SW7110709_CURRENT PERMIT_20111006

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

VAR
NCDENR
North Carolina Department of Environment and
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins
Governor Director
October 6, 2011
Mr. William E. Bagnell, Associate Vice Chancellor
East Carolina University, Campus Operations
1001 East Fourth Street
Greenville, NC 27858-4043
Dear Mr. Bagnell:
Natural Resources
Subject: Stormwater Permit No. SW7110709
ECU School of Dental Medicine — Community
Service Learning Center No. 2
High Density Commercial Wetland Project
Pasquotank County
Dee Freeman
Secretary
The Washington Regional Office received a complete Stormwater Management Permit Application for
ECU School of Dental Medicine — Community Service Learning Center No. 2 on August 5, 2011.
Staff review of the plans and specifications has determined that the project, as proposed, will comply
with the Stormwater Regulations set forth in Session Law 2008-211 and Title 15A NCAC 2H.1000.
We are forwarding Permit No. SW7110709 dated October 6, 2011, for the construction of the subject
project.
This permit shall be effective from the date of issuance until October 6, 2021, 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) 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, P.O. Drawer
27447, Raleigh, NC 27611-7447. Unless such demands are made this permit shall be final and
binding.
If you have any questions, or need additional information concerning this matter, please contact Scott
Vinson, or me at [phone].
Sihcerel ,
Al Hodge
Regional Supervisor
Surface Water Protection Section
AH/ sv: K:\WQS\STORMWATER\PERMIT\SW7110709
cc: Todd Fisher, PE — Cole Jenest & Stone, PA
Elizabeth City Planning / Building Inspections
ashington Regional Office
North Carolina Division of Water Quality Internet: w .ncyvaterquality.org One
943 Washington Square Mall Phone: [phone] FAX: [phone] NorthCarolina
Washington, NC 27889 FAX: [phone] Natura ly
An Equal Opportunity 1 Affirmative Action Employer

State Stormwater Management Systems
Permit No. SW7110709
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
East Carolina University
ECU School of Dental Medicine — Community Service Learning Center No. 2
US Hwy 17 Business, Elizabeth City, Pasquotank County
FOR THE
construction, operation and maintenance of a constructed wetland in compliance with
the provisions of Session Law 2008-211 and 15A NCAC 2H .1000 (hereafter referred to
as the "stormwater rules') and the approved stormwater management plans and
specifications and other supporting data as attached and on file with and approved by
the Division of Water Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until October 6, 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 1.7 of this permit. The stormwater control has been
designed to handle the runoff from 33,480 square feet of impervious area. An
additional 1,454 square feet of impervious area is allowed to bypass the control
system per a redevelopment credit allowance.
3. The tract will be limited to the amount of built -upon area indicated in Section 1. of
this permit, the submitted application and per approved plans.
4. All stormwater collection and treatment systems must be located in either
dedicated common areas or recorded easements. The final plats for the project
will be recorded showing all such required easements, in accordance with the
approved plans.
5. The runoff from the built -upon area within the permitted drainage area of this
project must be directed into the permitted stormwater control system.
6. The built -upon areas associated with this project shall be located at least 50 feet
landward of all perennial and intermittent surface waters.
Page 2 of 7

State Stormwater Management Systems
Permit No. SW7110709
The following design criteria have been provided in the constructed wetland
system and must be maintained at design condition:
a. Drainage Area, ftz:
b. Total Impervious Surfaces, ftZ:
C. Design Storm, inches:
d. Permanent Pool (PP)Elevation, FMSY_:
e. Shallow Water (PP) Surface Area, ft :
f. Temporary Pool (TP) Elevation, FnSL:
g. Shallow Land (TP) Surface 5rea, ft
h. Required Storage Volume, ft
i. Permitted Storage Volume, ft3:
j. Controlling Orifice:
k. Permitted Forebay Volume, ft3:
I. Receiving Stream/River Basin:
M. Stream Index Number:
n. Classification of Water Body:
II. SCHEDULE OF COMPLIANCE
57,643
33,480
1.50
4.00
1,800
5.00
1,800
4,231
4,513
1.00" 0 pipe
472
Knobbs Creek/Pasquotank
30-3-8
"C; Sw"
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all time 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 re -vegetation of slopes and the vegetated filter strip.
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, orifice device, level
spreader, filter strip, catch basins and piping.
g. Access to the outlet structure must be available at all times.
4. Records of maintenance activities must be kept for each permitted BMP. The
records will indicate the date, activity, name of person performing the work and
what actions were taken.
5. Access to the stormwater facilities shall be maintained via appropriate
easements at all times.
6. Decorative spray fountains will not be allowed in the stormwater treatment
system.
The facilities shall be constructed as shown on the approved plans. This permit
shall become void unless the facilities are constructed in accordance with the
conditions of this permit, the approved plans and specifications, and other
supporting data.
Page 3 of 7

