HomeMy WebLinkAboutNC0024970_Application (ATC)_20191014 APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 1
State of North Carolina
Department of Environmental Quality
Division of Water Resources
SECTION 1: INSTRUCTIONS AND INFORMATION
A. The Division of Water Resources will accept this application package for review only if all of the items are provided and the
application is complete. Failure to submit all of the required items will result in the application package being returned as incomplete
per 15A NCAC 02T .0105(b).
B. Plans and specifications must be prepared in accordance with 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute
133-3, North Carolina General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES
Wastewater Treatment Facilities.
C. The plans and specifications submitted must represent a completed final design that is ready to advertise for bid.
D. Any content changes made to this Form ATC-12-14 shall result in the application package being returned.
E. The Applicant shall submit ONE ORIGINAL and ONE DIGITAL COPY (CD) of the application, all supporting documentation and
attachments. All information must be submitted bound or in a 3-ring binder, with a Section tab for each Section, except the
Engineering Plans.
F. Check the boxes below to indicate that the information is provided and the requirements are met.
G. If attachments are necessary for clarity or due to space limitations, such attachments are considered part of the application
package and must be numbered to correspond to the item referenced.
H. For any project that requires review under the State Environmental Policy Act (SEPA), an Authorization to Construct cannot be
issued prior to the completion of a State Clearinghouse advertisement period for a FONSI, EIS, etc. unless the project qualifies for
a Determination of Minor Construction Activity.
I. For more information, visit the Division of Water Resources web site at: https://deq.nc.gov/about/divisions/water-resources/water-
resources-permits/wastewater-branch/npdes-wastewater/authorization-to-construct.
J. In addition to this Authorization to Construct, the Applicant should be aware that other permits may be required from other Sections
of the Division of Water Resources (for example: reclaimed water facilities permits; Class A or B biosolids residuals permit).
SECTION 2: APPLICANT INFORMATION AND PROJECT DESCRIPTION
A. APPLICANT
Applicant’s name Charlotte Water
Signature authority’s name per 15A NCAC 02T .0106(b) David Czerr
Signature authority’s title Interim Director
Complete mailing address 5100 Brookshire Blvd., Charlotte, NC 28216
Telephone number (704) 391-5159
Email address dwczerr@ci.charlotte.nc.us
B. PROFESSIONAL ENGINEER
Professional Engineer’s name Peter Schuler
Professional Engineer’s title Vice President
North Carolina Professional Engineer’s License No. 19323
Firm name Brown and Caldwell
Firm License number F-0785
Complete mailing address 309 E. Morehead St. Suite 160, Charlotte, NC 28202
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 2
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Telephone number 704.373.7111
Email address pschuler@brwncald.com
C. NPDES PERMIT
NPDES Permit number NC0024970
Current Permitted flow (MGD) – include permit
flow phases if applicable 64.0 MGD Monthly Average
D. PROJECT DESCRIPTION
Provide a brief description of the project: The Charlotte Water design-build McAlpine Creek Wastewater Management Facility
(WWMF) Reliability and Process Improvements (RPI) Project includes improvements to the secondary treatment processes. The
overall project includes secondary clarifier equipment replacement, aeration tank equipment replacement, upgrades to the
process aeration blower facilities, miscellaneous hydraulic improvements, biological process modeling, hydraulic modeling,
process aeration modeling and unit process condition assessments. Construction Package CP-4A includes modifications to
Aeration Tanks (ATs) 15 through 19. The project includes replacement of the existing anerobic zone mixer with top-mounted
hyperboloid mixer to improve the mixing efficiency. The existing AT aeration system will be upgraded to include new flexible
membrane disc diffusers, new process control instrumentation, new overhead process aeration piping, and installation of new
aeration control valves within each AT to enhance process control and increase aeration efficiency. Other AT improvements
include replacement of the effluent weir and AT effluent channel ferric chloride feed point as well as structural repairs to the
tank walls. The CP-4A project includes HVAC and electrical upgrades to Building 10 which provide the power and
instrumentation controls to ATs 15 – 19.
