WQ0016750_Application_20041021

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FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 1
OF W ATFR D� CC State of North Carolina
R—FRO Department of Environment and Natural Resources
7 OCT Z Z Division of Water Quality
o n1A �p� FAST -TRACK APPLICATION
�f6t� aVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
(Pressure sewers systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included the following list of required application package items by checking the
space provided next to each item. Failure to submit all required items will lead to your application being returned as
incomplete or additional processing and review time. This form may be photocopied for use as an original.
I. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. Any changes to this form will result in the application being returned. The Division of Water Quality
(Division) will only accept application packages that have been fully completed with all applicable items
addressed. You do not need to submit detailed plans and specifications unless you respond NO to Item B(12)
II. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR).
19111. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a
privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN)
which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the
sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities
Commission's Public Staff that states that an application for a franchise has been received, that the service area
is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the
CPCN or letter must match that provided in Item A(2a) of this application.
❑ IV. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if
the sewer extension is permitted by a private applicant and will be serving residential or commercial lots (e.g.,
houses, condominiums, townhomes, outparcels, etc.) that will be sold to another entity. If the applicant is a
homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF
THE PROJECT WILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED.
❑ V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WWTF is different from the applicant,
submit two copies of a flow acceptance letter from the owner of the downstream sewers and WWTF, if different.
Flow acceptance letters must contain the following minimum information: applicant and project name, amount of
flow accepted, and name and permit number of the receiving sewers/WWTF. The flow acceptance must not
expire prior to permit issuance and must be dated less than a year prior to the application date.
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific flow acceptance
letter.
VI. Map — Submit an 8.5-inch by 11-inch COLOR copy of the portion of a 7.5-minute USGS Topographic Map along
with this form. The map should identify the entire project area location as well as the closest downslope surface
waters as clearly as possible. Each map portion must be labeled with the map name and number, the identified
location of the sewer line and pump stations, and be of clear and reproducible quality. For instance, if the project
involves 4 miles of interceptor sewer that traverses over or near several different waterbodies (or counties,
basins, etc.), the map should have location ID's shown for each different waterbody (where the sewer line is within
100 feet of such waterbody - see Instruction VII). This location ID is self chosen and used to cross reference the
location in Section C of the permit application.
VII. Stream Classifications — Section C
• If any portion of the project is within 100 feet of any down slope surface water, Section C must be completed
for the pertinent sections.
• If the entire project area is a minimum of 100 feet away from any down slope surface waters BUT there is a
pump station involved where a history of power outage is to be used to provide adequate design storage
instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that
the closest down slope surface water is Class C (see 15A NCAC 2H .0219(h)(3)(D)).
• Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast -Track
Sewer Systems)" available from http://h2o.enr.state.nc.us/ndpu or by contacting the appropriate regional
office.
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FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2
❑ Vlll. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) [15A NCAC
01 C .0500], this application can not be used. Send the project application on Form PSFMGSA 10/99 to the
Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be
processed until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS) has been
issued. A copy is to be submitted with that permit application.
Yf IX. Certifications — Section D
The application must be certified by both the applicant and 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 2H .0200, the Gravity Sewer Minimum Design Criteria (most
recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains
(most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents
is subject to NC Board referral.
