WQ0040715_Application (FTSE)_20190320

Love, Barry F.
From: Luckman, Debbie
Sent: Monday, March 18, 2019 1:56 PM
To: Love, Barry F
Subject: FW: [External] RE: Fast Track application for Phillips Place Ph. 2
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Nonb Cuohna Dept of Euvuomeotal Quality
iaow 704-235-2111 (Office)
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From: Sean Kaufman[mailto:[e-mail]]
Sent: Monday, March 18, 2019 1:06 PM
To: Luckman, Debbie <[e-mail]>
Cc: Mellissa Oliver <[e-mail]>
Subject: [External] RE: Fast Track application for Phillips Place Ph. 2
Debbie,
There was a typo on the submitted application and the one you received should be for Phillips Place Ph. 1, which I
mailed an electronic copy to you for last Thursday. Everything else on the application is correct and after looking it over I
believe in only refers to the wrong phase number once in the 'Project Information' Section. Let me know if this is going
to cause a problem receiving approval moving forward.
Thanks,
SEAN KAUFMAN,
Designer I Charlotte I (o) 704.333.0325
LandDesign.com
From: Mellissa Oliver
Sent: Monday, March 18, 2019 11:24 AM
To: Kait Yeatts <[e-mail]>; Nathan Doolittle <[e-mail]>; Eric Pohlmann
<[e-mail]>; Sean Kaufman <[e-mail]>
Subject: RE: Fast Track application for Phillips Place Ph. 2
Yes —Sean and I can handle.

Deborah Luchman
EnvaommemW dssalmres and Crammer Service
North Carolina Depac6nad of Emmwmeosal Quality
704-235-2111(Ofice)
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LandDesip.
CREATING PLACES
THAT MATTER.
March 3, 2019
Mooresville Regional DENR Office
Division of Water Quality
610 E. Center Ave.
Mooresville, NC 28301
RE: Phillips Place Phase 1
LandDesign PN: 1018296
Dear Sir/Madam,
RECEIVED/NCDENR/DWR
MAR 15 2019
4'VQROS
MOORESVILLE- REGIONAL OFFICE
Lincoln Harris Investments are proposing to redevelop part of a 2.73 acre parcel from what is currently a
coffee shop, to a showroom with an attached kitchen.
We are classifying this project as replacement of an existing sewer with no new flow expected. The
proposed sewer system contains 370 L.F. of private 8" DIP. The private 8" DIP system will connect to an
existing Charlotte Water 8" system located within Fairview Road.
Included in this submittal is 2 copies of the Fast -Track Application form, $480 Application fee check, Color
Site Map and Certifications. Thank you for your assistance with this project, please feel free to contact me
at 704.333.0325 or [e-mail] should you have any questions and/or comments.
Sincerely,
I)A,k
Rob Keidel, PE
Senior Associate I Charlotte (o) 704.333.0325
LANDDESIGN.COM
223 N. GRAHAM STREET • CHARLOTTE, NC 28202 • 704.333.0325
CHARLOTTE • WASHINGTON D.C. • DALLAS • ORLANDO • SAN FRANCISCO • BOULDER

State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 - FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: 14 00L/0 15 (to be completed by DWR)
All items must be completed or the application will be returned RECEIVED/NCDENR/DWR
I. APPLICANT INFORMATION: MAR 15 20j9
I. Applicant's name: Phillips Place Owner, LLC (company, municipality, HOA, utility, etc.) WORDS
MOORESVILLE REGIONAL OFFICE
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: John Harris per 15A NCAC 02T .0106(b)
Title: President
4. Applicant's mailing address: 4725 Piedmont Row Drive
City: Charlotte State: NC Zip: 28210-
5. Applicant's contact information:
Phone number: [phone] Email Address: melanie.junenlincolnharris.com
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II. PROJECT INFORMATION: i ,p / `f y a I 4 i h o �� �e f f �o
r %1asR j P
1. Project name: Phillips Place Phase 2 5. n K t - Fm a �i
h
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date: _
If new construction but part of a master plan, provide the existing permit number: W000
3. County where project is located: Mecklenbure
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.146021 ° Longitude:-80.825280'
5. Parcel ID (if applicable): 18314113
(or Parcel ID to closest downstream sewer)
11IPCK�)`►6YiI1f117.1�Y111►1AC�)7i�I:11�1 [�Ii;l7
1. Professional Engineer: Robert Keidel License Number: 37425
Firm: LandDesign
Mailing address: 223 N. Graham St.
City: Charlotte State: NC Zip: 28202-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Sugar Creek W WTP Permit Number: NCO024937
Owner Name: Charlotte -Mecklenburg Utilities
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s): Charlotte Water
FORM: FTA 04-16 Page 1 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 NN/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 NN/A
3. If the Applicant is a Home/Property Owners' Association has an Operational Agreement (FORM HOA) been attached?
❑ Yes ❑No NN/A
4. Origin of wastewater: (check all that apply)
❑ Residential Owned N 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/Commercial 100 % Commercial
_ % Industrial (See 15A NCAC 02T .0103(20))
"Is there a Pretreatment Program in effect? ❑ Yes [-]No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes N 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','
No. of Units
Flow
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
0 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.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 0 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:
N Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f) & (g) ® Yes [-]No
➢ 19 A NCAC 0?T n' MM enntsin mininmm senarations that shall he nrovided for sewer systems:
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, HOW, 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'ools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.0305(s) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnaee
➢ If noncompliance with 02T.0305(f) or (a), 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 ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buffer Pennittin Branch
ranch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes [-]No
Per 15A NCAC 02T.0 I 05(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.04021 "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) at, the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

