WQ0017761_More Information Received_20230221

Initial Review
Reviewer
Nathaniel.Thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Permit Number (IR) * W00017761
Applicant/Permittee Mark W. Kemp and Hope N. Kemp
Email Notifications
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
Name* Mark W Kemp
Email Address*
[e-mail]
Project Information
.........................
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
3362141038
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edoes.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number:*
WQ0017761
Has Current Existing permit number
Applicant/Permittee Address*
5549 New Windsor Tr, Burlington,NC 27217
Facility Name*
5549 New WindsorTrl. SFR
Please provide comments/notes on your current submittal below.
The original address of 5549 New Oak Trail was changed to 5549 New Windsor Trail when we had a new driveway put in. The physical residence
has not changed. The original engineer stamped documents were for New Oak Trail.
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
kempsept2.pdf 2.03MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has
been received by the Non -Discharge Branch. Application fees must be submitted by check or money order and made payable to the
North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
t% '"14 WGA%,a
Submission Date 2/21/2023

RANDY L. FAIRCLOTH CONSTRUCTION,INC.
FAX COVER SHEET
227-2334 (phone)
226-7987 (FAX)
513-9115 (digital pager)
FAX TO: Lisa Thomas
FROM: Randy Faircloth
RE: Engineer's Certificate
DATE: 1/3/03
2 pages including cover
Hello. Here is the engineer's certification for 5549 New Oak Trail,
Burlington, NC 27217. Please page me at 513-9115 if you have any
questions.
Thank you for your help.
Randy Faircloth

