WQ0041452_Application (FTSE)_20200122

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State of North Carolina
Dcp• rtment of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACT: SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: W d V _ I t y (to be completed by DWR)
All items must be completed or the nnnlicution will be returned
1. APPLICANT INFORMATION:
1. Applicant's name: B&B Country Inn. LLC (company. municipality. HOA. utility. etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State. Count% ❑ Municipal ® Other
3. Signature authority's name: Joe Bert~ hill per I5A NCAC 021" .0106(h)
Title: Owner
4. Applicant's mailing address: 705 Bermhill Rd
Citv: Roxboro State: NC Zip: 27574-�
5. Applicant's contact information:
Phone number: (316) 598-I 144 Email Address: hobfarm.ircenturvlink.net
11. PROJECT INFORMATION:
I. Project name: B&B Country Inn RV Park
2. Application.Troject status: ® Proposed (Ne%% Permit) ❑ Gxisting Permit/Project
If a modification. provide the existing permit number: WQ00 and issued date:
If new construction but part ol'a master plan. provide the existing permit number: WQ00
3. County Where project is located: Person
4. Approximate Coordinates (Decimal Degrees): Latitude: 30.450563" Longitude:-78.935754
5. Parcel I D (if applicable): 0918-00-82-6456
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
L Professional Engineer: Matt Hastings License Number: 38098
First: Summit Desittin and Engineering Services
Mailing address: 606 Broad Street, Suite C
City: South Boston State: VA zip: 24592-
Phone number: [phone] Email Address: matt.hastines-u,summitdc.net
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORiNIATION:
I. Facility Name: City of Roxboro W WTP Permit Number: NCO021024
Owner Name: Citv of Roxboro
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I. Permit Number(s): WQ ----- Downstream (Receiving) Se%%er Size: 8 inch
Svslcm_Wide Collection S%,stem Permit Number(s) (ifapplicahle): WQCS00048
Owner Name(s): City of Roxboro
rORIVI: FTA 04-16 Page I of5

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Duality Section_
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional 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
Alexander, Cabarrus, Catawba, Cleveland,
Mooresville Regional Office
610 E. Center Avenue
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional 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
Currituck, Dare, Gates, 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, Pender
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Allegheny, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Suny, Watauga, Wilkes, Yadkin
[phone]
3 3

VI. GENERAL REQUIREMENTS
I. I f the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and ]Necessity been attached'?
[:]Yes ❑No ®NfA
2. If the Applicant is a Developer of lots to be sold, has a Dc%eloner's_Operational Agreement
(Fnittil: DEN) been attached?
❑ Yes [-]No ®N/A
3. If the Applicant is a Home/Property Owners' Association. has an Operational Agreement FORM: HOA been attached?
[:]Yes [:]No ON. -'A
4. Origin of►waste►cater: (check all that apply):
❑ Residential Owned ❑ Retail (stores. centers, malls)
❑ Car Wash
® Residential Leased ❑ Retail ►►ith food preparation service
❑ Hotel and'or Motels
❑ School / preschool / day care ❑ Medical ; dental ; %eterinarw facilities
❑ Swimming Pool ;Clubhouse
❑ Food and drink facilities ❑ Church
❑ swimming Poollrilter Backwash
❑ Businesses / offices / factories ❑ Nursing Home
❑ Other (Explain in Attachment)
5. Nature ofwastewater: 100 % Domestic/Commercial % Commercial
% Industrial (see 15A NCAC 02'r .0103(2O))
'Is there a Pretreatment Program in effect? ❑ Yes ® No
6. Has a Ilo►v reduction been approved under 15A NCAC 02 r .0114 I ? ❑ Yes ©Na
Irves, provide n conv_of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f)
Daily Design Flow °''
No. of Units
Flow
RV Sites
100 gal/day
III
11.100 GPD
Cabins
240 gal/day
5
1.200 GPD
gal/day
GPD
gal/day
GPD
gal/
GPD
gal/
GPD
Total
12.300 GPD
I/
a See 15A NCAC 02T .0114(b). d e I and e 2 l'or caveats to ►wastc►tater 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 cast of -the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0I 14(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01141 shall be
determined using available flow data, water using fixtures. occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 12,300 GPD (per 15A NCAC 02T .0114) /
;� Do not include future flo►►s or previously permitted allocations ✓
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sever where Ilo►► 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 ne►w flow expected
❑ Other (Explain):
FORNI: FTA 04-16 Page 2 of

