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Transmittal Letter II�� jI ICI JjI7J;�,�/t�q, II III 1I
Date: October 7, 2019 I n (' J rmm
Project Name: Cummings Cove Phase IrX 1.L IS\l\
CDC Project: 21803 OCT - 7 2019
To: State of North Carolina Water Quality Regional operations
Department of Environmental Quality Asheville Regional Office
Division of Water Recourses
2090 US Highway 70
Swannanoa, North Carolina 28778
Via _ Mail _Overnight x Hand Delivered _Pick up ® CDC Office
pies----- -------Date------ "------- ...._...._.... -------- '... Description ......................... __---------
1 10-03-2019 Check in the amount of $480.00
_.._------..._........... ...--.---------------------------.-..-.
1 10-03-2019 Cover Letter
----- -------- ............ ............ .--- ._.......... ......... ..---------------- '-------- .-------- ..-_...-..-.--.
1 10-03-2019 Sealed 24"06" plans
--------------------------------------------------------------------------------------------------------------------------
--
1 10.04-2019 FTA 04-16 Fast Track Sewer Application
1 10-31-2018 FTSE 04-16 Flow Tracking Acceptance Application
............................................................................................................................
1 10-03-2019 Site Map
......................................................
'ch I Cain, PE
Mailing Address: P.O. Box 5432, Asheville, NC 28913
168 Patton Avenue Asheville, NC 28801 52 Walnut Street— Suite 9, Waynesville,NC 29786
Phone [phone] Fax [phone] Phone: [phone] Fax: [phone]

CDCM
October 3, 2019
State of North Carolina
Department of Environmental Quality
Division of Water Recourses
2090 US Highway 70
Swannanoa, North Carolina 28778
Mom
wi) 00JO&ZI
RE: Cummings Cove Phase IX
Fast Track Sewer System Extension Permit
CDC Project No. 21803
7
Dear Reviewer.
Please find enclosed a fast track sewer system extension permit application package for the subject
project for your review and approval. The Cummings Cove Phase IX subdivision will consist of
27 residential units within the overall Cummings Cove mast rCpTa—ndevelopment. The project is
located at 299 Cummings Ridge Trail in Henderson County. Please find enclosed the following
items for your review and approval:
• Check (#5861) a in the amount of $480.00
• Set of sealed 24" x 36" plans
• FTA 04-16 Fast Track Sewer Application
• DEV 11-17 Developer's Operation Agreement
• FTSE 04-16 Flow Tracking Acceptance Application
• Site Map
Please do not hesitate to call if you have any questions or need any additional information during
your review.
Siinnceererelyyy,
0���
MichaelCain, PE
Civil Design Concepts, PA
water Quallty Regional Operations
Asheville Regional Office
Mailing Address: P.O. Box 5432, Asheville, NC 28813
168 Patton Avenue, Asheville, NC 28801 52 Walnut Street Suite 9, Waynesville, NC 28786
Phone [phone] Fax [phone] Phone: [phone] Fax: [phone]

00040W
State of North Carolina
D„ %� Department of Environmental Quality
*/�*/.. Division of Water Resources
' 15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCAC 02T, 15A NCAC 02T.0300, Division policies and good engineering mractires.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that require an environmental assessment in accordance with 15A NCAC IC .0100;
➢ Projects that do not meet any part of the minimum design criteria (MDC) document;
➢ Projects that involve a variance from the requirements of ISA NCAC 2T;
Y Pressure sewer systems utilizing septic tank -effluent pumps (STEPs) or simplex grinder pumps;
➢ STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
➢ Vacuum sewer systems.
General— When submitting an application, please use the following instructions as a checklist in order to ensure all required items
are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and
reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
® Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: ETA 04-16) Application (Required for All Application Packages):
E3 Submit the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
® If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina Secretary of State.
❑ If the Applicant Type in Item 12 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
® The Project Name in Item II.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Engineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 021' .0106(b).
Per ISA NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in ISA NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: ETA 04-I6 & SUPPORTING DOCUMENTATION Page 1 of 3

