SW7080904_CURRENT PERMIT_20211231

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

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
BRIAN WRENN
Director
Nags Head Partners, LLC
Attn: Brantley Tillman
1004 Wake Forest Road
Raleigh, NC 27604
Subject:
Dear Brantley Tillman.
NORTH CAROLINA
Environmental Quality
December 31. 2020
Stormwater Permit No. SW7080904
The Shoppes at 10.5
High Density Stormwater Project
Dare County
The Washington Regional Office received a complete Stormwater Management Permit
Application for the modification of The Shoppes at 10.5 project on November 24, 2020. Staff
review of the plans and specifications has determined that the project, as proposed, will comply
with the Stormwater Regulations set forth in Title 15A NCAC 2H.1000. We are forwarding
Permit No. SW7080904 dated December 31, 2020 for the construction of the subject project.
The modification adds 2,454 square feet of additional BUA to the project. However, the overall
BUA has been reduced by 3,561 square feet through survey of actual BUA.
This permit shall be effective from the date of issuance until December 30, 2021, shall void
permit SW7080904 issued on September 18, 2008 and shall be subject to the conditions and
limitations as specified therein, and does not supercede any other agency permit that may be
required. Please pay special attention to the conditions listed in this permit regarding the
Operation and Maintenance of the SCM(s), recordation of deed restrictions, certification of the
SCM's, procedures for changing ownership, and transferring the permit. Failure to establish
an adequate system for operation and maintenance of the stormwater management system,
to record deed restrictions, to certify the SCM's, to transfer the permit, or to renew the permit,
will result in future compliance problems.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have
the right to request an adjudicatory hearing upon written request within thirty (30) days following
receipt of this permit. This request must be in the form of a written petition, conforming to
Chapter 150E of the North Carolina General Statutes, and filed with the Office of Administrative
Hearings, 6714 Mail Service Center, Raleigh, NC 27699-6714. Unless such demands are
made this permit shall be final and binding.
Please contact me at [phone] if you have any questions.
Sincerely,
12,
William Carl Dunn, PE
Environmental Engineer
CC' Cathleen Saunders, PE — Qulble & Associates, PC ([e-mail])
Town of Nags Head Inspections — Cory Tate ([e-mail])
Washington Regional Office
n� n North Carolina Department of Env(, onmental Quality Division of Energy, bLneial and Land Resources
Washington Regional Office 943 Washington Square Moll I Washington, North Carolina 27889
252 VJb 6481

J.
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES
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
Nags Head Partners, LLC
The Shoppes at 10.5
Dare County
FOR THE
construction, operation and maintenance of an infiltration basin and two infiltration trenches in
compliance with the provisions of 15A NCAC 2H .1000 (hereafter referred to as the
"stormwater rules') and the approved stormwater management plans and specifications and
other supporting data as attached and on file with and approved by the Division of Water
Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until December 30, 2021 and shall be
subject to the following specified conditions and limitations:
I. DESIGN STANDARDS
1 This permit is effective only with respect to the nature and volume of stormwater
described in the application and other supporting data
2. This stormwater system has been approved for the management of stormwater runoff
as described in Section 1.6 and 1.7 of this permit. The stormwater control has been
designed to handle the runoff from 259,275 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated on page 3 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.
5. The runoff from all built -upon area within the permitted drainage area of this project
must be directed into the permitted stormwater control system.

