating that the existing sewer service to be removed shall be coordinated with TOSP for .
disruption and reconnection.
S. Clarify fire line to be DIP with a dedicated utility easement.
6.: In order to ensure the early coordination and implementation of the erosion control for this project, it. is
requested that.a pre -construction conference be held. Representatives of the owner, engineer, contractor, and
this office should attend. Please notify Mn Barry Hinson at [phone] when scheduling this conference.
7. At the pre -conference, the representative of this office will deliver a set of plans clearly marked as approved for
erosion control .by the Town. After the installation of temporary erosion control measures and devices the
representative of this office will issue the Town of Southern Pines Grading Permit. The Grading Permit must be
posted on the job site. During all phases of construction, the contractor must work only from a set of approved
plans. The marked set of plans and a copy of this letter most be on the site at the time of any construction
activity.
8. The developer is responsible for obtaining any and all permits and approvals necessary for the
development of this project prior to the commencement of this land -disturbing activity. This could
include the Division of Environmental Management under storm water regulations, the US Army Corps of
Engineers under Article 404 jurisdiction, local county or town agencies under their local ordinances, or others
that may be required. This approval cannot supersede any other permit or approval; however; in the case of a
Cease and Desist Order from the Corps of Engineers, that Order would only apply to wetland areas. All other
lands must still be in compliance with the Sedimentation Pollution Control Act.
9. If any area.omsite falls under the jurisdiction of Section 404 of the 'Clean Water Act:, the developer is
responsible to the orders of the US Army Corps of Engineers. Any erosion measures that fall within
jurisdictional wetland areas must be relocated to the transition point between the wetlands and the highlands to
assure that the migration of sediment will not occur. If that relocation presents a problem or contradicts any
Phone: [phone] Fax: [phone]

requirements of the Corps of Engineers, it is the responsibility of the developer to inform the Erosion Control
Inspector so that an adequate contingency plan can be made to assure sufficient erosion control on -site. Failure
to do so will be considered a violation of the approval.
10. This project is subject to the National Pollutant Discharge Elimination System (NPDES) and covered by the
enclosed general storm permit NCGO10000 (Construction Activities). Should you have questions concerning
this permit, contact Ms. Belinda Henson, Division of Environmental Management, at 910-433-3300.
It. Any borrow material brought onto this site must be from a legally permitted mine site or other approved source.
A single use borrow or waste area site is only permissible if it is operated under control of the financially
responsible person or firm that is developing this site. An approved erosion and sediment control plan is
required for all single use borrow and waste sites.
12, Following the installation of all initial erosion control measures, you should notify this office to request an
inspection prior to proceeding with any grading.
13. Following completion of the project, you should notify this office to schedule a final inspection. The purpose of
this inspection is to ensure that all erosion control requirements have been met.
14. This permit ie valid only for 8:e land uwner(s) and financially responsible person(s) as listed on the plans and
Financial Responsibility/Ownership Form. Any changes must be reported to this office on an amended
Financial Responsibility/Ownership form.
15. With this approval the construction inspector for the Town of Southern Pines or his agent has the right to enter
the permitted property to provide for periodic inspection of the land -disturbing activity in accordance with
North Carolina general statue 113a-61.1.
14. The approval of this plan, by the Town of South ern Pines, in no way is meant to relieve the design professional
of his or her responsibility for the project design.
This approval is subject to the satisfactory performance of the erosion control measures under field conditions.
Should it be determined that the requirements of the Sedimentation Pollution Control Act of 1973 (G.S. I I3A, 51-
66) and the Soil Erosion and Sedimentation Control Ordinance of the Town of Southern Pines are not being met,
revisions to the plan and its implementation will be required.
This permit allows for a land disturbance, as called for on the application plan, not to exceed 3_6 acres and/or the
construction limits as shown on the plans. Exceeding these limits will be a violation of this permit and would
require a revised plan and additional application fee.
Amendments to the plan should be submitted to this office under the same procedure as followed for the original
plan.
We look forward to working with you on this project.
Sincerely,
Town of Southern Pines
Brenton S. Lockamy, P.E.
Town Engineer
Enclosure
cc: Tom Goodwin, P.E. Hobbs, Upchurch & Associates
David R. White, Director of Public Services
Barry Hinson, Construction Inspector
Roger Kennedy, Chief Building Inspector
Kathy Blake, AICP, Town Planner
Bart Nuckols, Planning Director
Belinda Henson, NCDENR, Division of Land Quality
Mike Lawyer, NCDENR, Division of Land Quality
Owen Herbert, Engineering Technician

