73082_MHC Twin Lakes LLC_20190530

Ø, 'CAMA
/ =1 DREDGE & FILL No. 73082 A -g�, CC�y
GENERAL PERMIT , Z�*Co 4,y50 Previous permit# T`j
)C la New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued /' /
As authorized by the State of North Carolina,Department of Environmental Quality 1"---
-�I ,
and the Coastal Resources��qp Commission in an area of environmental concern pursuant to 15A NCAC El Rules attached.
Applicant Name I i-JC �w;ti 1 a k' S j 4 (-�- Project Location: County o i,/t,.^f-
Address . ,', :: - l A /2; v F .-;,,)� ,p1 G' ,< , -' '.-fir- d v Street I Address/State R ill Lot#(s) 12 /// G 1
City l State ZIP (1:-.'-J ,r, '_')cc,- 2h 1,--. / / A ,,vn,,/,] /`�/,`C
Subdivision ��.. ,, ;!D :IT. ,.,/,j r a u=^ Ct ;
Phone#( !2) - 1�l —/ � �0 E-Mail _
Authorized Agent , ;,--If-// G i,3, ,-,,�., City /, - �w;,,, '_1 r-� ZIP I? ..)cc'-)
❑CW ❑EW PTA ❑ES ❑PTS Phone# ( ) River Basin 7 T-
Affected El OEA El HHF /❑IH ❑UBA El N/A
AEC(s): Adj.Wtr. Body,:;/i.47 a - -//- fi (nat /man/unkn)
❑ PWS: l
Closest Maj.Wtr. Body f-•:" �' '.� fie.,``., ✓
ORW: yes / no-) PNA yes /o)o,
Type of Project/Activity . ,-a u, 'ICI CI ,., �...✓ i, -,P :._.„,,,,_-/,, .- e s ,a r•a
(Scale:2\/ 1a )
Pier(dock)length ' 1
Fixed Platform(s) I
Floating Platform(s) au■■■1INION■■■R■■■ MIFinger pier(s)
Groin length
number
Bulkhead/Riprap length 1 I III II■I■■ji■I■■■■■■1
avg distance offshore . Q M �� �
NIIIIIII ■■■■�
• max distance offshore D11::1
iiiiiiiiilfliilliliiiiiiiliiFi
Boathouse/Boatlift
Beach Bulldozing II id ihm iIIii6i!Ii1iIIuuIIi
i, s.
UIIIIiiI!IIlIIihiöiMIII!I --.
Shoreline Length _ a J`� '--� HHHHH1HHIiiIIhiHHhI
11 ! 41 Ell
1
SAV; not sure yes no 1 11 ■Ir l'�li 713D11111111' Moratorium: n/a yes no,11 11 111 'Tl,
Photos: yes 1V6Th ■ ■■■■■■■■■ ■■■■ ■■■■ �■ ■■■ ME■
i i i �
Waiver Attached: yes moo) i
A building permit may be required by: I I See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) j
[ J ---fe-)-. '' ' ,
( Notes/Special Conditions /,,/ 1,--- '( t-%'` ' 0`-1 .
'1 .j,4-" ,k"-.5 ba. F;e. -13e---. 416,v-i— ,/ ..,-
Agent plicant Printed Name Pern�itr'S P' ed Name /
Si * //'/ ement on back of permit** Signature �J
i ure Please read compliant p ) �L ) �'J
�i4 0 / ,�.J .�� / .-' /,.) �2J/c-, �, . / /,., -zc. Z V
Application Fee(s)
Check# Issuing Date Expiration Date

Alfa&
NC®ENR
BUFFER AUTHORIZATION CERTIFICATE FOR SHORELINE STABILIZATION
A riparian buffer authorization is required for shoreline stabilization activities within the Tar-Pamlico& Neuse River basins
per Division of Water Resources (DWR) regulations 15A NCAC 02B.0259 &0233. The Division of Coastal Management
(DCM) through a Memorandum of Understanding with the Division of Water Resources(DWR) has reviewed your project
proposal and has determined that the project as proposed complies with the aforementioned regulations.
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization as
long as the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to comply
with this Buffer Authorization may subject the property owner&the party(contractor) performing the construction &/or
land clearing to a civil penalty by DWR of up to$25,000 per day per violation.
1. Impacts: Impacts to woody vegetation from clearing and filling in Zone 1 (begins at the most landward of either
the waters edge or the coastal wetland line and extends 30 feet landward)shall be minimized to what must be
impacted for the sound installation of the shoreline stabilization project. Unnecessary clearing and filling in the
buffer is a violation of the riparian buffer rules.
2. Clearing &Grading: Clearing and grading of Zone 2 (begins at the landward edge of Zone 1 and extends 20 feet
landward) is allowed provided that it is re-vegetated immediately and Zone 1 is not compromised, which includes
maintaining diffused (non-channelized)flow of storm water runoff through the buffer.
3. Construction Corridors: Construction corridors are allowed for shoreline stabilization projects, but they must be
satisfactorily restored as described in condition 5 below.
4. Potential Overwash: For vertical shoreline stabilization projects(bulkheads)only; sites where wave overwash is
expected to be severe, the first ten (10)feet landward (unless specifically authorized otherwise by DCM)from the
structure may be maintained as a stable lawn in order to provide for structural stability.
5. Temporary Stabilization: Immediately post-construction, bare soils must be stabilized as quickly as possible by
providing a temporary ground cover. Newly seeded areas should be protected with mulch and/or erosion matting.
This ground cover is a temporary measure used to address erosion until site restoration can be accomplished.
6. Site Restoration: At minimum, pre-project site conditions must be re-established.A site that was wooded prior to
this shoreline stabilization project must be restored with woody vegetation at a stem density of 320 stems per
acre. Non wooded sites may be re-vegetated with woody vegetation. Restoration must be completed by the first
subsequent planting season (November 1 through March 30)after completion of the bulkhead.
• Pre-project site conditions:
7. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your property
indicating the location of the shoreline stabilization structure and any associated clearing, grading, and
construction corridors. This drawing will be used to aid in compliance and monitoring efforts.
By your signature below you agree to be held responsible for meeting all of the above listed conditions and verify that all
information is complete and accurate.
Agent or Applicant Printe Name / Permit Office i e
A or Applicant Signatur .�J Issue Date
/
CAMA GENERAL PERMIT#: 730 C1 b Z.
Washington Office Morehead City Office Wilmington Office
943 Washington Square Mall 400 Commerce Avenue 127 Cardinal Drive Ext.
Washington,NC 27889 Morehead City,NC 28557 Wilmington,NC 28405-3845
Phone [phone] Phone [phone] 910-796-7215
An Equal Opportunity/Affirmative Action Employer—50%Recycled/10%Post Consumer Paper