State Stormwater Management Systems
Permit No. SW7110709
Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A
modification may be required for those deviations.
9. 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.
10. The permittee shall submit to the Director and shall have received approval for
revised plans, specifications, and calculations prior to construction, for any
modification to the approved plans, including, but not limited to, those listed
below:
a. Any revision to any item shown on the approved plans, including the
stormwater management measures, built -upon area, details, etc.
b. Project name change.
C. Transfer of ownership.
d. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
e. Further subdivision, acquisition, lease or sale of all or part of the project
area. The Project area is defined as all property owned by the permittee,
for which Sedimentation and Erosion Control Plan approval or a CAMA
Major permit was sought.
f. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
11. The 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.
12. The permittee shall submit final site layout and grading plans for any permitted
future areas shown on the approved plans, prior to construction.
13. A copy of the approved plans and specifications shall be maintained on file by
the Permittee at all times.
III. GENERAL CONDITIONS
This permit is not transferable except after notice to and approval by the Director.
In the event of a change of ownership, or a name change, the permittee must
submit a completed Name/Ownership Change form, to the Division of Water
Quality, signed by both parties, and accompanied by supporting documentation
as listed on page 2 of the form. The project must be in good standing with the
Division. The approval of this request will be considered on its merits and may or
may not be approved.
2. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request.
3. Failure to abide by the conditions and limitations contained in this permit may
subject the Permittee to enforcement action by the Division of Water Quality, in
accordance with North Carolina General Statute 143-215.6A to 143-215.6C.
Page 4 of 7

State Stormwater Management Systems
Permit No. SW7110709
4. The issuance of this permit does not preclude the Permittee from complying with
any and all statutes, rules, regulations, or ordinances, which may be imposed by
other government agencies (local, state, and federal) having jurisdiction.
5. In the event that the facilities fail to perform satisfactorily, including the creation
of nuisance conditions, the Permittee shall take immediate corrective action,
including those as may be required by this Division, such as the construction of
additional or replacement stormwater management systems.
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 issued shall continue in force and effect until revoked or terminated.
The permit may be modified, revoked and reissued or terminated for cause. The
filing of a request for a permit modification, revocation and re -issuance or
termination does not stay any permit condition.
8. Unless specified elsewhere, permanent seeding requirements for the stormwater
control must follow the guidelines established in the North Carolina Erosion and
Sediment Control Planning and Design Manual.
9. Approved plans and specifications for this project are incorporated by reference
and are enforceable parts of the permit.
10. The issuance of this permit does not prohibit the Director from reopening and
modifying the permit, revoking and reissuing the permit, or terminating the permit
as allowed by the laws, rules and regulations contained in Session Law 2008-
211, Title 15A NCAC 2H.1000, and NCGS 143-215.1 et.al.
11. The permittee shall notify the Division of any name, ownership or mailing
address changes at least 30 days prior to making such changes.
12. This permit shall be effective from the date of issuance until October 6, 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 6 t h day of October, 2011.
OLINA ENVIRONMENTAL MANAGEMENT COMMISSION
i- _ for
Division of Water Quality
By Authority of the Environmental Management Commission
Stormwater Permit No. SW7110709
Page 5 of 7

State Stormwater Management Systems
Permit No. SW7110709
ECU School of Dental Medicine — Community Service Learning Center No. 2
Stormwater Permit No. SW7110709
Pasouotank County
Designer's Certification
I, , as a duly registered in the
State of North Carolina, having been authorized to observe (periodically/ weekly/ full
time) the construction of the project,
(Project)
for (Project Owner) hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the project
construction such that the construction was observed to be built within substantial
compliance and intent of the approved plans and specifications.
The checklist of items on page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
Signature
Registration Number
Date
SEAL
Page 6.of 7