THE COMPLETED FTA 02103 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND $400
FEE, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
Avery, Buncombe, Burke, Caldwell,
2090 US Highway 70
Cherokee, Clay, Graham, Haywood,
Swannanoa, North Carolina 28778
Henderson, Jackson, Macon,
[phone]
Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania,
Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Fayetteville, North Carolina 28301
Anson, Bladen, Cumberland, Harnett,
[phone]
Hoke, Montgomery, Moore, Robeson,
[phone] Fax
Richmond, Sampson, Scotland
Mooresville Regional Office
919 N Main Street
Mooresville, North Carolina 28115
Moor N
Mooresville,
Alexander, Cabarrus, Catawba,
66
Cleveland, Gaston, Iredell, Lincoln,
[phone] Fax
Mecklenburg, Rowan, Stanly, Union
Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe,
Raleigh, North Carolina 27699-1628
Franklin, Granville, Halifax, Johnston,
[phone]
Lee, Nash, Northampton, Orange,
[phone] Fax
Person, Vance, Wake, Warren,
Wilson
Washington Regional Office
Beaufort, Bertie, Camden, Chowan,
943 Washington Square Mall
Craven, Currituck, Dare, Gates,
Washington, North Carolina 27889
Greene, Hertford, Hyde, Jones,
[phone]
Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington,
_
Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus,
Wilmington, North Carolina 28405
Duplin, New Hanover, Onslow,
[phone]
Pender
[phone] Fax
Winston-Salem Regional Office
585 Waughtown Street
Alamance, Alleghany, Ashe, Caswell,
Winston-Salem, North Carolina 27107
Davidson, Davie, Forsyth, Guilford,
[phone]
Rockingham, Randolph, Stokes,
[phone] Fax
Surry, Watauga, Wilkes, Yadkin
For more information, visit our web site at: http://h2o.enr.state.nc.us/ndpu/
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FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number.
(to be completed by DWQ) (, j i V
1. Owner:
1a. Heater itilities Inc.
Full Legal Name (company, municipality, HOA, utility, etc.)
Z
1b. Jerry H. Tweed, Vice President
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Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
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1 c. The legal entity who will own this system is:
Individual Q Federal Murncipaht�/ ❑ State/County [] Private Partnership Corporation ❑Other (sped)-
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1d. 202 Mackenan Court 11e. Car
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Street Address I City ....
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1f. North Carolina 119
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State Zip Code
--- _...__._.._. _..-_.
.__.._....--.... .....- - -.. — -._... _._.... -- --
'1h. 919-467-7854 i. 919-460-1788 1j. .
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Telephone Facsimile E-mail
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2. Project (Facility) lnformation.
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a
_
2a. Woodlake Country Club - Magnolia Lane 2b. Moorpp.
Brief Project Name (permit will refer to this name) County Where Project is Located
1.
3. Contact Person.
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3a. Kevin S. Lindsey. Hobbs.
Name and Affiliation of Someone Who Can Answer Ouestions About this Application
b. 910-692-5616
Phone Number E-mail
1. Project is New ®Modification (of an existing permit) If Modification, Permit No.: W 0016750
For modifications, attach a separate sheet clearly explaining the reason for the modification (i.e. adding another
phase, changing line size4ength, etc.). Only include the modified information in this permit application - do not
duplicate project information in B(7) and B(10-11) that has already been included in the original permit.
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 111)
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Leasing units (lots, townhomes, etc. - skip to Item B(3))
❑ Homeowner AssocJDeveloper (Instruction IV)
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Selling units (lots, townhomes, etc. - go to HemB(2b))
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3, Heater Utilities, Inc.
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
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4a. Woodlake Country Club 4b.
LLName
of WWTF
I WWTF Permit No.
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5a.
b.
15c.
Receiving Sewer Size
Permit Number of Downstream Sewer (if known)
Owner of Downstream Sewer
6. The origin of this wastewater is (check all that apply):
W
❑3e5idential Subdivision ❑ Car Wash
Apartments/Condominiums ❑Institution /00
CL
% Domestic/Commercial
❑ Mobile Home Park ❑ Hospital
❑ School ❑ Church % Industrial
❑ Restaurant ❑ Nursing Home ! % Other (specify):
❑ Office ❑ Other (specify):
I
7. Volume of wastewater to be permitted in this project: /�Aogallons per day
8. If the permitted flow is zero, indicate why:
❑ Interceptor Line - Flow will be permitted is 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
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FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 4
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9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H
.0219(I) for Item 13(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than
that in 15A NCAC 2H .0219(I)(1-2) must be approved prior to submittal of this application. Submit a separate request to
the Division of Water Quality, Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 in
accordance with 15A NCAC 2H .0219(I)(3).
