WQ0044315_Application (FTSE)_20230418

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
Application Numbest �RWq 1 �N � (to be compteted by DwR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Lexington (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual
❑ Corporation ❑ General Partnership
❑ Federal
❑ State/County ® Municipal
3. Signature authority's name: Roger Jones, PE per 15A NCAC 02T .0106(b)
Title: Public Services Manager
4. Applicant's mailing address: 28 W. Center Street
City: Lexington State: NC
Zip: 27292-
5. Applicant's contact information:
Phone number: [phone]
Email Address: RDJones&Lexin tog nNC.gov
II. PROJECT INFORMATION:
1. Project name: Michael Alley to Arrington Rd. SS Ext.
❑ Privately -Owned Public Utility
❑ Other
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date: ,
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Davidson
4. Approximate Coordinates (Decimal Degrees): Latitude: 80.253814' Longitude:-39.847294'
5. Parcel ID (if applicable): 11-332-G-000-0014 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Nikole L. Kennerly License Number: 39649
Firm: Kennerly Engineering & Design, Inc.
Mailing address: 12133 N NC Hwy 150, Ste F
City: Winston-Salem State: NC Zip: 27127-
Phone number: [phone] Email Address: Nikole.kennerly(a,kennerlyengineering.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Lexington Regional Wastewater Treatment Plant Permit Number: NCO055786
Owner Name: City of Lexington
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ
2. Downstream (Receiving) Sewer Information: inch ❑ Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
FORM: FTA 06-21 Pagel of 5

VI. GENERAL REQUIREMENTS
1. 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. If the Applicant is a Home/Property Owners' Association, has an HOA/POA Operational Agreement (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ® N/A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel and/or Motels
® School / preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: _% Domestic 100 % Commercial % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ Yes ®No
➢ If yes, provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow 1,b
No. of Units
Flow
Daycare & Preschool facilities
25 gal/person
60
1500 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
1500 GPD
a See 15A NCAC 02T .0114(b), (d), (e)(1) 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.0114] shall be
determined using available flow data, water using fixtures,_ occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 1500 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow.
❑ Flow has already been allocated in Permit Number: Issuance Date:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 06-21 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
8 235 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 requirements is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: N/A
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: - °
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): gallons per minute (GPM) at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) 1 Length (feet) Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01C.Lb. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B):
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant 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
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 06-21 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(f) & gl? ❑ Yes ❑ No
15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'-Water mains (vertical - water over sewer preferred, 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, and associated wetlands.
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 associated with these waters (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WL.
10 feet
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
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
➢ If noncompliance with 02T.0305(fl or (g), see Section X.l of this application
*15ANCAC 02T.0305(e) contains alternatives where separations in 02T.0305(fl cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webpaQe
2. Does this project comply with the minimum separation requirements for water mains? [:]Yes ® No ❑ N/A
➢ If no, please refer to 15A NCAC 18C.0906(f) for documentation requirements and submit a separate document,
signed/sealed by an NC licensed PE, verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ❑ Yes ❑ No ® N/A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements for situations where separation cannot be met.
➢ No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ❑ Yes Basin name: ® No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 213.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ® No
or 401 Water Quality Certifications?
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications must be 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.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per 15A NCAC 02T.04021 "high -priority sewer" means any aerial sewer, sewer contacting surface waters,
siphon, or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through interference/conflict boxes require a variance approval.
➢ 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 permittee's individual System -Wide Collection permit.
FORM: FTA 06-21 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A 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, for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
concurrently with the approval of the permit, and projects requiring a variance approval may be subject to longer
review times. For proiects requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the project, the full technical review is required.
2. Professional Engineer's Certification:
I, Nikole L. Kennerl , attest that this application for _Michael Alley to Arrington Rd SS Ext.
(Professional Engineer's name from Application Item III.1.) (Project Name from Application Item II.I)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications, engineering calculations, and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 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. Misrepresentation of the application
information, including failure to disclose any design non-compliance with the applicable Rules and design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC 56.0701)
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
` 3 49
/� �/ � i
111110
I, __Roger Jones PE , attest that this application for _Michael Alley to Arrington Rd SS Ext.
(Signature Authority Name from Application Item 1.3.) (Project Name from Application Item II.1)
attest that this application 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. I understand that any
discharge of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included, 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.
Digitally signed by Roger Jones
Roger Jones DN cn=Roger Jones, -City of Le,ington, o,=Water Resources,
email=RDlOnes@Le,ingtonNC.gov, c=US
Signature: Date. 2023.04.121R04:33-U4.00 Date: 4/12/2023
FORM: FTA 06-21 Page 5 of 5