SECTION 3: APPLICATION ITEMS REQUIRED FOR SUBMITTAL FOR ALL PROJECTS
A. Cover Letter
The letter must include a request for the Authorization to Construct; the facility NPDES Number; a brief project description
that indicates whether the project is a new facility, facility modification, treatment process modification, or facility expansion;
the construction timeline; and a list of all items and attachments included in the application package.
If any of the requirements of 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina
General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment
Facilities are not met by the proposed design, the letter must include an itemized list of the requirements that are not met.
B. NPDES Permit
Submit Part I of the Final NPDES permit for this facility that includes Part A (Effluent Limitations and Monitoring Requirements)
for the monthly average flow limit that corresponds to the work that is requested for this project.
C. Special Order by Consent
If the facility is subject to any Special Orders by Consent (SOC), submit the applicable SOC.
Not Applicable.
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 3
State of North Carolina
Department of Environmental Quality
Division of Water Resources
D. Finding of No Significant Impact or Record of Decision
Submit a copy of the Finding of No Significant Impact or Record of Decision for this project.
Provide a brief description of any of the mitigating factors or activities included in the approved Environmental Document
that impact any aspect of design of this project, if not specified in the Finding of No Significant Impact or Record of Decision.
___________________________________________________________________________________________
___
Not Applicable.
E. Engineering Plans
Per 15A NCAC 02T .0504(c)(1), submit one set of detailed plans that have been signed, sealed and dated by a North Carolina
Licensed Professional Engineer.
Per 21 NCAC 56 .1103(a)(6), the name, address and License number of the Licensee’s firm shall be included on each sheet of
the engineering drawings.
Plans must be labeled as follows: FINAL DRAWING – FOR REVIEW PURPOSES ONLY – NOT RELEASED FOR CONSTRUCTION.
15A NCAC 02H .0124 requires multiple (dual at a minimum) components such as pumps, chemical feed systems, aeration
equipment and disinfection equipment. Is this requirement met by the design? Yes or No. If no, provide an
explanation: This requirement is satisfied by the WWMF 28 aeration tanks (ATs). The CP4A project includes modifications to
5 ATs and the remaining 23 ATs will be modified under later construction packages.
Plans shall include:
Plans for all applicable disciplines needed for bidding and construction of the proposed project (check as appropriate):
Civil Not Applicable
Process Mechanical Not Applicable
Structural Not Applicable
Electrical Not Applicable
Instrumentation/Controls Not Applicable
Architectural Not Applicable
Building Mechanical Not Applicable
Building Plumbing Not Applicable
Plan and profile views and associated details of all modified treatment units including piping, valves, and equipment (pumps,
blowers, mixers, diffusers, etc.)
Are any modifications proposed that impact the hydraulic profile of the treatment facility? Yes or No. If yes, provide
a hydraulic profile drawing on one sheet that includes all impacted upstream and downstream units. The profile shall include
the top of wall elevations of each impacted treatment unit and the water surface elevations within each impacted treatment
unit for two flow conditions: (1) the NPDES permitted flow with all trains in service and (2) the peak hourly flow with one
treatment train removed from service.
Are any modifications proposed that impact the process flow diagram or process flow schematic of the treatment facility?
Yes or No. If yes, provide the process flow diagram or process flow schematic showing all modified flow paths including
aeration, recycle/return, wasting, and chemical feed, with the location of all monitoring and control instruments noted.
F. Engineering Specifications
Per 15A NCAC 02T .0504(c)(2), submit one set of specifications that have been signed, sealed and dated by a North Carolina
Licensed Professional Engineer.
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 4
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Specifications must be labeled as follows: FINAL SPECIFICATIONS – FOR REVIEW PURPOSES ONLY – NOT RELEASED FOR
CONSTRUCTION.
