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HomeMy WebLinkAboutWQ0037754_Application_20150427RECEIVEu State of North Carolina Department of Environment and Natural Resources DWR APR 2 7 2015 Division of Water Resources �r FAST -TRACK APPLICATION (FTA 08-13) Division of Water ResourcAENR-FAYETTEVILLE REGIONAL OfWIGRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS General - When submitting this application, please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of requested additional information. For more information, visit the Surface Water Section's Collection Systems or; contact the Regional Office serving your county Unless otherwise noted, the Applicant shall submit one original and one copy of the application and supporting documentation to the appropriate Regional Office (see page 6). A. Cover Letter: E Include a brief project narrative describing the final design (i.e system and/or pump station to ultimately serve 500 homes, but flow for only 100 homes being requested now). For modifications, clearly explain the reason for the modification (i.e. adding another phase, changing line size, length, etc). B. Application Form (FTA 08-13): Ei Submit the completed and appropriately executed Fast -Track (FTA 08-13) Application. Any unauthorized content changes to this form shall result in the application being returned. If necessary for clarity or due to space restrictions, attachment to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer. You do not need to submit detailed plans and specifications unless you respond NO to item B(13). ® The Professional Engineer's Certification of the application shall be signed, sealed and dated by a North Carolina licensed Professional Engineer. ® The Applicant's Certification of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A NCAC 02T .0106(b). C. Application Fee: E Submit a check in the amount of $480 to: North Carolina Department of Environment and Natural Resources (NCDENR). y Checks shall be dated within 90 days of application submittal. D. Certificate of Public Convenience and Necessity (For Privately -Owned Public Utilities Only): ❑ Per 15A NCAC 02T .0115(a)(1), provide two copies of the Certificate of Public Convenience and Necessity from the North Carolina Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer extension, or ❑ Provide two copies of a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an application for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval is expected. ❑ The project name in the CPCN or letter must match that provided in Item A(2)a of this application. E. Operational Agreements (For Home/Property Owners' Associations and Developers of lots to be sold): - Home/Property Owners' Associations ❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (HOA 08-13). ❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws. Developers of lots to be sold ❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (DEV 08-13). Even if the project may be turned over to a municipality upon completion, Form DEV 01-12 is required, INSTRUCTIONS FOR APPLICATION FTA 08-13 & SUPPORTING DOCUMENTATION Page 1 of 6 F. Downstream Sewer, WWTF Capacity and Flow Tracking/Acceptance Form (FTSE 08-13) M Submit the completed and appropriately executed Flow Tracking/Acceptance for Sewer Extension Permit (FTSE 08-13) Form for all applications. Al The applicant (and owners of downstream sewers, pump stations and/or treatment facilities submitting form FTSE 08-13 certifies that the addition of the volume of wastewater to be permitted in this project has been evaluated along the route to the receiving treatment plant, and that the flow from this project will not cause capacity related sanitary sewer overflows or overburden any downstream pump station en route to the receiving wastewater treatment plant. y Where the applicant is not the owner of the downstream sewer, submit two copies of form FTSE 08-13 from the owner of the downstream sewer and owner of the WWTF, if different. The flow acceptance indicated in form FTSE 08-13 must not expire prior to permit issuance and must be dated less than one year prior to the application date. Submittal of this application and form FTSE 08-13 indicates that owner has adequate capacity and will not violate G.S. 143-215.67(a). Intergovernmental agreements or other contracts will not be accepted in lieu of a project - specific FTSE 08-13. G. Site Map (All Application Packages): ® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area and closest surface