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: MHC Twin Lakes, LLC, do Equity
Lifestyle Properties, Inc.
Mailing address: Two North Riverside Plaza, Suite 800, Chicago, IL 60606-2682
Telephone Number: 312-279-1880
I certify that I have authorized James W. Forman, Jr., P.E., Arendell Engineers,
agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of Twin Lakes RV Resort Sewer Collection
System Improvements.
at my property located at 1618 Memory Lane Chocowinity, Beaufort County, NC 27817
This certification is valid through May 8, 2022 (date).
(Property Owner Information)
Signature
George Gudgeon
Print or Type Name
Senior Vice President, Equity Lifestyle Properties, Inc.
Title, co. owner or trustee for property
5/14/2019
Date
[phone]
Telephone Number
qeorqe qudgeonequitylifestyle.com REc
Email Address `019
DC; ,,, -NIVARO

ARENDELL
1004 Arendell Street
Morehead City,North Carolina 28557
[phone]
N.C.Certification No.C-1509
RECEIVED
MAY 22 2019
May 8, 2019
DCM-WAFT®
Mr. Kelly Spivey
N. C Division of Coastal Management
Washington Regional Office
943 Washington Square Mall Phone: [phone]
Washington,NC 27889 Email: [e-mail]
Re: Request for CAMA General Permit for Construction of Underground Utilities
Twin Lakes RV Resort Sewer Collection System Improvements
Chocowinity, Beaufort County,NC
Dear Mr. Spivey:
On behalf of MHC Twin Lakes, LLC, we request a General Permit for construction of sewer collection
facilities at the Twin Lakes RV Resort in Chocowinity,North Carolina.
The proposed work shown on the attached site plan (sheet C-3) and is generally described as follows:
• Construction of approximate 970 linear feet of 6 inch gravity sewer and 6-4 ft. diameter manholes.
• Construction of approximately 3,144 linear feet of 1.5, 2, 2.5 and 3 inch PVC and galvanized iron
pipe force main, RV sanitary connections and connection to the City of Washington 8 in. force
main in Whichard's Beach Road.
• Construction of three sewer grinder pump stations including pre-cast concrete and fiberglass
cylindrical wetwells, controls, and single phase power.
The project is currently out for bids with construction scheduled to begin near the end of May 2019 and
completion in August 2019.
The following documents are attached in support of this request:
• Agent Authorization Form for Permit Applications, executed by the permittee.
• Adjacent Riparian Owner Statement, executed by permittee and Ottis Crisp, Jr. of Crisp
Enterprises, LLC,the adjacent property owner.
• Check for $400 payable to NCDEQ.
• Drawing Sheet C-3 and C-6, site plan and profile for pipe beneath the ditch in Memory Lane.
• Copy of DWR Permit WQ0040870, Issued April 25,2019 for Construction of Sewer
Improvements. Issuance of this permit was contingent upon the City of Washington agreeing to
accept the flow associated with these improvements.
If necessary, we will be glad to meet you at the site and answer any questions you have regarding the
project.

Mr. Kelly Spivey May 20,2019
Request for CAMA General Permit for Construction of Underground Utilities Page 2 of 2
Twin Lakes RV Resort Sewer Collection System Improvements
Chocowinity, Beaufort County,NC
Thank you for your help on this project.
Sincerely,
ARENDELL ENGINEERS
)dir
RECEIVED
.
MAY 222019
amen W. Forman, Jr., P.E.
President S �� � pp�� °'
®CM-��PHlfARO
CC: Jon Richards, Equity Lifestyle Properties, Inc.

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: MHC Twin Lakes, LLC, c/o Equity
Lifestyle Properties, Inc.
Mailing address: Two North Riverside Plaza, Suite 800, Chicago, IL 60606-2682
Telephone Number: 312-279-1880
I certify that I have authorized James W. Forman, Jr., P.E., Arendell Engineers,
agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of Twin Lakes RV Resort Sewer Collection
System Improvements.
at my property located at 1618 Memory Lane Chocowinity, Beaufort County, NC 27817
This certification is valid through May 8, 2022 (date).
(Property Owner Information)
RECEIVED
Signature
MAY 222019
George Gudgeon
Print or Type Name DCWARD
Senior Vice President, Equity Lifestyle Properties, Inc.
Title, co. owner or trustee for property
5/14/2019
Date
[phone]
Telephone Number
george qudgeoncequitylifestyle.com
Email Address