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & i11DC (Gravity Sewers)-
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
1588
PVC
6
3466
PVC
Section It & 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
Vill. PUMP STATION DESIGN CRITERIA (If Applicable) —02T .0305 & MDC (Pump Stations/Force plains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
3. Design Slow of the pump station: __ millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T_.0305(h)(1):
❑ 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
i► Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - I SA NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
i 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.
i 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.
16 3 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T .0305(f) & (L) ®Yes ❑ No
i l5A NCAC 02T.0305tf) contains minimum senarations that shall he nrnvided fnr sewer vuRtemc-
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 It impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (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 feet
**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 slope of embankment or cuts of 2 feel or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
i 15A NCAC 02T.0305(e) contains alternatives where separations in 02T_0305(f) cannot be achieved.
i **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
> If noncompliance with 02T.0305(f) or (L). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ®Yes ❑ No ❑ NrA
See the Division's draft separation requirements for situations where separation cannot be meet
i 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 .0200? ® Yes ❑ No ❑ WA
This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage,'authorization under a 404 Nationwide or ® Yes ❑ No
individual permits or 401 Water Quality Certifications?
Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15.A NCAC 02T_0105(c)16) (additional permits. —'certifications)? ® Yes ❑ No
Per 15A NCAC_ 02T.0105(c)(6), directly related environmental permits or certification applications arc 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 ® No ❑ N;'A
i 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.
16 4 5

X. CERTIFICATIONS:
I Does the submitted system comply with 15A NCAC 02T the Minimum lhsian C itcrvi for the Permittrnyat' pump suilions
and Puree Mains tWag vcrsiun and the Gravin Sever Nliaunurit De it � C rideria t11te5t repel{ant as applicable?
® Yes ❑ No
IfNo, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Annrov_sl of the request k required prior to submittal of the Fast Track Application and supporting documeal.
2. Professional Fnrineer's Certification.
sname from Application Item Ill.1.)
that this application for
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 I 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 I43-215.6B, any person who knowingly makes any false
statement, representation, or cerification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed 510,000, as well as civil penalties up to S25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date: ��� .fit i CARO
i SEAL
1: 8809" r-
r-y`tcrIo3�°
3. Applicant's Certification per 15A NCAC 02T .0106(b):
attest that this application far
name & title from Application Item 13.)
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 aII 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- I 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, ibis application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143 215.6A and 143-2I5.6B. any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which Fay
include a fine not in exceed S 10.000 as well as civil penalties up to S25,000 per violation.
Signature: - - } Date:
16.p}
FORM: l:TA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: B & B Country inn, LLC
Project Name for which flow is being requested: B & B Country Inn - RV Park
More than one FINE may be required fur a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Roxboro Wastewater Treatment Facility
b. WWTP Facility Permit 9: NC0021024
A11 flows are i►t MGD
c. WWTP facility's permitted flow 5.0
d. Estimated obligated flow not yet tributary to the WWTP 0.033
e. WWTP facility's actual avg. flow 2.03
f. Total flow for this specific request 0.014
g. Total actual and obligated flows to the facility 2.077
It. Percent of permitted flow used 41.54
II. 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)
(E)=(A-D)
Design
Average
Approx.
Obligated,
Total
Pump
Daily
Current
Not Yet
Current Flow
Pump Station
Station
Firm
Flog•**
Avg. Daily
Tributary
Plus
(Name or
Permit
Capacity,
(Firm! p0,
Flow,
Daily Flow,
Obligated
Available
Number)
No.
MGD
MGD
MGD
MGD
Flow
Capacity***
Arrowwood
0.15
0.375
0.063
0.0
0.063
0.087
* 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
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria. ty
*** 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)- Roxboro Wastewater Treatment Facility
Downstream Permit Dumber: NC0021024
Page I of 6
FTSE 10-18

