SW8991201_CURRENT PERMIT_20141210

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW8 3912 01
DOC TYPE]
CURRENT PERMIT
❑ APPROVED PLANS
❑ HISTORICAL FILE
❑ COMPLIANCE EVALUATION INSPECTION
DOC DATE
20 kli 12 L 0
YYYYMMDD

AMA.FMA
NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Govemor
December 10, 2014
Stephen, B. Cone, Vice President
Blue Gem, Inc.
1846 Banking Street
Greensboro, NC 27408
Subject: Stormwater Management Permit No. SW8 991201
Permit Transfer / Permit Extension / Approved Plan Revision
Porter's Neck South Plaza (aka Gold's Gym)
High Density Commercial Project
New Hanover County
Dear Mr. Cone:
John E. Skvada, III
Secretary
Effective August 1, 2013 the State Stormwater program was transferred from the Division of Water
Quality (DWQ) to the Division of Energy, Mineral and Land Resources (DEMLR). Please note that the
attached updated and transferred permit now references DEMLR as the Division responsible for
issuance of the permit.
On August 5, 2009, the Governor signed Session Law 2009-406. This law impacted any development
approval issued by the Division of Energy, Mineral and Land Resources under Article 21 of Chapter
143 of the General Statutes, which was current and valid at any point between January 1, 2008, and
December 31, 2010. The law extended the effective period of any stormwater permit that was set to
expire during this time frame up to three (3) years from its current expiration date. On August 2, 2010,
the Governor signed Session Law 2010-177, which granted an extra year for an extension of up to four
(4) years.
On February 7, 2014, the Division of Energy, Mineral and Land Resources (DEMLR) received a
completed Name/Ownership Change Form for the subject project. A file review and site inspection had
previously been performed on November 4, 2013 by DEMLR staff which noted several deficiencies. On
October 29, 2014, the consultant submitted revised plans and a certification that the required repair
work and plan revisions had been completed. The revised plans show the removal of 587 square feet of
previously permitted sidewalk to cover the addition of 587 square feet of building. The site was
reinspected on December 9, 2014 and as noted, in the enclosed inspection report, the site is currently in
compliance with the terms and conditions of the state stormwater permit.
As indicated on the Name/Ownership Change form, you have acknowledged receipt of a copy of the
permit, which includes the application and supplement forms, a copy of the designer's certification, a
copy of the approved plans and a copy of the required Operation and Maintenance agreement from the
previous permittee. By acknowledging receipt of the permit, and by signing the Name/Ownership
Transfer form, you have accepted the responsibility for complying with the terms and conditions
outlined in the permit. The Division is hereby notifying you that permit SW8 991201 has been
transferred on December 10, 2014 and to remind you that this permit shall be effective until May 24,
2024, which includes all the extensions. For your records, please find enclosed a copy of the updated
permit, a copy of the most recent inspection report, and a copy of the signed Name/Ownership Change
form. Please keep this cover letter and permit on file at all times.
This project is subject to the conditions and limitations as specified in the updated permit. Please pay
special attention to the conditions listed in this permit regarding the Operation and Maintenance of the
BMP(s), recordation of deed restrictions, procedures for changing ownership, transferring the permit,
and renewing the permit. Failure to establish an adequate system for operation and maintenance of
the stormwater management system, to record deed restrictions, to transfer the permit, or to renew the
permit, will result in future compliance problems.
Division of Energy, Mineral, and Land Resources
Land Quality Section -Wilmington Regional Office
127 Cardinal Drive Extension, Wilmington, North Carolina 28405 - [phone] / Fax: [phone]