State Stormwater Management Systems
Permit No. SW7110709
Certification Requirements:
1. The drainage area to the system contains approximately the permitted
acreage.
2. The drainage area to the system contains no more than the permitted
amount of built -upon area.
3. All the built -upon area associated with the project is graded such that the
runoff drains to the system.
4. All roof drains are located such that the runoff is directed into the system.
5. The outlet/bypass structure elevations are per the approved plan.
6. The outlet structure is located per the approved plans.
7. Trash rack is provided on the outlet/bypass structure.
8. All slopes are grassed with permanent vegetation.
9. Vegetated slopes are no steeper than 3:1.
10. The inlets are located per the approved plans and do not cause short-
circuiting of the system.
11. The permitted amounts of surface area and/or volume have been
provided.
12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
14. All required parts of the system are provided, such as a vegetated shelf,
and a forebay.
15. The required system dimensions are provided per the approved plans.
cc: NCDENR-DWQ Washington Regional Office
Elizabeth City Planning / Building Inspections
Page 7 of 7

DWQ USE ONLY
Date Received
Fee Paid
Permit Number
,� t,
S-oj
SW-711 ®?D
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 RE6'�t.' 1111M)
Department of Environment and Natural Resources
Division of Water Quality AUG 5- 2011
STORMWATER MANAGEMENT PERMIT APPLICATION FORM, Iy��Q,�
This form may be photocopied for use as an original V ` t�
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.):
East Carolina University School of Dental Medicine - Community Service Learning Center No. 2
2. Location of Project (street address):
1161 North Road Street
City:Elizabeth City County:Pasquotank Zip:27909
3. Directions to project (from nearest major intersection):
Driving north on US Highway 17 the site is located north of Villa Dr. across from Albemarle Hospital on the
west side of US highway 17
4. Latitude:36° 19' 20" N Longitude:76° 13' 15" W of the main entrance to the project.
it. PERMIT INFORMATION:
1. a. Specify whether project is (check one): ®New ❑Modification
b.If this application is being submitted as the result of a modification to an existing permit; list the existing
permit number N/A , its issue date (if known)N/A and the status of
construction: ®Not Started ❑Partially Completed* ❑ Completed* *provide a designer's certification
2. Specify the type of project (check one):
❑Love 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, N/A and the previous name of the project, if different than currently
proposed, N/A
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
❑NPDES Industrial Stormwater
®Sedimentation/Erosion Control: 1_8 ac of Disturbed Area
❑404/401 Permit: Proposed Impacts
b.If any of these permits have already been acquired please provide the Project Name, Project/Permit Number,
issue date and the type of each permit: in review
FormSWU-101 Version07Jun2010 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 12roiect):
Applicant/Organization:William E. Bagnell / East Carolina University
Signing Official & Title:Associate Vice Chancellor for Campus Operations
b. Contact information for person listed in item la above:
Street Address:East Carolina University Facilities Engineering & Architectural Services,1001 East Fourth
City:Greenville State:NC Zip:27858-4043
Mailing Address (if applicable):East Carolina University Facilities En&eeriny & Architectural Services,1001
City:Greenville
Phone: (252 ) 328-6858
Email:[e-mail]
State:NC Zip:27858-4043
Fax: (252 ) 328-4259
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/i
Signing Official &
b.Contact information for person listed in item 2a above:
Street Address:
City:
Mailing Address (if
State:
City: State:
Phone: ( ) Fax:
Email:
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:Michael Talton / East Carolina University
Signing Official & Title:P roject Manager
b.Contact information for person listed in item 3a above:
Mailing Address: Facilities Engineering & Architectural Services 1001 East Fourth Street
City:Greenville State:NC Zip:27858-4043
Phone: (252 ) 328-6858
Email:[e-mail]
Fax: (252 ) 328-4259
4. Local jurisdiction for building permits: North Carolina State Construction Office
Point of ContactDoug Edwards Phone #: (919 ) 807-4114
Form SWU-101 Version 07Jun2010 Page 2 of 7