---- - -- --- .... ._....... -- ........ . _. _. _. _... ....
/,2v gad fer bMroom 3 bedroom Per 0n1'1 40 uni'45 = 14 400 Pd
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10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) I Length (feet) Gravity or Force Main
j (use the pull down menu)
__ -- -- - - _----------.�.---- '7 _---.___ �.
aut
.---. . _ _ _ _ _._ ......_._....._
..............
ENTER TIE LEIN ES
MIL LENGTH N TOTAL L
_ - _- ___---_ Ird .
11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
Location ID
(self chosen - as shown on
I —�� ��—
1 Design Flow i Operational Point
�— � Power Reliability Option
(1- dual line feed; 2- permanent generator w/ATS; 3-
plans for cross-reference)
(MGD) GPM ® TDH
portable generator w/telemetry; 4-wet well storage)
.........._ _.. _ .. _
12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
Mai latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable?
es ❑ No If no, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested:
i
I
i
:SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANCE WITH YOUR APPLICATIONI
13. Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings - General Permit or 401 Certification? ❑ Yes ❑ No [�1/A
Sedimentation and Erosion Control Plan? ❑ Yes Ek< ❑ N/A
Stormwater? ❑ Yes ❑ No N/A
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FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 5
1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03
(FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as
necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality
Z ` regional office (see instructions for addresses) OR indicate the following:
__.._.. ..............-__.._ .......- ..._.....
--- _......._.. _..... _._ _......._
❑ A Stream Classification is not needed because all parts of the project are at least 100 feet away from any down slope
Q waterbody, AND
_.
() El A Stream Classification is not needed because the design does not depend on wet well storage as a power reliability
LL option for any pump station near a Class C down slope waterbody.
........ f
F Location ID on Map I
(self chosen - as shown on Name of i Waterbody Stream , Waterbody
J map for cross reference) Waterbody rt _County River Basin _Index Classification
_._.
tDe_Fear
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,
Submit the 8.5" x 11 " COLOR topographic map as required in Instruction VI
regardless of whether a classification is provided!
1. Applicant's Certification:
! 1, SIGNING OFFICIAL NAME, attest that this application for PROJECT NAME
j 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. 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
i as well as civil penalties up to $25,000 per violation.
a.
0/1cf AI
JSiing Offici 'gnatureDate
2. sional Engineer's Certification:
O/attest that this application for has 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 proposed design has been prepared in
Vaccordance with the applicable regulations, Gravity Sewer Minimum Design Criteria for Gravity Sewers adopted i`�-"ruary
_ 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June
LL 1, 2000 and the watershed classification in accordance with Division guidance. Although certain portions of this submittal
package may have been developed by other professionals, inclusion of these materials under my signature and seal
cc signifies that I have reviewed this material and have judged it to be consistent with the proposed design. Note: In
LU accordance with NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement,
0 representation, or certification in any application shall be guilty of a Class 2 misdemeanor which may include a fine not to
Q exceed $10,000 as well as civil penalties up to $25,000 per violation.
Professional Engineer Name
Engineering
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Address
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L
City State ! zip
Telephone Facsimile E-mail
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.,•GIN �
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lip "'Ntells0"
ieal, Siqnature & Date ���

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AMP.
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Name: LOBELIA
Date: 9/8/2004
Scale.- 1 inch equals 1000 feet
it,Odoo VVI ' � I I I I I 1 1 C)790 '1 1-
Location: 035' 14' 17. 0" N 079* 11' 54.3" W
Caption: Sewer for "The Maginolias" at Woodlake
Copyright (C) 1997,

DE -FRO
00. 2 1 2M4
DWQ
HEATER UTILITES PERMIT APPLICATIONS
MAGNOLIA LANE
DUPLEX DEVELOPMENT
PREPARED BY
HOBBS, UPCHURCH & ASSOCIATES, P.A.