Permit No. SW8 991201 Mod.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the
right to request an adjudicatory hearing by filing a written petition with the Office of
Administrative Hearings (OAH). The written petition must conform to Chapter 150B of the North
Carolina General Statutes, and must be filed with the OAH within thirty (30) days of receipt of
this permit. You should contact the OAH with all questions regarding the filing fee (if a filing fee
is required) and/or the details of the filing process at 6714 Mail Service Center, Raleigh, NC
27699-6714, or via telephone at 919-431-3000, or visit their website at www.NCOAH.com.
Unless such demands are made this permit shall be final and binding.
If you have any questions, need additional copies of the permit or approved plans, please
contact Linda Lewis with DEMLR in the Wilmington Regional Office at [phone].
Sincerely, C�
57ft Tracy Davis, P.E., Director
Division of Energy, Mineral and Land Resources
GDS/arl: \\\Stormwater\Permits & Projects\1999\991201 HD\2014 12 permit 991201
cc: Mr. Mike Valentino, Partner, I & V Properties, LLC
Phil Tripp, P.E., Tripp Engineering
Wilmington Regional Office Stormwater File
1���r"O�Cojfj
Robert H. Hochuh, Jr., J.?D., CFP®
I ATTORNEY AT LAW
Estate Planning Real Estate
' Estate Administration Financial Planning
Wills & Trusts Business Law & Planning
1 219 RACINE DRIVE TELEPHONE [phone]
SUITE A-6 TELEFAA 910-392-2005
WILMINGTON, NC 28403 rhochuli@attnet
Page 2 of 6

State Stormwater Management Systems
Permit No. SW8 991201 Mod.
STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
STATE STORMWATER MANAGEMENT PERMIT
HIGH DENSITY COMMERCIAL 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
Blue Gem, Inc.
Porters Neck South Plaza (aka Gold's Gym)
7979 Market St., Wilmington, New Hanover County
FOR THE
operation and maintenance of a wet detention pond 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 Energy, Mineral and Land
Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until May 24, 2024, 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 of this permit. The stormwater control has been
designed to handle the runoff from 67,212 square feet of impervious area.
3. The tract will be limited to the amount of built -upon area indicated in Sections 1.2
and 1.6 of this permit, and as shown on the 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(s) of this
project must be directed into the permitted stormwater control system.
Page 3 of 6

State Stormwater Management Systems
Permit No. SW8 991201 Mod.
6. The following design criteria have been approved for the wet detention pond and
must be maintained at design condition:
a. Drainage Area, 9cres:
Onsite, ft :
Offsite, ft2:
b. Total Impervious Surfaces, ft2:
C. Design Storm, inches:
d. Pond Design Depth, feet:
e. TSS removal efficiency:
f. Permanent Pool Elevation, FMSI :
g. Permanent Pool Surface Areq, ft
h. Permitted Storage Volume, ft :
i. Temporary Storage Elevation, FMSL:
j. Controlling Orifice:
k. Permitted Forebay Volume, ft3:
I. Fountain Horsepower, HP
M. Receiving Stream/River Basin:
n. Stream Index Number:
o. Classification of Water Body:
It. SCHEDULE OF COMPLIANCE
2.63
67,212
N/A
67,212
1.01,
6
90%
30.00
3,808
11,820
31.50
1.00" 0 pipe
2,436
N/A
UT Pages Creek / CPF24
18-87-22
"SA" (>1/2 mile)
1. The stormwater management system shall be constructed in its entirety,
vegetated and operational for its intended use prior to the construction of any
built -upon surface.
2. During construction, erosion shall be kept to a minimum and any eroded areas of
the system will be repaired immediately.
3. The permittee shall at all times provide the operation and maintenance
necessary to assure the permitted stormwater system functions at optimum
efficiency. The approved Operation and Maintenance Plan must be followed in
its entirety and maintenance must occur at the scheduled intervals including, but
not limited to:
a. Semiannual scheduled inspections (every 6 months).
b. Sediment removal.
C. Mowin.9 and re -vegetation 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, orifice device, flow
spreader, catch basins and piping.
g. Provide clear and unencumbered access to the outlet structure for
inspection and maintenance.
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.
5. The facilities shall be constructed in accordance with the conditions of this
permit, the approved plans and specifications, and other supporting data.
Page 4 of 6