6. The following design criteria have been provided in the infiltration basin and must be
maintained
at design condition:
a.
Drainage Area, acres:
6.52
b.
Total Impervious Surfaces, ftz:
199,150
G.
Design Storm, inches:
1.0
d.
Basin Depth, feet:
1.50
e.
Bottom Elevation, FMSL:
8.00
f.
Bottom Surface Area, ftz:
39,922
g.
Permitted Storage Volume, ft3:
67,750
h
Type of Soil:
Corolla, Duckston fine sands and
Newhan-Corolla complex
i.
Expected Infiltration Rate, in/hr:
20
j.
Seasonal High Water Table, FMSL:
6.00
k.
Time to Draw Down, hours.
9
I.
Receiving Stream/River Basin:Atlantic Ocean / Pasquatank River Basin
M.
Stream Index Number:
99-(7)
n.
Classification of Water Body:
"SB"
7. The following design criteria have been provided in the infiltration trenches and must
be maintained at design condition:
Trench T1
Trench T2
a. Drainage Area, acres
0.11
1.27
b Total Impervious Surfaces, ftz:
4,800
55,325
c Design Storm, inches:
1.0
d. Trench Dimensions, L x W x H, ft:
240x20x0.90
2,270x24.404.90
e. Bottom Elevation, FMSL:
10.60
9.30
f. Permitted Storage Volume, ft3:
1,728
19,917
g Type of Soil:
Corolla, Duckston fine sands and
Newhan-Corolla
complex
h. Expected Infiltration Rate, in/hr:
20

Seasonal High Water Table, FMSL: 6.00
Time to Draw Down, hours: 2.16 2.16
k. Receiving Stream/River Basin Atlantic Ocean / Pasquatank River Basin
Stream Index Number: 99-(7)
M. Classification of Water Body: "SB"
11 ai0L'dl1111/_VC414
The stormwater management system shall be constructed in its entirety, vegetated
and operational for its intended use prior to the construction of any built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of the
system will be repaired immediately.
3. The permittee shall at all times provide the operation and maintenance necessary to
assure the permitted stormwater system functions at optimum efficiency. The
approved Operation and Maintenance Plan must be followed in its entirety and
maintenance must occur at the scheduled intervals including, but not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowing and revegetation of slopes and the vegetated filter.
d. Immediate repair of eroded areas.
e. Maintenance of all slopes in accordance with approved plans and
specifications.
f. Debris removal and unclogging of bypass structure, infiltration media, flow
spreader, catch basins, piping and vegetated filter.
g. A clear access path to the bypass structure must be available at all times.
Records of maintenance activities must be kept 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.
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 condition prior to operation as a stormwater treatment device, and prior to
occupancy of the facility.

8. Access to the stormwater facilities shall be maintained via appropriate easements at
all times.
9. The permittee shall submit to the Director and shall have received approval for revised
plans, specifications, and calculations prior to construction, for any modification to the
approved plans, including, but not limited to, those listed below:
a. Any revision to any item shown on the approved plans, including the stormwater
management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project area.
The project area is defined as all property owned by the permittee, for which
Sedimentation and Erosion Control Plan approval or a CAMA Major permit was
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 at all times.
12. The Director may notify the permittee when the permitted site does not meet one or
more of the minimum requirements of the permit. Within the time frame specified in the
notice, the permittee shall submit a written time schedule to the Director for modifying
the site to meet minimum requirements. The permittee shall provide copies of revised
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
formal permit transfer request to the Division of Water Quality, accompanied by a
completed name/ownership change form, documentation from the parties involved,
and other supporting materials as may be appropriate. The approval of this request will
be considered on its merits and may or may not be approved. The permittee is
responsible for compliance with all permit conditions until such time as the Division
approves the transfer request.
2. Failure to abide by the conditions and limitations contained in this permit may subject
the Permittee to enforcement action by the Division of Water Quality, in accordance
with North Carolina General Statute 143-215.6A to 143-215.6C.
3. The issuance of this permit does not preclude the Permittee from complying with any
and all statutes, rules, regulations, or ordinances, which may be imposed by other
government agencies (local, state, and federal) having jurisdiction.
4. In the event that the facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action, including
those as may be required by this Division, such as the construction of additional or
replacement stormwater management systems.