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to MHC Twin Lakes, LLC c/o Equity Lifestyle Properties. Inc.
(Name of Property Owner)
On property located at 1618 Memory Lane, Chocowinity, NC 27817
(Address, Lot, Block, Road,etc.)
on Pamlico River/Chocowinity Bay ,in Chocowinity, Beaufort County and/or County)
The applicant has described to me, as shown below,the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
See attached drawings prepared by Arendell Engineers, Morehead City, NC, sheet C3 dated 4/22/19.
The proposed work is generally described as follows:
• Construction of approximate 970 linear feet of 6 inch gravity sewer and 6-4 ft. diameter manholes.
• Construction of approximately 3,144 linear feet of 1.5, 2,2.5 and 3 inch PVC and galvanized iron
pipe force main, RV sanitary connections and connection to the City of Washington 8 in. force main
in Whichard's Beach Road.
• Construction of three sewer grinder pump stations including pre-cast concrete and fiberglass
cylindrical wetwells, controls, and single phase power.
No construction is proposed in the riparian area of adjacent properties.
WAIVER SECTION (no waiver required)
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groirRECENED
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.) MAY 2 2 2019
N/A I do wish to waive the 15' setback requirement.
N/A I do not wish to waive the 15' setback requirement. WAR®
(Propert • ormation) (Adjacent Property\O r Information)
Signature Signature
George Gudgeon, Senior Vice President 0 v/-'
Print or Type Name Print or Type Name
Equity Lifestyle Properties. Inc. Crisp Enterprises, LLC
' 'o Riverside Plaza, Suite 800 ji C' N/->/2-/)ezA.- -
Mailing Address Mailing Address
Chicago, IL 60606 4!N G e- ° - r -u-i / i„l , L 7.S/i
City/State/Zip City/State/Zip
279-1880 ,Q-52 _ 9 - y` - Jt
Telephone Number Telephone Number
5/14/2019 5 1 ae'I /
Date Date
(Revised 6/1812012)

ROY COOPER
Governor .5
MICHAEL S.REGAN t,
secretory
LINDA CULPEPPER
Director NORTH CAROL INA
Environmental Quality
April 25, 2019
RECEIVED
George Gudgeon,Senior Vice President
MHC Twin Lakes, LLC MAY 2 2 2019
Two Riverside Plaza, Suite 800
Chicago, IL 60606-2682 —DCM AR®
Subject: Permit No. WQ0040820 9e�lEE ►1Y r1
MHC Twin Lakes, LLC
Twin Lakes RV Resort Sewer Collection System Improvements Project
Wastewater Collection System Extension
Beaufort County
Dear Mr. Gudgeon:
In accordance with your application received April 8, 2019, with additional information received April 24,
2019,we are forwarding herewith Permit No. WQ0040820, dated April 25, 2019,to MHC Twin Lakes, LLC
for the construction of the subject wastewater collection system extension. This permit shall be effective
from the date of issuance until rescinded and shall be subject to the conditions and limitations as specified
therein. This cover letter shall be considered a part of this permit and is therefore incorporated therein
by reference.
Please pay particular attention to the following conditions contained within this permit:
Condition 11.1: This permit shall not be automatically transferable; a request must be made and
approved.
Condition 11.4: Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 15A NCAC 02T.0403 or any individual system-wide collection system
permit issued to the Permittee.
Condition 11.7: Upon completion of construction and prior to operation of these permitted facilities,the
completed Engineering Certification form with checklist attached to this permit shall be
submitted with the required supporting documents to the address provided on the form.
Permit modifications are required for any changes resulting in non-compliance with
this permit, regulations, or the Minimum Design Criteria. [15A NCAC 02T.0116]
It shall be the responsibility of MHC Twin Lakes, LLC to ensure that the as-constructed project meets the
appropriate design criteria and rules. Failure to comply may result in penalties in accordance with North
Carolina General Statute §143-215.6A through §143-215.6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina-licensed Professional Engineer to
the licensing board.
North Carolina Department of Environmental Quality I Division of Water Resources
Washington Regional Office 1943 Washington Square Mail,Washington,NC 27889
252-946-6481

MHC Twin Lakes, LLC
Twin Lakes RV Resort Sewer Collection System Improvements Project
WQ0040820
April 25, 2019
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 30 days following receipt of this permit. This
request must be in the form of a written petition, conforming to Chapter 150B of North Carolina General
Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC
27699-6714. Unless such demands are made,this permit shall be final and binding.
If you need additional information concerning this matter, please contact Allen Clark at [phone]
or via e-mail at [e-mail].
Sincerely,
gottia TA444,11
for Linda Culpepper
Director, Division of Water Resources
By Robert Tankard
Assistant Regional Supervisor
Water Quality Regional Operations Section RECEIVED
Washington Regional Office
MAY 222019
cc: James W. Forman,Jr., PE (electronic copy)
Adam Waters, City of Washington (electronic copy) �n,
PERCS (electronic copy) DC '\ARO
Washington Regional Office Files
Page 2 of 8

