SW6221008_Application Form_20221027

Applicable Rules:
(select all that apply)
DWQ USE ONLY
Date Received Fee Paid Permit Number
Coastal SW —1995 Coastal SW — 2008 Ph II - Post Construction
Non -Coastal SW HQW / ORW Waters Universal Stormwater Management Plan
Other WQ Mgmt Plan:
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
This form may be photocopied for use as an original
Q�e��WXY I o) -i J Il"EilzI
1. Project Name (subdivision, facility, or establishment name - should be consistent with project name on plans,
specifications, letters, operation and maintenance agreements, etc.):
Stone Creek
2. Location of Project (street address):
Phil ' i Church Road
City:Raeford County:Hoke Zip:28376
3. Directions to project (from nearest major intersection):
The • • SY is located approximddy 1.708 S from the intersection of h i l l . •i Church Road and Dundee Circle
going east towards•_i_•Street.
4. Latitude:34° 58' 59.98" N Longitude:79° 8' 26.36" W of the main entrance to the project.
II. PERMIT INFORMATION:
1. a. Specify whether project is (check one): New Modification Renewal w/ Modificationt
tRenewals with modifications also requires SWIl-102 - Renewal Application Form
b. If this application is being submitted as the result of a modification to an existing permit, list the existing
permit number , its issue date (if known) . and the status of
construction: Not Started Partially Completed" Completed* *provide a designer's certification
2. Specify the type of project (check one):
Low Density High Density Drains to an Of -site Stormwater System Other
3. If this application is being submitted as the result of a previously returned application or a letter from DWQ
requesting a state stormwater management permit application, list the stormwater project number, if
assigned, and the previous name of the project, if different than currently
proposed,
4. a. Additional Project Requirements (check applicable blanks; information on required state permits can be
obtained by contacting the Customer Service Center at 1-877-623-6748):
CAMA Major Sedimentation / Erosion Control:14.04 ac of Disturbed Area
NPDES Industrial Stormwater 404/401 Permit: Proposed Impacts
b. If any of these permits have already been acquired please provide the Project Name, Project / Permit Number,
issue date and the type of each permit:
5. Is the project located within 5 miles of a public airport? No Yes
Form SWU-101 Version 06Aug2012 Page 1 of 6

If yes, see S.L. 2012-200, Part VI: littl2://pQrtal.ncdcor.org hvcblNN,q/Nvs/su/states",/rµies laws
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:Wolf Development Holding. LLC
Signing Official & Title:Robe.t Britt. Managing Partner
b. Contact information for person listed in item la above:
Street Address:2422 Wrightsville Avenue
City:W-Umington State:NC Zip:28403
Mailing Address (if applicable):
City:
Phone: (910 ) 740-2547
State:
Fax: ( )
Zip:
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:lm=h Coble Poole
Signing Official & Title:Owner
b. Contact information for person listed in item 2a above:
Street Address:PO Box 850
City:Raeford State:NC Zip:28376
Mailing Address (if applicable):
City:
Phone: ( 910 ) 527-9084
Email: [e-mail]
State: Zip:
Fax: ( )
3. a. (Optional) Print the name and title of another contact such as the projects construction supervisor or other
person who can answer questions about the project:
Other Contact Person/Organization:Wolf Development Holding, LLC
Signing Official & Title:Robert Britt_ Managing Partner
b. Contact information for person listed in item 3a above:
Mailing Address:24_2422 Wrightsville Avenue
_10•,•
Phone:1 J
State:NC Zip:28403
Fax: ( )
4. Local jurisdiction for building permits: Hoke Count; Planning/Zoning
Point of ContacHadde Lowery Phone #: (910 ) 875-8407
Form SWU-101 Version 06Aug2012 Page 2 of 7

IV. PROJECT INFORMATION
1. In the space provided below, bra summarize how the stormwater runoff will be treated.
Stormwater runoff from the developed areas of the site will be captured and treated in a wet pond.
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 H — Post Construction
3. Stormwater runoff from this project drains to the Cape Fear River basin.
4. Total Property Area: 53.696 acres 5. Total Coastal Wetlands Area: 0 acres
6. Total Surface Water Area: 0.14 acres
7. Total Property Area (4) — Total Coastal Wetlands Area (5) — Total Surface Water Area (6) = Total Project Area+:
53.556 acres
Total project area shall be calculated to exclude the following: the normal pool of impounded structures, the area
between the banks of streams and rivers, the area below the Normal High Water (NHW) 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 (BETA). 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 = 33.09 %
9. How many drainage areas does the project have?l (For high density, count 1 for each proposed engineered
stormwater BMP. For low density and other projects, use 1 for the whole property area)
10. Complete the following information for each drainage area identified in Project Information item 9. If there
are more than four drainage areas in the project, attach an additional sheet with the information for each area
provided in the same format as below.
Basin Information
Drainage Area
Drainage Area
Drainage Area
Drainage Area
Receiving Stream Name
Beaver Creek
Stream Class "
C
Stream Index Number "
18-31-19-5
Total Drainage Area (sf)
1,662,362
On -site Drainage Area (sf)
1,662,362
Off -site Drainage Area (sf)
Proposed Impervious Area
758,934
Impervious Area (total)
45.7
Form SWU-101 Version 06Aug2012 Page 3 of 7

