WQ0036796_Regional Office Historical File Pre 2018

EAST TRACK ENGINEERING CERTIFICATIoN
PSCENENNenENRfoWR
.2„24 2 4
Permittee; Town of Taylorsville Permit No, WQ0036796
Project: Taylorsvilie Golf Course Club House MOORESvg-LEREC;d0NAL OFPICE: Issue Date: 10/23/2013
Complete and submit this form to the permit issuing regional office with the following:
• One copy of the project record drawings (plan & profile views and detail drawings of sewer lines) of the wastewater
collection system extension. Final record drawings should be clear on the plans or on digital media (CD or DVD
disk) in pdf format Record drawings should indicate the design and the marked up changes during construction,
• Supporting design calculations (selected pumps, system curve, operating point, available storage if portable
generator(s) or storage greater than longest past three year outage reliability option selected) for any pump stations
permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in written summary form, Permit
modifications are required for any changes resulting in non-compliance with this permit, regulations or
minimum design criteria. Modifications should be submitted prior to certification.
This project shall not be considered complete nor allowed to operate until the Division has received this Engineer's
Certification and ail required supporting documentation. Therefore, it is hictri ecommended that this certification
be sent in a manner that provides proof of recei t b the Division.
PERIVIITTEE'S CERTIFICATION
ay& ad1731 the undersigned agent for the Permittee, hereby state that this project has
been constructed pursuant to the applicable standards & requirements, the Professional Engineer below has
provided applicable design/construction information to the Permittee, and the Permittee is prepared to operate &
maintain the wastewater collection system permitted herein or portions thereof.
i' D4kr e/ le14111
Printed Name, Title
Signat
4.7
Date
ENGINEERS CERTIFICATION
EJ Partial [1, nal
, as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (L1eriodicaIIy, fl weekly; I] full time) the construction of the subject project
for the Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation
of the construction such that the construction was observed to be built within substantial compliance of this
permit, 15A NCAC 02T; the Division of Water Resources's (Division) Gravity Sewer Minimum Design Criteria
adopted February 12, 1996 as applicable,: the Division's Minimum Design Criteria for the Fast -Track Permitting of
Pump Stations and Force Mains adopted June 1, 2000 as applicable, and other supporting materials.
North Carolina Professional Engineer's
Seal, signature, and date:
•
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
SURFACE WATER PROTECTION SUPERVISOR
MOORESVILLE REGIONAL OFFICE
610 EAST CENTER AVENUE, SUITE 301
MOORESVILLE, NC 28115
The Permittee is responsible for tracking all partial certificat ons up until a . ertification is received, Any
wastewater flow made tributary to the wastewater collection system extension prior to completion of this
Engineer's Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate
enforcement actions,
DWQ OrOy:
ofrom h htty

ST TRACK ENGINEERING CERTIFICATION
Permittee: Town of Taylorsville Permit No. VVQ0036796
Project: Taylorsville Golf Course Club House Issue Date: 10123/2013
Complete and submit this form to the permit issuing regional office with the following°
• One copy of the project record drawings (plan & profile views and detail drawings of sewer lines) of the wastewater
collection system extension. Final record drawings should be clear on the plans or on digital media (CD or DVD
disk) in pdf format, Record drawings should indicate the design and the marked up changes during construction,
• Supporting design calculations (selected pumps, system curve, operating point, available storage if portable
generator(s) or storage greater than longest past three year outage reliability option selected) for any pump stations
permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in written summary form Permit
modifications are re uired for an Chan es resulting in non-compliance with this permit, regulations or
ions should be submitted prior to certification.
des
This project shall not be considered complete nor allowed to operate until the Division has received this Engineer's
Certification and all required supporting documentation. Therefore, it is highly recommended that this certification
be sent in a manner that provides proof of receipt by the Division.
PERMITTEE'S CERTIFICATION
ad 0 doll the undersigned agent for the Permittee, hereby state that this project has
been constructed pursuant to the applicable standards & requirements, the Professional Engineer below has
provided applicable design/construction information to the Permittee, and the Permittee is prepared to operate &
maintain the wastewater collection system permitted herein or portions thereof.
Printed Name, Title
Signature Date
ENGINEER'S CERTIFICATION
El Partial Final
I, Pfii 1,V, 11142 4f as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (:)(beriodically, El weekly, El full time) the construction of the subject project
for the Permittee hereby state that, to the best of my abilities, due care and diligence was used in the observation
of the construction such that the construction was observed to be built within substantial compliance of this
permit, 15A NCAC 02T: the Division of Water Resources's (Division) Gravity Sewer Minimum Design Criteria
adopted February 12, 1996 as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of
Pump Stations and Force Mains adopted June 1, 2000 as applicable, and other supporting materials,
North Carolina Professional Engineer's
Seal, signature, and date:
vx•!:lijit
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
SURFACE WATER PROTECTION SUPERVISOR
MOORESVILLE REGIONAL OFFICE
610 EAST CENTER AVENUE, SUITE 301
MOORESVILLE, NC 28115
The Permittee is responsible for tracking all partial certifications up until a final certification is received, Any
wastewater flow made tributary to the wastewater collection system extension prior to completion of this
I Engineer's Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate
enforcement actions.
DWQ k:so Only:
Him Iron) illis pro,k2c1 is11ibu