5. The permittee grants DENR Staff permission to enter the property during normal
business hours for the purpose of inspecting all components of the permitted
stormwater management facility.
6. The permit may be modified, revoked and reissued or terminated for cause. The filing
of a request for a permit modification, revocation and reissuance or termination does
not stay any permit condition.
7. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
8. Approved plans and specifications for this project are incorporated by reference and
are enforceable parts of the permit.
The permittee shall notify the Division any name, ownership or mailing address
changes within 30 days.
10 This permit shall be effective from the date of issuance until December 30, 2021.
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.
Permit issued this the 315t day December 2020.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
z
for
Division of Energy, Mineral, and Land Resources
By Authority of the Environmental Management Commission
Permit Number SW7080904

"
DEMLR USE ONLY
Date Received
Fee Paid
Permit Number
I
zy 14,0
Sos • � o
'I'08 O0
Applicable Rules: ❑ Coastal SW -1995 ❑ Coastal SW - 2008 ❑ Ph II - Post Construction
(select all that apply) ❑ Non -Coastal SW- HQW/ORW Waters ❑ Universal Stormwater Management Plan
❑ Other WQ M mt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an anginal
1. GENERAL INFORMATION
1. Project Name (subdivision, facility, or establishment name -should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
The Shoppes at 10.5
2. Location of Project (street address):
2515 S Croatan I fighway
City:Nags Head County:Dare Z.ip:27959
3. Directions to project (from nearest major intersection):
Milepost 10.5 on US 158
4. Latitude:35' 59' 06.6" N Longitude:-75° 38' 387' W of the main entrance to the project.
it. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ❑New ®Modification ❑ Renewal w/ Modificationt
t Renewals with modifications also requires SWU-102 - Renermal Application Form
b.If this application is being submitted as the result of a modification to an existing permit, list the existing
permit numberSW7080904 , its issue date (if known)9/18/2008 , 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):
❑LAMA Major ❑Sedimentation/Erosion Control: _
❑NPDES Industrial Stormwater ❑404/401 Permit: Proposed Impacts
ac of Disturbed Area
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 ❑Ye.
Ifyes, see S.L.2012-200,Part VI: fill :::i/n,v(at.nrr'orua i�et,';r'r;i!rs-anti�et;cd.iLun:;
Form SWU-101 Version Oct. 31, 2013 Page I of

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: Nags Head Partners, LLC
Signing Official & Title:C Brantley Tillman
b. Contact information for person listed in item la above:
Street Address:1004 Wake Forest Rd
City:Raleigh State:NC Zip:27604
Mailing Address (if applicable):same
Phone:
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:
Signing Official &
b.Contact information for person listed in item 2a above:
Street Address:
Mailing Address
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
Signing Official &
b.Contact information for person listed in item 3a above:
Mailing Address:
City:
Phone:( )
Email:
Fax: ( }
4. Local jurisdiction for building permits: Town of Nags I lead
Point of ContactCory Tate Phone #: (252 } 449-6043
Fonn SWU-101 Version Oct. 31.2013 Page 2 of