h,STATE 4,
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a a
NORTH CAROLINA
Environmental Quality
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
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 the
MHC Twin Lakes, LLC
Beaufort County
for the construction and operation of approximately 969 linear feet of 6-inch diameter private PVC gravity
sewer;an 85—gallon per minute pump station (PS#4-Bathhouse)with duplex pumps,on-site audible and
visual high water alarms,telemetry and portable generator receptacle,along with approximately 20 linear
feet of 2-inch diameter GIP force main and 2,160 linear feet of 3-inch diameter PVC force main; a 42-
gallon per minute pump station (PS #5 - Cactus Lane) with duplex pumps, on-site audible and visual high
water alarms, telemetry and portable generator receptacle, along with approximately 15 linear feet of
1.25-inch diameter GIP force main, 452 linear feet of 2-inch diameter GIP force main, and 438 linear feet
of 2-inch diameter PVC force main; and, a 48-gallon per minute pump station (PS #6 - Camp Store and
Maintenance Area) with duplex pumps, on-site audible and visual high water alarms, telemetry and
portable generator receptacle, along with approximately 15 linear feet of 1.5-inch diameter GIP force
main and 63 linear feet of 2-inch diameter PVC force main to serve (39 RV spaces in the Cactus Lane
Sections A and CA; 14 fixture bathhouse; 15 employee camp store & maintenance facility; 10 person
swimming pool; and, laundry matte with 4 washers) as part of the Twin Lakes RV Resort Sewer Collection
System Improvements project,and the discharge of 11,325 gallons per day(permitted flows already being
received by City of Washington WWTP through NCDWM pump and haul permit) of collected domestic
wastewater into the City of Washington's WWTF existing sewerage system, pursuant to the application
received April 8, 2019, and additional information received on April 24, 2019 and in conformity with 15A
NCAC 02T;the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable;
the Division's Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and Force Mains
adopted June 1, 2000 as applicable; and other supporting data subsequently filed and approved by the
Department of Environmental Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the specified
conditions and limitations contained therein.
Roka T44,44441
for Linda Culpepper
Director, Division of Water Resources �rc'��®
By Authority of The Environmental Management Commission R CE
Permit Number: WQ0040820 R
Permit Issued: April 25, 2019 ryry
c \NAFt45
Page 3 of 8

SUPPLE T TO PER IT COVER S EET
MHC Twin Lakes, LLC is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension.The
sewage and wastewater collected by this system shall be treated in the City of Washington's WWTP in
accordance with Permit Number NC0020648.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as
applicable;and the Division's Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and
Force Mains adopted June 1, 2000 as applicable, unless specifically mentioned herein. Division approval
is based on acceptance of the certification provided by a North Carolina-licensed Professional Engineer in
the application. It shall be the Permittee's responsibility to ensure that the as-constructed project meets
the appropriate design criteria and rules.
Construction and operation contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
I. SPECIAL CONDITIONS
1. No flow in excess of the quantity permitted herein, 11,325 GPD,shall be made tributary to the subject
sewer system until an application for permit modification for an increase in flow has been submitted
to and approved by the Division. [15A NCAC 02T.0304(b)]
2. This permit shall become voidable unless the agreement between MHC Twin Lakes, LLC and the City
of Washington for the collection and final treatment of wastewater is in full force and effect. [15A
NCAC 02T.0304(g)].
3. The abandonment of any existing wastewater facilities including septic systems being replaced by new
sewer infrastructure shall be done in accordance with the applicable agency having compliance
oversight on such facilities. [15A NCAC 02T.0105(c)(6)]
II. STANDARD CONDITIONS
1. This permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be considered
on its merits and may or may not be approved. [15A NCAC 02T.0116; G.S 143-215.1(d3)]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 02T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for
the Fast-Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and
other supporting materials unless specifically mentioned herein. [15A NCAC 02T.0110]
RECEIVED
►� ; ,a 2, 2019
Page 4 of 8
DC tiVARO

3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T.0110]
4. The wastewater collection facilities shall be properly maintained and operated at all times. The
Permittee shall maintain compliance with an individual system-wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 02T .0403. If an individual
permit is not required,the following performance criteria shall be met:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or surface
water standards.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been developed and
implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day(i.e. 365
days per year). Pump stations that are connected to a telemetry system shall be inspected at
least once per week.
e. High-priority sewer lines shall be inspected at least once per every six-months and inspections are
documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Overflows and bypasses shall be reported to the appropriate Division regional office in accordance
with 15A NCAC 2B .0506(a), and public notice shall be provided as required by North Carolina
General Statute §143-215.1C.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease-related sanitary sewer overflows.
i. Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. Documentation shall be kept for Subparagraphs(a)through (i)of this Rule for a minimum of three
years with exception of the map, which shall be maintained for the life of the system.
5. The Permittee shall report by telephone to a water resources staff member at the Washington
Regional Office, telephone number [phone], as soon as possible, but in no casttel�er�t2jlcD
hours,following the occurrence or first knowledge of the occurrence of either of the fol owing: ett��
MAY 2 2 2019
Page 5 of 8 DCM- A O

a. Any process unit failure,due to known or unknown reasons,that renders the facility incapable
of adequate wastewater transport, such as mechanical or electrical failures of pumps, line
blockage or breakage, etc.; or
b. Any SSO and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volume,that reaches surface water
Voice mail messages or faxed information is permissible, but this shall not be considered as the initial
verbal report. Overflows and spills occurring outside normal business hours may also be reported to
the Division of Emergency Management at telephone number [phone] or [phone].
Persons reporting any of the above occurrences shall file a spill report by completing and submitting
Part I of Form CS-SSO (or the most current Division approved form) within five days following first
knowledge of the occurrence. This report must outline the actions taken or proposed to be taken to
ensure that the problem does not recur. Part II of Form CS-SSO(or the most current Division approved
form) can also be completed to show that the SSO was beyond control. [G.S. 143-215.1C(a1)]
6. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State. [15A NCAC 02T.0108(b)]
7. Upon completion of construction and prior to operation of these permitted facilities, the completed
Engineering Certification form with checklist attached to this permit shall be submitted with the
required supporting documents to the address provided on the form. A complete certification is one
where the form is fully executed, and the supporting documents are provided as applicable. Any
wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Engineer's Certification shall be considered a violation of the permit and shall subject the
Permittee to appropriate enforcement actions.
If the permit is issued to a private entity with an Operational Agreement,then a copy of the Articles
of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been appropriately
filed with the applicable County's Register of Deeds office shall be submitted with the certification.
A complete certification is one where the form is fully executed, and the supporting documents are
provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines &force
mains) of the wastewater collection system extension. Final record drawings should be clear on
the plans or on digital media (CD or DVD disk) and are defined as the design drawings that are
marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b. One copy of the supporting applicable design calculations including pipe and pump sizing,velocity,
pump cycle times, and level control settings, pump station buoyancy, wet well storage, surge
protection, detention time in the wet well, and force main, ability to flush low points in force
mains with a pump cycle,and downstream sewer capacity analysis. If a portable power source or
pump is dedicated to multiple stations, an evaluation of all the pump stations' storage capacities
and the rotation schedule of the portable power source or pump, include travel timeframes, shall
be provided.
RECEIVED
MAY22Z019
Page 6 of 8 ®��-Irtt ARC/