a, One copy of the project construction record drawings (plan & profile wmvs of sewer lines & force mains)
of the wastewater collection system extension. Final record drawings should be clear on the plans or on
digital media (CD ornVD d�sk) and are defined asthe design drawings that are marked LIP orannotated
with after construction information and show required buffers, separation distances, material changes,
etc
b. One copy o|the supporting pump station design calculations (selected pumps, system curve, operating
point, buoyancy calculations, available storage ifportable gencrator(darstorage greater than longest
past three year outage reliability option selected) for any pump stations permitted as part o|this project.
c Changes tnthe project that dnnot result in non-compliance with this permit, regulations, or the Minimum
Design Criteria should be dearly identified on the record drawings, on the certification in the space
provided, orinwritten summary form,
Prior toCertification (Final or Partial): Permit modifications are required for any changes resulting in non~
compUancevv\ththis permit (including pipe length increases ofl0%orgreater, increased flow, pump station
design capacity design increases of 5% or greater, and increases in the number/type of connections),
regulations,, or the Minimum Design Criteria. Requested modifications orvariances to the Minimum Design
Criteria will be reviewed on a case -by -case bads and each on its own merit. Please note that variances to the
Minimum Design Criteria should be requested and approved during the permitting process prior to
construction. After-ronvtrwchun requests are discouraged bythe Division and may not be approved, thus
requiring replacement o, repair prior to certification @ acdvat�nn,
0� A copy of the construction record drawings shall be maintained on file by the Permittee for the life of the
wastevvucerco|lecdonfac/|it/es.
9� Failure to abide. by the conditions and limitations contained in this permit; 15A NCAC2T;the Division's Gravity
Sewer Design Criteria adopted Fcbrwary12' l996avapplicable; the Division's Minimum Design Criteria for the
Fast -Track Permitting of Pump Station and Farce Mains adopted June 1, 2003 as applicable; and other
Supporting materials may subject the Pe/nn\tteetoanenforcement action bythe Division, in accordance with
North Carolina General Statutes §I43-215.GAthrough §l43'2l56{,construction ofadditional orreplacement
wmorvxamr omHecbon facilities, and/or referral of the North Carolina -licensed Professional Engineer to the
licensing board.
18. In the event that the wastewater collection facilities fail to perform sadsfactohhy, including the creation o/
nuisance conditions, the Pormittoe shall take immediate corrective action, including those as may be required
by this Division, such asthe construction of additional orrep[acement facilities,
IL The issuance of this permit shall not exempt the Pennittee hmco complying with any and al; statutes, rules,
regulations, or ordinances that may be imposed by other government agencies (local, state and federal) which
have jurisdiction, including but not |innimad to applicable river buffer rules in I5A N[AC 2B.0200erosion and
sedimentation control requirements in 15A NCA[Ch. 4 and under the Division's General Permit N[GBI8000
and any requirements pertaining to wetlands under 15A NCA[ 3B .0200 and 154 mCAC ZH .0500.

VWEST CONSULTANTS, PLLC
Consulting Engineers and Surveyors
405 South Sterling Street
Morganton, North Carolina 28655
Phone [phone] Fax [phone]
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lege. T r i#4:114/4"
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USE WITH. 77,C ENVELOPE Deluxe For BusIne55 I-BCC-225-6380 or www.nebs.com
SIGNE
P1:14N7 ED

North
pat McCrory
Governor
OI
CEO
Envlrenmen t and natural Resources 111
a Department Of John Skverla,
Vision 0 Weter Resources 5ecreta'Y
Charles Wa ti©tl, p. E.
©1re�
October 23, 2013
David Odom, Town Manager
Town of Taylorsville
67 Main Avenue Drive
Taylorsville, NC 28681
Permit No. W0036796
Subject
Town House
of Taylorsville
Taylorsville Golf
CCourse
cton System Extension
Wastewaterol4e
Alexander County
we are forwarding herewith Permit No,
Dear Mr. Odom:
2013, operation of
our application received October 21,the date of
with Town of Taylorsville for the construction
ofrom p
In accordance w+ y 2a13o to the permit shallThis
extension. This p specified ro therein. WC1p©36796, dated October 23, system prated
subject wastewater collectionbe
the subj hall subject to the conditions and limitations
are therefore incorporated
and spart of this p
issuance until rescinded,
cover letter and supplement shall be considered a
therein by
reference. ermit
n to the following conditions contained within this P
Please pay particular attend©ro erly operated and maintained
T 03 or any e,diwid rol system -wide and mai t
Condition 11.4:
Requires that the wastewater collection facilities be p
in accordance with 15A NCAC
permit issued to the Permittee. that the as constructed project meets the
Taylorsville to ensure s-cns in accordance with North
appropri
oign criteria
ty is the Town of Tay l may result in penalties with
It shall be responsibility Failure to comply construction of additional or replacement to
Carolina
design a iuteia and rules. h §143.215.6C,
roll w General Statute §143 , and/ throng
Ca
or referral of the North Carolina -licensed Professional Engineer
wastewater collection facilities, and.
the licensing board. table, you right
ermit are unacceptable, receipt have thes perght.
to any parts, requirements,request within 30 days following receipt
of North thi Carolina
or limitations contained in this p
hearing upon written Ceq conforming to Chap Raleigh,
This requestt anaujudie n the petition,
6714 Mail Service Center, �
General Statutes,
must be in form of a written p rve shall be final and binding,
Statutes, and filed with the Office
made this tile Administrative
Hearings,
NC 27E,g9-6714. Unless such demands ar
1617 Mail Service Ceer . ¢eogh North Cara.
Pone: 919.S07-6300 !,FAA':.91.9 5'07- ' 7
ir,twrrset; www.rtia'w iFrq{}�i/iv.or;;.
47}r,6fllOprk armity I� ,rna24ti Adikar, EMObitY
Z7699-1617