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111. Certification State
ment:
I I)PREk) certify to the best of 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 en 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.
rgning Official Signature D to
r u� U L 5FI6, tl. w-E-S
Title of Signing Official
Page 2of6
h1 SE 10-18

State of North Carolina
DWP
Department of Environmental Quality
Division of Water Resources
Division of Water Resources Watershed Classification Attachment (WSCAS 01-15)
These instructions are to be used when completing form WSCAS for sewer extension projects. Identifying
stream classifications that are affected by the project is necessary:
• To determine/confirm the minimum separation distance of sewer system components from classified
waters as specified in 15A NCAC 2T .0305(f)
• To determine/confirm any applicable river basin rules that may affect sewer system components
If any portion of the sewer extension comes within 100 feet of any surface water (waterbody) or wetland
a completed form is required. Determine the names of surface waters within 100 feet of the project or
along the project route and utilize either of the below options to determine stream classification:
Finding Stream Classifications (Man or List)
A map with designated streams and their associated classifications can be obtained at:
http://ncdenr maps arcgis com ands/webappviewer/index.html7id=Ge125ad762gf494694e259c8Odd64265
• Find/select the waterbody and record the river basin(s), stream index number and classifications
applicable to the project on the form
or
A listing of stream classifications based on river basin can be obtained at:
httoa/portal.ncdenr.org/web/wq/psLcsu/classifications (see left hand side of webpage)
• Select the river basin(s) (hydrological or alphabetically sorted) where your project is located
• Locate the name of the identified waterbody on the list for the selected basin
• For multiple listings of the same waterbody name in the report, select and verify the location
description. The term "source" in the description means the beginning of the waterbody segment
(most upstream point)
• Record the river basin(s), stream index number and classification applicable to the project on the form
Submittal Instructions
Label any unnamed tributaries as "UT to stream name" as the waterbody name on form per 15A NCAC 02B
.0301(i). See page 2 for additional notes on unnamed streams.
Submit a color copy of a USGS Topographic Map to identify the project area and surface waters. Each map or
maps must show the location of the sewer system and include location identifiers where the system traverses
over or near waterbodies. The map should have location ID's for each different waterbody and corresponding
classifications should be recorded.
**Note that these instructions do not need to be submitted**

MISCELLANEOUS
SUPPORTING
DOCUMENTS

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SOSID. 1697285
Date Filed: -NIU2111H 8:13:110 ANI
Elaine F. Marshall
North Carolina Secretary of State
State of Nonh Carolina
Department of the Secretary of State C2018 108 02527
Limited Liability Company
ARTICLES OF ORGANIZATION
Pursuant to §57D-2-20 of the General Statutes of North Carolina, the undersigned does hereby submit these Articles
of Organization for the purpose of forming a hmited liability company,
I. The name of the limited liability company is: B&B Countryi n n, LLC
(See Item Iof the instructions for appropriate entity dMgnaiton)
2. The name and address of each person executing these articles of organization is as follows: {State whether each
person is executing these articles of organization in die capacity of member, organizer or both by checking
all onnlinel+ln L,... %7►. T6:. a��.._ ...—.. I._ —_. A L- .1 ,
Name Business Address Capacity
Eugene C. Berryhill Jr, 705 Berryhill Rd, Roxboro, NC 27574 AMember MOrganizer
Joseph B. Berryhill 705 Berryhill Rd, Roxboro NC 27574 ❑>>Member MOrganizer
❑Member []Organizer
3. The name of the initial registered agent is: Eugene C. Berryhill Jr.
4. The street address and county of the initial registered agent office of the limited liability company is;
Number and strut 705 Berryhill Rd.
city Roxboro
State: NC Zip Code; 27574 County Person
5. The mailing_ address, if different from the street address, of the initial registered agent office is:
Number and Street
City
State. KC Zip Code: _ County:
6. Principal office information; (Select either a or b.)
a. f✓ The limited liability company has a principal office. ,!
The principal office telephone number: 336-597-2584
The street address and county of the principal office of the limited liability company is:
Number and street. 705 Berryhill Rd.
city; Roxboro
NC State; zip cede: 27574 county: Person
BUSINESS REGISTRATION DIVISION P_O. BOX 29622 Raleigh, NC 27626-0622
(Revised august. 2017) Forrn L•01