State of North Carolina
z1, �Sald Department of Environmental Quality
iv
Division of Water Resources
Division of Water Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: City of Lexington
Project Name for which now is being requested: Michael Alley to Arrington Rd SS Ext.
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.
a. WWTP Facility Name: Lexington Regional Wastewater Treatment Plant
b. WWTP Facility Permit #: NC0055786
All flows are in MGD
c. WWTP facility's permitted flow 6.5
d. Estimated obligated flow not yet tributary to the WWTP 0.2366
e. WWTP facility's actual avg. flow 2.8
f. Total flow for this specific request 0.0015 MGD
g. Total actual and obligated flows to the facility 3.0381
h. Percent of permitted flow used 46.7
I1. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / p fl, Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
* 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):
Downstream Permit Number:
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Roger Jones 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.
Digitally signed by Roger Jones �j
Roger Jones DN:cn=Rognes@exingt nNC.gxington, —Water Resources, 4/12/2023
email=[e-mail], c=DS
Date: 2023.04.1217:54:10 -04'00'
Signing Official Signature
Public Services Manager
Title of Signing Official
Date
Page 2 of 6
FTSE 10-18

{.:
KENNERLY
,ENGINEERING & DESIGN, INC.
12133 N. NC HWY 150, Ste. F
Winston-Salem, NC 27127
[phone]
[e-mail]
ALCON'S BILINGUAL LEARNING CENTER, INC.
1594. OLD US HWY 52
LEXINGTON, NC 27295
[phone]
MICHAEL ALLEY TO ARRINGTON RD
SANITARY SEWER EXTENSION APPLICATION
LEXINGTON, NC
Slp
Q �';7
A -
,/396649 Z
KED PROJECT #22-076
APRIL 2023

22-076 —Michael Alley to Arrington Rd
Sanitary Sewer Extension
Alcon's Bilingual Learning Center, Inc..
1594 Old US Hwy 52, Lexington, NC
NARRATIVE
This Project is located in Lexington, which is in Davidson County, North Carolina and is
proposed as the expansion of an existing Sanitary Sewer Line to serve an existing business that
is currently utilizing a septic system.
The expansion will include 2 new manholes and approximately 250 LF of 8" PVC Sanitary
Sewer Pipe. This expansion will serve the a specific parcel providing accessibility to other
parcels in the general vicinity.The flow has been accepted by the City of Lexington. Lexington
Utilities will take over the sewer as part of their public system.
KENNERLY
Sanitary Sewer Extension Application
_ :. _ � I � ENGINEERING & DESIGN. INC. April 2023

Non -Residential Sewer Worksheet ,
Adapt d from 15A N. C.A. C. 02T .0114
Please fill in the appropriate yellow boxes
Project Name:
San. Sewer Ext. for Alcon's Bilingual U.
Project Address:
Arrington Dr. & Michael Alley, Lexingt
Project Engineer/Developer:
Nikole Kennerly/ Kennerly Engineering
Telephone:
336.775.2118
Type of Establishment
Units
bemand
per Unit
d
Average Demand
g
(gpo)
Barber and beauty shops
Barber Shops(per chair
50
0
Beauty Shops(per booth or bowl
125
0
Businesses, offices and factories
General Business and office facilities(per employee/shift)
25
0
Factories, excluding industrial waste(per employee/shift)
25
0
Factories or businesses with showers or food preparation
(per employee/shift)
35
0
Warehouse(per loading bay)
100
0
Warehouse - self storage (not including caretaker residence)
(per unit
1
0
Churches
Churches without kitchens, day care or cams(per seat
3
0
Churches with kitchen(per seat
5
0
Churches providing day care or camps
(perperson-child & employee)
25
0
Fire, rescue and emergency response facilities
Fire or rescue stations without on site staff(perperson)
25
0
Fire or rescue stations with on -site staff(perperson/shift)
50
1 0
Food and drink facilities
Banquet, dining hall(per seat
30
0
Bars, cocktail lounges(per seat
20
0
Caterers(per 100 SF floors ace
50
0
Restaurant, full Service(per seat
40
0
Restaurant, single service articles(per seat
20
0
Restaurant, drive-in(per cars ace
50
0
Restaurant, carry out only (per 100 SF floors ace
50
0
Institutions, dining halls(per meal
5
0
Deli(per 100 SF floors ace
40
0
Bake(per 100 SF floors ace
10
0
Meat department, butcher shop or fish market
(per 100 SF floors ace
75
0
SpecialtV food stand or kiosk(per 100 SF floors ace
50
0
Hotels and Motels
Hotels, motels and bed & breakfast facilities,
without in -room cooking facilities(per room
120
0
Hotels and motels, with in -room cooking facilities(per room
175
0
Resort hotels(per room
200
0
Cottages, cabins(per unit
200
0
Medical, dental, veterinary facilities
Medical or dental offices(per practitioner/shift)250 0