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
stormwater will sheet flow from proposed sidewalk into the existing infiltration basin
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 It - Post Construction
3. Stormwater runoff from this project drains to the Pasguotank River basin.
4. Total Property Area: 10.47 acres
5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0 acres
7. Total Property Area (4) -Total Coastal Wetlands Area (5) - Total Surface Water Area (6) = Total Project
Area*:10,47 acres
Total project area shall be calculated to exclude the followin the normal p001 of imppounded structures, the area
between the banks of streams and rivers, the area below the Nonnal High Water (NHIM line or Mean High Water
(MHW) line, and coastal wetlands landward from the NHW (or MHW) line. The resultant project area is used to
calculate overall percent built upon area (BUA). Non -coastal wetlands landward of the NHW (or MHW) lice way
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 56.8 %
9. How many drainage areas does the project have?3 (For high densihj, count 7 foreach proposed engineered
stornuvater BMP. For low densihij and other projects, use 1 for the whole properhj area)
10. Complete the following information for each drainage area identified in Project Information item 9. if there
are more than four drainage areas in the 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 T1
Drainage Area T2
Drainage Area _
Receiving Stream Name
Atlantic Ocean
Atlantic Ocean
Atlantic Ocean
Stream Class *
SB
SB
SB
Stream Index Number *
99-(7)
99-(7)
99-(7)
Total Drainage Area (st)
284,011
4,800
55,325
On -site Drainage Area (sf)
284,011
4,800
55,325
Off -site Drainage Area (sf)
0
0
1 0
Proposed Impervious Area** (sO
199,150
4,800
55,325
°b Impervious Area** total
70.1 %
100%
100%
Im ervious** Surface Area
Drainage Area I
Drainage Area 11
Drainage Area 12
Drainage Area _
On -site Buildings/Lots (so
0
0
0
On -site Streets (so
0
0
0
On -site Parking (so
0
0
0
On -site Sidewalks (so
1,995.8
0
0
Other on -site (so
458.8
0
0
Future (so
0
0
0
Off -site (sf)
0
0
0
tixistin BUA*** (so
196,691
4,800
55,325
Total (so:
199,150
4,800
55,325
Stream Class and Index Ntunbercan bedetermined at: ni.in;/�r��f�/ru9G/t�s/r.vr l�r„uji��ttrnis
hu/pervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sufewalks, gravel areas, etc.
Form SWU-101 Version Oct. 31. 2013 Page 3 of

'Report only that amount of existing BUA that will remain after development. Do trot report any existing BUA that
is to be removed and which will be replaced by new BUA.
11. flow was the off -site impervious area listed above determined? Provide documentation. survey data
Projects in Union County: Conlact DE:41LR Central Office staff to check if the project is located irilhin a Threalened Rr
Endangered Species watershed that may be subject to more stringent slot mmwater requirements as per 15.4 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 6ttp;//pprL�l_Ilnlenr.org/w�rhju•y/wsf_uJbmpanrr.ua(.
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
hlll„//portal.nnlrn{,nr,;(i. b/n:51/l s/vu/scat s /forms do,s. 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./Jpm•tal ncdonr.(rt;/w•ebJ�cq,/ %L,/ w 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 httn:/Jpu tat.:l ncdcnr_url;f web/ny/us/so/stataw/f;,nns flocs.
�0WNE9 Sr_ -NE(> G.«'Y) ni }aIs
1. Original and one copy of the Stormwater Management Permit Application Form. J
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VII below)
3. Original of the applicable SupplernF �9rm(s) sealed sigLied and dated) and O&M �—
agreement(s) for each BMP. 0 Atg Gp
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to—L/1L,-yrU` `\'
http://www.envhelp.org/pages/onestopexpress.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/management for AAr
6. A USGS map identifying the site location. If the receiving stream is reported as class SA or the v�
receiving stream drains to class SA waters within'h mile of the site boundary, include the 1/2
mile radius 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 MI IW or NHW line of tidal
waters, and any coastal wetlands landward of the MI IW or NFIW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MI IW (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 stornwater 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, runoft calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
Fonn SWU-101 Version Oct. 31, 2013 Page 4 of 6