7
S
The mailine address, if different from the street address, of the principal office of the company is:
Number and Street:
City:
State: Zip Code: County:
b. ❑ The limited liability company does not have a principal office
Any other provisions which the limited liability company elects to include (e.g., the purpose of the entity) are
attached.
(Optional): Listing of Company Officials (See instructions on the importance of listing the company officials in the
9_ (Optional): Please provide a business e-mail address PCIVaCN Redaction
The Secretary of State's Office will a -mail the business automatically at tiic addicss provided above at no cost when a
document is fired. The e-mail provided will not be viewable on the w•ebsiie. For more information an why this service is
offered, please see the instructions for this document.
10, These articles will be effective upon filing, unless a future date is specified -
This is the 12 day of Apnl 12018
Lawz
C_ _&�k
k-
Signature
ELgene C. Sarryhill Jr. Member C710
Type or Print Namc and Title
The below space to be used if more than one organizer or member is listed in Item #2 above.
A
46 Z"±1 �11-
Signature
Joseph B. Berryhill Member con
Ty—peand Print l ame an Title
Signature,
Type and Pnnt Name and Title
NOTE:
1. Filing fee is S 125. This document must be filed with the Secretary' of State.
BUSINESS REGISTRATION DIVISION P.O. BOX 29622 Raleigh, NC 27626-0622
(Revised August 2017) Farm L-01

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Latitude and Longitude of a Point
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Clear! Resat Remove Last B,ue Marker Center Red Marker
Get the Latitude and Longitude of a Point
W;on you uck an Inc map, move lho marker or enter an address 11to iat rude and Sang Wde cocrdinates of the point
are msel"ed to the boxes 1ur'c51
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Show Point from Latitude and Longitude
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04 12 2019 02.45 OWNERSHIP
5413117 1 PROPERTY DESCRIPTION
TAX DESCRIPTION
MAP NUMBER
RD7!
B & B COUNTRY INN LLC
'26.45 ACRES
WOODSDALE
A58 74
RECORD NUMBER' 452
705 BERRYHILL RD
PLATBOOKIPAGE/DATE 16 580
ROUTE: WO 110 014
ROXBORO, NC 27574 -674 2
DEED: 979 647 5 11 2018
NB: 00000 00000
77 000 BOSTON RD ROXBORO
LISTER: PLC 11/S/2014
REVIEWER: PLC 116 2014
TOPO STREET I NOTES I AC NBHD
I ICHGD LAND F15 1 264500
, LAND CLASS SIZE_EIASERATE • ACF • AQ] . AD] RATE _ UNI'i'5 = LNOVALUR
I21XCLEARED1 1.150 3375 1.OS 1.00 3544. 1.150 407
2 31XWOODED 1 25.300 1689 1.0f 1.0 1772' 25.300 4483
ACREAGE FACTOR: FRONTAGE FACTOR: LAND VALUE 4890
!t OTHER FEATURES i SIZE � BASERAT—ETCOND t AQ] RATE UNITS VALUE
—
L
OTHER FEATURES VALUE:
FOUNDATION
XTR_XTRNISH
ROOF TYPE
ROOF MTRL
SIZE/QTY
STHT
BDRM
WALL FIN IH
FL
HEAT&AIR
HEAT F EL
BLDIN iF
IMPROVEMENT TYPE:
GRADE: I AYB: EYB:j I CONDITION:
DIMENSIONS:
STRUCTURE SKETCH -SF}• STHT =
AREA
RATE 'If GRDE + HEAT +' EXWL I' WLHT =11AD]RATE ' AREA
= RPCN •
DEPF • CNDF=.TR-VALU
HSF T5F RPCN-/HSF VALU-/H5F
STRUCTURE VALUE
CARD VALUE 48908
VALUATION THIS CARD + OTHER CARD = VALUE PREY-VAL P-N% OTHER CARDS VALUE
LAND
48908 48908 14100 0.29 TOTAL VALUE 4890
OTHER FEAT
0 0 0 000
STRUCTURE
0 0 0 000
T TAL
4B908 48908 14100 3,47
TAX YEAR: 2019 APPRAISED VALUE 4890
Person n N
REV LYEAR.2013 DEFERRED VALUE 0 TAXABLE VALUE 4R94