Town of
01outhe!?M
- r,�,
q I \ The Mid South Resort
Internationally Recognized for Program Excellence
Kelley Miller
P.O. Box 88
Southern Pines, NC 28387
910-692-7111
Public Works Department
140 Memorial Park Court • Southern Pines, NC 28387
August 18, 2010
®ENR-FRO
AUG 2 0 2010
Re: Approval with Modifications: . - ®WQ
Pine Needles Country Club — CGA Headquarters (TSPE # 216)
McDeeds Creek, Cape Fear River Basin, WS-111, HQW
Covered under 5/70 Provision: No, Under 24% (need NCDENR approval)
Project Location: Financially Responsible Owner/Developer:
150 Ridge Rd. Kelley Miller
Southern,Pines, NC 28387 P.O. Box 88
Lat: 35* I1' 44" N Southern Pines NC 28387
Long: 79° 23' 35" W
Plans Received: 8-12-10
Dear Mr. Miller:
910-692-7111
Our review of the above referenced erosion control plan has been completed. The plan submitted has been found
acceptable with modification and subject to the following stipulations:
1. This is not a stormwater,discharge permit approval. If you receive comments from DENR concerning
the stromwater permit, and the plans change, you will have to make a new full submittal as stated in,note
#2. Provide a copy of approved stormwater plans and calculations along with a copy of the permit when
issued.
2. Provide plans for final signature. PW will require 3 full size sets, 1 scaled -half size set, and a PDF copy of
signed/sealed plans.
3. Indicate tree protection location on plans.
4.:-Provide a note stating that the existing sewer service to be removed shall be coordinated with TOSP for .
disruption and reconnection.
5.. Clarify fire line to be DIP with a dedicated utility easement.
6.: In order to ensure the early coordination and implementation of the erosion control for this project, it, is
requested that a pre -construction conference be held. Representatives of the owner, engineer, contractor, and
this office should attend. Please notify Mr. Barry Hinson at [phone] when scheduling this conference.
7. At the pre -conference, the representative of this office will deliver a set of plans clearly marked as approved for
erosion control by the Town. Alter the installation of temporary erosion control measures and devices the
representative of this office will issue the Town of Southern Pines Grading Permit. The Grading Permit must be
posted on the job site. During all phases of construction, the contractor must work only from a set of approved
plans. The marked set of plans and a copy of this letter must be on the site at the time of any construction
activity.
8. The developer is responsible for obtaining any and all permits and approvals necessary for the
development of this project prior to the commencement ofthis land -disturbing activity. This could
include the. Division of Environmental Management under storm water regulations, the .US Army Corps of
Engineers underArticle 404 jurisdiction, local county or town agencies under their local ordinances; or others
that may be required; This approval cannot supersede any other permit or,approval;,however, in the case of a
Cease and Desist Order from the Corps of Engineers, that Order would only apply to wetland areas. All other
lands must still be in compliance with the Sedimentation Pollution Control Act.
9., If any area'.on site falls under the jurisdiction of Section 404 of the Clean Water Act:, the developer is
responsible to the orders of the US Army Corps of Engineers. Any erosion measures that fall within
jurisdictional wetland areas must be relocated to the transition point between the wetlands and the highlands to
assure that the migration of sediment will not occur. If that relocation presents a problem or contradicts any
Phone: [phone] Fax: [phone]

