WQ0024392_Application_20040914

FAST -TRACK APPLICATION for GRAVITY-
PUMP STATIONS, AND FORCE MAINS PAGE 1
0 A
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
FAST -TRACK APPLICATION
for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
jt��AIQ (Pressure sewers systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included the following list of required application package items by checking the
space provided next to each item. Failure to submit all required items will lead to your application being returned as
incomplete or additional processing and review time. This form may be photocopied for use as an original.
X I. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. Any changes to this form will result in the application being returned. The Division of Water Quality
(Division) will only accept application packages that have been fully completed with all applicable items
addressed. You do not need to submit detailed plans and specifications unless you respond NO to Item B(12).
X II. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR).
X III. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a
privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN)
which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the
sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities
Commission's Public Staff that states that an application for a franchise has been received, that the service area
is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the
CPCN or letter must match that provided in Item A(2a) of this application.
n/a IV. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if
the sewer extension is permitted by a private applicant and will be serving residential or commercial lots (e.g.,
houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If the applicant is a
homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF
THE PROJECT WILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED.
n/a V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WWTF is different from the applicant,
submit two copies of a flow acceptance letter from the owner of the downstream sewers and WWTF, if different.
Flow acceptance letters must contain the following minimum information: applicant and project name, amount of
flow accepted, and name and permit number of the receiving sewers/WWTF. The flow acceptance must not
expire prior to permit issuance and must be dated less than a year prior to the application date.
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific flow acceptance
letter.
X VI. Map — Submit an 8.5-inch by 11-inch COLOR copy of the portion of a 7.5-minute USGS Topographic Map along
with this form. The map should identify the entire project area location as well as the closest downslope surface
waters as clearly as possible. Each map portion must be labeled with the map name and number, the identified
location of the sewer line and pump stations, and be of clear and reproducible quality. For instance, if the project
involves 4 miles of interceptor sewer that traverses over or near several different waterbodies (or counties,
basins, etc.), the map should have location ID's shown for each different waterbody (where the sewer line is within
100 feet of such waterbody - see Instruction VII). This location ID is self chosen and used to cross reference the
location in Section C of the permit application.
nla VII. Stream Classifications — Section C
• If any portion of the project is within 100 feet of any down slope surface water, Section C must be completed
for the pertinent sections.
• If the entire project area is a minimum of 100 feet away from any down slope surface waters BUT there is a
pump station involved where a history of power outage is to be used to provide adequate design storage
instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that
the closest down slope surface water is Class C (see 15A NCAC 2H .0219(h)(3)(D)).
• Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast -Track
Sewer Systems)" available from http://h2o.enr.state.nc.us/ndpu or by contacting the appropriate regional
office.

FAST -TRACK APPPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2
n/a Vill. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC
01C .0500], this application can not be used. Send the project application on Form PSFMGSA 10/99 to the
Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be
processed until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS) has been
issued. A copy is to be submitted with that permit application.
X IX. Certifications — Section D
The application must be certified by both the applicant and a North Carolina Registered Professional Engineer
(PE). The applicant signature must match the signing official listed in Item A(1 b). The PE should NOT certify the
application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design Criteria (most
recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains
(most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents
is subject to NC Board referral.
THE COMPLETED FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND $400
FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
Avery, Buncombe, Burke, Caldwell,
59 Woodfin Place
Cherokee, Clay, Graham, Haywood,
Asheville, North Carolina 28801
Henderson, Jackson, Macon,
[phone]
Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania,
Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Fayetteville, North Carolina 28301
Anson, Bladen, Cumberland, Harnett,
[phone]
Hoke, Montgomery, Moore, Robeson,
[phone] Fax
Richmond, Sampson, Scotland
Mooresville Regional Office
919 N Main Street
Mooresville, North Carolina 28115
Moor No
Alexander, Cabarrus, Catawba,
Cleveland, Gaston, Iredell, Lincoln,
663le,
Mecklenburg, Rowan, Stanly, Union
[phone] Fax
Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe,
Raleigh, North Carolina 27699-1628
Franklin, Granville, Halifax, Johnston,
[phone]
Lee, Nash, Northampton, Orange,
[phone] Fax
Person, Vance, Wake, Warren,
Wilson
Washington Regional Office
Beaufort, Bertie, Camden, Chowan,
943 Washington Square Mall
Craven, Currituck, Dare, Gates,
Washington, North Carolina 27889
Greene, Hertford, Hyde, Jones,
[phone]
Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington,
Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus,
Wilmington, North Carolina 28405
Duplin, New Hanover, Onslow,
[phone]
Pender
[phone] Fax
Winston-Salem Regional Office
585 Waughtown Street
Alamance, Alleghany, Ashe, Caswell,
Winston-Salem, North Carolina 27107
Davidson, Davie, Forsyth, Guilford,
[phone]
Rockingham, Randolph, Stokes,
[phone] Fax
Surry, Watauga, Wilkes, Yadkin
For more information, visit our web site at: http://`h2o.enr.state.nc.uslndpul