waters. Each map must include at a minimum: 10, The location of the sewer line and pump stations and be of reproducible quality. Downstream connection points and the permit number for the receiving sewer (if known) Pump Station Locations and the longitude and latitude for each pump station (if applicable) ® Include a street level map showing all relevant project areas. H. Stream Classification (WSCAS 08-13) ❑ Submit the completed and appropriately executed Watershed Classification Attachment form (WSCAS 08-13) if any portion of the sewer system project is within 100 feet of any surface water or wetlands. ➢ A variance must be requested for encroachment within required setbacks or buffers pursuant to NCAC 02T .0305(f) Environmental Assessments (Projects subject to an Environmental Assessment (EA)): Projects involving an Environmental Assessment per 15A NCAC 01 C .0408, must be submitted for a full technical review and must be submitted to the PERCS Unit on application forms provided by the Division. Alternative Sewer Systems Projects involving low pressure sewer systems, vacuum sewer systems and other alternative sewer systems must be submitted for a full technical review and must be submitted to the PERCS Unit on application forms provided by the Division. K. Flow Direction Many wastewater treatment systems are entering into agreements for regionalization efforts and emergency treatment capacity. Parts of the system are installed so that the wastewater flow can be directed to more than one treatment facility. If this is the case with the project, please indicate in B(12) and give the permit number of the second facility. Certifications — Section C The application must be certified by both the applicant and the design engineer who is a North Carolina Registered Professional Engineer (PE). The applicant signature must match the signing official listed in Item A(1 b). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC Chapter 2T, The Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project. INSTRUCTIONS FOR APPLICATION FTA 08-13 & SUPPORTING DOCUMENTATION Page 2 of 6 USE THE TAB KEY TO MOVE FROM FIELD TO FIELD Application Number: • (to be completed by DVNR) Z _0 H Q 0 LL Z Z 0 H Q U_ J a a i Z 0 H Q 0 LL Z F— W tl ii 1. Owner/Permittee: 1 a. HOKE COUNTY Full Legal Name (company, municipality, HOA, utility, etc.) 1 b. Letitia Edens, County Manager Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials) 1 c. The legal entity who will own this system is: ❑ Individual ❑ Federal ❑ Municipality ® State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify): 1 d. P.O. Box 240 le. Raeford Mailing Address 1f. NC State 1 h. 910-848-0385 1g City 28376 Zip Code 1 j. Imcbryde@hokecounty.org Telephone Facsimile E-mail 2. Protect (Facility) Information: 2a. Turnberry - Section 2 2b. Hoke Brief Project Name (permit will refer to this name) County Where Project is Located 3. Contact Person: 3a. David A. Matthews, Senior Designer, Moorman, Kizer & Reitzel, Inc. Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. 910-484-5191 3c. davidm@mkrinc.com Phone Number E-mail 1. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.: 1 i. 910-875-2590 2. Owner is ® Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) 2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one ❑ Retaining Ownership (i.e. store, church, single office, etc.) or ❑ Public Utility (Instruction D) ❑ Leasing units (lots, townhomes, etc. - skip to Item B(3)) ❑ Homeowner Assoc./Developer (instruction E) ❑ Selling units (lots, townhomes, etc. - go to Item B(2b)) 3. City of Raeford Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project 4a. City of Raeford WWTP 4b. NCO026514 Name of WWTF WWTF Permit No. 5a. City of Raeford 5b. 18" ® Gravity 5c. W00033891 Modification Owner of Downstream Sewer Receiving Sewer Size ❑ Force Main Permit # of Downstream Sewer (Instruction F) 6. The origin of this wastewater is (check all that apply): ® Residential Subdivision ❑ Retail (Stores, shopping centers) % Domestic/Commercial ❑ Apartments/Condominiums ❑ Institution % Industrial ❑ Mobile Home Park ❑ Hospital ❑ School ❑ Church (Attach Description) ❑ Restaurant ❑ Nursing Home % Other ❑ Office ❑ Other (specify): (Attach Description) 7. Volume of wastewater to be allocated or permitted for this particular project: 36,000 gallons per day *Do not include future flows or previously permitted allocations 8. If the permitted flow is zero, indicate why: ❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line ❑ Flow has already been allocated in Permit No. ❑ Rehabilitation or replacement of existing sewer with no new flow expected (see 15A NCAC 02T .0303 to determine if a permit is required) FTA 08-13 APPLICATION Page 3 of 6 W D Z_ f- Z O U Z O H O U. Z H W a Tie 9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use data in accordance with 15A NCAC 2T .0114 (f). 