p. Vegetated buffers (where required). f
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 togs. Include an 8.5"xil" copy of the NRCS County Soils map with the Web SO
project area clearly delineated. For projects with infiltration BMPs, the report should also Suy
include the soil type, expected infiltration rate, and the method of determining the infiltration rate. I N ?—C
(Infiltration Devices submitted to WiRO: Schedule a site visit for DEMLR to aenfy the SHIVT prior
to submittal, [phone].) C
10. A copy of the most current property deed. Deed book: II Page No: 190 J
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 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.
http://www.secretaa.state-nc.us/Cor2orations/`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 hup; /12,gtaLnode-nr.nr,
sfornnvalcr-forms docs. Download the latest versions for each submittal.
In the instances where the applicant is different than the property owner, it is the responsibility of the property
owner to sign the deed restrictions and protective covenants form while the applicant is responsible for ensuring
that the deed restrictions are recorded.
By the notarized signature(s) below, the permit holder(s) certify that the recorded property restrictions and
protective covenants for this project, if required, shall include all the items required in the permit and listed
on the forms available on the website, that the covenants will be binding on all parties and persons claiming
under them, that they will run with the land, that the required covenants cannot be changed or deleted
without concurrence from the NC DEMLR, and that they will be recorded prior to the sale of any lot.
VIII. CONSULTANT INFORMATION AND AUTHORIZATION
Applicant: Complete this section if you wish to designate authority to another individual and/or firm (such as a
consulting engineer and/or firm) so that they may provide information on your behalf for this project (such as
addressing requests for additional information).
Consulting Engineer:Cathleen M. Saunders P.E.
Consulting Firm: Quible & Associates, PC
Mailing Address:P.O. Drawer 870
City:Kitty Hawk State -NC Zip:27949
Phone: [phone] Fax: [phone]
Email:[e-mail]
IX. PROPERTY OWNER AUTHORIZATION (if Con tact Information, item 2 has been filled out, complete this
section)
1, (print or type twine of person listed in Contact Information, item 2n) certify that I
own the property identified in this permit application, and thus give permission to (print or hjpe name of person
listed in Contact Information, item 1a) with (print or hjpe mane of organization listed in
Contact Information, item 1 n) 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.
norm SWU-101 Version Oct.31, 2013 Page 5 of

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.
Signatu
. a Notary Public for the State of ___ County of
do hereby certify that personally appeared
before me this _ day of
and acknowledge the due execution of the application for
a Stormwater permit. Witness my hand and official seal,
SEAL
My commission
X. APPLICANT'S CERTIFICATION
1, (pnnt or hype name of person listed in Contact Information, item ]a) C BrantlelTillman - Nags Head Partners LLC
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will orded, nd that the proposed project complies with the requirements of the
applicable stoytnw r rules will
1 NC�C 2H .1000 and any other applicable state stormwater requirements.
Date: //e /4 -,2,OdO
I,O&t_W_ -Q 55 a Notary Public for the State of i+lAy fit/ County of
do hereby certify that �5h_ / t t /I YK4/t personally appeared
before me this I0 day of _ goV6 MgB 2 Z0-2� and acWn� edge'the1d xecution of the application for
a stormwater permit. Witness my hand and official seal, __ �j}��J' !N •, �— ._
SEAL.
/,/
My commission expires fp4y � do'3
Form SWU-101 Version Oct. 31, 2013 Page 6 of 6

Operation &Maintenance Agreement,
Project Name:
Project Location:
The Shoppes at 10.5
2515 S. Croatan Highway
Maintenance records shall be Kept on the tollowmg BMP(s). This maintenance record shall be kept in a log in a known sel
location. Any deficient BMP elements noted in the inspection will be corrected, repaired, or replaced . ,t; =_c3s ",a; 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 &
Bioretention Cell Quanti
Dry Detention Basin
Grassed Swale
Green Roof
Infiltration Basin
Infiltration Trench
Level SpreaderNFS
Permeable Pavement
Proprietary System
Rainwater Harvesting
Sand Filter
Stormwater Wetland
Wet Detention Basin
Disconnected Impervious Area
User Defined BMP
Quantity:
Quantity:
Present:
Present:
O&M tables wil
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
Location(s):
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: C. Brantley Tillman
Title & Organization: Nags Head Partners, LLC
Street address: 1004 Wake Forest Rd
City, state, zip: Raleigh, NC 27604
Phone number(s):
Email:
Signature:
Date: //-®4-Rd.-?o
I, u 14A W, a Notary Public for the State of n
r
County of 6.'�/ ��1 do hearby certify. that ! 11L--
personally appeared before me this %Al day of ``-'and
acknowledge the due execution of the Op6rations and Maintenance Agreement .
Witness my:hand-and official seal, zL� a). ck ' —"
�fr l
Z My commission expires .% T- i>� OC 0 �'✓� t 1/13/2020
1.4 1.1 R V 1 orarlUar �'� Page i of 5