IV. PROJECT INFORMATION
1. In the space provided below, briefly summarize how the stormwater runoff will be treated.
East Carolina University is planning to build a Service Learning Center in Elizabeth City, NC as an extension
of the School of Dentistry. The proposed site is on the west side of US Highway 17 within with City of
Elizabeth City limits across from Albemarle Hospital. The development will consist of a 7,700 sf building and
associated parking and sidewalk improvements The stormwater will be treated using a constructed
stormwater wetland 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 PUDApproval Date:
❑ Valid Building Permit Issued Date:
❑ Other: Date:
b.If claiming vested rights, identify the regulation(s) the project has been designed in accordance with:
❑ Coastal SW —1995 ❑ Ph II — Post Construction
3. Stormwater runoff from this project drains to the Pasquotank River basin.
4. Total Property Area: 1.92 acres 5. Total Coastal Wetlands Area: 0.00 acres
6. Total Surface Water Area: 0.00 acres
7. Total Property Area (4) — Total Coastal Wetlands Area (5) — Total Surface Water Area (6) = Total Project
Area':1.92 acres
Total project area shall be calculated to exclude the folloeoing the normal ool of imppounded structures, the area
between the banks of streams and rivers, the area bel070 the Normal High Water (NHW) line or Mean High Water
(MHW) line, and coastal wetlands land7vard frmn 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) line may
be included in the total project area.
8. Project percent of impervious area: (Total Impervious Area / Total Project Area) X 100 = 41.8% (includes
future expansion) %
9. How many drainage areas does the project have?2 (For high density, count 1 for each proposed engineered
stormwater BMP. For l07o density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Form SWU-101 Version 07Jun2010 Page 3 of 7

dMi/l^S1 Qe�aN�t-,P.I t3uk
Basin Information
Drainage Area. ';
Drainage Area 2
Drainage Area _
Drainage Area _
Receiving Stream Name
Knobbs Creek
Knobbs Creek
Stream Class *
Juysdinlo�aI
J4rasd' aonM
C W
Stream Index Number *
57 )
26
Total Drainage Area (sf)
57,643
26,136
On -site Drainage Area (sf)
0
0
Off -site Drainage Area (sf)
0
1 0
Proposed Impervious Area** (sf)
1 33,480
1,454
°% Impervious Area** (total)
1 58.10%
5.6%
Impervious" Surface Area
Drainage Area 1
Drainage Area 2
Drainage Area _
Drainage Area _
On -site Buildings/Lots (sf)
7,848
0
On -site Streets (sf)
0
1,454
On -site Parking (sf)
19,280
0
On -site Sidewalks (sf)
1,997
0
Other on -site (sf)
0
0
Future (sf)
4,355
0
�^' C
Off -site (sf)
0
1 0
o
Existing BUA*** (sf)
0
0
Q, i g34- r
)o7, Jh.af P
Total (sf):
33,480
1,454
p, 0,01�J z 3 4.5 f
Y sf
* Stream Class and Index Number can be determined at: http:llportal.ncdenr.org/7ueb/zi;a/Vs/Csii/Classifications 4� slvt-b ..45
s,
** Impervious area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
sidewalks, gravel areas, etc.
** Report only that amount of existing BUA that will remain after development. Do not report any existing BUA that
is to be rentoved and which will be replaced by new BUA.
11. How was the off -site impervious area listed above determined? Provide documentation. N/A
Projects in Union County: Contact DWQ Central Office staff to check if the project is located within a Threatened &
Endangered Species watershed that may be subject to more stringent stormwater requirements as per NCAC 018.0600.
V. SUPPLEMENT AND O&M FORMS
The applicable state stormwater management permit supplement and operation and maintenance (O&M) forms
must be submitted for each BMP specified for this project. The latest versions of the forms can be downloaded
from http://portal.ncdenr.org/web/wq/ws/su/bmp-manual.
Vt. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from http://portaI.ncdenr.org/web/­wq/ws/su/`states%v`/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 httl2:/ /portal.ncdenr.org/%veb/wq/ws/su/statesw/forms-docs.
I
1. Original and one copy of the stormwater Management Permit Application Form. Is
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants N A
Form. (if required as per Part VII below)
3. Original of the applicable Supplement Form(s) (sealed, signed and dated) and O&M_
agreement(s) for each BMP.
4. Permit application processing fee of $505 payable to NCDENR. (For an Express review, refer to
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.)
Form SWU-101 Version 07Jun2010 Page 4 of 7