c. Changes to the project that do not result in non-compliance with this permit, regulations, or the
Minimum Design Criteria should be clearly identified on the record drawings, on the certification
in the space provided, or in written summary form.
Prior to Certification (Final or Partial): Permit modifications are required for any changes resulting
in non-compliance with this permit (including but not limited to pipe length changes of 10% or
greater, increased flow, pump station design capacity design increases of 5% or greater, and
increases in the number/type of connections), regulations, or the Minimum Design Criteria.
Requested modifications or variances to the Minimum Design Criteria will be reviewed on a case-by-
case basis and each on its own merit. Please note that variances to the Minimum Design Criteria
should be requested and approved during the permitting process prior to construction. After-
construction requests are discouraged by the Division and may not be approved, thus requiring
replacement or repair prior to certification & activation. [15A NCAC 02T.0116]
8. Gravity sewers installed greater than ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified until
corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case-by-case basis. Resolution of such request shall be evident prior to completing and submitting
the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the individual permit and construction record drawings shall be maintained on file by the
Permittee for the life of the wastewater collection facilities. [15A NCAC 02T.0116]
10. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 02T; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast-Track Permitting of Pump Station and Force Mains adopted June
1, 2000 as applicable; and other supporting materials may subject the Permittee to an enforcement
action by the Division, in accordance with North Carolina General Statutes§143-215.6A through§143-
215.6C, construction of additional or replacement wastewater collection facilities, and/or referral of
the North Carolina-licensed Professional Engineer to the licensing board. [15A NCAC 02T .0108(b-c)]
11. In the event that the wastewater collection 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 facilities.
[15A NCAC 02T.0110; 15A NCAC 02T.0108(b)]
12. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations,or ordinances that may be imposed by the Division any other Federal,State,or Local
government agencies which have jurisdiction or obtaining other permits which maybe required by the
Division or any other Federal, State, of Local government agencies. [G.S. 143-215.1(b)]
RECEIVED
MAY 2 2 2019
DCm-WAR®
Page 7 of 8

•
FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: MHC Twin Lakes, LLC
PERMIT#: WQ0040820
PROJECT: Twin Lakes RV Resort Sewer Collection System Improvements
ISSUE DATE: April 25, 2019
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation. It
• should be submitted in a manner that documents the Division's receipt. Send the required documentation
the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received. A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain
the wastewater collection system permitted herein or portions thereof.
Printed Name,Title Signature Date
ENGINEER'S CERTIFICATION
I, , as a duly registered Professional En sneer in the State of North Carolina,
having been authorized to observe (I I periodically, I I weekly, II full time) the construction of the
project name and location as referenced above for the above Permittee hereby state that, to the best of
my abilities, due care and diligence was used in the observation of the following construction:
969 linear feet of 6-inch diameter PVC gravity sewer; an 85—GPM pump station (PS #4) with duplex
pumps, on-site audible and visual high water alarms, telemetry and portable generator receptacle, 20
linear feet of 2-inch diameter GIP force main, 2,160 linear feet of 3-inch diameter PVC force main; 42-
GPM pump station (PS#5) with duplex pumps,on-site audible and visual high water alarms,telemetry
and portable generator receptacle, 15 linear feet of 1.25-inch diameter GIP force main, 452 linear feet
of 2-inch diameter GIP force main, and 438 linear feet of 2-inch diameter PVC force main; a 48-GPM
pump station (PS#6) with duplex pumps, on-site audible and visual high water alarms, telemetry and
portable generator receptacle, 15 linear feet of 1.5-inch diameter GIP force main, 63 linear feet of 2-
inch diameter PVC force main; such that the construction was observed to be built within substantial
compliance of this permit; 15A NCAC 02T; the Division of Water Resources' (Division) Gravity Sewer
Minimum Design Criteria adopted February 12, 1996 as applicable;the Division's Minimum Design Criteria
for the Fast-Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and
other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date:
ti C
n Final n Partial (include description) o rn
c.o Ci
0
NC DWR—Water Quality Regional Operations Section 943 Washington Square Mall,Washington, NC 27889
Washington Regional Office Phone: [phone]