100 Lots with 3 bedrooms @ 120 gpd per bedroom = 100 x 360 = 36,000 gpd for Turnberry - Section 2. This project will tie into into existing Townsend Creek Interceptor Outfall line. 10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary) Size (inches) 11 Length (feet) New Gravity or Additional Force Main 3,063 New Gravity 11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary) Pump Station Location ID: Longitude: (self chosen - as shown on plans/map for reference) Latitude: Design Flow Operational Point Power Reliability Option (MGD) GPM @TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length 2 - portable generator w/MTS Pump Station Location ID: Longitude: Latitude: (self chosen - as shown on plans/map for reference) Design Flow Operational Point Power Reliability Option (MGD) GPM @TDH 1 -permanent generator w/ATS; Force Main Size Force Main Length 2 - portable generator w/MTS 12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility? ❑ Yes ® No If Yes, permit number of 2"d treatment facility : (RO — if "yes" to B,12 please contact the Central Office PERCS Unit) 13. Does the sewer system comply with the Minimum Design Criteria for the Permitting of Pump Stations and Force Mains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as applicable? ® Yes ❑ No If No, please reference the pertinent minimum design criteria or regulation and indicate why a variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANCE WITH YOUR APPLICATION FTA 08-13 APPLICATION Page 4 of 6 14. Have the following permits/certifications been submitted for approval for the system or project to be served? Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No ® N/A Sedimentation and Erosion Control Plan? ® Yes ❑ No ❑ N/A Trout Buffer Waiver? [--]Yes [:]No ® N/A Stormwater? ® Yes ❑ No ❑ N/A 15. Does this project include any high priority lines (15A NCAC 02T .0402 (2)) involve aerial lines, siphons, or interference manholes)? These lines will be considered high priority and must be checked once every six months Check if Yes: ❑ and provide details: 1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name) 1, Letitia Edens attest that this application for Turnberry - Section 2 has been reviewed by me and is accurate and complete to the best of my knowledge. 1 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. Note: In accordance with North Carolina General Statutes 143-215.6A and 143- 215.6B, any person who knowingly makes any false statement, representation, or certification in any application 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 nirt Official Si y / rS Date ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY' TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER TO 15A NCAC 02T .0305 Z O F' 2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name) Q V I, Jiames M. Kizer, Jr., P.E. attest that this application for Turnberry- Section 2 has OL been reviewed by me and is accurate, complete and consistent with the information in the engineering plans, calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best of my knowledge the W proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer Minimum Design V Criteria for Gravity Sewers adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division Vguidance. 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 NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application 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. 2a. James M. Kizer, Jr., P.E. Professional Engineer Name 2b. Moorman, Kizer & Reitzel, Inc. Engineering Firm 2c. P.O. Box 55374 Mailing Address 2d. Fayetteville 2e City 2g. 910-484-5191 2h. 910-484-0388 2i. .N�i:.A1lJ fr,- NC 2f. 28305 State Zip jkizerjr@mkrinc.com Telephone Facsimile E-mail NC PE Seal, Signature & Date FTA 08-13 APPLICATION Page 5 of 6 THE COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION (ORIGINAL AND COPY) SHALL BE SUBMITTED TO THE APPROPRIATE REGIONAL OFFCF.: REGIONAL OFFICE ADDRESS COUNTIES SERVED Asheville Regional Office 2090 US Highway 70 Avery, Buncombe, Burke, Caldwell, Cherokee, Swannanoa, North Carolina 28778 Clay, Graham, Haywood, Henderson, Jackson, (828) 296-4500 Macon, Madison, McDowell, Mitchell, Polk, (828) 