HomeMy WebLinkAboutWQ0042729_Application (FTSE)_20210810Date: 08/04/2021
To:
RECEIVED/NCDEQ/DWR
AUG 5 2021
S
MOORESVILLE REGIONAL OFFICE
NCDEQ
Mooresville Regional Office — Water Quality Section
610 E. Center Avenue
Mooresville, North Carolina 28115
From: BGE — Andrew Grant, PE / Josh Breed, PE
Reference: Shopton Road Townhomes
COVER LEI 1 ER
Item No.
1.
Number of Copies
2
Description
Fast Track Application (Form: FTA 04-16) (1 Original &
1 Copy)
2.
1
Flow Tracking/Acceptance Form (Form: FTSE 04-16)
3.
1
8.5"xl 1" Color USGS Topographic Map
4.
1
Site Map
5.
1
NC Secretary of State Business Documentation
6.
1
Developers Operational Agreement
7.
1
Application Fee — Check #DHrnl-00028846 ($480.00)
Please find to enclosed documents to support the permitting of a private gravity PVC sewer system to
serve 58 homes with a required flow of 11,020 GPD located in Charlotte, NC.
BGE
Andrew Grant, PE (980) 220-2322
agrant@bgeinc.com
Josh Breed, PE (980) 349-7756
agrant@bgeinc.com
Serving. Leading. Solving.`"
121 West Trade Street, Suite 1030 • Charlotte, North Carolina 28202 • 980-220-2322
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
I.
II.
Application Number: KI` C 6 °11A 1 j(to he completed by DWR)
All items must be completed or the application will be returned
APPLICANT INFORMATION:
1. Applicant's name: BC SHOPTON ROAD, LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal
3. Signature authority's name: LEVI MIXON per 15A NCAC 02T .0106(b)
Title: Authorized Officer
4. Applicant's mailing address: 336 JAMES RECORD ROAD SW
City: HUNTSVILLE State: AL Zip: 35824-
5. Applicant's contact information:
Phone number: (256) 350-1322 Email Address: levi@builttoinvest.com
PROJECT INFORMATION:
1. . Project name: SHOPTON ROAD TOWNHOMES
2. Application/Project status: ® Proposed (New Permit)
❑ Other
❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: MECKLENBURG
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.1722° Longitude:-80.9587°
5. Parcel ID (if applicable): 14110124
(or Parcel ID to closest downstream sewer)
CONSULTANT INFORMATION:
1. Professional Engineer: ANDREW P. GRANT
Firm: BGE, INC.
Mailing address: 1 1 1 1 METROPOLITAN AVE, SUITE 250
City: CHARLOTTE State: NC Zip: 28204-
Phone number: (908) 500-8951 Email Address: agrant@bgeinc.com
License Number: 044291
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: MCALPINE CREEK, IRWIN CREEK, SUGAR CREEK Permit Number: NC0024970, NC0024945,
NC0024937
Owner Name: CHARLOTTE WATER
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size:
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
inch
FORM: FTA 04-16 Page 1 of 5
VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
® Yes ❑No ❑N/A
3. Idle Applicant is a Home/Property Owners' Association, has an Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential Owned ❑ Retail (stores, centers, malls)
❑ Residential Leased ❑ Retail with food preparation/service
❑ School / preschool / day care
El Food and drink facilities
❑ Businesses / offices / factories
❑ Medical / dental / veterinary facilities
❑ Church
❑ Nursing Home
5. Nature of wastewater : 100 % Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
❑ Car Wash
El Hotel and/or Motels
❑ Swimming Pool /Clubhouse
❑ Swimming Pool/Filter Backwash
El Other (Explain in Attachment)
>Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? El Yes R. No
If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a,b
No. of Units
Flow
3 BEDROOM TOWNHOMES
190 gal/unit
58
11,020 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
11,020 GPD
a See 15A NCAC 02T .0114(b), (d), (e)(I) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 11,020 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16
Page 2 of 5
VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8"
1019
PVC
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: . Longitude: -
3. Design flow 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)(I)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)( 1 )(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(11)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
I. Does the project comply with all separations found in I5A NCAC 02T .0305(f) & (g)
➢ I5A NCAC 02T.0305(f) contains minimum separations that shall be provided for sewer systems:
® Yes ❑ No
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-I waters of Class I or
Class II 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 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(f) or (g), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ® Yes ❑ No ❑ N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No ® N/A
➢ This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Permitting Branch
Yes ® No
5. Does project comply with I5A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per I5A NCAC 02T.0I05(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ N/A
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5
X. CERTIFICATIONS:
1. Does the submitted system comply with I5A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VA DC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
1, 14A (- J f.