E. Flow TrackingtAcceptance Form (Form: FTSE 04-16) (It Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67(a).
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identity the entire project
area and closest surface waters.
➢ Location of the project (gravity sewer, pump stations & force main)
➢ Downstream connection points and pennit number (if known) for the receiving sewer
® Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modification Packages):
❑ Submit the most recently issued existing permit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
This alternative is only available for average daily flows less than 15,000 gallons per day
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible
with the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed
contractor, stating that `the portable power generation unit or portable, independently -powered pumping units, associated
appurtenances and personnel are available for distribution and operation of this pump station."
If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump
stations' storage capacities and the rotation schedule of the portable power source or pump, including travel
timeframes, shall be provided in the case of a multiple station power outage. (Required at time of certification)
E Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
® Per 15A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to bold the utility franchise for the area to be served by
the sewer extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or that
franchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (FORM: HOA).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
® Developers of lots to be sold
ID Per 15A NCAC 02T.0115(b), submit the properly executed Operational Agreement (FORM: DEV).
For more information, visit the Division's collection systems wehsite
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Reolonal Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Reolonal Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba; Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Reolonal Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Curriluck, Dare, Gales, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Suite 300
Alamance, Allegheny, Ash&, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Water Quality Section
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of 3

m0 WQ °d 10 e of ND 2U
DW R Carolina
Depart nt of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
'Dlvlslon of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: (m be completed by Dm)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: FUL TRACK. LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: GEORGE ELMORE per 15A NCAC 02T .0106(bl
Title: MANAGER
4. Applicant's mailing address: 95 DEPOT STREET
City: WAYNESVILLE State: NC Zip:28786-
5. Applicant's contact information:
Phone number: [phone] Email Address: mcain( cdceo.com
11. PROJECT INFORMATION:
1. Project name: Cummings Cove Phase IX �AfJVj.� ..fyi=1—��N
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
Ifa modification, provide the existing permit number: W000_ and issued date:
If new construction but pan of a master plan, provide the existing permit number: WO
3. County where project is located: Henderson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.3157' Longitude:-82.5557"
5. Parcel ID(ifapplicable): 9549-004242
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION: 555I---I���� /,'�q}�'�t-r
1. Professional Engineer: Michael Cain License Number: 047788 2 lS Iq I' I q�
Firm: Civil Design Concepts �t \ d,L) III 1
Mailing address: 168 Patton Ave OCT
, City: Asheville State: NC Zip: 28801
Phone number: 828 252-5388 Email Address: mcain(@,cdego.com Water y Regional 0
(_) Quality
Re I operations
IV. WASTEWATER TREATMENT FACILITY(WWTF) INFORMATION: gOnal f(ICe
1. Facility Name: Cummings Cove Permit Number: NCO057541
Owner Name: Cummings Cove Company, LLC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size:_ inch
System Wide Collection System Permit Number(s) (if applicable): W QCS
Owner Name(s):
FORM: FTA 04-16 Page 1 of 5