avid Odom
October 2
Page Two
If you need additional for on concerning this ma
2194 or via e-mail at [e-mail]
Electronic copy David Poore, P.„
cc: Mooresville Regional Office
Water Resources Central Piles
PES (electronic copy)
e
lease contact Michael Parker at (7 4) -
Sincerely,
rThmas Reeder
Division of Water Rescaurces
by Michael Parker
Regional Supervisor
Water Quality Regional Operations Section

STATE OF NORTH CARLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT O►F ENVIRONMENT AND NATURAL RESOURCES
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 1 of Chapter 143, General Statutes of North Carolina a
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the
Town of Taylorsville
Alexander County
for the construction and operation of approximately 906 linear feet of 8-inch gravity sewer to serve the
Taylrsvllie Golf Course Club House, and the discharge of 300 gallons per day of collected domestic
wastewater into the Town of Taylorsville's existing sewerage system, pursuant to the application
received October 21, 2013, and in conformity with 15A NCAC 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 as applicable, the Division's Minirnum Design Criteria for the
Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable; and other
supporting data subsequently filed and approved by the Department of Environment and Natural
Resources and considered a part of this permit,.
This permit shall be effective from the date of issuance until rescinded and shall `be subject to the
specified conditions and limitations contained therein.
sued this the 23rd day of October,2013,
for Thomas Reeder, Director
Division of Water Resources
By Authority of The Environmental Management Cornet ssion
Permit Number; WQ0036796

rPER IT C VER SHEET
Town Tylorsille is hereby authoriz to:
then operate upon certification the aforementioned wastewater collection extension;
id wastewater collected by this system shall be treated in the Town of Taylorsvilles
atment Facility prior to being discharged into the receiving stream,
pis project does not constitute an acceptance of any part of the project that does not
2T; the Division of Water Resources (Division) Gravity Sewer l linimurn Design Criteria
iry 1, 1996 as applicable; and the Division's Minimum Design Criteria for the Fast -Track
ump Stations and Force Mains adopted June 1, 2000 as applicable, unless specifically
Division approval is based an acceptance of the certification provided by a North
d-Professional Engineer in the application. It shall be the Permitte&s responsibility to
as -constructed project meets the appropriate design criteria and rules.
d operation is contingent upon compliance with the Standard Conditions and any Special
titled below.
ADITIONS
e, the additinal rastcwater flow volume made tributary to this sewer extension is believed to
alue permitted herein, a modification shall be requested for this permit from the Division of
ce to properly allocate the subject wastewater flow.
tress of the quantity perm tted herein, 3 0 GPD, shall be made tributary to the subject seer
an application for permit modification for an increase in flow has been submitted to and
:he Division of Water Resources.
this permit the Alexander County Health Department and the Alexander County Building
apartment are advised that, no certificates of occupancy are to be granted prior to the submittal
gineer's certification;