FAST, -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number: (to
aq3�` —
(to be completed by DWQ) 7�_
1. Owner.
1 a HpntPr 1 Itilitiec Water and Wastewater Services
Full Legal Name (company, municipality, HOA, utility, etc.)
Z 1 b. Jerry H. Tweed Vice President
0 Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
Q1 Th I I f ho will own this s stem is:
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C. a ega en ty w y
❑ Individual ❑ Federal ❑ Municipality ❑ State/County ❑ Private Partnership X Corporation ❑ Other (specify)-
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1 d. 202 MacKenan Court le. Cary
Street Address City
}
1f. North Carolina 1 9• 27511
State Zip Code s
1 h. 919-467-8712 1 i. 919-460-1788
Telephone Facsimile E-mail
2. Project (Facility) Information:
2a. Woodlake Section 10 Seagull Drive 2b. Moore
Brief Project Name (permit will refer to this name) County Where Project is Located
3. Contact Person: j
3a. William W. Dreitzler, P.E.
Name and Affiliation of Someone Who Can Answer Questions About this Application I
3b. 919-774-7303 3c. [e-mail]
Phone Number E-mail
1. Project is X New ❑ Modification (of an existing permit) If Modification, Permit No.: —
For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another
phase, changing line size/length, etc.). Only include the modified information in this permit application - do not
duplicate project information in B(7) and B(10-11) that has already been included in the original permit.
2. Owner is ❑ Public (skip to Item B(3)) X Private (go to Item 2(a))
- --------...-----_`.— ...... --­­­1 .............. _.............. ........
2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one)
❑ Retaining Ownership (i.e. store, church, single office, etc.) or X Public Utility (Instruction III)
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction IV) f
X Selling units (lots, townhomes, etc. - go to Item B(2b)) I
3. Heater Utilities Water and Wastewater Services
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
_._............................- ....... .............. ................ .... .._._... .._..................._...-------- _ .. - ---
4a. Woodlake WWTF 4b. NC 0061719
Name of WWTF WWTF Permit No.
5a. Heater Utilities fib. WWTP Discharge 5c NC 0061719
Owner of Downstream Sewer Receiving Sewer Size Permit Number of Downstream Sewer (if known) —
6. The origin of this wastewater is (check all that apply):
_....................-_._9..........--.......---.._............_..........._-.._....._._...--__.........._....._..__............_..-_.------....------............._—._.._...._..._......._._........_.........__.........._._............._..__.._.._.._..__.................. -... ........ _................. _...
......_......._...--
X Residential Subdivision ❑ Car Wash
❑ Apartments/Condominiums ❑ Institution 100 % Domestic/Commercial
❑ Mobile Home Park ❑ Hospital %Industrial
El School ❑ Church
❑ Restaurant ❑ Nursing Home % Other (specify):
❑ Office ❑ Other (specify):
7. Volume of wastewater to be permitted in this project: 12,240 gallons per day
8. If the permitted flow is zero, indicate why:
❑ Interceptor Line - Flow will be permitted is subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected

10/04/04 09:09 FAX [phone] ms consultants 19002
)FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4
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- - ­- . ...... ­_­ ........ .... .. .. .. .. ...... .. .... . ­.1.1-1.11 ...... ..... ... . ....... .. .....
9. Provide the wastewater flow calculations used In determining the permitted flow in accordance with 15A NCAC 2H
.021 9(l) for Item 13(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than
that in 15A NCAC 2H .0219(l)(1-2) must be approved prior to submittal of this application. Submit a separate request to
the Division of Water Quality, Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 in
accordance with 15A NCAC 2H .0219(l) (3).
.... ....... .. .. . - -------
34 residential lots X 360 gpd/lot = 12,240 gpd
10- Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Gravity or Force Main
Length (feet)
Size (inches) (use the pull down menu)
1,752 Gravity
4 630 Force Main
ENTER TOTAL LINE LENGTH IN MILES 0.45
11 Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
Location ID Power Reliability Option
(self chosen - as shown on, Design Flow Operational Point (1 -dual line feed; 2- permanent generator w1ATS; 3-
plans for cross-refer c (MGD) GPM @ TDH portable -wet well storage)
_.. generator w/telemetry; 4
W1VV # 10 0.031 MGD 200..gp.M. 4 oft 3
12, Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of P,--- +jons and Force,
Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable?,
X Yes E No If no, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested. -
SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
13. Have the following r,-,mi-t--s,/-c—e,-rt—ifi—c-at—io--ns—b-e--en submitted for approval?
Wetland/Stream Crossings - General Permit or 401 Certification? 0 Yes 0 No X N/A
Sedimentation and Erosion Control Plan? X Yes E]No [:1 N/A
Stormwater? (automatic with S&EC permit) X Yes El No [I N/A
. ........... ....... ..... .. ... ........ . ..... ....... ...........