requirements of the Corps of Engineers, it is the responsibility of the developer to inform the Erosion Control
Inspector so that an adequate contingency plan can be made to assure sufficient erosion control on -site. Failure
to do so will be considered a violation of the approval.
10. This project is subject to the National Pollutant Discharge Elimination System (NPDES) and covered by the
enclosed general storm permit NCG010000 (Construction Activities). Should you have questions concerning
this permit, contact Ms. Belinda Henson, Division of Environmental Management, at 910-433-3300.
11. Any borrow material brought onto this site must be from a legally permitted mine site or other approved source.
A single use borrow or waste area site is only permissible if it is operated under control of the financially
responsible person or firm that is developing this site. An approved erosion and sediment control plan is
required for all single use borrow and waste sites.
12. Following the installation of all initial erosion control measures, you should notify this office to request an
inspection prior to proceeding with any grading.
13. Following completion of the project, you should notify this office to schedule a final inspection. The purpose of
this inspection is to ensure that all erosion control requirements have been met.
^. This pernit !s :a!id only for the land owner(s) and financially resnAnsible person(R) as listed on the plans and
Financial Responsibility/Ownership Form. Any changes must be reported to this office on an amended
Financial Responsibility/Ownership form.
15. With this approval the construction inspector for the Town of Southern Pines or his agent has the right to enter
the permitted property to provide for periodic inspection of the land -disturbing activity in accordance with
North Carolina general statue 113a-6 L 1.
14. The approval of this plan, by the Town of Southern Pines, in no way is meant to relieve the design professional
of his or her responsibility for the project design.
This approval is subject to the satisfactory performance of the erosion control measures under field conditions.
Should it be determined that the requirements of the Sedimentation Pollution Control Act of 1973 (G.S. I I3A, 51-
66) and the Soil Erosion and Sedimentation Control Ordinance of the Town of Southern Pines are not being met,
revisions to the plan and its implementation will be required.
This permit allows for a land disturbance, as called for on the application plan, not to exceed 3_6 acres and/or the
construction limits as shown on the plans. Exceeding these limits will be a violation of this permit and would
require a revised plan and additional application fee.
Amendments to the plan should be submitted to this office under the same procedure as followed for the original
plan.
We look forward to working with you on this project.
Sincerely,
To/wwnn of Southern Pines
rY
Brenton S. Lockamy, P.E.
Town Engineer
Enclosure
cc: Tom Goodwin, P.E. Hobbs, Upchurch & Associates
David R. White, Director of Public Services
Barry Hinson, Construction Inspector
Roger Kennedy, Chief Building Inspector
Kathy Blake, AICP, Town Planner
Bart Nuckols, Planning Director
Belinda Henson, NCDENR, Division of Iand Quality
Mike Lawyer, NCDENR, Division of Land Quality
Owen Herbert, Engineering Technician

PA
NCDENR
Permit Number: 51--"6106 is Y
(to be provided by DWO)
coo wATt.
y y
C<
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL 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.
t t eiy+r
L'.P,ROilECT�INFORMATION!'lt:'+;E'iio- „ ,#y,•,•,,ir in s7, 1 ..dt,
Project name Pine Needles Country Club
Contact name Tom Wanko
Phone number 910-692-5616
Date July, 2010
Drainage area number 1
II? DESIGN INFORMATION 't,
Site Characteristics
Drainage area 25,199 ffz
Impervious area 16,072 ft2
Percent impervious 63.8% %
Design rainfall depth 1.0 inch
Peak Flow Calculations
Is pre/post control of the 1-yr, 24-hr peak flow required?
Y (Y or N)
1-yr, 24-hr runoff depth
0.13 in
1-yr, 24-hr intensity
3.09 in/hr
Pre -development 1-yr, 24-hr peak flow
0.040 ft'/sec
Post -development 1-yr, 24-hr peak flow
- 0.050 ft'/sec
Pre/Post 1-yr, 24-hr peak control
0.010 h /sec
Storage Volume: Non -SA Waters
Minimum volume required
1,310.0 ft'
Volume provided
- 3,035.0 ft'
OK
Storage Volume: SA Waters
1.5' runoff volume
ft3
Pre -development 1-yr, 24-hr runoff
W
Post -development 1-yr, 24-hr runoff
rya
Minimum volume required
0 ft3
Volume provided
ft3
Cell Dimensions
Fording depth of water
12 inches
OK
Fording depth of water
1.00 ft
Surface area of the top of the bioretention cell
3,503,0 ft2
OK
Length:
ft
Width:
ft
-or- Radius
ft
Media and Soils Summary
Drawdown time, ponded volume
8 hr
OK
Drawdown time, to 24 inches below surface
16 hr
OK
Drawdown time, total:
24 hr
In -situ soil:
Soil permeability
32.00 in/hr
OK
Planting media soil:
Soil permeability
1.50 inihr
OK
Soil composition
% Sand (by volume)
85%
OK
% Fines (by volume) -
10%
OK
% Organic (by volume)
5%
OK
Total:
100%
Phosphorus Index (P-Index) of media
10 (unitless)
OK
Form SW401-Bioretention-Rev.8
June 25, 2010 Parts I and II. Design Summary, Page 1 of 2