V1. GENERAL REQUIREMENTS
I . If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM DEVI been attached?
®Y ❑No ❑N/A
3. Ifthe Applicant is a Home/Property
Owners' A
social n has an Operational Agreement (FORM HOA) beenattached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply).
® Residential Owned
❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased
❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care
❑ Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities
❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories
❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial %Commercial
I % Industrial (See 15A NCAC 02T.0103(20))
'—fIs there a Pretreatment Program in effect? ❑ Yes ®No
6. Hasa flow reduction been approved under 15A NCAC 02T .01 14(f) ❑ Yes ® No
➢ If yes. Provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(D)
Daily Design Flow ""
No. of Units
Flow
Residential (3-bedroom units)
360 gal/unit/day
27
9720 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Tor'(
li 9720 �P
a See 15A NCAC 02T .0114(b) (d) (a)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per I SA NCAC 02T .0114(c), design flo rates for establishments not identified [in table 15A NCAC 02T.01 141 shall be
determined using available flow data, ter using fixtures, occupancy or operation patterns, and other measured data.
Wastewater generated by project: 9720 PD (per I SA NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number: _
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain): _
FORM: FTA 04.16 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T.0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
354
SDR 35
8
535
DIP
➢ Section 11 & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (if Applicable) 02T.0305 & MDC (Pump Stations/Fmce Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or na :1
2. Approximate Coordinates(Decimal Degrees): Latitude: 5�° Longitude:-82.5548°
3. Design flow of the pump station:.0112 millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): 30 gallons per minute at 117.6 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
2
678
PVC
6. Power reliability in accordance with 15A NCAC 02T.0305(h)(I):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B):
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
® Portablepower source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
ITTMTRX-OMT�
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations'storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B.0200 & 15A NCAC 02T.0305(Q):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (e) N Yes ❑ No
➢ ISA NCAC n9T OinS/fl rnntainc minimum cenamtinnc that vhall he nrnvided fur eewer cvctemc•
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water mains horizontal
10 feet
Reclaimed water lines vertical - reclaimed over sewer
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
-*Any private or public water supply source, including any wells, WS-1 waters of Class 1 or
Class II impounded reservoirs used as a source of drinking water
100 feet
**Waters classified W S (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation and wetlands see item IX.2
50 fee[
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top sloe of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical) _
36 inches
➢ 15A NCAC 02T.0305fe) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ •*Stream classifications can be identified using the Division's NC Surface Water Classifications weboat e
➢ If noncompliance with 02T.0305(f) or (e) see Section X of this application
2, Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No N N/A
➢ Seethe Division's draft separation requirements for situations when separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .02009 ❑ Yes ❑ No N N/A
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes N No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)f6) (additional permits/certifications)? N Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?'
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes N No ❑ N/A
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-I6 Page 4 of 5

X. CERTIFICATIONS:
�- 1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Citeria for the Permitting of Pump Stations
and Force Mains (latest version) and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
1fNo, complete and submit the Variance/Altemative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required Prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
Michael Cain attest that this application for
(Professional Engineer's name from Application Item 111.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that 1 have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date: C A R 0 ,/
�, ;
SEAL
_ ° 047788 °
FNGINEEs�
NEI J
3. Applicant's Certification per 15A NCAC 02T.0106(b):
T / % MO R _ MIdAZ4 iv P 2. attest that this application for
(Signature Authority's name & title from Application Item 1.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. 1 will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be remmed to me as
incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date: OC! Slt „ZOI
FORM: FTA 04-I6 Page 5 of

�® D
State of North Carolina
��L department Environmental Quality
Division
ion of Water Resources
9VtVIW,.,fWr Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: FUL TRACK, LLC Project Name for which flow is being requested: Cummings Cove Phase IX IM.W F T,4 -W
More than one FTSE maybe reyuiredfor a single project if the owner of the WWTP is not responsible for ali pump
stations along the route of the proposed wash waterflow.
1. Complete this section only if you are the owner of the wastewater treatment plant. .
a.
WWTP Facility Name: Cummings Cove
b.
WWTP Facility Permit #: NC0057541
Al! flows are in MGD
c.
WWTP facility's permitted flow
0.08 MGD
d.
Estimated obligated flow not yet tributary to the WWTP
0.00052
e.
WWTP facility's actual avg. flow
0.0 5648
f.
Total flow for this specific request
.O'1' I
g.
Total actual and obligated flows to the facility
. 46648
It.
Percent of permitted flow used -
42%
I1. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (B)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Nameor Permit Capacity,* (Firm /pt), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
5 0.006
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pi) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is <0.
Downstream Facility Name (Sewer):
Downstream Permit Number: NC0057541
Page 1 of 6
FTSE 10-18

111. Certification Statement:
I JUANITA JAMES certify to the bestof my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to cause any
capacity related sanitary sewer overflows or overburden any downstream pump station on route to the
receiving treatment plant under normal circumstances, given the implementation of the planned
improvements identified in the planning assessment where applicable. This analysis has been performed
in accordance with local established policies and procedures using the best available data. This
certification applies to those items listed above in Sections I and II plus all attached planning assessment
addendums for which I am the responsible party. Signature of this form certifies that the receiving
collection system or treatment works has adequate capacity to transport and treat the proposed new
wastewater. '-�)
Title of Signing Official
Page 2 of 6
FTSE 10-18