5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor llytz�__
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'h mile of the site boundary, include the'1h
mile radius on the map.
7. Sealed, signed and dated calculations.
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development/Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
g. Revision number and dates.
h. Identify all surface waters on the plans by delineating the normal pool elevation of
impounded structures, the banks of streams and rivers, the MHW or NHW line of tidal
waters, and any coastal wetlands landward of the MHW or NHW lines.
• Delineate the vegetated buffer landward from the normal pool elevation of impounded
structures, the banks of streams or rivers, and the MHW (or NHW) of tidal waters.
i. Dimensioned property/project boundary with bearings & distances.
j. Site Layout with all BUA identified and dimensioned.
k. Existing contours, proposed contours, spot elevations, finished floor elevations.
1. Details of roads, drainage features, collection systems, and stormwater control measures.
m. Wetlands delineated, or a note on the plans that none exist. (Must be delineated by a
qualified person. Provide documentation of qualifications and identify the person who
made the determination on the plans.
n. Existing drainage (including off -site), drainage easements, pipe sizes, runoff calculations.
o. Drainage areas delineated (included in the main set of plans, not as a separate document).
p. Vegetated buffers (where required).
9. Copy of any applicable soils report with the associated SHWT elevations (Please identify
elevations in addition to depths) as well as a map of the boring locations with the existing
elevations and boring logs. Include an 8.5"xll "copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHWT prior
to submittal, [phone].) P9efc7y 'mow wim
10. A copy of the most current property deed. Deed book: Page No: QQGC%S%
11. For corporations and limited liability corporations (LLC): Provide documentation from the NC /A
Secretary of State or other official documentation, which supports the titles and positions held
by the persons listed in Contact Information, item 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.
http://www.secretary.state.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
http'//portal ncdenr org/web/wq/ws/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 of

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:R. Todd Fisher PE
Consulting Firm: Colelenest & Stone PA
Mailing Address:150 Fayetteville Street Suite 950
City:Raleigh
Phone: (919 ) 719-1800
Email:[e-mail]
colejenetststone.com
State:NC Zip:27601
Fax: (919 ) 719-1819
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, eornplete this
section)
I, (print or type name of person listed in Contact Information, item 2a) certify that I
own the property identified in this permit application, and thus give permission to (print or type name of person
listed in Contact Information, item la) 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 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.
1, , a Notary Public for the State of , County of
do hereby certify that
before me this _ day of
personally appeared
and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
SEAL
My commission
Form SWU-101 Version 07Jun2010 Page 6 of

X. APPLICANT'S CERTIFICATION
I, (print or type name of person listed in Contact Information, itent la) William E. Bagnell
certify that the information included on this permit application form is, to the best of my knowledge, correct and
that the project will be constructed in conformance with the approved plans, that the required deed restrictions
and protective covenants will be recorded, and that the proposed project complies with the requirements of the
applicable stormwater rules under 15A NCAC 2H .1000, SL 2006-246 (Ph. II - Post Construction) or SL 2005-211.
Signature: aA . D�tate: �' 2�E U
I R e, bb t c c a B I -.2 C 11 a otary Public for the State of Al 1, —County of
P 1 tl do hereby certify that I 1 4 WI C. Q 4 9 n J j personally appeared
before me this A day of ILA I Y and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal, rli4A.t
SEAL
My commission expires O 9 / d 21201 Y
Form SWU-101 Version 07Jun20I0 Page 7 of 7