State Stormwater Management Systems
Permit No. SW8 991201 Mod.
6. Upon completion of construction, prior to issuance of a Certificate of Occupancy,
and prior to operation of this permitted facility, a certification must be received
from an appropriate designer for the system installed certifying that the permitted
facility has been installed in accordance with this permit, the approved plans and
specifications, and other supporting documentation. Any deviations from the
approved plans and specifications must be noted on the Certification. A
modification may be required for those deviations.
7. If the stormwater system was used as an Erosion Control device, it must be
restored to design condition prior to operation as a stormwater treatment device,
and prior to occupancy of the facility.
8. Access to the stormwater facilities for inspection and maintenance shall be
maintained via appropriate recorded 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. Redesign or addition to the approved amount of built -upon area or to the
drainage area.
C. 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.
d. Filling in, altering, or piping of any vegetative conveyance shown on the
approved plan.
e. The construction of any permitted future built -upon area listed on the
application.
10. A copy of the approved plans and specifications shall be maintained on file by
the Permittee at all times. At the time the permit is transferred to a new owner,
the permittee shall forward the approved plans to the new owner.
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.
III. GENERAL CONDITIONS
1. Any individual or entity found to be in noncompliance with the provisions of a
stormwater management permit or the stormwater rules is subject to
enforcement action in accordance with NCGS 143 Article 21.
2. 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.
3. In the event that the facilities fail to perform satisfactorily 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.
Page 5 of 6

State Stormwater Management Systems
Permit No. SW8 991201 Mod.
4. This permit is not transferable to any person or entity except after notice to and
approval by the Director. The permittee shall submit a completed and signed
Name/Ownership Change Form, accompanied by the supporting documentation
as listed on the form, to the Division of Energy, Mineral and Land Resources at
least 60 days prior to any one or more of the following events:
a. An ownership change including the sale or conveyance of the project area in
whole or in part;
b. Bankruptcy;
c. Foreclosure;
d. Dissolution of the partnership or corporate entity;
e. A name change of the current permittee;
f. A name change of the project;
g. A mailing address change of the permittee;
5. The permittee is responsible for compliance with all permit conditions until such
time as the Division approves the transfer request.
6. 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.
7. The permit remains in force and effect until modified, revoked, terminated or
renewed. 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, renewal 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 permittee shall submit a permit renewal request at least 180 days prior to
the expiration date of this permit. The renewal request must include the
appropriate documentation and the processing fee.
Permit revised and transferred this the 10`h day of December 2014.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
ivision of Energy, Mineral and Land Resources
By Authority of the Environmental Management Commission
Page 6 of 6

DEMLR USE ONLY
Date Received
Fee Paid ex ress only)
Permit Number
- U-ZG!
—o-
�SGvB C/9'/Z01
aCCTh /l- i3- ZG(¢
State of North Carolina
Department of Environment and Natural Resources
Division of Energy, Mineral and Land Resources
STORMWATER MANAGEMENT PERMIT PLAN REVISION APPLICATION FORM
This form rray be photocopied for use as an original
I. GENERAL INFORMATION
1. Stormwater Management Permit Number: SW8 991201
2. Project Name: Porters Neck South Plaza
3. Permit Holder's name (specify the name of the corporation, individual, etc.):
4. Print Owner/Signing Officia['s name and title (person legally responsible for permit):
Stephen B. Cone, Vice President EC E N V 1
5. Mailing Address for person listed in item 2 above: NOV 10 2M
201 N. Front Street, Suite 214
City:Wilmington State:NC t—Z p 284D'1—'
Phone: (910 ) 262-6560 Fax:
Email:cotieat![e-mail]
II. PLAN REVISION INFORMATION
1. Summarize the plan revision proposed (attach additional pages if needed):
Plan has been revised to show a building adition of 587 sf and the removal of 587 sf of concrete sidewalk
resulting in no net change in impervious area.
III. 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. The complete
application package should be submitted to the DEMLR Office that issued the permit.
1. Please indicate that you have provided the following required information by initialing in the space provided
next to each item.
In L
• Original £+ 1 copy of the Plan Revision Application Form
• Two (2) copies of revised plans (must be revisions of original approved plan sheet(s)) S
If applying for Express review (onht available in 20 coastal counties):
• Application fee of $500.00 (nade payable to NCDENR)
VI. APPLICANT'S CERTIFICATION
I, (print or hype name of person listed in General Information, item 3) Stephen /l. Cone
certify that I have authorized these plan revisions and that the information included on this plan revision
application is, to the s f m k owI dge, correct and complete.
Signature: Date: 11 '-o
Plan Revision Form Rev. Oct. 31. 2013