Important maintenance procedures:
The drainage area will be carefully managed to reduce The sediment load to The infiltration basin.
Immediately after the infiltration basin is established, the vegetation will be watered twice weekly if needed until
the plants become established (commonly six weeks).
No portion of the infiltration basin will be fertilized after the initial fertilization that is required to establish the
vegetation.
- The vegetation in and around the basin will be maintained at a height of approximately six inches.
After the infiltration basin is established, it shall be inspected once a quarter and within 24 hours after every stone event
greater than 1.0 inches (or 1.5 inches if in a Coastal County). Records of operation and maintenance shall be kept in a known
set location and shall be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired immediately.
BMP element:
Potential problem:
How to remediate the problem:
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 remove the gully, and then plant a
infiltration basin
erosive gullies have formed.
ground cover and water until it is established. Provide lime and a one-
time fertilizer application.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the sediment off -site.
swale
applicable).
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to smooth it over and provide erosion
swale (if applicable).
control devices such as reinforced turf matting or riprap to avoid future
problems with erosion.
The forebay
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.
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.
The main treatment area
A visible layer of sediment
Search for the source of the sediment and remedy the problem if
has accumulated.
possible. Remove the sediment and dispose of it in a location where it
will not cause impacts to streams or the BMP. Replace any media
that was removed in the process. Revegetate disturbed areas
immediately.
Water is standing more than
Replace the top few inches of filter media and see if this corrects the
5 days after a storm event.
standing water problem. If so, revegetate immediately. If not, consult
an appropriate professional for a more extensive repair.
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.
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.
TORM-EZ 11/1312020
ersion 1.4 O&M Manual Page 3 of 5

receiving water
Erosion or other signs of Contact the local NC Depar
damage have occurred at the (Resources Regional Office.
TORM-EZ
1111312020
ersion 1.4 O&M Manual Page 4 of 5

Permeable Pavement Maintenance Requirements
At all times, the pavement shall be kept free of:
Debris and particulate matter through frequent blowing that removes such debris, particularly during the fall and
spring.
- Piles of soil, sand, mulch, building materials or other materials that could deposit particulates on the pavement.
- Piles of snow and ice.
Chemicals of all kinds, including deicers.
The permeable pavement will be inspected once a quarter. Records of operation and maintenance will be kept in a known set
location and will be available upon request.
Inspection activities shall be performed as follows. Any problems that are found shall be repaired immediately.
BMP element:
Potentialproblem:
How to 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 remove the gully, then plant ground
permeable pavement
erosive gullies
cover and water until established.
A vegetated area drains
Regrade the area so that it drains away from the pavement, then plant
toward the pavement.
ground cover and water until established.
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 surface of the
Trash/debris present
Remove the trash/debris.
permeable pavement
Weeds
Do not pull the weeds (may pull out media as well). Spray them with a
systemic herbicide such as glyphosate and then return within the wee
to remove them by hand. (Another option is to pour boiling water on
them or steam them.)
Sediment
Vacuum sweep the pavement.
Rutting, cracking or slumping
Consult an appropriate professional,
or damaged structure
Observation well
Water present more than five
Clean out clogged underdrain pipes. Consult an appropriate
days after a storm event
professional for clogged soil subgrade.
Educational sign
Missing or is damaged.
Replace the sign.
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.
TORM-EZ
11/13/2020
ersion 1.4 O&M Manual Page 5 of 5