11. STANDARD CONDITIONS
I . This permit isnot transferable. |nthe event thee is a desire for the wastewater collection facilities to change
ownership, or there i, a name change ofthe permit�tpe, a formal permit request shall be submitted to the
Division accompanied by documentation from the parties involved, and other supporting materials as may be
appropr<arp. The approval of this request shall be considered an its merits and may or may not be approved.
2� This permit shall become voidable unless the wastewater collection facilities are constructed in accordance
with the conditions of this permit; llA NC4C 2lC the Division of Water Resource's (Division) Gravity Sewer
Minimum Design Criteria adopted Febmaryl2' 1996 as applicable,- the Division's Minimum Design Criteria for
the Fast -Track Permitting ofPump Stations and Force Mains adopted June l' 2000as applicable; and other
supporting materials unless specifically mentioned herein.
3, This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data.
4 The wastewater collection facilities shall be properly maintained and operated at all times. The Perm/ttec
shall maintain compliance with an individual system -wide collection system permit for the operation and
maintenance ufthese facilities as required by 15A m[AC 2T 0401 If an individual permit is not required, the
following performance criteria shall bemet asprovided in 15ANCA[2TU403:
a. The sewer system shall be effectively maintained and operated ntaH times tuprevent discharge to land or
surface waters, and to prevent any contravention of groundwater standards or surface water stanclards.
bA map of the sewer system shall be developed and shall be actively maintained.
c An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule,, spare parts inventory and overflow response has been developed and
imp|emented,
ci Pump stations that are not connected to telemetry system shall beinspected every day(|.e. 365 days
per year). Pump stations that are connected ,o a telemetry system shall be inspected at least once per
week,
e. High -priority sewer lines shall be inspected at least once per every six -months and inspections are
documented. ,
f, A general observation of the entire sewer system shall be conducted at least once per yea
g, Overflows and bypasses dnaN he reported oothe appropriate Division regional office in accordance with
15A NCA[ 2B .0S86(a)' and public notice shall be provided as required by North Carolina General Statute
§I43-215.I[�
h, A Grease Control Program is in place as follows-,
L For public owned collection systems, the Grease Control Program shall include at least biannual
distribution of educational materials for both commercial and residential users and the legal means to
require grease interceptors at existing establishments, The plan ohoU also include legal means for
inspections of the grease interceptors, enforcement for violators and the legal means to control
grease entering the system from other public and private satellite sewer systems,

orvatelyowned collection systems, the Grease Control Program shall include azleast br-annuo|
ihuUon of grease education materials to users of the collection system by the perm/ttre or its
?yentadve,
se education materials shall be distributed more often than required in Parts (l)and (2)ufthis
aragraph if necessary to prevent grease -related sanitary sewer overflows,
,vays and easementsshall be maintained in the full easement width for personnel and equipment
ity
totioo shall be kept for Subparagraphs (a) through (i) of this Rub for a minimum of three years
mUonofthe map, which shall bemaintained for the life of the system.
.e Notification:
shall report bytelephone {ua water quality staff member atthe Mooresville Regional Office,
nbc, (704) 663'I699' as soon as possible, but in no case more than 24 hours or on the next
)Ilowing the occurrence or first knowledge of the occurrence of either of the following:
noceounit failure, due toknown orunknown reasons, that renders the facility incapable mf
ate vvo5trwatertransport, Such as mechanical or electrical failures ufpumps, line blockage or
iQe'e1c.;mr
I)and/or sp0over 1,DV0 galhonco/
I)and/o,spill, regardless ofvolume, that reaches surface water
sages orfaxed information is permissible, but this shall not beconsidered asthe initial verbal
wsand spills occurring outside normal business hours may also bereported Lnthe Division of
mgemenc at telephone mumber(80U) 858'8358 ur(919) 733'3300. Persons reporting any of
renoes shall file a spill report by completing and submitting Part I of Form CS-SSO (or the rnost
approved form) within five days following first knowledge of the occurrence. This report must
,nstaken nrproposed tn betaken lo ensure that the problem does not recur, Part U of Form
ios|current Division approved form) can also he completed to show that the SS8vvas beyond
,he gravity sewers, pump stations, and force mains shall bescheduled soasnot cointerrupt
x|sdnQ utilities nor result in an overflow or bypass discharge ofwastewater to the surface
'.0116, upon completion of construction and prior to operation of these permitted facilities,
n#ineering Certification form attached tothis permit shall besubmitted with the required
nentstothe address provided unthe. form, Acomplete certification isone where the form is
dthe supporting documents are provided asapplicable, Any wastewater flow made tributary
er collection system extension prior to completion of this Engineer's Certification shall be
xi000fthe permit and shall subject the Permiueetoappropriate enforcement actions,
ssoad to a private entity with an Operational Agreement, then a copy of the Articles of
"clarations/Covenants/Restrictions, and Bylaws that have been appropriately filed with the
�5Register ofDeeds office shall besubmitted with the certification.
cation bone where the form isfully executed and the supporting document are provided as
,uin8documentation shall include the foUowhng�

*
^
u One ozpY of the project construction record drawings (plan & profile views of sewer lines & force mains)
of the wastewater collection system extension. Final record drawings should be clear on the plans or on
digital media (CD or QVIDdisk) and are defined authe design drawings that are marked uporannotated
with after construction information and show required buffers, separation distances, material changes,
etc
b. One copy of the supporting pump station design calculations (selected pumps, system curve, operating
point buoyancy calculations, available storage if portable generator(s) or storage greater than longest
past three year outage reliability option selected) for any pump stations permitted as part of this project.
Changes tnthe project that do not result in non-compliance with this permit, regulations, or the Minimum
Design Criteria should be clearly identified an the record drawings, on the certification in the space
provided, orimwritten summary form,
Prior to Certification (Final or Partial): Permit modifications are required for any changes resulting in non-
compliance with this permit (including pipe length increases ofl096orgreater, increased Mnvv' pump station
design capacity design increases of S% or greater, and increases in the number/type of connections),
regulations, or the Minimum Design Criteria. Requested modifications orvariances to the KHininounn Design
Criteria will be reviewed on a case -by -case basis and each on its own merit. Please note that variances to the
Minimum Design Criteria should be requested and approved during the permitting process prior to
construction, After -construction requests are discouraged hythe Division and may not be approved, thus
requiring replacement or repair prior tn certification & activation.
8. A copy of the construction record drawings shall be maintained on file by the Permitnee for the life of the
wastewater collection facilities.
9� Failure to abide bythe conditions and limitations contained in this permit; 15A N[A[ ZT/ the Division's Gravity
Sewer Design Criteria adopted February 12, 1996 as applicable; the Div�sion's Minimum Design Criteria for the
Fast -Track Permitting of Pump Station and Force Mains adopted June l' ZOOO as applicable; and other
supporting materials may subject the Permitteetoan enforcement action bythe Division, inaccordance with
North Carolina General Statutes §l4J'Z15.6A through §143'Zl5.6C,construction ofadditional o/replacement
wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to the
licensing board
10. In the event that the wastewater collection facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action, including those as may be required
by this Division, such as the construction of additional or replacement facilities.
lI. The issuance of this permit shall not exempt the Ponmitteehnm complying with any and all statutes, ro|es,
eQu|advos' or ordinances that maybe imposed by other government agencies (local, state and federal) which
have jurisdiction, including but not limited to applicable river buffer rules in ISA N[A[ 2B .0200, erosion and
sedimentation control requirements in I5A N[A[[h. 4and under the Division's General PennizmCGUl0B00
and any requirements pertaining towetlands under I5Am[A[2B.U2OOand 154NCA[2V.Q500,

'NFERING C0RTIFI[CAlQ0N
^
fTaylormvU|e Permit No.VVQ003679s
vU|eGolf Course Club House Issue Date: 10/23/2013
this form tnthe permit issuing regional office with the following:
)ngectreomnddrawingo(p|an&pmfi|eviawaanddetai|dnywinguofmewerhnes)ofthowmwtewater
extension. Final record drawings should be clear on the plans or on digital media (CO or DVO
�Record drawings should indicate the design and the marked up changes during construction.
n calculations (selected pumpa, ayaham curve, operating point, available storage J portable
)rage greater than longest past three year outage reliability option selected) for any pump stations
of this project
/nqoot should be clearly identified on the record drawings or in written summary form, Permit
,e required for any ohmnqwsresulting in non_oomp|imnuwwith this permit, regulations or
.uhteha. Modifications should besubmitted prior tocertification.
be considered complete nor allowed to operate until the Division has received this Engineer's
yquiredsupporting documentation. Therefore, dinhiqNyrecommended that this certification
that provides proof of receipt by the Division.
Psmw|TTes`aCsRnFuzAnoN
. the undersigned agent for the Ppmnittee.hereby state that this project has
/rouont to the applicable standards & requirements, the Professional Engineer below has
1esign/constmction information hothe Pmrm)ttee. and the Permittee is prepared tnoperate &
etarcollection system permitted herein orportions thereof,
Signature Date
ENGINEER'S CERTIFICATION
[]Partial F-1Fina|
' as a duly registered Professional Engineer in the Stab* of North Caro|ina,
ed to observe ([_ periodically, E weekly, [] full time) the construction of the subject project
�bystate that, tothe best ofmyabilities, due care and diligence vvasusedinLhembsen/adon
;Uch that the construction was observed to be built within substantial compliance of this
)2T; the Division of Water Renources^s (Division) Gravity Sewer Minimum Design Criteria
` 1906 as applicable,, the Division's Minimum Design Criteria for the Fast -Track Permitting of
orce Mains adopted June 1, 2000 as applicable� and other supporting materials.
'emskonalEnoineer's
J date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TOTHE FOLLOWING ADDRESS
SURFACE WATER PROTECTION SUPERVISOR
PWOORESVILLEREGIONAL OFFICE
610EAST CENTER AVENUE, SUITE 381
80OORESVWLLE,NC2811S
apomdtde for tracking all partial certifications up until u final certification is received. Any
ide tributary to the wastewater collection system extension prior to completion of this
Dn shall be considered a violation of the permit and shall subject the Permittee to appropriate
/6huur to:

"Pr
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD
OwneriPermittee:
la, Town of Taylorsville
Full Legal Name (company, municipality, HOA, utility, etc.
Application Number:
(to be completed by DWR)
" 51,11 k.
0 lb. David Odom, Town Manager
Signing Official Name and Title (Please review 15A NCAC 21 .0106 (b) for authorized signing officials)
0
LL
cL
2
0
Lk
z
LLI
th
lc The legal entity who will own this system is:
Li Individual n Federal L Municipality Ei State/County E,1 Private Partnership Corporation LI Other (specify):
ld. 67 Main Avenue Drive
Mailing Address
1f. NC
State
lh [phone]
Telephone
Facsimile
2. Project (Facility) Information:
2a, Taylorsville Golf Clubhouse
Brief Project Name (permit will refer to this name
3. Contact Person:
3a. David Odom
le, Taylorsville
City
1 g. 28681
Zip Code
lj, townmanager@tay)orsvillenc.com
E-mail
2b Alexander
County Where Project is Located
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b, [phone]
Phone Number
3c. townmanager@taylorsvillenccom
E-marl
1 Project is El New H Modification (of an existing permit) If Modification, Permit No
,-
2. Owner is N Public (skip to Item B(3))
Ei Private (go to Item 2(a))
2a. If private, applicant will bei
Retaining Ownership (i.e. store, church, single office, etc) or
Li Leasing units (lots, lownhomes, etc. - skip to item B(3))
Li Selling units (lots., townhomes, etc, go to item B(2b))
Town of Taylorsville
Owner of Wastewater Treatment Facility
4a. Taylorsville WWTP
Name of WWTF
5a.
Town of Taylorsville 5b 8 [1] Gravity
Owner of Downstream Sewer Receiving Sewer Size 11 Force Main
6 The origin of this wastewater is (check all that apply):
Residential Subdivision
Ll Apartments/Condominiums
CD Mobile Home Park
El School
Restaurant
{: Office
2b. If sold, facilities owned by a (must choose one)
Eli Public Utility (Instruction D)
Ej Homeowner Assoc./Developer (Instruction E)
'F) Treating Wastewater From This Project
4b NC0026271
VVVV1T Permit No.
5c, AlexA-2000-014
Permit # of Downstream Sewer (Instruction F)
El Retail (Stores, shopping centers)
Institution
[I] Hospital
Church
111 Nursing Home
Ni Other (specify):VN,Viet.04---
100 % Domestic/Commercial
% Industrial
(Attach Description
% Other
7, Volume of wastewater to be allocated or permitted for this particular project: 300
*Do not include future flows or previously permitted allocations
8, If the permitted flow is zero, indicate why:
(Attach Description)
gallons per day
Li Pump Station, Outfatl or Interceptor Line where flow will be permitted in subsequent permits that connect to lhis ine
E] Flow has already been allocated in Permit No.
Ej Rehabilitation or replacement of existing sewer with no new flow expected
(see 15A NCAC 02T ,0303 to determine if a permit is required)
12-1A 08-13 .APPLICA'TiON Page 3 of

9, Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T Cl114 for
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7), Values other than that in 15A NCAC 2T ,0114 (b) and (c) must be supported with actual water or wastewater use
data in accordance with 15A NCAC 2T ,0114 (f).
Permitted flow based on water reading meters
10 Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet)
8"
New Gravity or Additional
Force Main
906 New gravity
z
11 Summary of Pump Stations wl associated Force Mains to be Permitted (attach additional sheets as necessary)
0 Pump Station Location ID: (self chosen - as shown on plans/map for reference)
Longitude; Latitude:
z
0
Design Flow
Operational Point Power Reliability Option
(MGD)
GPM @TDFI 1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator wfMTS
C4
0
LI-
Pump Station Location ID: (self chosen - as shown on plans/map for reference)
cd
Longitude: Latitude:
Design Flow Power Reliability Option
Operational Point
(MGD) permanent generator wIATS; Force Main Size Force Main Length
GPM ©TON
2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
fl Yes Z No If Yes, permit number of 2ncl treatment facility
(RO — if "yes" to B,12 please contact the Central Office PERCS Unit)
13, Does the sewer system comply with the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains
(latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A, NCAC Chapter 2T as applicable?
El Yes El] 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
Fit APRLACATION Pagie 4 of 6

14, Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401Certification? Li Yes 0 No 0 N/A
Sedimentation and Erosion Control Plan? [1] Yes 0 No Z N/A
Trout Buffer Waiver? Li Yes 0 No 0 N/A
Stormwater? 0 Yes No N/A
15 Does this project include any high priority lines (15A NCAC 02T 0402 (2)) involve aerial lines, siphons, or nterferenceinterference
manholes)? These lines will be considered high priority and must be checked once every six months
Check if Yes: ID and provide details:
Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
1, David Odom , attest that This application for Town of Taylorsville 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 pep�ties up to $25,000 per violation.
la.
Signin Official Signature
./ ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMTY
TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER TO 15A NCAC 02T .0305
0
1— 2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
d
1, David Poore ,attest that this application for Town of Taylorsville has been reviewed by me and is accurate, complete
and consistent with the information in the engineering plans, calcutations, and all other supporting documentation to the
best of my knowledge: 1 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 adopted Februaty
12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June
1, 2000 and the watershed classification in accordance with Division guidance, 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 arid have judged it to be consistent with the proposed design. Note: In accordance with
NC General Statutes 143-215,6A and 143-215,6P, 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. David Poore
Professional Engineer Name
2b. West Consultants, PLLC
Engineering Firrn
2c. 405 South Sterling Street
Mailing Address
2d, Morganton
City
2e. NC 2f 28655
State Zip
2g [phone] 2h. 1828) 433-5662 21, dpoore eawest-consultan
Telephone Facsimile E-mail
s corn
NC PE Seal, Signature & Date
FTA 08-13 APPLICATION Page 5 016