10/04/04 W
ms consultants, inc.
engineers, architects, planners
336 B Cartbage Street
Sanford, NC 27330
[phone]
FAX: [phone]
FAX COVER PAGE
DATE, October 4 2004
SUBJECT: Woodlake Section 10 — Revised FTA Pate 4
JOB NO.
TRANSMISSION TO:
NAME:
COMPANY:
FAX #:
RECEIVED FROM:
NAME:
Mike Lawyer (and/or altemate Staffl
DWq
910-486-0707
William W. Dreitzler, P.E.
T
If you did not receive 2 pages (including cover letter) please contact Bill or Kay
at [phone] as soon as possible.
MESSAGE:
Received your message and am re -sending the revised page 4 of the Woodlake Section 10 FTA.
Please call me at your convenience if you need any additional information. The contractor is
standin b read to be n construction. Thanks for our assistance.
The infofineUon contained in this facelmlle message Is confidential Information and Intended only for the use of the indlvldual only or enllty named above. ' I11e reader o` n1:1
nhsnge is not the Intended recipient, or the employee or agent raoondble to deliver t0 the intended recipient• you arc hereby notified That any dissemination, dislAbulion or copying
or this communlcalion is slricUy Dronlbited. If you have received tnls communlcatien in error, please Irnmedlately notary us by lelcphonc
OcWbcr 4, 20G4
,r:vwbm�%mssrDT—\CoKELWORDrsRF\MsTiwN"� ;2_"wrr

FAST -TRACK APPLICATION for GRAVITY.SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5
_... ...— ..... _... . _
1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03
(FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as
necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality
Z regional office (see instructions for addresses) OR indicate the following:
X A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope
waterbody; AND,
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() X A Stream Classification is not needed because the design does not depend on wet well storage as a power reliability
LL option for any pump station near a Class C down slope waterbody.
FP Location ID on Map
Cl)Q (self chosen - as shown on Name of Waterbody Stream Waterbody
J map for cross-reference) Waterbody County River Basin Index Classification
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Submit the 8.5" x 11 COLOR topographic map as required in Instruction VI
regardless of whether a classification is provided!
- --- -- ------------------------ - -- —._. --- ...— _-----._. - -- - ---
1. Applicant's Certification:
1, Jerry H. Tweed, attest that this application for Woodlake Section 10, Seagull Drive 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. Note: In accordance with North Carolina General Statutes 143-215.6A and
143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application
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
$?", 0 per violation.
1a. / J zg--' L/\,A-1 'It J
rssiiOfficial Si tur Date
2.onal Engi eer's Certification:
Z I attest that this application for Woodlake Section 10, Seagull Drive has been reviewed by me and is accurate, complete
0 and consistent with the information in the engineering plans, calculations, and all other supporting documentation to the
F— best of my knowledge. I further attest that to the best of my knowledge the proposed design has been prepared in
Q accordance with the applicable regulations, Gravity Sewer Minimum Design Criteria for Gravity Sewers adopted February
V 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June
LL 1, 2000 and the watershed classification in accordance with Division guidance. Although certain portions of this submittal
�., package may have been developed by other professionals, 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
LLI accordance with NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement
(� representation, or certification in any application 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.
2a. William W. Dreitzler, P.E.
Professional Engineer Name
2b. ms consultants, inc.
Engineering Firm
2c. 336-B Carthage Street
Address
2d. Sanford
City
2g. 919-774-7303
Telephone
2h
2e. N.C. 2f. 27330
State Zip
919-774-6109 2i. [e-mail]
Facsimile E-mail
Seal, Signature & Date