SUPPLEMENT-EZ COVER PAGE
LOAD SUPPLEMENT FORMS
PROJECT INFORMATION
1
Protect Name
The Shoppes at 10.5
2
Project Area ac
10.47
3
Coastal Wetland Area ac
0
4
Surface Water Area ac
0
5
Is this project High or Low Density?
High
6
Does this project use an off -site SCM?
No
COMPLIANCE WITH 02H.1003(4)
7
Width of vegetated setbacks provided feet
>59
8
Will the v elated setback remain v elated?
Yes
9
Is BUA other that as listed in .1003 4 c-0 out of the setback?
Yes
10
1 Is streambank stabilization proposed on this protect?
No
NUMBER AND TYPE OF SCMs:
11
Infiltration System
1
12
Bioretention Cell
0
13
Wet Pond
0
14
Stormwater Weiland
0
15
Permeable Pavement
2
16
Sand Filter
0
17
Rainwater Harvestin RWH
0
18
Green Roof
0
19
Level Spreader -Filter Strip LS-FS
0
20
Disconnected Impervious Surface (DIS)
0
21
Treatment Swale
0
22
Dry Pond
0
23
StomnFilter
0
24
Silva Cell
0
25
Bayfilter
0
26
Filters
0
LOAD SUPPLEMENT FORMS
DESIGNER CERTIFICATION
27
Name and Title:
Cathleen M. Saunders, P.E.
28
Or anlzation
Quible & Associates, P.C.
29
Street address:
8466 Caratoke Highway
30
City, State, Zip:
Powells Point NC 27949
31
Phone numbers :
252-491-8146
32
Email,
- [e-mail]
Certification Statement:
II certify, under penalty of law that this Supplement -Fs form and all supporting information were prepared under my direction or
isupennsion; that the information provided in the form is, to the best of my knooledge and belief, true, accurate, and complete; and
that the engineering plans, specifications, operation and maintenance agreements and other supporting information are consistent
with the information provided here.
RpIll'',,,
�OQ�oFESS/p�'%'
SEAL
A.JAA435�
Signalurj of Designer
// 11'6120

DRAINAGE AREAS
1
Is this a high densityeject?
Yes
2
li If so number of drainage areas/SCMs
3
3
Is all/part of this project subject to previous rule
versions?
I Yes
FORMS LOADED
DRAINAGE AREA INFORMATION
Entire Site i
1
2 1
3
4
Type of SCM
N/A
Infiltration System
Permeable
Pavement
Permeable
Pavement
5
Total BUA from project (sq ft)
199150 sf
sf
sf
6
1995 rules
SL 2006-246
2008 rules
2017 rules
7
New BUA on subdivided lots (subject to
pemnittinq) (sq ft)
sf
1995 rules
SL 2006-246
2008 rules
2017 rules
8
New BUA outside of subdivided lots (subject
to vemnittinal lsf)
st
1995 rules
SL 2006-246
2008 rules
2017 rules
9
Ursne - tofai area Isq RI
sr
1995 rules
SL 2UU6-24b
2UO8 rules
2U1 /rules
1 U
Umsne bUA (sq mj
St
199b rules
SL LUUb-24b
zuud rules
zu1 / rules
Il
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kin
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l Hub rules
aL Louo-Lvo
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INFILTRATION SYSTEM
21
Was the soil investigated in the footprint and at the elevation of the infilbation
system?
No
22
SHWT elevation (fmsl)
6.00
23
Depth to SHWT per sods report (m)
24
Ground elevation at boring in soils report (fmsl)
25
Is a detailed hydrogeologic study attached if the separation is between 1 and 2
feet?
26
Soil infiltration rate (infhr)
20.00
27
Factor of safety (FS) (2 is recommended):
4.00
jEfevations
29
Bottom elevation (fmsl)
8 ft
30
Storage elevation (fmsl)
9.5 it
31
jBypass elevation (fmsl)
32 Bottom surface area, fir: 3891-5 ft
1 33 1Storege elevation surface area (ft') 48449. ft
one
mease use rats space to provice any
46 system(s):
2. Required Design Volume; 20. Pretreatment would be permeable pavements
upstream or based on Interconnected basins. 22-26 soils data is based on the
existing permit; 44. Provided Design Volume