Permit Number51-/ldU7Q
(to be provided by DWD)
Basin Elevations
Temporary pool elevation
450.00 fmsl
Type of bioretention cell (answer "Y" to only one of the two
following questions):
Is this a grassed cell?
N (Y or N)
Is this a cell with trees/shrubs?
Y (Y or N) OK media depth
Planting elevation (top of the mulch or grass sod layer)
449 fmsl
Depth of mulch
4 inches OK
Bottom of the planting media soil
446 fmsl
Planting media depth
3 ft
Depth of washed sand below planting media soil
0.33 It
Are underdrains being installed?
N (Y or N)
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
0 fit
the bottom of the cell to account for underdrains
Bottom of the cell required
445.67 fmsl
SHWT elevation
440 first
Distance from bottom to SHWT
5.67 ft OK
Internal Water Storage Zone (IWS)
Does the design include IWS
N
(Y or N)
Elevation of the lop of the upturned elbow
fmsl
Separation of IWS and Surface
449 It
Planting Plan
Number of tree species
11
Number of shrub species
19
Number of herbaceous groundcover species
6
OK
Additional Information
Does volume in excess of the design volume bypass the
Y�
(Y or N)
OK
bioretention cell?
Does volume in excess of the design volume flaw evenly distributed
through vegetated filter?
N
Y or N)
Excess volume must pass through filter.
�jgsr J'
i
What is the length of the vegetated filter.?
�
' It
Does the design use a level spreader to evenly distribute flow?
N
(Y orN)
Show how flow is evenly distributed.
Is the BMP located at least 30 feet from surface waters (50 feet if
SA waters)?
Y
(Y or N)
OK
Is the BMP localed at least 100 feet from water supply wells?
Y
(Y or N)
OK
Are the vegetated side slopes equal to or less than 3:19 -
Y
(Y or N)
OK
Is the BMP located in a proposed drainage easement with access
Y
(Y or N)
OK
to a public Right of Way (ROW)?
Inlet velocity (from treatment system)
1 fUsec
OK
Is the area surrounding the cell likely to undergo development in
N
(Y or N)
OK
the future?
Are the slopes draining to the bioretention cell greater than 20%?
N--
(Y or N)
OK
Is the drainage area permanently stabilized?
Y
(Y or N)
OK
Pretreatment Used
(Indicate Type Used with an "X" in the shaded cell)
Gravel and grass
(8inches gravel followed by 3-5 it of grass)
X
Grassed swale
OK
Forebay
Other
Form S W 401-eioretention-Rev.8
June 25, 2010 Parts I and II. Design Summary, Page 2 of 2