STATE yA,
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NORTH CAROLINA
PUBLIC STAFF
UTILITIES COMMISSION
August 4, 2004
Mr. Rudy Shaw
Heater Utilities, Inc.
P.O. Drawer 4889
Cary, NC 27519
RE: Heater Utilities, Inc.
Docket No. W-274, Sub 485
Notification of Contiguous Extension
Magnolia Lane at Woodlake Subdivision, Moore County
TO WHOM IT MAY CONCERN:
The Public Staff has received the notification of intention to begin operations in area
contiguous to present service area to provide water and sewer utility service in Magnolia
Lane at Woodlake Subdivision in Moore County, North Carolina. The Public Staff
anticipates that approval will be granted upon investigation and review of the submitted
application.
Please feel free to call if you have any questions or if I can be of further assistance.
Since ly,
7
Kenneth E. Rudder, Utilities Engineer
Public Staff - Water Division
c: Ron Brown
Executive Director Communications Economic Research Legal
Transportation
733-2435 733-2810 733-2902 733-6110
733-7766
Accounting Consumer Services Electric Natural Gas
Water
733-4279 733-9277 733-2267 733-4326
733-5610
4326 Mail Service Center • Raleigh, North Carolina 27699-4326 • Fax [phone]
An Equal Opportunity / Affirmative Action Employer

ms consultants, inc.
engineers, architects, planners
336-B Carthage Street
Sanford, North Carolina 27330-4207 `J
Phone: [phone]
Fax: [phone]
www.msconsultants.com
September 10, 2004
NC DENR
Division of Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, N.C. 27699-1628
Reference: Woodlake Section 10, Seagull Drive: Fast Tract Application Form
Vass, North Carolina
Dear Sirs:
Please find included one original and one copy of the completed and executed Fast -Track
Application for Gravity Sewers, Pump Stations, and Force Mains. In addition, find
attached:
• $400.00 Application Fee
• Notification of Contiguous Extension Letter
• 8 %2 x 11 USGS Quadrangle Map of Site
If after review you have any questions, or if you require any additional information,
please contact me at your earliest convenience. The sanitary sewer design was reviewed
and approved by Heater Utilities prior to this submittal. The pump station is located at
the end of Seagull Drive near the existing Heater Utilities Woodlake Wastewater
Treatment Facility.
Sincerely,
s consullttants, inc.
William W. Dreitzler, P.E.
Technical Manager
Cc: Mr. Don Williams, Heater Utilities
Ms. Dee Regan, Woodlake Resort and Golf Club
Offices in: Akron, Canton, Cleveland, Columbus, Youngstown, OH; Charleston, WV; Indianapolis, IN; Pittsburgh, PA; Sanford, NC

ms consultants, inc.
engineers, architects, planners
336-B Carthage Street
Sanford, North Carolina 27330-4207
Phone: [phone]
Fax: [phone]
www.msconsultants.com
September 27, 2004
Mr. Paul Rawls
Division of Water Quality
Fayetteville Regional Office
225 Green Street
Suite 714
Fayetteville, N.C. 28301-5043
SE-? 2 8 2004
DWQ
Reference: Woodlake Resort and Golf Club, Phase 3, Vass, North Carolina
Fast Track Application
Dear Mr. Rawls:
As a follow-up to the Temporary Pump and Haul Permit for lot 4582, we had indicated
that the permanent FTA for the development would be forthcoming. The FTA was
submitted on September 10, 2004. However, the package was inadvertently submitted to
the Raleigh Regional Office. While you may have already been forwarded the package
from Raleigh, I wanted to provide you with a copy of the application to assure you that
we had followed up with a prompt submittal of the FTA for the Woodlake project.
Please call me at your convenience if you have any questions or if you require any
additional information with this package.
Sincerely,
ms consultants, inc.
CMU ,
William W. Dreitzler, P.E.
Technical Manager
Cc: Mr. Don Williams, Heater Utilities
Offices in: Akron, Canton, Cleveland, Columbus, Youngstown, OH; Charleston, WV; Indianapolis, IN; Pittsburgh, PA; Sanford, NC