,III
Iq II
iEX. SEWER
PHILLIPS PLACE PHASE 1
CHARLOTTE, NORTH CAROLINA
2015 TOPO

PHILLIPS PLACE PHASE 1
CHARLOTTE, NORTH CAROLINA
2018 ARIAL

SOSID: 1798100
Date Filed: 1/29/2019 11:24:00 AM
Elaine F. Marshall
North Carolina Secretary of State
C2019 024 01030
State of North Carolina
Department of the Secretary of State
APPLICATION FOR CERTIFICATE OF AUTHORITY
FOR LIMITED LIABILITY COMPANY
Pursuant to §57D-7-03 of ibe General Statutes of North Carolina, the undersigned limited liability company hereby applies for a
Certiticate of Authority to transact business in the State of North Carolina, and for that purpose submits the following:
1. The name of the limited liability company is Phillips Place Owner, LLC
and if the limited liability company name is unavailable for use in the State of North Carolina, the name the limited
liability company wishes to use is .
2. The state or country under whose Laws the limited liability company was formed Is
Delaware
3. principal office information: (Select either a or b j
a. *The limited liability company has a principal office.
The principal office telephone number: 704-714-7600
The street address and county of the principal office of the limited liability company is:
Number and street: 4725 Piedmont Row Dr., Suite 800
Charlotte
State: NC ZipCode:•28210 County: Mecklenburg
The mailing address, tfdifferent from the street adrlress, of the principal office of the corporation is:
Number and Street:
City:
State:_ Zip Code: County:
b. ❑ The limited liability company does not have a principal office.
4. The name of the registered agent in the State of North Carolina is:
Cogency Global Inc.
The street address and county of the registered agent's office in the State of North Carolina is:
Number and Street:212 South. Tryon Street, Suite 1000
Charlotte State: NC
ZipCode:28281 County: Mecklenburg
6. The North Carolina mailing address, fdy)erenl from the street address, of the registered agent's office in the State of North
Carolina is:
Number and
Stale: NC
Zip Code: County:
BUSINESS REGISTRATION DIVISION P,O. BOX 29622 RALEIOH, NC 27626-0622
(Revised July 2017) (Form L-09)

Delaware Pagel
The First State
I, JEFFREY W. BULLOCK, SECRETARY OF STATE OF THE STATE OF
DELAWARE, DO HEREBY CERTIFY "PHILLIPS PLACE: OWNER, LLC" XS DULY
FORMED EWER THE LAWS OF THE STATE OF DELAWARE AND IS IN GOOD
STANDING AND HAS A LEG" EXISTENCE SO FAR AS THE RECORDS OF THIS
OFFICE SHOW, AS OF THE TWENTY-FOURTH DAY OF JANUARY, A.D, 2019,
AND I DO HEREBY FURTHER CERTIFY THAT THE SAID "PHILLIPS PLACE
OWNER, LLC" WAS FORMED ON THE TWENTY-SECOND DAY OF JANUARY, A.D.
2019,
AND I DO HEREBY FURTHER CERTIFY THAT THE ANNUAL TAXES HAVE BEEN
ASSESSED TO DATTI,
7247828 8300
SR# 20190463647
you may verifythis certificate online at corp.delaware.gov/authver.shtml
yn�, ;-I.
JkytiY IW 940o , W411WAr "-. .
Authentication: 202134554
Date: 01-24-19