Specifications shall include:
Specifications for all applicable disciplines needed for bidding and construction of the proposed project (check as
appropriate):
Civil Not Applicable
Process Mechanical Not Applicable
Structural Not Applicable
Electrical Not Applicable
Instrumentation/Controls Not Applicable
Architectural Not Applicable
Building Mechanical Not Applicable
Building Plumbing Not Applicable
Detailed specifications for all treatment units and processes including piping, valves, equipment (pumps, blowers, mixers,
diffusers, etc.), and instrumentation.
Means of ensuring quality and integrity of the finished product including leakage testing requirements for structures and
pipelines, and performance testing requirements for equipment.
Bid Form for publicly bid projects.- Project is design-build.
G. Construction Sequence Plan
Construction Sequence Plan such that construction activities will not result in overflows or bypasses to waters of the State.
The Plan must not imply that the Contractor is responsible for operation of treatment facilities. List the location of the
Construction Sequence Plan as in the Engineering Plans or in the Engineering Specifications or in both: Engineering
Specifications Section 01 12 16.
H. Engineering Calculations
Per 15A NCAC 02T .0504(c)(3), submit one set of engineering calculations that have been signed, sealed and dated by a North
Carolina Licensed Professional Engineer; the seal, signature and date shall be placed on the cover sheet of the calculations.
For new or expanding facilities and for treatment process modifications that are included in Section 4.C, the calculations shall
include at a minimum:
Demonstration of how peak hour design flow was determined with a justification of the selected peaking factor. Not
Applicable because the WWMF design flows have not changed.
Influent pollutant loading demonstrating how the design influent characteristics in Section 4.B.2 of this form were
determined. Not Applicable because WWMF design loading are not changed with construction project and will not change
the unit process performance or impact the effluent pollutant loading.
Pollutant loading for each treatment unit demonstrating how the design effluent concentrations in Section 4.B.2 of this form
were determined. Not Applicable because the upgrades do not modify the unit process design and will not change the effluent
pollutant loading.
Hydraulic loading for each treatment unit. Not Applicable because no hydraulic changes were made to any treatment units.
Sizing criteria for each treatment unit and associated equipment (blowers, mixers, pumps, etc.) – See McAlpine Creek WWMF
RPI Aeration Tank Upgrades Preliminary Design Report for sizing of aeration headers and diffuser counts.
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 5
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Total dynamic head (TDH) calculations and system curve analysis for each pump specified that is included in Section 4.C.6. –
Not applicable because no pumps were specified for this design.
Buoyancy calculations for all below grade structures. Not Applicable because no below grade structures are included in design
and tanks are existing.
Supporting documentation that the specified auxiliary power source is capable of powering all essential treatment units. –
Not Applicable because existing plant power will be used including any necessary auxiliary power. However, WWMF has
several generators capable of powering all essential treatment units.
I. Permits
Provide the following information for each permit and/or certification required for this project:
Permit/Certification
Not
Applicable
Date
Submitted
Date
Approved
Permit/
Certification
Number
If Not Issued Provide
Status and Expected
Issuance Date
Dam Safety N/A
Soil Erosion and Sediment Control N/A
USCOE / Section 404 Permit N/A
Water Quality Certification (401) N/A
USCOE / Section 10 N/A
Stormwater Management Plan N/A
CAMA N/A
NCDOT Encroachment Agreement N/A
Railroad Encroachment Agreement N/A
Other:
J. Residuals Management Plan
For all new facilities, expanding facilities, or modifications that result in a change to sludge production and/or sludge
processes, provide a Residuals Management Plan meeting the requirements of 15A NCAC 02T .0504(j) and 15A NCAC 02T
.0508; the Plan must include:
A detailed explanation as to how the generated residuals (including trash, sediment and grit) will be collected, handled,
processed, stored, treated, and disposed.
An evaluation of the treatment facility’s residuals storage requirements based upon the maximum anticipated residuals
production rate and ability to remove residuals.