Operations and Maintenance Verification
I acknowledge and agree by my signature below that I am responsible for the performance of the
maintenance procedures listed in the original Operations and Maintenance Agreement. I agree to notify
DWQ of any problems with the system or prior to any changes to the system or responsible party.
Print name:/�, 4-7
Title:
Address:
Signature:
Date: O
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
a Notary Public for the State of , newk�NQ%�� kjC--,4
County of JS -1AA(%ttNU, do hereby certify that !V,',_�it—.
personally appeared before me this day of sac *MINI , and acknowledge the due
execution of the forgoing stormwater BMP maintenance requirements. Witness my hand and official
seal,
Notary Signa re:
SEAL'
My commission expires: 1z "I — i �
Form SWU-102 (Renewal Form) Version 02.16.09 Page 3 of 3

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STATE STORMWATER PERMIT NAME/OWNERSHIP CHANGE FORM
I. CURRENT PERMIT INFORMATION
1. Stormwater Management Permit Number:
2. Project Name: PORTERS NECK SOUTH PLAZA (GOLD GYM) 7979 MARKET ST
3. Current Permit Holder's Company Name/Organization: I & V PROPERTIES, LLC
4. Signing Official's Name: MIKE VALENTINO Title: MANAGING PARTNER
5. Mailing Address: 6700 NETHERLANDS DR UNIT G
City: WILMINGTON State: NC Zip: 28405
6. Phone: [phone] EXT 106 Fax: ()
IL PROPOSED PERMITTEE / OWNER / PROJECT I ADDRESS INFORMATION
This request is for: (please check all that apply)
❑ Name change of the owner (Please complete Items 1, 2 and 3 below)
❑ Name change of project (Please complete Item 5 below)
® Change in ownership of the property/company (Please complete Items 1, 2, 3, and 4 below)
❑ Mailing address / phone number change. (Please complete Item 4 below)
❑ Other (please explain):
1. Proposed permittee's company name/organization: BLUE GEM INC.
S% en
2. Proposed permittee's signing official's name: B. CONE
3. Proposed permittee's title: VICE PRESIDENT
4. Mailing Address: 1846 BANKING ST.
City: GREENSBORO State: NC Zip: Z7408
Phone:( 336) 275-0756 Fax:( )
5. New Project Name to be placed on permit:
Please check the appropriate box. The proposed permittee listed above is:
❑ HOA or POA (Attach documentation showing that the HOA or POA owns, controls, or has a
recorded easement for all areas that contain stormwater system features. Print name of HOA or
POA in #1 above and provide name of HOA/POA's authorized representative in #2 above)
❑ The property owner
❑ Lessee (Attach a copy of the lease agreement and complete Property Owner Information on
page 4)
©Purchaser (Attach a copy of the pending sales agreemen al of this transfer will be
granted upon receipt of a copy of the recorded de
❑ Developer (Complete Property Owner Informatio n ppaagge RECEIVED
Rv. FEB 0 7 2014

