SW6210904_Minor Modification Form_20230523

DEMLR USE ONLY
Date Received Fee Paid Permit Number
STORMWATER PERMITTING FORM 7: RECEIVED
MINOR MODIFICATION
Standard Permitting Program —No Fee for Minor Modification MAR 2 l 2023
D>wMLR-S+.orm=ter Program Express Permitting Program —See Express Fee Schedule
DE&FAYETTEXLE REGIONAL OFFICE
Only complete applications packages will be accepted and reviewed. This form and the required items (with
original signatures) must be sent to the appropriate DEMLR Regional Office, which can be determined by locating
the project on the interactive online map at: http.//deq.nc.gov/contact/regional-offices.
This form is to only to be used by the current permittee to notify the Division of a minor
modification. Pursuant to Rule 15A NCAC 02H.1002, a minor modification is a change to the project that:
1) does not increase the net built-upon area; and/or
2) does not change the size or design of the SCM(s).
A. GENERAL INFORMATION
1. State Stormwater Permit Number: SW6210904
2. Current Permit Holder's Company Name/Organization: Greenfield Serenity, LLC
3. Signing Official's Name: Yang Song
4. Signing Official's Title: Manager
5. Mailing Address: 8601 Six Forks Road Suite 270
City: Raleigh State: NC ZIP: 27615
6. Street Address (if different):
City: State: ZIP:
7. Phone: [phone] Email: ysong(a�greenfieldcommunities.com
8. Describe the minor modifications that you are requesting, including any revised BUA allocations (attach
additional pages or supporting tables similar to Section IV.10 of the original application, if needed):
Due to easement changes during construction 2 lots are being removed (143 and 169) MAIS 5,060 SF.
Lot 170 increased MAIS by 506 SF Lot 295 increased MAIS by 900 SF Lot 298 decreased MAIS b
350 and Lot 299 decreased MAIS by 350 SF. The net reduction is 4,354 SF
B. SUBMITTAL REQUIREMENTS
Please mark"Y"to confirm the items are included with this form. Please mark X'if previously provided. if not
applicable or not available, please mark N/A.:
Y 1. Two hard copies (with original signatures) and one electronic copy of this completed form.
Y 2. Two hard copies and one electronic copy of the revised plan sheets (must be a revision of the
originally approved plan sheets).
Y 3. If there is reallocation of lot BUA, a copy of the revised recorded deed restrictions and protective
covenants OR the proposed recorded deed restrictions and protective covenants documenting
the changes and a signed agreement to provide the final recorded document.
NIA 4. If applicable, the appropriate Express review fee.
Stormwater Permit Form 7: Minor Modification Page 1 of 2 July 14, 2017