Permit No:✓ w a / )
(to be assigned by DWD)
IIL?'REQUIRED'ITEMS'CHECKGSTx„",h`,aF`ir�`,.�:, .�,•,�',,a,tii .�",`..+�� ,;.�',i�i;.°'".iri.-„-k.t t>,..:�:&��{�
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.
Pagel Plan
Initials
Sheet No.
C-4 1. Plans (1' - 50' or larger) of the entire site showing:
- Design at ultimate build -out,
- Off -site drainage (if applicable),
- Delineated drainage basins (include Rational C coefficient per basin),
- Cell dimensions,
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement.
l t' w
2 Plan details (1' = 30' or larger) for the bioretenlion cell showing:
- Cell dimensions
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Design at ultimate build -out,
- Off -site drainage (if applicable),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement.
- Indicate the P-Index between 10 and 30
C3. Section view of the bioretenlion cell (1' = 20' or larger) showing:
- Side slopes, 3:1 or lower
- Underdram system (if applicable), and
- Bioretention cell layers [ground level and slope, pre-treatment, ponding depth, mulch depth, fill media
depth, washed sand, filter fabric (or choking stone if applicable), #57 stone, underdrains (if applicable),
SHWT level(s), and overflow structure]
1
VU)
4. 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 DWD, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information All
elevations shall be in feet mean sea level (fmsl). Results of soils tests of both the planting soil and the in
situ soil must include:
- Soil permeability,
- Soil composition (% sand, % fines, % organic), and
y-���'�
-T iW
-P-index.
C—�4 /L, Z 5. A detailed planting plan (1' = 20' or larger) prepared by a qualified individual showing:
A variety of suitable species, .
- Sizes, spacing and locations of plantings,
- Total quantity of each type of plant specified,
-A planting detail,
- The source nursery for the plants, and
- Fertilizer and watering requirements to establish vegetation.
T(-W
G- 11 6. A construction sequence that shows how the bioretention cell will be protected from sediment until the
entire drainage area is stabilized.
7. The supporting calculations (including underdrain calculations, if applicable).
—(
r f'IA7
6. A copy of the signed and notarized inspection and maintenance (I&M) agreement.
9. A copy of the deed restriction.
Foan SW401-eloretendon-Rev.7 Part III, Page 1 of 1

Bioretention Basin Supporting Calculations
Area - #1
Inflow Calculations
Drairia eArea A'-
25,199 SF
0.58 Acres
Pre=de I me A&n NiousyArea" "
11,857 SF
0.27 Acres
Post-develo ment lm eivious Area rt..;Ir : _ :i.,' :,
16,072 SF
0.37 Acres

Permit Number: �61"66 76-�
(to be provided by DWQ)
Drainage Area Number f
Bioretention 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 operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will be taken to prevent sediment from entering the bioretention cell.
— Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, I will inspect it once a month 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:
Potentialproblems:
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
bioretention cell
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,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or 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.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
Form SW401-Bioretention O&M-Rev.3
Page 1 of 4

BMP element:
The pretreatment area
The bioretention cell:
vegetation
The bioretention
soils and mulch
Flow is bypassing
pretreatment area and/or
gullies have formed.
Sediment has accumulated to
a depth greater than three
inches.
Erosion has occurred
Weeds are present.
Best professional practices
show that pruning is needed
to maintain optimal plant
health.
Plants are dead, diseased or
dying.
Tree stakes/wires are present
six months after planting.
Mulch is breaking down or
has floated away.
Sous anu/ or muicn are
clogged with sediment.
An annual soil test shows that
pH has dropped or heavy
metals have accumulated in
the soil media.
How 1
Regmde if necessary to route all
flow to the pretreatment area.
Restabilize the area after grading.
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
restabilize the pretreatment area.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems.
Remove the weeds, preferably by
hand.
Prune according to best professional
practices.
Determine the source of the
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Remove tree stake/wires (which
can kill the tree if not removed).
Spot mulch if there are only random
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Determine the extent of the clogging
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
Dolomitic lime shall be applied as
recommended per the soil test and
toxic soils shall be removed,
disposed of properly and replaced
with new planting media.
Form SW401-Bioretention O&M-Rev.3
Page 2 of 4

BMP element:
Potentialproblems:
How I will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
(if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
Outlet.
733-1786.
Form SW401-Bioretention O&M-Rev.3
Page 3 of 4

Permit Number: '514k 66
(to be provided by DIVQ)
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: Pine Needles Country Club CGA Site
BMP drainage area number:
Print name:Kelly Miller
Address: 1005 Midland Road, PO Box 88, Southern Pines, NC 28387
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.
[, sly 60 PER &kA& a Notary Public for the State of
Jai County of &jaC- , do hereby certify that
k(-1 (4 P-_ KANE/, personally appeared before me this -
day of 7)LL . b1D , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
SANDRA COOPERMAN
NOTARY PUBLIC
MOORE COUNTY, NC
SEAL
My commission expires n-6 6- �
Form SW401-Bioretention I&M-Rev. 2
Page 4 of 4