1;1
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SSW N/O Change Rev24Sept2012 Page 1 of 4
III. REQUIRED ITEMS
A request to transfer a permit will not be approved by the Division of Water Quality (DWQ) unless all
of the applicable required items listed below are included with the submittal. Failure to provide the
listed items may result in processing delays or denial of the transfer.
1. This completed_ and signed form.iThis certification must be completed and signed -by -both -the
current -permit -holder -and -the -new -applicant -if -this -is a -change -of ownership!
2. Legal documentation of the property transfer to a new owner.
3. A copy of any recorded deed restrictions, covenants, or easements, if required by the permit.
4. The designer's certification (DWQ Engineer and Designer Certification Forms are available from
each DWQ Regional office), if required by the permit and if not already submitted to DWQ.
5. If the proposed permittee is a firm, partnership, association, institution, corporation, limited liability
company, or other corporate entity, provide documentation showing the authority of the named
representative to act on behalf of the proposed permittee.
6. The $40.00 processing fee. If this is an initial transfer from the original permittee the processing
fee is not required. Subsequent ownership transfers will require the $40.00 processing fee.
IV. CURRENT PERMITTEE'S CERTIFICATION
Please check one of the following statements and fill out the certification below that statement:
❑ Check here if the current permittee is only changing his/herrits name, the project name, or
mailing address, but will retain the permit. I, , the
current permittee, hereby notify the DWQ that I am changing my name and/or I am changing my
mailing address and/or I am changing the name of the permitted project. I further attest that this
application for a name/ownership change is accurate and complete to the best of my knowledge. I
understand that if all required parts of this application are not completed or if all required supporting
information and attachments listed above are not included, this application package will be returned
as incomplete.
® Check here if current permittee is transferring the property to a new owner and will not retain
ownership of the permit.
I, MIKE VALENTINO, MANAGING PARTNER OF I & V PROPERTIES LLC , the current permittee,
am submitting this application for a transfer of ownership for permit # SW8991201 . I hereby notify
DWQ of the sale or other legal transfer of the stormwater system associated with this permit. I have
provided a copy of the most recent permit, the designer's certification for each BMP, any recorded
deed restrictions, covenants, or easements, the DWQ approved plans and/or approved as -built
plans, the approved operation and maintenance agreement, past maintenance records, and the
most recent DWQ stormwater inspection report to the proposed permittee named in Sections II and
V of this form. I further attest that this application for a name/ownership change is accurate and
complete to the best of my knowledge. I understand that if all required parts of this application are
not completed or if all required supporting information and attachments listed above are not included,
this application package will be returned as incomplete. I assign all rights and obligations as
permittee to the proposed permittee named in Sections II and V of this f this
SSW N/O Change Rev24Sept2012 Page 2 of 5 FEB 0 7 2014
BY:�

transfer of ownership cannot be approved by the DWQ unless and until the facility is in compliance
with the permit. /
Signature: ^� /1 �C Date: 7
1, Hannah SrnoKe Meal , a Notary Public for the State of
N000 CAMVm na , County of tAml Nannvef , do hereby certify that
M1610. 6 personally appeared before me this the
4h day of JQvtUaYU 20A—, and ackr>;�jde the due execution of the
for of g i trument. Witness my hand and official seal, \`�`�0k tii��'%(Notary Seal)
P
Q�NOWTY P bllc �!'w
ry Signat re ==av Nooc�oveiCo
(unN
V. PROPOSED PERMITTEE CERTIFICATION: Thy 9886n must,V- omp leted by the
Proposed Permittee for all transfers of ownership)
Sty
I, 5 -M B.-CONE, VICE PRESIDENT OF BLUE GEM, INC. , hereby notify the DWQ that I
have acquired through sale, lease or legal transfer, the responsibility for operating and maintaining
the permitted stormwater management system, and, if applicable, constructing the permitted system.
I acknowledge and attest that I have received a copy of: (check all that apply to this permit)
the most recent permit
K the designer's certification for each BMP any ���
recorded deed restrictions, covenants, or easements
the DWQ approved plans and/or approved as -built FEB 0 7 2014
ra lans the approved operation and maintenance
greement BY:
past maintenance records from the previous permittee (where required)
DWQ stormwater inspection report showing compliance within 90 days prior to this transfer
I have reviewed the permit, approved plans and other documents listed above, and I will comply with
the terms and conditions of the permit and approved plans. I acknowledge and agree that I will
operate and maintain the system pursuant to the requirements listed in the permit and in the
operation and maintenance agreement. I further attest that this application for a name/ownership
change is accurate and complete to the best of my knowledge. I understand that if all required parts
of this application are not completed or if all uired supporting information and attachments listed
above are not includefi trip a tion p ac'e will be returned as incomplete.
Signature:
Date:
a Notary Public for the State of
11mu,� County of NW) f,9U .0bYA
c,,& AL__. personally appeared
Q _ day ofQ�I��,� a 200�, and acknowle
forgoing instrument. Witness my hand and official seal,
J (No
S9\ N/O Change Rev24Sept2012 Page 3 of 5
certify that
46, -�
b1ON
5
�' 31NtlNa�/
the