Veterinary offices not including boarding) (perpractitioner/shift)
250
0
Veterinary hospitals, kennels, animal boarding facilities
(per pen, cage, kennel or stall
20
0
Hospitals, medical(per bed
300
0
Hospitals, mental(per bed
150
0
Convalescent, nursing, rest homes without laundry facilities
(per bed
60
0
Convalescent, nursing, rest homes with laundry facilities
(per bed
120
0
Residential care facilities(perperson)
60
0
Parks, recreation, camp grounds, R-V parks and other outdoor activity facilities
Campgrounds with comfort station, without water or sewer
hookups(per campsite)
75
0
Campgrounds with water and sewer hookups(per campsite)
100
0
Campground dump station facility (per space)
50
0
Construction, hunting or work camps with flush toilets(perperson)
60
0
Construction, hunting or work camps with chemical or portable
toilets(perperson)
40
0
Parks with restroom facilities(per plumbing fixture
250
0
Summer camps without food preparation or laundry facilities
(perperson)
30
0
Summer camps with food preparation and laundry facilities
(perperson)
60
0
Swimming pools, bathhouses and spas(perperson)
10
0
Schools, preschools and day care
Day care and preschool facilities
60
25
1500
Schools with cafeteria, gym and showers
15
0
Schools with cafeteria
12
0
Schools without cafeteria, gym or showers
10
0
Boarding schools(perperson-student & employee)
60
0
Service stations, car wash facilities
Service stations, gas stations(per plumbing fixture
250
0
Car wash facilities(per bay)
1200
0
Sports centers
Bowling center(per lane
50
0
Fitness, exercise, karate or dance center(per 100 SF
50
0
Tennis, racquet ball(per court
50
0
Gymnasium(per 100 SF
50
0
Golf course with only minimal food service(per plumbing fixture
250
0
Country clubs per member orpatron)
60
0
Mini golf, putt-putt(per plumbing fixture
250
0
Go-kart, motocross(per plumbing fixture
250
0
Batting cages, driving ranges(per plumbing fixture
250
0
Marinas without bathhouse(per slip)
10
0
Marinas with bathhouse(per slip)
30
0
Video game arcades, pool halls(per plumbing fixture
250
0
Stores, shopping centers, malls and flea markets
Auto, boat, recreational vehicle dealerships/showrooms
with restrooms(per plumbing fixture
125
0
Convenience stores, with food preparation(per 100 SF
60
0
Convenience stores, without food preparation
(per plumbing fixture
250
0

Flea markets(per stall
30
0
Shopping centers and malls with food service(per 1000 SF
130
0
Stores and shopping centers without food service(per 1000 SF
100
0
Misc.
Self service laundry facilities(per machine
500
0
Public access restrooms(per plumbing fixture
325
0
Stadiums, auditoriums, theaters, community centers(per seat
5
0
Transportation terminals — air, bus, train, ferry, port and dock
5
0
Totals
Version 04117123