It"FIE COMPLETED AP
REGIONAL OFFICE
Asheville Regional Office
Fayetteville Region& Office
Mooresville Regional Office
Raleigh Regional Office
Washington Regional Office
Wilmington Reg
ice
CATION AND SUPPORTING DOCUMENTATION ORIGINAL AND COPY} SIIAI_xt, I3E
SUBMITTED TO THE APPROPRIATE REGIONAL OFFICE:
Winston-Salem Regional Office
ADDRESS
2090 US Highway 70
Swannanoa, North Carolin
[phone]
[phone] Fax
COUNT ES SERVED
Avery, Buncombe, Burke, Caldwell, Cherokee,
28778 Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowell, Mitchell, Polk,
Rutherford, Swain, Transylvania, Yancey
225 Green Street Suite 714
Fayetteville, North Carolina 28301-5094
[phone]
[phone] Fax
610 E. Center Avenue, Suite 301
Mooresville, North Carolina 28115
[phone]
[phone] Fax
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
919) 791-4200
919) 788-7159 Fax
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax.
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
585 Waughtown Street
Winston-Salem, North Carolina 27107
[phone]
[phone] Fax
Anson, Bladen, Cumberland„ Harnett, Hoke,
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Chatham, Durham, Edgecombe, Franklin,
Granville, Halifax, Johnston, Lee, Nash,
Northampton, Orange, Person, Vance, Wake,
Warren, Wilson
Beaufort, Bertie, Camden, Chowan, Craven,
Currituck, Dare, Gates, Greene, Hertford, Hyde,
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onslow, Pender
Alamance, Allegheny, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
3 APPLICAT"IC

Data use subject to license.
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2,000 0 ft
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PLAT BOOK E PAGE GA
1342 MA, NAYE5. JR.
52%31564
LOT #2
BRUSHY MOUNTAA
RECREATION ASSOCIATION, 84C..
72/298 T2/.04, 72/520
84/586, 723496

State of North t.`arolina
Department of Environment and Natural Resources
ision of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(I'`I'SI 08-1 3i)
Project Applicant i ante;. "1 ow.w°n of
Project Hanle for %vilich flow
Afore. than c
.stations
aropos d wastewater flow,
•sville Go
ClUbhott,
II"Tp is not re,s°pon,sable
Comt
a. WWTP Facititwr Name: Ta),:lo
ant.
h. WWTP Facilit ` Permit : NCO()26271
c. WWTP fac-
d. Estimated obligate
c. WWTP facility's actual avg. flow
f, 'f otal flow for this specific request
c 'Foul actual and obligated flog is to
cent of perm tted 11ovv used
flow
OH'S are in
.408
.0003
.473
.57
propo
ction for each pu.tllp station you are responsible for along the route
'
r flow.
cd between the pro
(A)
Design
Average Daily,
Fitni FloAw�**
Capacity, tFirttl pl},
MGD MGi)
can be ach
0,9
Ca
I with t
0.144
360
ction point and the WWTP:
TP:
(B)
(C)
Ohl igated,
Approx. Not Yet
Current Avg. Tributary
Daily Flow, Daily Flow,
M G D MU D
85
092
pump station is defined as the
t pump taken out of service.
()
B+C) (E)—(A-t))
Obligated
Flow
.0088
92
inium pumped flow
Design Average Daily Flown is the firm capacity of the pump station di
factor (pt) not Less than 2.:5.
A Planning Assessment Addei dum. shall be attached for each pumpstation located
between the project connection point and the WWTI' where the Available Capacity is
Capacity*"
0.135
()„?68
►king
Page t of 6
FESLR 0813

ar
DaVicy t 3c c r
the plat
a leas lies
tatet cent:
to
treatn
ted sanit rr° sew
rig treatment plan
nprov means identified
rn performed in aec cinder e
abledata. Tinser`
eJ planningassess Bent udder
to rt indicatesac .eptance cif"this r
addenda]
Page
and that th
r t��t�erflcr��°s
f taricier r cart
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ect leas e.rr alrrate
f ftrrr tkis pree
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try those i7
for
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en the implants
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policies and procedures Tres u i
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pcnslrle