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APW
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Notary Signature
Additional copies of the original permit and the approved Operation and Maintenance agreement can
be obtained from the appropriate Regional Office of the Division of Water Quality.
This completed form, including all supporting documents and processing fee (if required), should be
sent to the appropriate Regional Office of the North Carolina Department of Environment and Natural
Resources, Division of Water Quality, as shown on the attached map.
Please note that if the Proposed Permittee listed above is not the property owner, the property owner
must complete and sign page 4 of this document. Both the lessee / developer and the property
owner will appear on the permit as permittees.
VI. PROPERTY OWNER CONTACT INFORMATION AND CERTIFICATION
If the Proposed Permittee listed in Sections ll and V of this form is not the Property Owner, the
Property Owner must provide his/her Contact Information below and sign this form:
Printed Name:
Organization: _
Title within the
Street Address.
City:
Mailing Address:
City:
Phone:
Email:
State:
(if different from street address)
State:
Fax:
Zip:
Zip:
I certify that I own the property identified in this permit transfer document and have given permission
to the Proposed Permittee listed in Sections II and V to develop and/or, lease the property. A copy
of the lease agreement or other contract, which indicates the party responsible for the construction
and/or operation and maintenance of the stormwater system, has been provided with the submittal.
As the legal property owner I acknowledge, understand, and agree by my signature below, that I will
appear as a permittee along with the lessee/developer and I will therefore share responsibility for
compliance with the DWQ Stormwater permit. As the property owner, it is my responsibility to notify
DWQ by submitting a completed Name/Ownership Change Form within 30 days of procuring a
developer, lessee or purchaser for the property. I understand that failure to operate and maintain the
stormwater treatment facility in accordance with the permit is a violation of NC General Statute
(NCGS) 143-215.1, and may result in appropriate enforcement action including the assessment of
civil penalties of up to $25,000 per day, pursuant to NCGS 143-215.6.
Signature of the property owner
SSW N/O Change Rev24Sept2012 Page 4 of 5
Date:

;yt%uw..;�c.

a Notary Public for the State of
County of
do hereby certify that
personally appeared before me this the
day of , 20, and acknowledge the due execution of the
forgoing instrument. Witness my hand and official seal,
Notary Signature
SSW N/O Change Rev24Sept2012 Page 5 of 5
(Notary Seal)
ECEIVE')
FES 0 7 2014
BY: ...........
_

TE 99115
Permit No. SW8 991201
(to be provided by DWQ)
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
WET DETENTION BASIN SUPPLEMENT
This form may be photocopied for use as an original
DWO Stormwater Management Plan Review:
A complete stormwater management plan submittal includes a wet detention basin supplement for each basin,
design calculations, plans and specifications showing all basin and outlet structure details, and a signed and
notarized operation and maintenance agreement.
1. PROJECT INFORMATION (please complete the following information):
Project Name: Porters Neck South Plaza
Contact Person: Phillip Tripp Phone Number: (910 )�763-5100
For projects with multiple basins, specify which basin this worksheet applies to: 1
elevations R
E C E 9 V ED
Basin Bottom Elevation 24.0 ft. (floor of the basin) MAY t % 2000
Permanent Pool Elevation 30.0 ft. (elevation of the orifice)
Temporary Pool Elevation 31.5 ft. (elevation of the discharge structure ovgr& 0WQ
areas
Permanent Pool Surface Area 3808 sq.ft. (water surface area at the orifice elevation)
Drainage Area 2.63 ac. (on -site and off -site drainage to the basin)
Impervious Area 1-4i�t Sy Lac. �t�t(on-site and off -site drainage to the basin)
volumes
Permanent Pool Volume 11,820 cu.ft. (combined volume of main basin and forebay)
Temporary Pool Volume 6,734 cu.ft. (volume detained above the permanent pool)
Forebay Volume 2,436_ cu.ft. (approximately 20% of total volume)
Other parameters
SA/DA0.0332 (surface area to drainage area ratio from DWQ table)
Diameter of Orifice 1.00 in. (2 to 5 day temporary pool draw -down required)
Design Rainfall 1 in.
Design TSS Removalz 90 % (minimum 85% required)
Form SWU-102 Rev 3.99 Page 1 of 4