'
4- O--N !n O
cCCp •}, , � L N
N
Q) p ::
Ln
O W
Li
7m
—
�,
1'•.
�1
l.1 Q LL iQ L
I C;
Q cn N r Q M
l' i,UT
y 4�
`+-
p..w v
I
oo�
m m
f
i
0�
f
o Ln E V,
00 _
N
O X
W
1 .1
W (6 Ln
Q U)
i-i..l QD
Cc
a l
+ I O
in c
'4-1
f�
L
q:
D U:
Z
LA
':sue,..
rw
•a-�--L
1 `F �•-+�''�
!
�. ,
O._
�
�
W
m
m
dr a
f
te
i;-
f
' 1
i
1:
'
.I
x.. ..m�,�s.:krc,.,a„�,,,,�•��,._
..,� -....
, w..e•.xw.s....ra' ..,- >.�'"`.'�'^'�%`'-_
Ij
.

U
'x
•
tD
O
i
Q
LO
gym.
�'
f
O
i
y' Xis f i
CSm i
aY
U f"r. p.
h>
�frf�
S
on
R.
ff�B .i�{3 '��e•l. o-i Tr
+ 4-' o
r
W"
O N
CDO N
N

KENNERLY_
ENGINEERING & DESIGN, INC.
NC Department of
TRANSMITTAL LETTER: Environmental 0'l;_
Received
Date: April 14, 2023
To: Jenny Graznak
Assistant Regional Supervisor
NCDWQ-Water Resources Quality
450 Hanes Mill Road, Suite 300
Winston-Salem, NC 27103
From: Nikole L. Kennerly, PE
Project Name: Michael Alley to Arrington Rd SS Ext
Project Number: 22-076
We transmit:
❑ by mail
❑ by overnight carrier
❑ by courier
® Hand Delivered
The following:
❑ prints
❑ specifications
❑ change order
❑ shop drawings
® Application
For:
® your approval
® your review
❑ revision/submission
❑ distribution
El
APR 18 2023
Winston-Salem
Regional Office
❑ as requested by
❑ as approved by
❑ please acknowledge
receipt
❑ return enclosures
Copies
Date
Number
Description
1
4/14/23
Original Application (FTA 06-21
1
4/14/23
Copy of Application
1
4/14/23
Flow Acceptance form FTSE 10-18
1
4/14/23
Check for $480
2
Calculations
Comments: Please find attached one (1) Original Application and (1) Copy of the
Application, Flow Acceptance Form, a check for $480, 2 sets of calculations for the
above referenced project.
If enclosures are not as noted, please notify us at once.
Signed:
Phone: [phone]
12133 N. HWY 150, Ste. F Winston-Salem, NC 27127 Fax: [phone]
www.kennerlyengineering.com

KENNERLY
ENGINEERING & DESIGN, INC.
Jenny Graznak
Assistant Regional Supervisor
NC Environmental Quality Water Resources Section
450 Hanes Mill Road
Winston-Salem, NC 27103
RE: Project Name: Michael Alley to Arrington Rd SS Ext.
County: Davidson
City: Lexington
Address: 1594 Old US HWY 52
Submitted by: Kennerly Engineering.
Dear Ms. Graznak,
April 14, 2023
NC Department of
Enviror�lient la Quality
A'
Winston-Salem
Regional Office
Kennerly Engineering & Design, Inc. (KED) submits to you for your review, comment, and
approval two (2) copies of the application, two (2) sets of calculations and a check for the permit
fee of the above referenced project.
The proposed 8" PVC Sanitary Sewer Line will be installed to serve Alcon's Bilingual Learning
Center. The sanitary sewer line will be placed under Arrington Rd (SR 1846) and Michael Alley
(SR 1981) to serve the subject property. The proposed sanitary sewer line has been designed
with a slope of 0.5% in an attempt to avoid the existing water line along the north side of Arrington
Drive. The proposed sanitary sewer line for this permit will be approximately 235 linear feet.
Should you have any questions, please do not hesitate to contact us at 336.775.2118.
Sincerely,
Nikole L Kennerly, PE
President
Enclosures: 1 signed original application, 1 copy of the application, 1 check for the permit fee
and 2 sets of calculations.
Phone: [phone]
12133 N. HWY 150, Ste. F Winston-Salem, NC 27127 Fax: [phone]
www.kennerlyengineering.com