CERTIFICATION CHECKLIST
To be completed by the certifying engineer prior to operation of the permitted sewers, per 15A NCAC 02T.0116.
Certifying Engineer:
Certification Review Date:
Project Name:
WQ00 Project County:
1) Has permittee information changed since the permit was issued (or last modified): change of mailing address,
change of ownership, transfer from developer to HOA/POA, etc. Yes No
• If yes, please provide either a change of ownership form or new contact information. Note that transfer of
permits from the developer to the HOA/POA must occur with the first certification.
2) Have the as-built drawings have been signed,sealed, and dated by an N.C. PE? n Yes No
3) Final Engineering certification? n Yes No
• If Partial Engineering certification, provide detailed narrative including what is being certified in the current
phase,what was previously certified(if applicable),and what is left to be certified.
4) Adequate information related to sewer lines: Ti Yes n No n N/A
• Three feet minimum cover has been provided for all sewers unless ferrous pipe was installed.
• Minimum diameters for gravity sewers are 8-inches for public lines and 6-inches for private lines.
• Manholes have been installed: At the end of each line, at all changes in grade, size, or alignment, at all
intersections, and at distances not greater than 425 feet; minimum diameter shall be 4 feet (48-inches).
5) Adequate information related to pump stations: I I Yes No N/A
• Ensure power reliability option was selected per 15A NCAC 02T.0305(h).
6) Was project construction completed in accordance with all of the following: n Yes I I No Ti N/A
• 15A NCAC 02T, Minimum Design Criteria (MDC)for the permitting of Gravity Sewers (latest version), and MDC
for the Permitting of Pump Stations and Force Mains (latest version)?
If not, a variance approval is required in accordance with 15A NCAC 02T.0105(b), prior to certification and operation.
• Contact the Central Office to discuss the variance to determine a course of action.
• Applicant must submit two copies of the variance request form, plans, specifications, calculations, and any other
pertinent information to the Central Office (one hard copy, one digital copy).
• The central office will review the variance request, and if approvable, specific language regarding the variance
will be incorporated into the permit, either via a special condition or a supplementary letter. A copy of the
reissued permit with variance language or the variance letter must be maintained with the original documents.
7) Does the project contains high priority lines (15A NCAC 02T.0402(2))? Ti Yes No
• If yes,ensure that the permit already contains the necessary condition related to high priority lines 15A NCAC
02T.0403 (a)(5). If the permit does not include this language,the Fast Track reviewer will reissue the permit with
the appropriate language.
8) Are Permit modifications are required for any changes resulting in non-compliance with this permit(including but not
limited to pipe length changes of 10%or greater,change in flow, pump station design capacity design change of 5%or
greater,and/or change in the number/type of connections)? Ti Yes n No ®®��(('++ ����C
• If yes, a permit modification request must be submitted to the appropriate Regional Office, aRa'kti4$le41E�
permit with revised certification must be issued prior to certification and operation.
NC DWR—Water Quality Regional Operations Section 943 Washington Square Mall,Washingt C "78
Washington Regional Office Phone: [phone]

ARENDELL
_ S 4140N4_NTA_
1004 Arendell Street
Morehead City, North Carolina 28557
[phone]
N.C.Certification No.C-1509
RECFVFD
i3
May 8, 2019
DO MAi A R
Mr. Kelly Spivey
N. C Division of Coastal Management
Washington Regional Office
943 Washington Square Mall Phone: [phone]
Washington,NC 27889 Email: [e-mail]
Re: Request for CAMA General Permit for Construction of Underground Utilities
Twin Lakes RV Resort Sewer Collection System Improvements
Chocowinity, Beaufort County,NC
Dear Mr. Spivey:
On behalf of MHC Twin Lakes, LLC, we request a General Permit for construction of sewer collection
facilities at the Twin Lakes RV Resort in Chocowinity,North Carolina.
The proposed work shown on the attached site plan(sheet C-3) and is generally described as follows:
• Construction of approximate 970 linear feet of 6 inch gravity sewer and 6 -4 ft. diameter manholes.
• Construction of approximately 3,144 linear feet of 1.5, 2, 2.5 and 3 inch PVC and galvanized iron
pipe force main, RV sanitary connections and connection to the City of Washington 8 in. force
main in Whichard's Beach Road.
• Construction of three sewer grinder pump stations including pre-cast concrete and fiberglass
cylindrical wetwells, controls, and single phase power.
The project is currently out for bids with construction scheduled to begin near the end of May 2019 and
completion in August 2019.
The following documents are attached in support of this request:
• Agent Authorization Form for Permit Applications, executed by the permittee.
• Adjacent Riparian Owner Statement, executed by permittee and Ottis Crisp, Jr. of Crisp
Enterprises, LLC,,the adjacent property owner.
• Check for$400 payable to NCDEQ.
• Drawing Sheet C-3 and C-6, site plan and profile for pipe beneath the ditch in Memory Lane.
• Copy of DWR Permit WQ0040870, Issued April 25, 2019 for Construction of Sewer
Improvements. Issuance of this permit was contingent upon the City of Washington agreeing to
accept the flow associated with these improvements.
If necessary,we will be glad to meet you at the site and answer any questions you have regarding the
project.

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: MHC Twin Lakes, LLC, do Equity
Lifestyle Properties, Inc.
Mailing address: Two North Riverside Plaza, Suite 800, Chicago, IL 60606-2682
Telephone Number: 312-279-1880
I certify that I have authorized James W. Forman, Jr., P.E., Arendell Engineers,
agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of Twin Lakes RV Resort Sewer Collection
System Improvements.
at my property located at 1618 Memory Lane Chocowinity, Beaufort County, NC 27817
This certification is valid through May 8, 2022 (date).
(Property Owner Information)
R IV ED
Signature
George Gudgeon
Print or Type Name „v AR
? s ,
Senior Vice President, Equity Lifestyle Properties, Inc.
Title, co. owner or trustee for property
5/14/2019
Date
[phone]
Telephone Number
george qudgeon(c�equitylifestyle.com
Email Address