299-7043 Fax Rutherford, Swain, Transylvania, Yancey Fayetteville Regional Office 225 Green Street Suite 714 Anson, Bladen, Cumberland, Harnett, Hoke, Fayetteville, North Carolina 28301-5094 Montgomery, Moore, Robeson, Richmond, (910) 433-3300 Sampson, Scotland (910) 486-0707 Fax Mooresville Regional Office 610 E. Center Avenue, Suite 301 Alexander, Cabarrus, Catawba, Cleveland, Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg, Rowan, (704) 663-1699 Stanly, Union (704) 663-6040 Fax Raleigh Regional Office 1628 Mail Service Center Chatham, Durham, Edgecombe, Franklin, Raleigh, North Carolina 27699-1628 Granville, Halifax, Johnston, Lee, Nash, (919) 791-4200 Northampton, Orange, Person, Vance, Wake, (919) 788-7159 Fax Warren, Wilson Washington Regional Office 943 Washington Square Mall Beaufort, Bertie, Camden, Chowan, Craven, Washington, North Carolina 27889 Currituck, Dare, Gates, Greene, Hertford, Hyde, (252) 946-6481 Jones, Lenoir, Martin, Pamlico, Pasquotank, (252) 975-3716 Fax Perquimans, Pitt, Tyrrell, Washington, Wayne Wilmington Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin, New Wilmington, North Carolina 28405 Hanover, Onslow, Pender (910) 796-7215 (910) 350-2004 Fax Winston-Salem Regional Office 585 Waughtown Street Alamance, Alleghany, Ashe, Caswell, Davidson, Winston-Salem, North Carolina 27107 Davie, Forsyth, Guilford, Rockingham, Randolph, (336) 771-5000 Stokes, Surry, Watauga, Wilkes, Yadkin (336) 771-4630 Fax FTA 08-13 APPLICATION Page 6 of 6 Jp0 0 PK Airpark 0 W r 250 00C BROWN RD 8 Ab I� r Z p AAIERICANA DR a� 4�z rG� 9f In T P � �P EJ fpr� Z �y rrn >p p 9 i T a z � BpHIpLN a n, o ON T DR l.AWRENCE RD RYE LN 165 %6 BUCKEYE DR BEECH OR n A N SCALE 1:24 000 1 0.5 0 KILOMETERS 1 1000 500 C METERS 1000 1 OS C i MILES 1000 0 1000 2000 3000 4000 5000 6000 7000 FEET CONTOUR INTERVAL 10 FEET NORTH AMERICAN VERTICAL DATUM OF 1988 This map was produced to conform with the National Geospatial Program US Topo Product Standard, 2011. A metadata file associated with this product is draft version 0.6.II CORr LN ads ROdSE O Wayside VV JOHNSON MILL RD p t��Ir'v o o, ti ?/i,Q.iRGG .2 WILLA MAE LN Johnsons tRUNIAN DR s Mill x c_ n :e zoo N p c A Z puppy CREEK CIR g N y ARBOR ST 9 0 O op '68 %9 870001mE I 79*07 ROAD CLASSIFICATION Expressway Local Connector CAROLINA ® Secondary Hwy Local Road Ramp. _. 4WD 9 Interstate Route US Route O State Route QUADRANGLE LOCATION Niagara Lobelia Overhills McCain Nicholson CFifdele Creek Wagram Raeford Parhmn NICHOLSON CREEK, NC 2013 ADJOINING 7.5 QUADRANGLES T RECEIVED APR 2 7 2015 State of North Carolina Department of Environment and Natural Resources DWR-FAYETTEMLLE REGIONAL OFFICE Division of Water Resources Division of Water itesom, e, Flow TrackinglAcceptance for Sewer Extension Applications (FTSE 08-13) Project Applicant Name: City of Raeford Project Name for which flow is being requested: Turnberry Subdivision - Section 1 xtio More than one M. E 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. 1. Complete this section only if you are the owner of the wastewater treatment plant. a. WWTP Facility Name: City of Raeford WWTP b. WWTP Facility Permit #: NCO026514 All flows are in MGD c. WWTP facility's permitted flow 3.00 d. Estimated obligated flow not yet tributary to the WWTP 1.07 e. WWTP facility's actual avg. flow 1.93 f. Total flow for this specific request .05184 g. Total actual and obligated flo%vs to the facility 3.04 h. Percent of permitted flow used 16001„ 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: (A) (B) (C) (D)=(B+C) (E)=(A-D) Design Obligated. Pump Average Daily Approx. Not Yet Total Current Station Firm Flow" Current Avg. Tributary Flow Plus (Name or Capacity,* (Firm 1 pf), Daily Flow, Daily Flow. Obligated Available Number) MGD MGD MGD MGD Flow Capacity*** 800 gpd na Kiverbrook � -1111 i 1.063 .05 .02 .07 _ .997 * The Finn Capacity of any purnh station is defined as the maximum hrmped iloiN that can be achieved with the largest pump taken out of service. ** Design Avera;!e Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) not less than 2.5. *** A Planning Asscssment Addendum shall be attached for each pump station located between the project connection point and the WWII' %i here the Available Capacity is <0. Page 1 of 6 l: TS E: 08-13 Ill. Certification Statement: I Dennis Baxley 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 11 plus all attached planning assessment addendurns for which I am the responsible party. Signature of this form