ms consultants, inc.
engineers, architects, planners
336-B Carthage Street
Sanford, North Carolina 27330-4207
Phone: [phone]
Fax: [phone]
www.msconsultants.com
September 10, 2004
NC DENR
Division of Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, N.C. 27699-1628
DENR-FRO
SEP 2 8 2004
DWO
Reference: Woodlake Section 10, Seagull Drive: Fast Tract Application Form
Vass, North Carolina
Dear Sirs:
Please find included one original and one copy of the completed and executed Fast -Track
Application for Gravity Sewers, Pump Stations, and Force Mains. In addition, find
attached:
$400.00 Application Fee
Notification of Contiguous Extension Letter
8 %2 x 11 USGS Quadrangle Map of Site
If after review you have any questions, or if you require any additional information,
please contact me at your earliest convenience. The sanitary sewer design was reviewed
and approved by Heater Utilities prior to this submittal. The pump station is located at
the end of Seagull Drive near the existing Heater Utilities Woodlake Wastewater
Treatment Facility.
Sincerely,
nis consultants, inc.
William W. Dreitzler, P.E.
Technical Manager
Cc: Mr. Don Williams, Heater Utilities
Ms. Dee Regan, Woodlake Resort and Golf Club
Offices in: Akron, Canton, Cleveland, Columbus, Youngstown, OH; Charleston, WV; Indianapolis, IN; Pittsburgh, PA; Sanford, NC

SEP-24-2004 10:41 HEATER UTLITIE-;
919 460 1788 P.02
NORTH CAROLINA
PUBLIC STAFF
UTILITIES COMMISSION
September 24, 2004
Mr. Rudy Shaw -
Heater Utilities, Inc.
P.O. Drawer 4889
Cary, NC 27519
RE: Heater Utilities, Inc.
DocKet No. W-274, Sub 496
Notification of Contiguous Extension
Woodlake, Phase III (Section 10, Seagull Drive) Subdivision, Moore County
TO WHOM IT MAY CONCERN:
The Public Staff has received the notification of intention to begin operations in area
contiguous to present service area to provide water and sewer utility service in Woodlake,
Phase III (Section 10, Seagull Drive) Subdivision in Moore -County, North Carolina. The
Public Staff anticipates that approval will. be granted upon investigation and review of the
submitted application.
Please feel free to call if you have any questions or if I can be of further assistance.
Since ely,
2
Kenneth E. Rudder, Utilities Engineer
Public Staff - Water Division
c: Ron Brown
Executive Director COmmGnicalions Econotuic Resumb L-Pi Tmagonotioa
733-2435 733-2810 733-2902 733-6110 733-7766
Aecountiag Consumer Swieu4 61eetric Nuum) Gas Water
733-4279 733-9277 733-2267 733.4326 733-5610
TOTHL P . Cir ,

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3
0
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USE THE TAB KEY TO MOVE FROM FIELD TO FIELDi Application Number.
(to be completed by DWQ)-------
1 Owner. _
1a. Heater Utilities Water and Wastewater Services
Full Legal Name (company, municipality, HOA, utility, etc.) `
1b Tweed,Jerry H. Vice President
Signing OfficialNam Name and (Pleas t
e review 15A NCAC 2H .0208(b) for authorized signing offi Is!)
F,
1c. The legal entity who will own this system is:
.............._._._..-. d _.. _.__.........._.._..........a ity Q State/County [] Private Partnership. _X Corpor
...._._..._...
❑ individual Federal Municipality t
1d. 202 MacKenan Court 1e. Cary
Street Address City
1f. North Carolina i1g. 27511
State Zip Code
1 h. 919467-8712 111. 919460-1788
Telephone Facsimile -
..._..........t. .
E mail
2. Project (Facility) Information:
_ ...•.f .......
2a. Woodlake Section 10, Seagull Drive 2b. Moore
Brief Project Name (permit will refer to this name) County Where Project is Located
3, Contact Person:
3a. William W.
Name and Affillation of Someone Who Can Answer Questions About this Application
3b. 919-774-7303 3c. [e-mail]
Phone Number E-mail
t
1. Project is X New ❑ Modification (of an existing permit) If Modification, Permit No.:
For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another
phase, changing line sizellength, etc.). Only include the modified information In this permit application - do not
duplicate project information In B(7) and B(10-11) that has already been Included in the original permit`
2. Owner is ❑ Public (skip to hem B(3
2a. 0 private, applicant will be:
X Private (go to Item NO
2b. If sold, facilities owned by a (must choose
❑ Retaining Ownership (i.e. store, church, single office, etc.) on X Public Utility (Instruction III)
Z ❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (Instruction IV)
O X Selling units (lots, townhomes, etc. - go to Item B(2b))
Q 3. Heater Utilities Water and Wastewater Services - -_
owner of �n, �e.�� •. _� 1013
MAGNOLIAS AT WOODLAKE
400 Nloodiake Blvd
PO Box 648
Vass, NC 28394
TO THE
ORDER OF
WAcHOVIA
WOO&O'ki COm
FOR
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FANGN 39001
DATE
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