Impervious' Surface Area
Drainage Area 1
Drainage Area
Drainage Area
Drainage Area
On -site Buildings/Lots (sf)
532,000
On -site Streets (sf)
168,501
On -site Parking (sf)
On -site Sidewalks (sf)
58,433
Other on -site (sf)
Future (sf)
Off -site (sf)
Existing BUA*** (sf)
Total (sf):
758,934
* Stream Class and Index Number can be determined at: Irff �: ��rrtal.rrr_dcnr.or,t[Loebl�n�rJs/c:su/classiticatic>rrs
** Im ery us area is defined as the built upon area including, but not limited to, buildings, roads, parking areas,
s: ewa 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 removed 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 15A 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 BUT specified for this project. The latest versions of the forms can be downloaded
fromi,ty J,rs :r;
VI. SUBMITTAL REQUIREMENTS
Only complete application packages will be accepted and reviewed by the Division of Water Quality (DWQ).
A complete package includes all of the items listed below. A detailed application instruction sheet and BMP
checklists are available from hict doe_. 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 htt ): }?ortal.ncdennore/web/wq/ws/su imams.)
Please indicate that the following required information have been provided by initialing in the space provided
for each item. All original documents MUST be signed and initialed in blue ink. Download the latest versions
for each submitted application package from http: / oor Litt enn rg— / to eb i ",,,i / w,; i su / state4w / forms does.
Initials
1. Original and one copy of the Stormwater Management Permit Application Form.
2. Original and one copy of the signed and notarized Deed Restrictions & Protective Covenants
Form. (if required as per Part VII 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.envheII2.org / pages I onestopexpresshtml 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 06Aug2012 Page 4 of 7

5. A detailed narrative (one to two pages) describing the stormwater treatment/managementfor the
project. This is required in addition to the brief summary provided in the Project
Information, item 1.
6. A USCS map identifying the site location. If the receiving stream is reported as class SA or the
receiving stream drains to class SA waters within 1h mile of the site boundary, include the mile
radius on the map.
7. Sealed, signed and dated calculations (one copy).
8. Two sets of plans folded to 8.5" x 14" (sealed, signed, & dated), including:
a. Development / Project name.
b. Engineer and firm.
c. Location map with named streets and NCSR numbers.
d. Legend.
e. North arrow.
f. Scale.
gg 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"x11" copy of the NRCS County Soils map with the
project area clearly delineated. For projects with infiltration BMPs, the report should also
include the soil type, expected infiltration rate, and the method of determining the infiltration rate.
(Infiltration Devices submitted to WiRO: Schedule a site visit for DWQ to verify the SHWT prior to
submittal, [phone].)
10. A copy of the most current property deed. Deed book: 370 Page No: 460
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. ham: / www.==t=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 , t l)(1. cdenr.c)rg Z web / wa ; ws / su / s ,pies"l
@orniw 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 DWQ, and that they will be recorded prior to the sale of any lot.
Fonn SWU-101 Version 06Aug2012 Page 5 of 7

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:Carlo Pardo PE
Consulting Firm: Bowman North Carolina. Ltd
Mailing Address•4006 Barret Drive, Suite 104
City:Raleigh
Phone: (919 ) 553-6570
State:NC Zip:27609
Fax: ( )
IX. PROPERTY OWNER AUTHORIZATION (if Contact Information, item 2 has been filled out, complete this
section)
I, (print or type name of person listed in Contact Information, item 2a) LQ=h Coble Poole , 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 1a) Robert Britt with (print or type name of organization listed in
Contact Information, item 1a)Wol{Develonm_ent Holding. LLC 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 assessmenLof civil penaltigs of W to $25,000 per day, pursuant to NCGS 143-215.6.
Date: Zd D S f 2a
I, v a Notary Public fo the State of t County of
do hereby certify that JCL9LL3kJ�. personally appeared
before me this 9L day of 20-?-Z . a cknowledge the due execution of the application for
e
a stormwater permit. Witness my hand and official seal, rd
F?A CA MCKENZlE
NOTARY R)SUC
ROBESON COUNTY. NC
SEAL
My commission expires c�C N� 2 Z
v
Form SWU-101 Version 06Aug2012 Page 6 of 7

X. APPLICANT'S CERTIFICATION
I, (print or type name of person Iisted in Contact Information, item 1a) Robert Britt
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 N AC 2H .1000 and any other applicable state stormwater requirements.
Signature: Date: lO iZa
I, �t`� a Notary Public forthe State of r County of
e o ____,do hereby certify that 20bUci 6 r ' ,H personally appeared
before me this cQL, day of , 2>dZ Z, and acknowledge the due execution of the application for
a stormwater permit. Witness my hand and official seal,
RABECCA MCPCENZIE
NOTARY PUBLIC
ROBESON COUNTY, NC
cow a
SEAL
My commission expires cQ0 LL 2oz-�'
Form 5WU-101 Version 06Aug2012 Page 7 of 7