A permit for residuals utilization or a written commitment to the Applicant from a Permittee of a Department approved
residuals disposal/utilization program that has adequate permitted capacity to accept the residuals or has submitted a
residuals/utilization program application.
If oil, grease, grit or screenings removal and collection is a designated unit process, a detailed explanation as to how the
oil/grease will be collected, handled, processed, stored and disposed.
Not Applicable.
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 6
State of North Carolina
Department of Environmental Quality
Division of Water Resources
SECTION 4: PROJECT INFORMATION
A. WASTEWATER TREATMENT PLANT FLOW INFORMATION – COMPLETE FOR NEW OR EXPANDING FACILITIES
1. Provide the following flow information:
Plant Flows
Existing Plant Design 64.0 MGD
Current NPDES Permit Limit 64.0 MGD
Current Annual Average
(past 12 months) 47.9 MGD
For Past 12 Months:
Start Date: January/2018
End Date: December/2018
For Past 24 Months:
Start Date: January/2017
End Date: December/2018
Maximum Month 61.9 MGD 61.9 MGD
Maximum Day 104.9 MGD 104.9 MGD
Peak Hour 110 MGD 110 MGD
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 7
State of North Carolina
Department of Environmental Quality
Division of Water Resources
B. WASTEWATER TREATMENT FACILITY DESIGN INFORMATION – COMPLETE FOR NEW OR EXPANDING FACILITIES AND
FOR TREATMENT PROCESS MODIFICATIONS
1. Have all of the requirements of 15 NCAC 02H. 0100, 15A NCAC 02T, North Carolina General Statute 133-3, North Carolina
General Statute 143-215.1, and Division of Water Resources Minimum Design Criteria for NPDES Wastewater Treatment
Facilities been met by the proposed design and specifications? Yes or No. If no, provide justification as to why the
requirements are not met, consistent with 15A NCAC 02T .0105(n): _ _______________
___ _ ___
2. Provide the design influent and effluent characteristics that are used as the basis for the project design, and the NPDES
permit limits for the following parameters:
Parameter
Influent
Concentration -
Current Annual
Average (past
12 months) if
Available
Project Basis of Design
NPDES Permit Limits
(monthly average)
Design Influent
Concentration
(Must be
supported by
Engineering
Calculations
[Section 3.H])
Design Influent
Load
(Must be
supported by
Engineering
Calculations
[Section 3.H])
Design Effluent
Concentration and/or
Load
Ammonia Nitrogen
(NH3-N) 27.6 mg/L 23.0 mg/L 12,300 lb/day
1.0 mg/L Summer 1.0 mg/L Summer
1.9 mg/L Winter 1.9 mg/L Winter
Biochemical
Oxygen Demand
(BOD5)
265 mg/L 345 mg/L 184,100 lb/day
4.0 mg/L Summer 4.0 mg/L Summer
8.0 mg/L Winter 8.0 mg/L Winter
Fecal Coliform 200 per 100 mL 200 per 100 mL
Nitrate + Nitrite
Nitrogen (NO3-N +
NO2-N)
N/A mg/L N/A mg/L
Total Kjeldahl
Nitrogen 45.9 mg/L
Total Nitrogen
N/A mg/L N/A mg/L
N/A lb/year N/A lb/year
Total Phosphorus 5.7 mg/L 6.9 mg/L 3,700 lb/day
2.0 mg/L 2.0 mg/L
1,067 lb/year 1,067 lb/year
Total Suspended
Solids (TSS) 339 mg/L 440 mg/L 234,900 lb/day 15.0 mg/L 15.0 mg/L
3. Based on the “Project Basis of Design” parameters listed above, will the proposed design allow the treatment facility to
meet the NPDES Permit Limits listed above? Yes or No. If no, describe how and why the Permit Limits will not be
met:
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 8
State of North Carolina
Department of Environmental Quality
Division of Water Resources
4. Per 15A NCAC 02T .0505(j), by-pass and overflow lines are prohibited. Is this condition met by the design? Yes or No
If no, describe the treatment units bypassed, why this is necessary, and where the bypass discharges:
5. Per 15A NCAC 02T .0505(k), multiple pumps shall be provided wherever pumps are used. Is this condition met by the
design? Yes or No. If no, provide an explanation: Pumps are not included in this design.