ssti
ROY COOPER
Governor s l '�
MICHAEL S.REGAN
Secretary
-
LINDA CULPEPPER 4Nurs"°`4`'
Director NORTH CAROLINA
Environmental Quality
April 25, 2019
FitD
George Gudgeon, Senior Vice President
MHC Twin Lakes, LLC
Two Riverside Plaza,Suite 800
Chicago, IL 60606-2682
Subject: Permit No. WQ0040820
MHC Twin Lakes, LLC
Twin Lakes RV Resort Sewer Collection System Improvements Project
Wastewater Collection System Extension
Beaufort County
Dear Mr. Gudgeon:
In accordance with your application received April 8, 2019, with additional information received April 24,
2019, we are forwarding herewith Permit No. WQ0040820, dated April 25, 2019,to MHC Twin Lakes, LLC
for the construction of the subject wastewater collection system extension. This permit shall be effective
from the date of issuance until rescinded and shall be subject to the conditions and limitations as specified
therein. This cover letter shall be considered a part of this permit and is therefore incorporated therein
by reference.
Please pay particular attention to the following conditions contained within this permit:
Condition 11.1: This permit shall not be automatically transferable; a request must be made and
approved.
Condition 11.4: Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 15A NCAC 02T.0403 or any individual system-wide collection system
permit issued to the Permittee.
Condition 11.7: Upon completion of construction and prior to operation of these permitted facilities,the
completed Engineering Certification form with checklist attached to this permit shall be
submitted with the required supporting documents to the address provided on the form.
Permit modifications are required for any changes resulting in non-compliance with
this permit, regulations, or the Minimum Design Criteria. [15A NCAC 02T.0116]
It shall be the responsibility of MHC Twin Lakes, LLC to ensure that the as-constructed project meets the
appropriate design criteria and rules. Failure to comply may result in penalties in accordance with North
Carolina General Statute §143-215.6A through §143-215.6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina-licensed Professional Engineer to
the licensing board.
North Carolina Department of Environmental Quality I Division of Water Resources
Washington Regional Office 1943 Washington Square Mail,Washington,NC 27889
252-946-6481

est
..,1'- ' ' i
NORTH CAROLINA
Environmental Quality
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
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 the
MHC Twin Lakes, LLC
Beaufort County
for the construction and operation of approximately 969 linear feet of 6-inch diameter private PVC gravity
sewer;an 85—gallon per minute pump station (PS#4-Bathhouse)with duplex pumps,on-site audible and
visual high water alarms,telemetry and portable generator receptacle,along with approximately 20 linear
feet of 2-inch diameter GIP force main and 2,160 linear feet of 3-inch diameter PVC force main; a 42-
gallon per minute pump station (PS #5 -Cactus Lane) with duplex pumps, on-site audible and visual high
water alarms, telemetry and portable generator receptacle, along with approximately 15 linear feet of
1.25-inch diameter GIP force main, 452 linear feet of 2-inch diameter GIP force main, and 438 linear feet
of 2-inch diameter PVC force main; and, a 48-gallon per minute pump station (PS #6 - Camp Store and
Maintenance Area) with duplex pumps, on-site audible and visual high water alarms, telemetry and
portable generator receptacle, along with approximately 15 linear feet of 1.5-inch diameter GIP force
main and 63 linear feet of 2-inch diameter PVC force main to serve (39 RV spaces in the Cactus Lane
Sections A and CA; 14 fixture bathhouse; 15 employee camp store & maintenance facility; 10 person
swimming pool; and, laundry matte with 4 washers) as part of the Twin Lakes RV Resort Sewer Collection
System Improvements project,and the discharge of 11,325 gallons perday(permitted flows already being
received by City of Washington WWTP through NCDWM pump and haul permit) of collected domestic
wastewater into the City of Washington's WWTF existing sewerage system, pursuant to the application
received April 8, 2019, and additional information received on April 24,2019 and in conformity with 15A
NCAC 02T;the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable;
the Division's Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and Force Mains
adopted June 1, 2000 as applicable; and other supporting data subsequently filed and approved by the
Department of Environmental Quality and considered a part of this permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the specified
conditions and limitations contained therein.
Ulla .1;04441,44i
for Linda Culpepper
Director, Division of Water Resources '.' I�,
By Authority of The Environmental Management Commission 'y`' �''—"
Permit Number: WQ0040820
Permit Issued: April 25, 2019 0
Page 3 of 8

3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T.0110]
4. The wastewater collection facilities shall be properly maintained and operated at all times. The
Permittee shall maintain compliance with an individual system-wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 02T .0403. If an individual
permit is not required,the following performance criteria shall be net:
a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or surface
water standards.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been developed and
implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day(i.e. 365
days per year). Pump stations that are connected to a telemetry system shall be inspected at
least once per week.
e. High-priority sewer lines shall be inspected at least once per every six-months and inspections are
documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Overflows and bypasses shall be reported to the appropriate Division regional office in accordance
with 15A NCAC 2B .0506(a), and public notice shall be provided as required by North Carolina
General Statute §143-215.1C.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease-related sanitary sewer overflows.
i. Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. Documentation shall be kept for Subparagraphs (a)through (i)of this Rule for a minimum of three
years with exception of the map, which shall be maintained for the life of the system.
5. The Permittee shall report by telephone to a water resources staff member at the Washington
Regional Office,telephone number [phone], as soon as possible, but in no cas T lrl .4
hours,following the occurrence or first knowledge of the occurrence of either of the following.`
Page 5 of 8 ,fib