CONSULTANTS Par
October 1 ` 20 l 3
frGirg Str organt 8655
28 433 5661 /" 33 333 3662 /,
oastsft r ts.co
North Carolina Dr partnte tt of .1on et t at d Natural Iesoure s
Division of Water t cralitr
Mooresville Regional ional Office
610 F. Center Avenue,, Suite 01
Mooresville, NC 28116
RE: "1TW1 of`l'"aylorsville uitar "° ion ensio to
Serve Taylorsville (i 1f Course Club f lou
€v1 tv° Concern;
Please find enclosed the folio
FTA 08-18 Application l'orrr 1 Origin1 Copy)
Application Pee `I ovvn of Trydorsville C
copies of Flow Tracking/Acceptance I orrtt 1 `l f 8-
-he project is t serve a nev," drib house art the: -ray' ar ville Golf Course also called Brushy Mount itt
C olfCourse which is located in''aest Tas"lorsville ogghway U1 - 4 NC 0 in Alexander County. The
proposed project cvxill prr vide sewer service to serve a r sv club house which will replace the existing
clubhouse, which 'is curr my relying on an individual septic tank, This project includes the construction
of90( linear feet of new 8" grav its sewer lhr s and five manholes, which will connect to the "1'ovs n of
Taylorsville"s existing wastewater system, T1 e flow for this elublanuse is based on the water meter
readings for the e isti tg clubhouse since it is to be the same sire vv ith the same facilities,
P1 x
Sincerely,
kilos s= ifyou seed at
CON C TANT a, PE
David Poore, Pb, CPFSC
c

WEST CONSULTANTS, PLLC
Consulting Engineers and Surveyors
405 South Sterling Street
Morganton, North Carolina 28655
Phone [phone] Fax [phone]
TO NCDENR - DWQ (Mooresville)
610 E. Center Avenue, Suite 301
Mooresville NC 28115
WE ARE ENDING YOU
Shop drawings
Copy of letter
PIES DAT
2 10/16/13
2 10/16/13
1 10/16/13
Attached Under separate cover via
Plans
Other:
Prints
Change order
THESE ARE TRANSMITTED as checked below:
REMARKS
COPY TO
PROM4T,3127G
mw
For your approval
LETTER OF
TRANSMITTAL
NUMBERVHONE
3125
ATTENTION
RE
Town of Taylorsville, NC - Fairway
Oaks System Extension to Clubhouse
DATE
10/17/2013
the following items.
Specifications
DESCRIPTION
'ast Track Application (ETA 08-13)
Flow Tracking/Acceptance For Sewer Extension Application
Application Fee ($480.00) Pd By Town Of Taylorsville
Samples
Approved as submitted Resubmit copies for approval
For your use Approved as noted Submit copies for distribution
As requested Returned for corrections Return corrected prints
For review and comment Other
FOR BIDS DUE/DATE:
If enclosures are not as noted, please notifyus at once,
USE MTH 77'117. ENVELOPE Deluxe For Busnes,s 1-8(X)-225-060 Dr www,n,p,b5.con,
PRINTS RETURNED AFTER LOAN TO US

Per rrnit Number WQ0036796
Central rrle : ,t' _
10/23/13
Permit Tracking Slip
Program Category
Non -discharge
Permit Type .Sst Dank
Gravity Sewer Extension, Pump Stations, Pressure Sewer
Extensions
Primary Reviewer
ntnhael. parker
Coastal SW Rule
Permtier Flowi
300
acttltty
Facility Name
T y°lorsville Goff Course Clubhouse
boo doh Address
Owner
Owner Name
Town of Taylorsville
Dates/Events
Status
Active
Version
1,00
Project Type
New Project
Permit Ciesslfidation
Individual
Permit Contest Affiliation
Major/ inor Region
Minor Mooresville
County
Alexander
Radii Con t ,Affiliation
Owner Type
Government r Municipal
Owner Affiliation'
David Matthew Robinette
204 Main Ave Dr
raylarsville
Schedu
Odd issue App RecReceivedDraft tnnitiated Issuance
1 012 /
10/2111
Regulated Activities
Wastewater collection
Outfall NULL.
Waterbody Name
Pubf Notie Issue
10/23/13
Requested/Received Events
ddltsrarral information received
. dditional information requested
ilex Number
NC 28681
Effective
10/23/13
Expiration
CurrentCie Subbasin

PAY
6HE
ORDER
OF
I DOCLI ENT HAS:TT VI HTk3T"E FLU4 C S: qlk Y UNDEK S t .i 11 HT::'
TOWN OF TAYLORSVILLE
67 MAIN AVENUE DRIVE
TAYLORSVILLE, NORTH CAROLINA'2S68'1
ivaitvC.}�T?.
13uscc�ddh-
0 4
HECI< DAT
041838 10/16/2013 00000C10 4
' FOUR HUNDRED EIGHTY AND XX1100 DOLLARS" " — • """° °"
NCDENR DIVISION OF WATER RESOURCES
610 E CENTER AVENUE SUITE 301
MOORESVILLE, NC 28115
IGNATU
Tr
CHECK AMOUNT
8480.00
"'TOO, utias+:N boOne at boo boon appry bod as
Mgi.xred by Ptxa t.o Government 4:ttaa�et
ar F,�sa , Combol, Act."