Footnotes:
I. When using the Division SA/DA tables, the correct SA/DA ratio for permanent pool sizing should be computed based upon the
actual impervious % and permanent pool depth. Linear interpolation should be employed to determine the correct value for non-
standard table entries.
2. In the 20 coastal counties, the requirement for a vegetative filter may be waived if the wet detention basin is designed to provide
90% TSS removal. The NCDENR BMP manual provides design tables for both 85%TSS removal and 90% TSS removal.
II. REQUIRED ITEMS CHECKLIST
The following checklist outlines design requirements per the Stormwater Best Management Practices Manual
(N.C. Department of Environment, Health and Natural Resources, February 1999) and Administrative Code
Section: 15 A NCAC 2H .1008.
Initial in the space provided to indicate the following design requirements have been met and supporting
documentation is attached. If the applicant has designated an agent in the Stormwater Management Permit
Application Form, the agent may initial below. If a requirement has not been met, attach justification.
Applicants Initials
a. The permanent pool depth is between 3 and 6 feet (required minimum of 3 feet).
b. The forebay volume is approximately equal to 20% of the total basin volume.
i J c. The temporary pool controls runoff from the design storm event.
d. The temporary pool draws down in 2 to 5 days.
NA e. If required, a 30-foot vegetative filter is provided at the outlet (include non -erosive flow
1"
calculations).
f. The basin length to width ratio is greater than 3:1.
g: The basin side slopes above the permanent pool are no steeper than 3:1.
h. A submerged and vegetated perimeter shelf with a slope of 6:1 or less (show detail).
i. Vegetative cover above the permanent pool elevation is specified.
j. A trash rack or similar device is provided for both the overflow and orifice.
k. A recorded drainage easement is provided for each basin including access to nearest right-
of-way.
I. If the basin is used for sediment and erosion control during construction, clean out of the
basin is specified to be performed prior to use as a wet detention basin
m. A mechanism is specified which will drain the basin for maintenance or an emergency.
W. WET DETENTION BASIN OPERATION AND MAINTENANCE AGREEMENT
The wet detention basin system is defined as the wet detention basin, pretreatment including forebays and the
vegetated filter if one is provided.
This system (check one) ❑ does X does not incorporate a vegetated filter at the outlet.
This system (check one) ❑ does X does not incorporate pretreatment other than a forebay.
Fonn SWU-102 Rev 3.99 Page 2 of 4