Permit Number5-%4 `M (of
(to be provded by DWO)
ff
v"A
Ni
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
BIORETENTION CELL 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.
L PROUECT.INFORMATION , k , IJ,'•'r 3,
Project name Pine Needles Country Club
Contact name Tom Wanko
Phone number 910-692-5616
Date July, 2010
Drainage area number 2
IL, DESIGN INFORMATION v t- i 3`
Site Characteristics
Drainage area 9,771 ft'
Impervious area 6,344 ftz
Percent impervious 64.9% %
Design rainfall depth 1.0 inch
Peak Flow Calculations
Is pre/post control of the 1-yr, 24-hr peak Flow required?
Y (Y or N)
1-yr, 24-hr runoff depth
0.13 in
1-yr, 24-hr intensity
3.09 inlhr
Pre -development 1-yr, 24-hr peak flow
0.030 ft3lsec
Post -development 1-yr, 24-hr peak flow
0.020 ft3/sec
Pre/Post 1-yr, 24-hr peak control
-0.010 ft3/sec
Storage Volume: Non-SAWaters
Minimum volume required
5W.0 ft3
Volume provided
1,072.0 ft3 OK
Storage Volume: SAWaters
1.5" runoff volume
ft3
Pre -development 1-yr, 24-hr runoff
ft3
Past -development 1-yr, 24-hr runoff
it
Minimum volume required
0 113
Volume provided
ft3
Cell Dimensions
Pending depth of water
12 inches OK
Pending depth of water
1.00 ft
Surface area of the top of the bioretention cell
1,355.0 ft2 OK
Length:
ft
Width:
ft
-or- Radius
It
Media and Soils Summary
Drawdown time, bonded volume
8 hr
OK
Drawdown time, to 24 inches below surface
16 hr
OK
Drawdown time, total:
24 hr
In -situ soil:
Soil permeability
32.00 In/hr
OK
Planting media soil:
Soil permeability
1.50 inlhr
OK
Soil composition
• Sand (by volume)
85%
OK
% Fines (by volume)
10%
OK
• Organic (by volume)
5%
OK
Total: 100%
Phosphorus Index (P-Index) of media
10 (unitless)
OK
Form SW401-Bioretention-Rev.8
June 25, 2010
Parts I and It. Design Summary, Page 1 or 2

Basin Elevations
Permit Number: 5k&ot /Q
(to be provided by DWO)
Temporary pool elevation
451.80 fmsl
Type of bioretention cell (answer "Y' to only one of the two
following questions):
Is this a grassed cell?
N (Y or N)
Is this a cell with trees/shrubs?
Y (Y or N) OK media depth
Planting elevation (top of the mulch or grass sod layer)
450.8 fmsl
Depth of mulch
4 inches OK
Bottom of the planting media soil
447.8 fmsl
Planting media depth
3 ft
Depth of washed sand below planting media soil
0.33 ft
Are underdrains being installed?
N (Y or N)
How many clean out pipes are being installed?
What factor of safety is used for sizing the underdrains? (See
BMP Manual Section 12.3.6)
Additional distance between the bottom of the planting media and
0 It
the bottom of the cell to account for underdrains
Bottom of the cell required
447.47 fmsl
SHWT elevation
440 fmsl
Distance from bottom to SHWT
7.47 it OK
Internal Water Storage Zone (IWS)
Does the design include IWS N (Y or N)
Elevation of the top of the upturned elbow fmsl
Separation of IWS and Surface 450.8 It
Planting Plan
Number of tree species 4
Number of shrub species 8
Number of herbaceous groundcover species 1 OK
Additional Information
Does volume in excess of the design volume bypass the Y (Y or N)
bioretention cell?
Does volume in excess of the design volume flow evenly distributed N (Y or N)
through a vegetated filter?
What is the length of the vegetated filter? ft
Does the design use a level spreader to evenly distribute flow?
Is the BMP located at least 30 feel from surface waters (50 feet if
SA waters)?
Is the BMP located at least 100 feet from water supply wells?
Are the vegetated side slopes equal to or less than 3:1?
Is the BMP located in a proposed drainage easement with access
to a public Right of Way (ROW)?
OK
Excess volume must pass through filter. sr�5
N (Y or N) Show how Flow is evenly distributed. C _ _ nn/({�
Y (Y or N) OK �f �`�"�s,..�(F�'-o'1
.s5
Y (Y or N) OK
Y (YorN) OK
Y (Y or N) OK
Inlet velocity (from treatment system) - 1 ft/sec OK
Is the area surrounding the cell likely to undergo development in N (Y or N) OK
the future?
Are the slopes draining to the bioretention cell greater than 20%? N (Y or N) OK
Is the drainage area permanently stabilized?
Pretreatment Used
(Indicate Type Used with an X' in the shaded cell)
Gravel and grass
(8inches gravel followed by 3-5 ft of grass)
Grassed Swale ,
Forebay
Other
Y (Y or N) OK
X
OK
Form SW401-Bimrelention-Rev.8
June 25, 2010 Pans 1 and II. Design Summary, Page 2 of 2