(Professional Engineer's name from Application Item 111.1.)
attest 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. 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 (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that 1 have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
K t- , f � 1 tt ✓� ' 2� c rt f-
(Signature Authority's name & title from Application Item 1.3.)
SEAL
044291
'•e42' GNU I N EE•'' �,
attest that this application for
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. 1 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, this application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature:
Date:
FORM: FTA 04-16
Page 5 of 5
STATE OF NORTH CAROLINA
COUNTY OF MECKLENBURG
Permit No. 1,1-100 4L217�
DEVELOPER'S OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (di) and entered into this day of
, by and between the North Carolina Environmental Management
Commission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
BC SHOPTON ROAD, LLC , a corporation/general partnership registered/licensed to do
business in the State of North Carolina, hereinafter known as theDEVELOPER.
WITNESSETH:
1. The DEVELOPER is the owner of the certain lands lying in MECKLENBURG County, upon
which it is erecting and will erect dwelling units and other improvements, said development to beknown
as AVERY PLACE (hereinafter the Development).
2. The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVELOPER has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and operate the Disposal System.
4. The DEVELOPER has created or shall create unit ownership in said dwellings units, other improvements
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C or 47F of the North Carolina General Statutes.
5. The DEVELOPER has caused to be formed or will cause to be formed at the time of filing of the
Declaration, AVERY PLACE TOWNHOME HOMEOWNERS ASSOCIATION (hereinafter
Association), a non-profit corporation organized and existing under and by the virtue of the laws of the State
of North Carolina, for the purpose, among others, of handling the property, affairs and business of the
Development; of operating, maintaining, re -constructing and repairing the common elements of the lands
and improvements subject to unit ownership, including the Disposal System; and of collecting dues and
assessments to provide funds for such operation, maintenance, re -construction andrepair,
6. The COMMISSION desires to assure that the Disposal System of the Development is properly constructed,
maintained and operated in accordance with law and permit provisions in order to protect the quality of the
waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and DEVELOPER do hereby mutually agree as follows:
1. The DEVELOPER shall construct the Disposal System in accordance with the permit and plans and
specifications hereafter issued and approved by the COMMISSION, and shall thereafter properly operate
and maintain such systems and facilities in accordance with applicable permit provisions and law.
2. The DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed in accordance with the permit and approved plans, and the staff of
the Division of Water Resources has inspected and approved of the facilities. In order to change the name
of the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request must include a copy of the Association Bylaws and Declaration.
3. The DEVELOPER shall not transfer, convey, assign or otherwise relinquish or release its responsibility for
the operation and maintenance of its Disposal System until a permit has been reissued to the DEVELOPER's
successor.
FORM: DEV 03-19 Page 1 of 2
4. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and the provisions of the permit for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority for
expenditures by the Association except for Federal, State, and local taxes and insurance.
5. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System will
be maintained out of the common expenses. In order to assure that there shall be funds readily available to
repair, maintain or construct the Disposal System, beyond the routine operation and maintenance expenses,
the Declaration and Association Bylaws shall provide that a fund be created out of the common expenses.
Such fund shall be separate from the routine maintenance funds allocated for the facility and shall be part
of the yearly budget.
6. In the event the common expense allocation and separate fund are not adequate for the construction, repair,
and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for special
assessments to cover such necessary costs. There shall be no limit on the amount of such assessments, and
the Declaration and Bylaws shall provide that such special assessments can be made as necessary at any
time.
7. If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city,
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit mayrequire as condition of accepting the Development's wastewater.
8. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary dissolution without having made adequate provision for the continued
proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall provide in the
Association Bylaws that the Association shall not enter into voluntary dissolution without first having
transferred its said system and facilities to some person, corporation or other entity acceptable to and
approved by the COMMISSION by the issuance of apermit.