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KISUMt4lT
DESIGN AND ENGINEERING SERVICES
SANITARY SEWER
SUBMITTAL
DOCUMENTS
B&B COUNTRY INN, LLC.
RV PARK
PROJECT#: 18-0226
ORIGINAL SUBMITTAL: DECEMBFR 2019
REVISED 03/03/2020
OWNERIAPPLICANT:
B&B COUNTRY INN, LLC
ENGINEER/CONSULTANT:
Matt Hastings, PE
Summit Design and Engineering
606 Broad Street, Suite C
South Boston, VA 24589
P (434)5794604 / f [phone]
tnan.hast ings it sumin iide.net

SUMMARY:
B&B Country Inn, LLC is in the process of developing a RV park on a 26.45 acre parcel on the
north side of Roxboro off Boston Rd in Person County. The approved development is for I I I
RV sites and 5 cabins. Although this has been approved they are not likely to build more than I
cabin and 45 lots in the foreseeable future. This is the northern most road loop on the plans.
Additional lots or cabins will be built as needed in the future.

Cashion, Ted f
D� ��
From: Andrew Oakley <[e-mail]>
Sent: Monday, February 24, 2020 10:31 AM
To: Cashion, Ted
Subject: [External) Re: B&B Country Inn RV Park fast track sewer extension application
■ External email. Do not elide links or open attu:hments.unless you verif-y, Send all'sris'—''-p1douem011 as an attat lment to
e ort
No problem on flow.
Sent from my iPhone
On Feb 24, 2020, at 10:03 AM, Cashion, Ted <[e-mail]> wrote:
***CAUTION: This email originated from outside of the organization. Do not click links or open
attachments unless you recognize the sender and know the content is safe.***
Matt, Joe, and Andrew,
We are reviewing the subject application and have a question or 2 .
Matt — please supply the downstream sewer permit number and the system wide collection system
permit number as required in item V of the application.
Item VI.7 notes the RV site daily design flow as 120 gpd. The 2T rules allow for 100 end/campsite. Do
you want to use the 120 gpd/campsite; or the 2T value of 100 gal/campsite?
Campgrounds with water and sewer hookups 100 al cam site
Also, the flow calculation for the 5 cabins is incorrect. It appears the correct flow would be 5 x 240 gpd =
1200 gpd. (not 1,020 gpd).
Please submit a revised page 2 with all corrections needed.
Andrew, we'll need your approval to the flow changes. Do you approve of these changes to the flow
volumes?
Mr. Berryhill, as the applicant, we'll need your approval also on the changes to the application.
An email response approving these changes is fine.
Thx,
ted
Ted Cashion

Cashion, Ted
From: Matt Hastings, PE <[e-mail]>
Sent: Tuesday, March 3, 2020 9:58 AM
To: Cashion, Ted; '[e-mail]' ([e-mail])
Cc: Robinson, Jason; [e-mail]
Subject: [External] RE: B&B Country Inn RV Park fast track sewer extension application
Externals WIL 60 rioIfts or."n.attach ents uri ess.* v+Oy. Send all-susp[claus email as ab attathmerit to
Andy,
Are you ok with 100 gpd? That should be more than sufficient for an RV spot. If you are ok with it I'll revise the
application.
Also do you have the downstream sewer permit number WQ????????
I found the collection system number WQCS00048 number but can't find the other number and the WWTP doesn't have
it either.
Let me know.
Thanks
Matt Hastings, PE
Land Development Department Manager - VA
Tel: [phone]
Fax: 919=732-6676
Cell: 434-579-4604
SUMt11T
DESIGN AND ENGINEERING SERVICES
From: Cashion, Ted <[e-mail]>
Sent: Monday, February 24, 202010:04 AM
To: Matt Hastings, PE <[e-mail]>;'[e-mail]' ([e-mail])
<[e-mail]>
Cc: Robinson, Jason <[e-mail]>; [e-mail]
Subject: B&B Country Inn RV Park fast track sewer extension application
Matt, Joe, and Andrew,
We are reviewing the subject application and have a question or 2 .