Permit Number: sIV? I I o7e,'7
(to be provided by DIVA)
Drainage Area Number:
Stormwater Wetland Operation and Maintenance Agreement
I will keep a maintenance record on this BMP. This maintenance record will be kept in a
log in a known set location. Any deficient BMP elements noted in the inspection will be
corrected, repaired or replaced immediately. These deficiencies can affect the integrity
of structures, safety of the public, and the removal efficiency of the BMP.
Important maintenance procedures:
— Immediately after the stormwater wetland is established, the wetland plants will
be watered twice weekly if needed until the plants become established
(commonly six weeks).
No portion of the stormwater wetland will be fertilized after the first
fertilization that is required to establish the wetland plants.r
— Stable groundcover will be maintained in the drainage area to reduce the JUL J 2011
sediment load to the wet detention basin. — Once a year, a dam safety expert will inspect the embankment. hell, VA R0
After the wet detention pond 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:
Potentialproblem:
How I will remediate theproblem:
The entire BMP
Trash/debris is present.
Remove the trash/debris.
The perimeter of the
Areas of bare soil and/or
Regrade the soil if necessary to
wetland
erosive gullies have formed.
remove the gully, and then plant a
ground cover and water until it is
established. Provide time and a
one-time fertilizer application.
Vegetation is too short or too
Maintain vegetation at a height of
long.
approximately six inches.
The inlet device: pipe or
The pipe is clogged (if
Unclog the pipe. Dispose of the
swale
applicable).
sediment off -site.
The pipe is cracked or
Replace the pipe.
otherwise damaged (if
applicable).
Erosion is occurring in the
Regrade the swale if necessary to
swale (if applicable).
smooth it over and provide erosion
control devices such as reinforced
turf matting or riprap to avoid
future problems with erosion.
Form SW401-Wetland O&M-Rev.3
Page I of 4

BMP element:
Potentialproblem:
How 1 will remediate theproblem:
The forebay
Sediment has accumulated in
Search for the source of the
the forebay to a depth that
sediment and remedy the problem if
inhibits the forebay from
possible. Remove the sediment and
functioning well.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Erosion has occurred.
Provide additional erosion
protection such as reinforced turf
matting or riprap if needed to
prevent future erosion problems,
Weeds are present.
Remove the weeds, preferably by
hand. If a pesticide is used, wipe it
on the plants rather than s ra in .
The deep pool, shallow
Algal growth covers over
Consult a professional to remove
water and shallow land
50% of the deep pool and
and control the algal growth.
areas
shallow water areas.
Cattails, phragmites or other
Remove the plants by wiping them
invasive plants cover 50% of
with pesticide (do not spray) -
the deep pool and shallow
consult a professional.
water areas.
Shallow land remains flooded
Unclog the outlet device
more than 5 days after a
immediately.
storm event.
Plants are dead, diseased or
Determine the source of the
dying.
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.
Best professional practices
Prune according to best professional
show that pruning is needed
practices.
to maintain optimal plant
health.
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth
possible. Remove the sediment and
of the deep pools.
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Form S W401-Wetland O&M-Rev.3 Page 2 of 4

BMP element:
Potentialproblem:
How I will remediate theproblem:
The embankment
A tree has started to grow on
Consult a dam safety specialist to
the embankment.
remove the tree.
An annual inspection by an
Make all needed repairs.
appropriate professional
shows that the embankment
needs repair
Evidence of muskrat or
Use traps to remove muskrats and
beaver activity is present.
consult a professional to remove
beavers.
The micropool
Sediment has accumulated
Search for the source of the
and reduced the depth to 75%
sediment and remedy the problem if
of the original design depth.
possible. Remove the sediment and
dispose of it in a location where it
will not cause impacts to streams or
the BMP.
Plants are growing in the
Remove the plants, preferably by
micropool.
hand. If a pesticide is used, wipe it
on the plants rather than spraying.
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 NC Division of Water
damage have occurred at the
Quality 401 Oversight Unit at 919-
outlet.
733-1786.
Form SW401-Wetland O&M-Rev.3 Page 3 of 4

L
Permit Number:
(to be provided by DR'Q)
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:ECU School of Dental Medicine -Community Service Learnine Center #2
I3M11 drainage area number:
Print name:William E. I3agnell
'ride:East Carolina University. Associate Vice Chancellor for Campus Operations
Address: 1001 East Fourth Street, Greenville, NC 27858-4043
Phone:[phone]
Signature:
Date:
Note: The legally responsible party should not be a homeowners association unless more than SO%of
the lots have been sold and a resident of the subdivision has been named the president.
t b LCCF al' a_Notary Public for the State of
Nox-4A ea/o h'r4a' , County of Pt -ff , do hereby certify that
Wi liiom F . Ba qne personally appeared before me this 0/
clay of TUNe, a , and acknowledge the due execution of the
forgoing stormwater wetland maintenance requirements. Witness my hand and official
seal,
SEAL 110
My commission expires o 1 qq z% g Q
Forst SW40I-Welland O&M-Rev.3
Page 4 of 4