Permit No' (uu N�
(to be assigned by D WD)
IIL'I"REQUIRED`ITEMS'CHECKLIW", " 1n t i •l 'i' 3 "; .
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.
Pagel Plan
Initials Sheet No.
1. Plans (1' - 50' or larger) of the entire site showing:
- Design at ultimate build -out,
- Off -site drainage (if applicable),
- Delineated drainage basins (include Rational C coefficient per basin),
- Cell dimensions,
- Pretreatment system,
- High Flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement.
2. Plan details (1" = 30' or larger) for the bioretention cell showing,
- Cell dimensions
- Pretreatment system,
- High flow bypass system,
- Maintenance access,
- Recorded drainage easement and public right of way (ROW),
- Design at ultimate build -out,
- Off -site drainage (if applicable),
- Clean out pipe locations,
- Overflow device, and
- Boundaries of drainage easement.
- Indicate the P-Index between 10 and 30
TFI/J C'lq 3. Section view of the bioretention cell (1" = 20' or larger) showing:
- Side slopes, 3:1 or lower
- Underdrain system (if applicable), and
- Bioretention cell layers [ground level and slope, pre-treatment, pending depth, mulch depth, fill media
depth, washed sand, filter fabric (or choking stone if applicable), #57 stone, underdrains (if applicable),
SHWT level(s), and overflow structure]
W 4. 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 DWO, by completing & submitting the soils
investigation request form. County soil maps are not an acceptable source of soils information. All
elevations shall be in feel mean sea level (fmsl). Results of soils tests of both the planting soil and the in
situ soil must include:
- Soil permeability,
- Soil composition (% sand, % fines, % organic), and
-P-index.
5. A detailed planting plan (1' = 20' or larger) prepared by a qualified individual showing:
A variety of suitable species,
- Sizes, spacing and locations of plantings,
- Total quantity of each type of plant specified,
A planting detail,
- The source nursery for the plants, and
�7-��Fertilizer and watering requirements to establish vegetation.
T r C41 6. A construction sequence that shows how the bioretention cell will be protected from sediment until the
-('�� ' entire drainage area is stabilized.
t rw 7. The supporting calculations (including underdrain calculations, if applicable).
S. A copy of the signed and notarized inspection and maintenance (I&M) agreement.
9. A copy of the deed restriction.
Form SW401-Bioretention-Rev.7 Part III, Page 1 of 1

Bioretention Basin Supporting Calculations
Area - #2
Peak Inflow Calculations
Drains e'Area A= "' ", a+ ' ' '•>>
9,771 SF
0.22 Acres
Pre=develo ment lm ervious Area
9,122 SF
0.21 Acres
Post=develo pment,Im er0oUs Area v ri .' Pr"
6,344 SF
0.15 Acres