9. The agreements set forth in numbered paragraphs 1, 2, 3, 4, 5, 6, 7, and 8 above shall be conditions of any
permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair and
operation of the Disposal System.
10. A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where the Declaration is
filed and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of the
Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL BC SHOPTON ROAD, LLC
MANAGEMENT COMMISSION
Name of DEVELOPF
B
S. Daniel Smith (Signature)
Director, Division of Water Resources
LEVI MIXON, AUTHORIZED OFFICER
Print Name and Title
(Date) (Date)
FORM: DEV 03-19 Page 2 of 2
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: BGE, Inc.
Project Name for which flow is being requested: Shopton Road Townhomes
More than one FTSE may be required for 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. 0
a. WWTP Facility Name: McAlpine Creek, Irwin Creek, Sugar Creek 3
b. WWTP Facility Permit #: NC0024970, NC0024945, NC0024937
All flows are in MGD
c. WWTP facility's permitted flow 99.00
d. Estimated obligated flow not yet tributary to the WWTP 9.642
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
74.742
0.01102
84.395
85.3%
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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:
Pump
Station
(Name or
Number)
Pump
Station
Permit
No.
Eagle Lake
Firm
Capacity, *
MGD
0.441
(A)
Design
Average
Daily Flow**
(Firm / pf),
MGD
(B) (C)
Obligated,
Approx. Not Yet
Current Tributary
Avg. Daily Daily Flow,
Flow, MGD MGD
0.176 0.024 0.011
(D)=(B+C)
Total Current
Flow Plus
Obligated
Flow
0.035
(E)=(A-D)
Available
Capacity***
0.141
* 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.
*** 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): Steele Creek Road Trunk
Downstream Permit Number: Unknown
Page 1 of 6
FTSE 10-18
III. Certification Statement:
Keri Cantrell 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.
6/14/2021
Signing Official Signature
Chief Engineer
Title of Signing Official
Date
Page 2 of 6
FTSE 10-18
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State of North Carolina
Department of the Secretary of State
Limited Liability Company
ARTICLES OF ORGANIZATION
Date Filed: 5/12/2021 4:39:00 PM
Elaine F. Marshall
North Carolina Secretary of State
C2021 132 02747
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 limited liability company.
1. The name of the limited liability company is: BC Shopton Road, LLC
(See Item 'of the Instructions for appropriate entity designation)
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 the capacity of a member, organizer or both by checking
all applicable boxes.) Note: This document must be signed by all persons listed.
Name Business Address Capacity
C. Tucker Herndon 222 2nd Avenue South, Suite 2000, Nashville TN 37201 ❑Member QOrganizer
❑Member ❑Organizer
❑Member ❑Organizer
3. The name of the initial registered agent is: Universal Registered Agents, Inc.
4. The street address and county of the initial registered agent office of the limited liability company is:
Number and Street 176 Mine Lake Court, Suite 100
City Raleigh State: NC Zip Code: 27615 County: Wake
5. The mailing address, if different from the street address, of the initial registered agent office is:
Number and Street
City State: NC Zip Code:
6. Principal office information: (Select either a or b.)
a. The limited liability company has a principal office.
The principal office telephone number: (256) 509-21 12
County:
The street address and county of the principal office of the limited liability company is:
Number and Street: 336 James Record Road
City: Huntsville State: AL Zip Code: 35824 County: Madison
BUSINESS REGISTRATION DIVISION P.O. BOX 29622 Raleigh, NC 27626-0622
(Revised August. 2017) Form L-01
The mailing 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.
7. Any other provisions which the limited liability company elects to include (e.g., the purpose of the entity) are
attached.
8. (Optional): Listing of Company Officials (See instructions on the importance of listing the company officials in the
creation document.
Name
Title
Business Address
9. (Optional): Please provide a business e-mail address:
The Secretary of State's Office will e-mail the business automatically at the address provided above at no cost when a
document is filed. The e-mail provided will not be viewable on the website. For more information on 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 12th day of May
,2021
Signature
C. Tucker Herndon, Organizer
Type or Print Name and Title
The below space to be used if more than one organizer or member is listed in Item #2 above.
Signature Signature
Type and Print Name and Title Type and Print Name and Title
NOTE:
1. Filing fee is $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) Form L-01