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: MHC Twin Lakes, LLC
PERMIT#: WQ0040820
PROJECT: Twin Lakes RV Resort Sewer Collection System Improvements
ISSUE DATE: April 25, 2019
This project shall not be considered complete nor allowed to operate in accordance with Condition 7 of
this permit until the Division has received this Certification and all required supporting documentation. It
• should be submitted in a manner that documents the Division's receipt. Send the required documentation
the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received. A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I,the undersigned agent for the Permittee, hereby state that this project has been constructed pursuant
to the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain
the wastewater collection system permitted herein or portions thereof.
Printed Name,Title Signature Date
ENGINEER'S CERTIFICATION
I, , as a duly registered Professional En sneer in the State of North Carolina,
having been authorized to observe (n periodically, n weekly, full time) the construction of the
project name and location as referenced above for the above Permittee hereby state that,to the best of
my abilities, due care and diligence was used in the observation of the following construction:
969 linear feet of 6-inch diameter PVC gravity sewer; an 85—GPM pump station (PS #4) with duplex
pumps, on-site audible and visual high water alarms, telemetry and portable generator receptacle, 20
linear feet of 2-inch diameter GIP force main, 2,160 linear feet of 3-inch diameter PVC force main; 42-
GPM pump station (PS#5)with duplex pumps,on-site audible and visual high water alarms,telemetry
and portable generator receptacle, 15 linear feet of 1.25-inch diameter GIP force main, 452 linear feet
of 2-inch diameter GIP force main, and 438 linear feet of 2-inch diameter PVC force main; a 48-GPM
pump station (PS#6) with duplex pumps, on-site audible and visual high water alarms, telemetry and
portable generator receptacle, 15 linear feet of 1.5-inch diameter GIP force main, 63 linear feet of 2-
inch diameter PVC force main; such that the construction was observed to be built within substantial
compliance of this permit; 15A NCAC 02T; the Division of Water Resources' (Division) Gravity Sewer
Minimum Design Criteria adopted February 12, 1996 as applicable;the Division's Minimum Design Criteria
for the Fast-Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and
other supporting materials.
North Carolina Professional Engineer's Seal w/signature &date:
n Final n Partial (include description) rn
NC DWR—Water Quality Regional Operations Section 943 Washington Square Mall,Washington,NC 27889
Washington Regional Office Phone: [phone]

CERTIFICATION CHECKLIST
To be completed by the certifying engineer prior to operation of the permitted sewers, per 15A NCAC 02T.0116.
Certifying Engineer:
Certification Review Date:
Project Name:
WQ00 Project County:
1) Has permittee information changed since the permit was issued (or last modified): change of mailing address,
change of ownership,transfer from developer to HOA/POA, etc. I I Yes n No
• If yes, please provide either a change of ownership form or new contact information. Note that transfer of
permits from the developer to the HOA/POA must occur with the first certification.
2) Have the as-built drawings have ben signed,sealed, and dated by an N.C. PE? Yes I I No
3) Final Engineering certification? n Yes n No
• If Partial Engineering certification, provide detailed narrative including what is being certified in the current
phase,what was previously certified(if applicable),and what is left to be certified.
4) Adequate information related to sewer lines: Yes I No I I N/A
• Three feet minimum cover has been provided for all sewers unless ferrous pipe was installed.
• Minimum diameters for gravity sewers are 8-inches for public lines and 6-inches for private lines.
• Manholes have been installed: At the end of each line,at all changes in grade, size, or alignment, at all
intersections, and at distances not greater than 425 feet; minimum diameter shall be 4 feet (48-inches).
5) Adequate information related to pump stations: I I Yes n No N/A
• Ensure power reliability option was selected per 15A NCAC 02T.0305(h).
6) Was project construction completed in accordance with all of the following: n Yes n No n N/A
• 15A NCAC 02T, Minimum Design Criteria (MDC)for the permitting of Gravity Sewers (latest version), and MDC
for the Permitting of Pump Stations and Force Mains (latest version)?
If not, a variance approval is required in accordance with 15A NCAC 02T.0105(b), prior to certification and operation.
• Contact the Central Office to discuss the variance to determine a course of action.
• Applicant must submit two copies of the variance request form, plans,specifications, calculations, and any other
pertinent information to the Central Office (one hard copy, one digital copy).
• The central office will review the variance request, and if approvable, specific language regarding the variance
will be incorporated into the permit, either via a special condition or a supplementary letter. A copy of the
reissued permit with variance language or the variance letter must be maintained with the original documents.
7) Does the project contains high priority lines (15A NCAC 02T.0402(2))? Yes I I No
• If yes, ensure that the permit already contains the necessary condition related to high priority lines 15A NCAC
02T.0403 (a)(5). If the permit does not include this language,the Fast Track reviewer will reissue the permit with
the appropriate language.
8) Are Permit modifications are required for any changes resulting in non-compliance with this permit(including but not
limited to pipe length changes of 10%or greater,change in flow,pump station design capacity design change of 5%or
greater,and/or change in the number/type of connections)? I I Yes I I No
Ev=
• If yes, a permit modification request must be submitted to the appropriate Regional Office, aodif etl "T
permit with revised certification must be issued prior to certification and operation.
NC DWR—Water Quality Regional Operations Section 943 Washington Square Mall,Washington, NC 27889
Washington Regional Office Phone: [phone]

NC Division of Coastal Mgt> Habitat impact Computer Sheet
Applicant: ;tin > i_ z-
Date: tiA Z 0 I `)
General Permit#:
Describe below the HABITAT disturbances for the application. All values should match the name,and units of measurement
found in your Habitat code sheet.
' TOTAL Sq. Ft. FINAL Sq. Ft. TOTAL Feet FINAL Feet
(Applied for. (Anticipated final (Applied for. (Anticipated final
DISTURB TYPE Disturbance total I disturbance. Disturbance disturbance.
Habitat Name Choose One includes any Excludes any total includes Excludes any
anticipated restoration any anticipated restoration and/or
restoration or and/or temp restoration or temp impact
temp impacts) I impact amount) temp impacts) amount)
aR Lt.o --2_ 2
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Dredge❑ Fill❑ Both ❑ Other ❑
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Dredge❑ Fill❑ Both ❑ Other ❑ I
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Dredge❑ Fill❑ Both ❑ Other ❑
Dredge❑ Fill❑ Both ❑ Other ❑