6. Per 15A NCAC 02T .0505(l), power reliability shall be provided consisting of automatically activated standby power supply
onsite capable of powering all essential treatment units under design conditions, or dual power supply shall be provided
per 15A NCAC 02H. 0124(2)(a). Is this condition met by the design? Yes or No. If no, provide (as an attachment
to this Application) written approval from the Director that the facility: Existing plant power supply including standby power
will be used.
Has a private water supply that automatically shuts off during power failures and does not contain elevated water
storage tanks, and
Has sufficient storage capacity that no potential for overflow exists, and
Can tolerate septic wastewater due to prolonged detention.
7. Per 15A NCAC 02T .0505(o), a minimum of 30 days of residual storage shall be provided. Is this condition met by the
design? Yes or No. If no, explain the alternative design criteria proposed for this project in accordance 15A NCAC
02T .105(n): The design does not impact the generation of residuals.
8. Per 15A NCAC 02T .0505(q), the public shall be prohibited from access to the wastewater treatment facilities. Explain how
the design complies with this requirement: No modifications were made to existing perimeter controls that prevent access
to the facility by the public.
9. Is the treatment facility located within the 100-year flood plain? Yes or No. If yes, describe how the facility is
protected from the 100-year flood: Flood walls exist in areas that could be affected.
C. WASTEWATER TREATMENT UNIT AND MECHANICAL EQUIPMENT INFORMATION – COMPLETE FOR NEW OR
EXPANDING FACILITIES AND FOR MODIFIED TREATMENT UNITS
1. PRELIMINARY AND PRIMARY TREATMENT (i.e., physical removal operations and flow equalization):
Treatment Unit No. of
Units Type Size per Unit Plan Sheet
Reference
Specification
Reference
Calculations
Provided?
(Yes or No)
Manual Bar Screen MGD at peak hourly flow
Mechanical Bar
Screen MGD at peak hourly flow
Grit Removal MGD at peak hourly flow
Flow Equalization -- gallons
Primary Clarifier Circular ft diameter; ft side
water depth
Primary Clarifier Rectangular square feet; ft side
water depth
Other
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 9
State of North Carolina
Department of Environmental Quality
Division of Water Resources
2. SECONDARY TREATMENT (BIOLOGICAL REACTORS AND CLARIFIERS) (i.e., biological and chemical processes to remove
organics and nutrients)
Treatment Unit No. of
Units Type Size per Unit Plan Sheet
Reference
Specification
Reference
Calculations
Provided?
(Yes or No)
Aerobic Zones/
Tanks
5 Zones
/ 5 ATs
Activated
Sludge 116,300 gallons per zone 46 51 33 Yes
Anoxic Zones/
Tanks gallons
Anaerobic
Zones/Tanks
1 Zone /
5 ATs
Activated
Sludge 145,400 gallons per zone 46 41 23 No
Sequencing Batch
Reactor (SBR) -- gallons
Membrane
Bioreactor (MBR) -- gallons
Secondary Clarifier Circular ft diameter; ft
side water depth
Secondary Clarifier Rectangular square feet; ft
side water depth
Other
3. TERTIARY TREATMENT
Treatment Unit No. of
Units Type Size per Unit Plan Sheet
Reference
Specification
Reference
Calculations
Provided?
(Yes or No)
Tertiary Clarifier Circular ft diameter; ft
side water depth
Tertiary Clarifier Rectangular square feet; ft
side water depth
Tertiary Filter square feet
Tertiary Membrane
Filtration square feet
Post-Treatment
Flow Equalization -- gallons
Post-Aeration gallons
Other
4. DISINFECTION
Treatment Unit No. of
Units Type Size per Unit Plan Sheet
Reference
Specification
Reference
Calculations
Provided?