ColeJenest
& Stone
Shaping the Environment
Realizing the Possibilities
Land Planning
Landscape Architecture
Civil Engineering
Urban Design
200 South Tryon Street, Suite 1400 Charlotte, NC 28202
P+ 704 376 1555 f, 704 376 7851 art+www.colejeneststone.com
February 5, 2013
Charlotte
Raleigh
REECEIVED
F E B 7 2013
Mr. Scott Vinson �— V Y! �I �o
North Carolina Department of Environment and Natural Reso e
Division of Water Quality
943 Washington Square Mall
Washington, North Carolina 27889
Re: 50267 — ECU Dental Learning Center— Elizabeth City
Dear Scott:
Construction of the storm water management facility for the referenced project, as
permitted under the North Carolina Department of Environment and Natural Resources
Division of Water Quality Storm Water Permit Number SW7110709, has been
completed. A copy of the Designer's Certification covering the storm water wetland is
enclosed.
Please let us know if you require anything further.
Best regards,
COLEJENEST & STONE, P.A.
R. Todd Fisher, PE
Senior Project Manager
smm
Enclosure
cc: Mr. Michael W. Talton, NCARB — ECU
Ms. Jennifer Amster, AIA, LEED AP BD+C — BJAC
P:\SDSKPROJ\50261\ Correspon0encas\2013\020513 - Stormwater Canification\020513 - S. Vinson - Stormwater Certdiwlian.tloc

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Made from loopo post-msumer fiber.

ColeJenest
& Stone
Shaping the Environment
Realizing the Possibilities
Land Planning
Landscape Architecture
Civil Engineering
Urban Design
200 South Tryon Street, Suite 1400 Charlotte, NC 28202 Charlotte
P. 704 376 1555 f, 704 376 7851 ar),www.colejeneststone.com Raleigh
ECU Dental Learning Center— Elizabeth City
Storm Water Permit No. SW7110709
Pasquotank County
Designer's Certification
I, R. Todd Fisher , as a duly registered Professional Engineer in the State of
North Carolina, having been authorized to observe periodically the construction of the
project,
ECU Dental Community Service Learning Center No. 2 Elizabeth City. NC
(Project)
for East Carolina University (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 on Page 2 of this form is included in the Certification.
Noted deviations from approved plans and specification:
1. None.
_� SEAL
Signature: -.r
Registration Number: 25tG1
.Date: 2 ' ri • t'3
-*O4, g*.SS16-. CO
�9
SEAL
025163
,9 �•�NG INE�•. �Q
'•..lODD 0'e'. `�
P:\SDSKPROJ\50267\ Conespondences120131020513 - Stonm ater Certification\020513 Engineer Certification (Stormwater),da

P.
Land Planning
Landscape Architecture
Civil Engineering
Urban Design
Made from too;/JFw—q;consumerifiber.

ColeJenest
& Stone
200 South Tryon Street, Suite 1400 Charlotte, NC 28202 Charlotte
P. 704 376 1555 r, 704 376 7851 urt,www.colejeneststone.com Raleigh
ECU Dental Learning Center — Elizabeth City
Storm Water Permit No. SW7110709
Pasquotank County
Certification Requirements:
Shaping the Environment
Realizing the Possibilities
J 1.
The drainage area to the system contains approximately the permitted
acreage.
/may
2.
The drainage area to the system contains no more than the permitted
amount of built -upon area.
3.
All the built -upon area associated with the project is graded such that the
runoff drains to the system. (QEe VLAti�
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.
Land Planning
+
`/"
� 7.
Trash rack is provided on the outlet/bypass structure.
Landscape Architecture
+
8.
All slopes are grassed with permanent vegetation, per the vegetation plan.
Civil Engineering
I�
9.
Vegetated slopes are no steeper than 3:1. '
Urban DesignS,S�/`�'
vw 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.
15.
The required system dimensions are provided per the approved plans.
PASDSKPROJ\50267\_CorrespontlencaA2013\020513 - Slormwaler Certifcation\020513 Engineer Certification (StormwateQ.tloa

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Land Planning
Landscape Architecture
Civil Engineering
Urban Design
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