Pennit Number: 5Z-4 toa 2e
(to be provided by DIVQ)
Drainage Area Number: ?i
Bioretention 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 operation and maintenance procedures:
— Immediately after the bioretention cell is established, the plants will be watered
twice weekly if needed until the plants become established (commonly six
weeks).
— Snow, mulch or any other material will NEVER be piled on the surface of the
bioretention cell.
— Heavy equipment will NEVER be driven over the bioretention cell.
— Special care will be taken to prevent sediment from entering the bioretention cell.
— Once a year, a soil test of the soil media will be conducted.
After the bioretention cell is established, 1 will inspect it once a month 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:
Potentialproblems:
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
bioretention cell
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,
The pipe is clogged (if
Unclog the pipe. Dispose of the
stone verge or 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.
Stone verge is clogged or
Remove sediment and clogged
covered in sediment (if
stone and replace with clean stone.
applicable).
Form SW401-Bioretention O&M-Rev.3 Page l of 4

BMP element:
The pretreatment area
The bioretention
vegetation
soils and mulch
Flow is bypassing
pretreatment area and/or
gullies have formed.
Sediment has accumulated to
a depth greater than three
inches.
Erosion has occurred.
Weeds are present.
Best professional practices
show that pruning is needed
to maintain optimal plant
health.
are dead, diseased or
dying.
Tree stakes/wires are present
six months after planting.
Mulch is breaking down or
has floated away.
Soils and/or mulch are
clogged with sediment.
An annual soil test shows that
pH has dropped or heavy
metals have accumulated in
the soil media.
How I will remediate the problem:
Regrade if necessary to route all
flow to the pretreatment area.
Restabilize the area after grading.
Search for the source of the
sediment and remedy the problem if
possible. Remove the sediment and
restabilize the pretreatment area.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
Remove the weeds, preferably by
hand.
Prune according to best professional
practices.
Determine the source of the
problem: soils, hydrology, disease,
etc. Remedy the problem and
replace plants. Provide a one-time
fertilizer application to establish the
ground cover if a soil test indicates
it is necessary.
Remove tree stake/wires (which
can kill the tree if not removed).
Spot mulch if there are only random
void areas. Replace whole mulch
layer if necessary. Remove the
remaining much and replace with
triple shredded hard wood mulch at
a maximum depth of three inches.
Determine the extent of the clogging
- remove and replace either just the
top layers or the entire media as
needed. Dispose of the spoil in an
appropriate off -site location. Use
triple shredded hard wood mulch at
a maximum depth of three inches.
Search for the source of the
sediment and remedy the problem if
Dolomitic lime shall be applied as
recommended per the soil test and
toxic soils shall be removed,
disposed of properly and replaced
with new planting media.
Form SW401-Bioretention O&M-Rev.3
Page 2 of 4

BMP element:
Potentialproblems:
How 1 will remediate theproblem:
The underdrain system
Clogging has occurred.
Wash out the underdrain system.
if applicable)
The drop inlet
Clogging has occurred.
Clean out the drop inlet. Dispose of
the sediment off -site.
The drop inlet is damaged
Repair or replace the drop inlet.
The receiving water
Erosion or other signs of
Contact the NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outict.
733-1786.
Form SW40 I -Bioretention O&M-Rev.3 page 3 of 4

t
Pernut Number: %"t't,V aQ
(to be provided by DIVQ)
I acknowledge and agree by my signature below that 1 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: Pine Needles Country Club CGA Site
BMP drainage area number: 2
Print name:Kelly Miller
Address: 1005 Midland Road, PO Box 88, Southern Pines, NC 28387
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.
t`/ PEA --t A IV , a Notary Public for the State of
I_Li hl -C /,(County of 960 RF , do hereby certify that
KL - rL personally appeared before me this AL
day of `ShIL� 0!p , and acknowledge the due execution of the
forgoing bioretention maintenance requirements. Witness my hand and official seal,
SANDRA COOPERIMAN
NOTARY PUBLIC
MOORE COUNTY, NC
SEAL
My commission expires D
Form SW401-Bioretention IRM-Rev. 2
Page 4 of 4