FROM SIMMONS ENGINEERING FAX N0. : 336-222-4637 Sep. 26 2001 01:48PM P2 `
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CERTIFICATE OF OCCUPANCY
Al-AMAN= E COUNTY INSPECTIONS CONSTRUCTION PERMIT 23943--2001
124 West Eli Street Graham, NC 27253 [phone] FAX:[phone]
Description of work:SFE TWO STORY 4724 HEATED Applieant:INSULATING INC
Project Address: 5549 NEW OW TRAIL Tax Office Ill: 5 2 59 Census Tract: 214.00
Township:105-FAUCETTE Jurisdiction: O-COUNTY Subdivision:10HN NEWMAN Lot:5
Owner: KEMP MARK 6 HOPE
Contact:
Developer:
Architect:
Enqineer:
Directions: Notes:SHALL COMPLY WITH THE WATERSHED ORD SEE LETTER
FROM STATE ON SPECIAL SEPTIC SYSTEM L MT VERN RD
GO 1 3/4 M RDAD WILL BEND LEFT LOOK FOR 4 MAILBX
C3ENERAL. C.LiNS'TRUCTION Cost: 600000 PERMIT Cost: 567.00 09213E:001 SFE CLOSED
Contractor:RANDY L FAIRCLOTH CONST INC FAIRCLOTH RANDY L 5029 S NC 49 BURLINGTON NC 27215
License No: 33115 Classification:UNLIMITED SPLN18580196 227 2334 0 513 9115 0
Type of Construction:6 Occuppancq:R3 Propert use:SFR Saw Service:YES
Building9 size: 86X 86' 0 5F/Floor 5200 Square Feet Total O'Building height 2 Stories 0 Rooms 4 Bedrooms 5 Baths
basement:N/A Heated:N/A Fixtures:N/A Sewage-pump:N/A OX 01- 0 Square Ft On -premises sign:
PLUMSIIV13 CONSTRUCTIONV Cost : 8000 PERMIT' Cost: 83. 00 04122002 FILE CLOSED
Contractor:JEFF HORNER PLUMBING CO INC HORNER JEFF 228 ROM RD HAW RIVER NC 2725E
License No: 7969 Class ification:P CLASS I BUILDER 421 3690 0 260 6917 0
3 Bath tab I Dish Washer 0 Drink Fntn. 0 Disposal 0 Floor Drain 5 Lavatory 2 Shower 1 Sink
I Laundry Sink 1 Wash Machine 5 Water Closet I Water Heater 0 Urinal I Sewer Conn. I Water Conn. 0 Hot Tub/Spa
0 Icemaker 0 22 Total Fixtures
MECFIANICF7L CONSTRUCTION Cost: 24100 PERMIT Cost: 112.0Q 04122002 MEE CLOSED
Contractor:CHISHOLM SERVICE INC CHISHOLM MIKE P O BOX 1977 BURLINGTON NC 27216
License No: 6327 Classification:HI23 CLASS 1 ELEC U 226 0571 0 382 19H 0
Ductwork oniy:N/A Gas Piping onlyy:N/A
Source of-fuel:ELEC LP _ 108000 Cooling BTU iGO000 Freating-BTU O'Refrig. BTU'- 20BOOG'Total"BTU -`" 6
Type of heat:SPLIT Ox O'Restaurant hood 0 Unit heaters 0 Gas appliances 0 HP24HP36HiO0C48
ELE'CTKICAi_ CONSTRUCT'ION Cost: 5000 PERMIT Cost: 55.00 10022001 ELE CLOSED
Contractor:FREENAN ELECTRIC FREEMAN ALBERT L 506 ORANGE DR ELON COLLEGE NC 27244
License No: 10516 Classification LIMITED 584 9090 0 516 4522 0
New Service Occupancy:R3 400 Amps 240 Volts Under•ground:N/A Wire heat:N/A Wire Sign:N/A Saw-service:N/A LCD's:N/A
PriorService Occupancy; 0 Amps 0 Volts Power Co: Miscellaneous:
INBUL_Al-1011 CONSI-RUCTION Cost: 4000 PERMIT Cost: 25.00 ir5072,002 IEE CE_OSED
Contractor;INSULATING INCORPORATED RENN LARRY 1212 HOME CT RALEIGH NC 27603
License No: 0 Classification:SPECIAL INSULATION 800 933 68B4
Ceiling:BATTS 0.00"Thick R30 Walls:BATTS 0.00"Thick R14 Floors:BATTS 0.00"Thick R19 Thermal Envelope criteria:.
SF'RINKLEiR CONSTRUCTION Cost : 0 PERMIT Cost- 0. 00 00000000
Contractor:
SO'inkler 5yst2e: N/�E
rI (E :'4LFii1M CONiSTRUCTION Clost: 0 PERMIT Cost: C),()Cr 000Cr00CiCr
Contractor:
Fire alarm system:N/A
State Dept. of Insurance Plan Approval:N/A 0 Sheets Spec Approval:N/A 0 Sheets
State Dept. of Labor Boiler Approval:N/A Elevator Approval:N/A
Slate or reaeral Hazardous Waste Germit:NO Grading more than L 00 acres:NO Flood Hazard Area.NO WOCA:YES
Local Plans: Zoning: Health Permit: 0 Improvement:YES Completion:NO System:NEW WE Water$ 0 S/D ok:
Setbacks: 501Front 50'Back 20'Left 20'Right Buffer description. -NIA
This certificate issl.red pi.rr5,.rant to the requrirementei of North
Carolina General Stati_ttes 153A-363, 160A-423 certifying that
at the time of issuance, this structl_rre was in compliance to
all applicable state and local laws. This certificate does
not approve any t_:se or occr_rpancy of the premises with regard
to any work., material , or any other element of constr�_rction
not..r covered by slb.jectPe 'Mit. _
6
napector �e

01/12/1996 e3:29 9104497440 &ILL TURNER PAGE 01
Permit No. WQ0017761
April 5.2000
ENQINEER'S CERTIFICATION
Partial t! Final
as a duly. regisureci Professional Engineer in the State of North
Carolina, having been authorized to observe(00odieally; raeekly,.full time) the construction of the project,
Project Mante Location and County
for the Permittee hereby state that to the ppy tb,u �4 slilt.45
ensc was used in the observation of
the construction such that the construettvMIX CrCdldtst1"v�t3rr si�tsfantial'cbtnpiianae and intent of this
permit, the appro yeglans and spealfioations, and other,suppotting materials.
Signature s (lV�.�''+.-�-- Registration No.
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