(Yes or No)
Ultraviolet Light
(Parallel; in
series)
gal/day per bank at
peak hourly flow;
number of banks;
number of lamps/bank
Chlorination (Gas;
tablet; liquid)
gallons of contact
tank/unit
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 10
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Dechlorination (Gas;
tablet; liquid)
gallons of contact
tank/unit
5. RESIDUALS TREATMENT
Treatment Unit No. of
Units Type Size per Unit Plan Sheet
Reference
Specification
Reference
Calculations
Provided?
(Yes or No)
Gravity Thickening
Tank square feet; ft side
water depth
Mechanical
Thickening/
Dewatering
dry lb/hour
Aerobic Digestion gallons
Anaerobic
Digestion gallons
Composting dry lb/hour
Drying dry lb/hour
Other
6. PUMP SYSTEMS (include influent, intermediate, effluent, major recycles, waste sludge, thickened waste sludge and plant
drain pumps)
Location No. of
Pumps Purpose Type
Capacity of
each pump Plan Sheet
Reference
Specification
Reference GPM TDH
7. MIXERS
Location No. of
Mixers Purpose Type
Power of
each Mixer
(HP)
Plan Sheet
Reference
Specification
Reference
Aeration Tank 15 1
Anaerobic zone
mixing to maintain
solids in suspension
Top-Mounted
Hyperboloid Mixer 3 HP D-10-121 46 41 23
Aeration Tank 16 1
Anaerobic zone
mixing to maintain
solids in suspension
Top-Mounted
Hyperboloid Mixer 3 HP D-10-121 46 41 23
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 11
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Aeration Tank 17 1
Anaerobic zone
mixing to maintain
solids in suspension
Top-Mounted
Hyperboloid Mixer 3 HP D-10-125 46 41 23
Aeration Tank 18 1
Anaerobic zone
mixing to maintain
solids in suspension
Top-Mounted
Hyperboloid Mixer 3 HP D-10-125 46 41 23
Aeration Tank 19 1
Anaerobic zone
mixing to maintain
solids in suspension
Top-Mounted
Hyperboloid Mixer 3 HP D-10-125 46 41 23
8. BLOWERS
Location No. of
Blowers Purpose Type
Capacity of
each Blower
(CFM)
Plan Sheet
Reference
Specification
Reference
9. ODOR CONTROL
Location No. of
Units Purpose Type Plan Sheet
Reference
Specification
Reference
D. SETBACKS – COMPLETE FOR NEW WASTEWATER TREATMENT STRUCTURES
1. The minimum distance for each setback parameter to the wastewater treatment/storage units per 15A NCAC 02T .0506(b)
are as follows:
Setback Parameter
Minimum Distance
Required from Nearest
Treatment/Storage
Unit
Is Minimum Distance
Requirement met by the
Design? If “No”, identify
Setback Waivers in Item D.2
Below
Any habitable residence or place of assembly under separate
ownership or not to be maintained as part of the project site 100 ft Yes No
Any private or public water supply source 100 ft Yes No
Surface waters (streams – intermittent and perennial, perennial
waterbodies, and wetlands) 50 ft Yes No
Any well with exception of monitoring wells 100 ft Yes No
Any property line 50 ft Yes No
APPLICATION FOR AUTHORIZATION TO CONSTRUCT PERMIT (FORM ATC-12-14)
Application for Authorization to Construct Permit (FORM ATC-12-14) Page 12
State of North Carolina
Department of Environmental Quality
Division of Water Resources
2. Have any setback waivers been obtained per 15A NCAC 02T .0506(d)? Yes or No. If yes, have these waivers been
written, notarized and signed by all parties involved and recorded with the County Register of Deeds? Yes or No. If
no, provide an explanation: There are no new structures.