Maintenance activities shall be performed as follows:
After every significant runoff producing rainfall event and at least monthly:
a. Inspect the wet detention system for sediment accumulation, erosion, trash accumulation,
vegetated cover, and general condition.
b. Check and clear the orifice of any obstructions such that drawdown of the temporary pool occurs
within 2 to 5 days as designed.
2. Repair eroded areas immediately, re -seed as necessary to maintain good vegetative cover, mow vegetative
cover to maintain a maximum height of six inches, and remove trash as needed.
3. Inspect and repair the collection system (i.e. catch basins, piping, swales, riprap, etc.) quarterly to
maintain proper functioning.
4. Remove accumulated sediment from the wet detention basin system semi-annually or when depth is
reduced to 75% of the original design depth (see diagram below). Removed sediment shall be disposed
of in an appropriate manner and shall not be handled in a manner that will adversely impact water quality
(i.e. stockpiling near a wet detention basin or stream, etc.).
The measuring device used to determine the sediment elevation shall be such that it will give an accurate
depth reading and not readily penetrate into accumulated sediments.
When the permanent pool depth reads 4.5 feet in the main pond, the sediment shall be removed.
When the permanent pool depth reads 2.25 feet in the forebay, the sediment shall be removed.
BASIN DIAGRAM
(fill in the blanks)
Sediment R�moval El. 27.75
Bottom *vation 27.0 T,2�% --
Permanent Pool Elevation 30.0
Sediment Removal Elevation 25.5 y 75%
Bottom Elevation
FOREBAY MAIN POND
5. Remove cattails and other indigenous wetland plants when they cover 50% of the basin surface. These
plants shall be encouraged to grow along the vegetated shelf and forebay berm.
6. If the basin must be drained for an emergency or to perform maintenance, the flushiI�se6imeent
through the emergency drain shall be minimized to the maximum extent possible. E B V E D
APR 2 0 2000
Form SWU-102 Rev 3.99 Page 3 of 4 DWQ
PROJ #

7. -All components of the wet detention basin system shall be maintained in good working order.
I acknowledge and agree by my signature below that 1 am responsible for the performance of the seven
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print name: Joe Albanese, Bradlev Pointe, LLC
Title: Member/Manager
Address: 1650 Military Cutoff Road Suite 200 Wilmin ton NC 28403
Phone: 9 -
Signature:
Date:
Note: The legalky�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.
1, _Monica V. Loughlin , a Notary Public for the State of North Carolina,
County of New Hanover do hereby certify that Joe Albanese
personally appeared before me this day of _November 1999. and acknowledge the due
execution of the forgoing wet detention basin maintenance requirements. Witness my hand and official seal,
:U
.. DG
%ems.
MEIRIIIt1G1oJ\�\.
SEAL
My commission expires 08/07/01
Form S WU-102 Rev 3.99 Page 4 of 4

TE 99115/13036
State Stormwater Management Systems
Permit No. SW8 991201
Porters Neck South Plaza
Stormwater Project No. SW8 991204
New Hanover County
Engineer's Certification
I, Phillip G. Tripp , as a duly registered Professional Engineer in the
State of North Carolina, having been authorized to observe (periodically/weekly/full
time) the construction of the project,
Porters Neck South Plaza
(Project)
for Blue Gem, Inc. (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 specifications:
Signature
Registration Number
Date 1�) • Zq • 4-
rIEQ EVE
OCT 2 9 2014
av,CNBc(`il?Di
SEAL
..
F ESg�Q�
SEAL
y 17374
R°Odi°IGREGO W�e��

State Stormwater Management Systems
Permit No. SW8 991201
Certification Requirements: Page 2 of 2
—0-1. 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.
Z7. 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.
—0-12. Required drawdown devices are correctly sized per the approved plans.
13. All required design depths are provided.
Z__14. All required parts of the system are provided, such as a vegetated shelf, a
forebay, and the vegetated filter.
—0--15. The required dimensions of the system are provided, per the approved
plan.

07/0G/2009 14:59 91035e2010 NCDENR PAGE 07/07
TEJ6.9mu5
/ State Stormwater Management Systems
Permit No. SW8 991201
Country Haven Station
Stormwater Permit No. SW8 991201
New Hanover County
Designer's Certification
I, �Rhuj& b• —rQtpN , as a duly registered fa*F6Sv*-4or- WWAt6t-G in
the State of North Carolina, having been authorized to observe (periodicallylw&A!54uli tixx) the construction of
the project,
for ReAow P.,, i .e e • (Project Owner) hereby state that, to the best of my abilities, due care
and diligence wd 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_—Q4I �U
Registration Number t 574-
Date A. IZ• OI
pU�r �mgrpipi
\.1\`\�CAR
ShEP� T'
J� y��•,Fj�,GINE`Q�'.Q`
RE���
°'�u�rmm�a""°•
SEAL