STATE OF NORTH CAROLINA
COUNTY OF HENDERSON
Permit No.
DEVELOPER'S OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (dl) and entered into this day of
, by and between the North Carolina Environmental Management
Commission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
FUL TRACK, LCC , a corporation/general partnership registered/licensed to do
business in the State of North Carolina, hereinafter known as the DEVELOPER.
WITNESSETH:
1. The DEVELOPER is the owner of the certain lands lying in HENDERSON County, upon
which it is erecting and will erect dwelling units and other improvements, said development to be known
as CUMMINGS COVE PHASE IX (hereinafter the Development).
2. The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVELOPER has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and operate the Disposal System.
4. The DEVELOPER has created or shall create unit ownership in said dwellings units, other improvements
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C or 47F of the North Carolina General Statutes.
5. The DEVELOPER has caused to be formed or will cause to be formed at the time of filing of the
Declaration, the (Unit Owners' Association) (hereinafter
Association), a non-profit corporation organized and existing under and by the virtue of the laws of the State
of North Carolina, for the purpose, among others, of handling the property, affairs and business of the
Development; of operating, maintaining, re -constructing and repairing the common elements of the lands
and improvements subject to unit ownership, including the Disposal System; and of collecting dues and
assessments to provide funds for such operation, maintenance, re -construction andrepair.
6. The COMMISSION desires to assure that the Disposal System of the Development is properly constructed,
maintained and operated in accordance with law and permit provisions in order to protect the quality of the
waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and DEVELOPER do hereby mutually agree as follows:
1. The DEVELOPER shall construct the Disposal System in accordance with the permit and plans and
specifications hereafter issued and approved by the COMMISSION, and shall thereafter properly operate
and maintain such systems and facilities in accordance with applicable permit provisions andlaw.
2. The DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed in accordance with the permit and approved plans, and the staff of
the Division of Water Resources has inspected and approved of the facilities. In order to change the name
of the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request must include a copy of the Association Bylaws andDeclaration.
3. The DEVELOPER shall not transfer, convey, assign or otherwise relinquish or release its responsibility for
the operation and maintenance of its Disposal System until a permit has been reissued to the DEVELOPER's
successor.
FORM: DEV 11-17 Page 1 of

4. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and the provisions of the permit for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify, the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority for
expenditures by the Association except for Federal, State, and local taxes andinsuance.
5. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System will
be maintained out of the common expenses. In order to assure that there shall be fords readily available to
repair, maintain or construct the Disposal System, beyond the routine operation and maintenance expenses,
the Declaration and Association Bylaws shall provide that a fund be created out of the common expenses.
Such fund shall be separate from the routine maintenance funds allocated for the facility and shall be part
of the yearlybudget.
6. In the event the common expense allocation and separate fund are not adequate for the construction, repair,
and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for special
assessments to cover such necessary costa. There shall be no limit on the amount of such assessments, and
the Declaration and Bylaws shall provide that such special assessments can be made as necessary at any
time.
7. If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city,
town, village, county, water and sewer authorities, or other unit of government shall herainafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit mayrequire as; condition of accepting the Development's wastewater.
8. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary dissolution without having made adequate provision forthe continued
proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall provide in the
Association Bylaws that the Association shall not enter into voluntary dissolution without first having
transferred its said system and facilities to some person, corporation or other entity acceptable to and
approved by the COMMISSION by the issuance of &permit.
9. The agreemets set forth in numbered paragraphs 1, 2, 3, 4, 5, 6, 7, and 8 shove shall be conditions of any
permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair and
operation of the Disposal System.
10. A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where the Declaration is
Shad and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of the
Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL FUL TRACK, LLC
MANAGEMENT COMMISSION Name EVELg_
B -
Linda Culpepper (S.
IniMmDirector, Division ofWeterResources /GEORGE ELMORE
Print Name and Title
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