indicates acceptance of this wastewater flow. Signing e?ffivial Signature Date Page 2 of 6 FTSE 08-13 April 21, 2015 Mr. Trent Allen NCDENR 225 Green Street Suite 714 Systel Building Fayetteville, NC 28301 Re: Fast -Track Application for Gravity Sewer Mains Turnberry Subdivision — Section 2 Hoke County, NC Dear Mr. Allen, ENGINEERS IWM PLANNERS SURVEYORS MOORMAN, KIZER & REFUEL, INC. 115 Broadbot Ave. P.O. Box 53774 Fayetteville, NC 28305 (910)484-5191 Fax: (910) 484-0388 www.mkrinc.com RECEIVEY APR 2 7 2015 DENR-FAYETTEMLE REGIONAL OFFICE Enclosed is one original and one copy of the Fast -Track Application, check for $480.00 and attachments for gravity sewer mains for the Turnberry — Section 2 Development in Hoke County. This project is located off of US 401 South — Fayetteville Road in Hoke County and is an addition to existing Turnberry Phase I development. The work associated with this section will include gravity sewer infrastructure to serve a total of 100 lots at build out. Project will be build in three (3) section proposed. Section 2, Part 1 will have 51 lots. Section 2, Part 2 will have 29 lots. Section 2, Part 3 will have 20 lots. Flows generated from this development will discharge into existing Raeford WWTP. I would appreciate you reviewing this application as soon as possible and letting me know if you have any questions or need additional information. Please feel free to give me a call or e-mail me at the (910-484-5191) or davidmkmkrinc.com. Sincerely, David A. Matthews, Senior Designer DAM:dam Encl. Cc: Hoke County Utilities Leonard McBryde III, P.E. USE THE TAB KEY TO MOVE FROM FIELD TO FIELD Application Number: (to be completed by DWR) 1. OwneMPennittee: 1a. HOKE COUNTY Full Legal Name (company, municipality, HOA, utility, etc.) --- - ------ Z- O -- ----- - -- _ — - - - --- ----- -- - -- ---- - ---- ---- __. _.... ----- — -_ _ 1 b. Letitia Edens, County Manager Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials) 1 c. The legal entity who will own this system is: Individu 10 Federal Municipality ®State/County ❑ Prorate Partnership Corporation ❑ Other (specify): O 1 d. P.O. Box 240 1e. Raeford LL Mailing Address City '-- Z-- Z - - -- ------ -- - - --- -- -- - _ 1 f. NC 1 g. 28376 Z` State Zip Code .1 h. 910-848-0385 '1 i. 910-875-2590 1 mcbryde@-hokecounty.org _1j. Telephone Facsimile E-mail V 2 Project /Facility) Information: a2a. Tumberry - Section 2 2b. Hoke a - Brief Project Name (permit will refer to this name) County Where Project is Located - .--Coun— her Q 3. Cct ontaPerson: 'Q 3a. David A. Matthews, Senior Designer, Moorman, Kizer & Reitzel, Inc. Name and Affiliation of Someone Who Can Answer Questions About this Application 3b. 910-484-5191 3c. davidm@mkrinc.com Phone Number E-mail 1. Project is ® New ❑ Modification (of an eAsting permit) If Modification, Permit No.: 2. Owner is ® Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) Lin 7&OYD 'R0PER� AND DEVELOPMENT, INC. l P.O. BOX 53630 FAYETTEVILLE, NC 28305-3630 (910) 423-6700 PAY THE SUM OF: "'*Four Hundred Eighty Dollars PAY TO THE ORDER OF: N.C.DEPT.OF ENVIRONMENT&NATURAL RESOURCE CHECK NUMBER: FIDELITY BANK 4612 66-3581531 CHECK DATE: 04/14/2015 CHECK AMOUNT: `"***480.00 4612 f �!" W AUTHORIZED SIGNATUf.�E �9� �� ADES �� 8. If the permitted flow is zero, indicate why: ❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line ❑ Flow has already been allocated in Permit No. ❑ Rehabilitation or replacement of existing sewer with no new flow expected (see 15A NCAC 02T .0303 to determine if a permit is required) FTA 08-13 APPLICATION Page 3 of 6 Central Files: APS _ SWP 5/11/2015 Permit Number WQ0037754 Permit Tracking Slip Program Category Status Project Type Non -discharge Active New Project Permit Type Version Permit Classification Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions 1.00 Individual Primary Reviewer trent.allen Coastal SWRule Permitted Flow 36,000 Facility Permit Contact Affiliation Facility Name Major/Minor Region Turnberry - Section 2 Minor Fayetteville Location Address County Hoke Facility Contact Affiliation Owner Owner Name Owner Type Hoke County Non -Government Owner Affiliation Letitia Edens 227 N Main St Dates/Events Raeford NC 28376 Scheduled Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration 5/11/2015 4/27/2015 5/11/2015 5/11/2015 Regulated Activities Requested /Received Events Wastewater collection Additional information requested Additional information received Outfall Waterbody Name Streamindex Number Current Class Subbasin