Matt — please supply the downstream sewer permit number and the system wide collection system permit number as
required in item V of the application.
Item VI. 7 notes the RV site daily design flow as 120 gpd. The 2T rules allow for 100 gpd/campsite. Do you want to use
the 120 gpd/campsite; or the 2T value of 100 gal/campsite?
Campgrounds with water and sewer hookups 100 gal/campsite
Also, the flow calculation for the 5 cabins is incorrect. It appears the correct flow would be 5 x 240 gpd = 1200 gpd. (not
1,020 gpd).
Please submit a revised page 2 with all corrections needed.
Andrew, we'll need your approval to the flow changes. Do you approve of these changes to the flow volumes?
Mr. Berryhill, as the applicant, we'll need your approval also on the changes to the application.
An email response approving these changes is fine.
Thx,
ted
Ted Cashion
Water Quality Regional Operations
Division of Water Resources
NC Department of Environmental Quality
Raleigh Regional Office
919-791-4254
ted.cashion( ncdenr.eov
1628 Mail Service Center
Raleigh, NC 27699-1628
3800 Barrett Drive
Raleigh, NC 27609
�DEEQ`
r
Iarp.ar:TMni tf imructwatal p;.sS�
Subscribe to Collection System & Sewer Permitting Updates
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statute or other regulation.

Cashion, Ted
From: Matt Hastings, PE <[e-mail]>
Sent: Tuesday, March 3, 2020 11:11 AM
To: Cashion, Ted; '[e-mail]' ([e-mail])
Cc: Robinson, Jason; [e-mail]
Subject: (External] RE: B&B Country Inn RV Park fast track sewer extension application
Attachments: Sewer Calcs.pdf
� 'ernAl,email: Do notdI& hks or open attachments uriless you verify.. $eAd all suspicious email as an attathmenbto
��?PJ#a�;rarn�,n e.eov
Ted,
Here is the updated package. Andy informed me that he already told you he was ok with the flows.
Let me know if you need more.
Thanks
Matt Hastings, PE
Land Development Department Manager - VA
Tel: [phone]
Fax: [phone]
Cell: 434-579-4604
SUI'�*ltllT
DESIGN AND ENGINEERING SERVICES
From: Cashion, Ted <[e-mail]>
Sent: Monday, February 24, 202010:04 AM
To: Matt Hastings, PE <[e-mail]>;'[e-mail]' ([e-mail])
<[e-mail]>
Cc: Robinson, Jason <[e-mail]>; [e-mail]
Subject: B&B Country Inn RV Park fast track sewer extension application
Matt, Joe, and Andrew,
We are reviewing the subject application and have a question or 2 .
Matt — please supply the downstream sewer permit number and the system wide collection system permit number as
required in item V of the application.
Item VI.7 notes the RV site daily design flow as 120 gpd. The 2T rules allow for 100 gpd/campsite. Do you want to use
the 120 gpd/campsite; or the 2T value of 100 gal/campsite?
Cam rounds with water and sewer hooku s 100 ai cam site

Also, the flow calculation for the 5 cabins is incorrect. It appears the correct flow would be 5 x 240 gpd =1200 gpd. (not
1,020 gpd).
Please submit a revised page 2 with all corrections needed.
Andrew, we'll need your approval to the flow changes. Do you approve of these changes to the flow volumes?
Mr. Berryhill, as the applicant, we'll need your approval also on the changes to the application.
An email response approving these changes is fine.
Thx,
ted
Ted Cashion
Water Quality Regional Operations
Division of Water Resources
NC Department of Environmental Quality
Raleigh Regional Office
919-791-4254
ted.cashionPncdenr.eoy
1628 Mail Service Center
Raleigh, NC 27699-1628
3800 Barrett Drive
Raleigh, NC 27609
�D- �E
�Eq
�Vt13S :'M11t C1 (T1YfpfRltP:ll �:IF��
Subscribe to Collection Sygtem & Sewer_ Permitting Updates
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties unless the content is exempt by statute or other regulation.