300 S.W. BROAD STREET
SOUTHERN PINES, NORTH CAROLINA
JULY 2004

NINE Hobbs, Upchurch & Associates, P.A.
Consulting Engineers
ISO300 S.W. Broad Street • Post Office Box 1737 • Southern Pines, NC 28388
November 19, 2004
NCDENR — Fayetteville Regional Office
Division of Water Quality
225 Green Street, Suite 714
Fayetteville, North Carolina 28301
Re: Magnolia Lane
Sanitary Sewer Improvements
Woodlake Country Club
HUA No. VA0301.320
To Whom It May Concern:
DENR-FRO
OC I 1 1200
DWQ
Please find enclosed the original and one (1) copy of the Fast -Track Application, Flow
Acceptance Letter, Map, Stream Classifications, Certifications, and Design Calculations
for the above referenced project. Also enclosed is the application fee of $400.00.
If you should have any further questions or concerns regarding this information, please
do not hesitate to contact this office.
Sincerely,
HOBBS, UPCHURCH AND ASSOCIATES, P.A.
Kevin S. Lindsay, P.E.
Project Manager
Southern Pines, NC • Telephone [phone] Fax [phone] • e-mail: [e-mail]
Myrtle Beach • Nags Head Raleigh • Charlotte • Beaufort

NORTH CAROLINA
PUBLIC STAFF
UTILITIES COMMISSION
August 4, 2004
Mr. Rudy Shaw
Heater Utilities, Inc.
P.O. Drawer 4889
Cary, NC 27519
RE: Heater Utilities, Inc.
Docket No. W-274, Sub 485
Notification of Contiguous Extension
Magnolia Lane at Woodlake Subdivision, Moore County
TO WHOM IT MAY CONCERN:
The Public Staff has received the notification of intention to begin operations in area
contiguous to present service area to provide water and sewer utility service in Magnolia
Lane at Woodlake Subdivision in Moore County, North Carolina. The Public Staff
anticipates that approval will be granted upon investigation and review of the submitted
application.
Please feel free to call if you have any questions or if I can be of further assistance.
Since ly,
Kenneth E. Rudder, Utilities Engineer
Public Staff - Water Division
c: Ron Brown
Executive Director Communications Economic Research Legal Transportation
733-2435 733-2810 733-2902 733-6110 733-7766
Accounting Consumer Services Electric Natural Gas Water
733-4279 733-9277 733-2267 733-4326 733-5610
4326 Mail Service Center • Raleigh, North Carolina 27699-4326 • Fax [phone]
An Equal Opportunity / Affirmative Action Employer

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! i
Application Number:
(to be completed by DWQ).()��� (e ") SD
1.
Owner.
la.
Heater Utilities, Inc.
Full Legal Name (company, municipality, HOA, utility, etc.)
Z
1b.
Jerry H. Tweed, Vice President
0
-._
Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
..... ._ .... -- --- -- --- __. _ _... .. ...._ _ .. - -- — ---
Q
1 c.
The legal entity who will own this system is:
El Individual ❑ Federal 0 Municipality ❑ State/County 0 Private Partnership ❑ Corporation ❑ Other
C
1d.
202 Mackenan Court
Ile. Cary
0
LL_._...
Street Address
City
--
Z
1f.
North Carolina
19• 27511
Z
State ..
Zip Code
-- - - -- -- - ---- - ----------
0
'1h.
---- - ---------
919-467-7854 li. 919 460-1788
1j• jhtweed@aguaamerira rnm
QTelephone
Facsimile
E-mail
tJ
2.
Project (Facility) Information:
_
a2a.
Woodlake Country Club - Magnolia Lane ?b Moore
p„
7
Brief Project Name (permit will refer to this name)
County Where Project is Located
3.
c ori t*a-- ci Person:
-
Q
3a.
Kevin S. Lindsev. Hobbs- ilnrhttrrh iv Acsnci_a_tes__P_A_
i' PAY
TO THE
ORD OF
FOR
r
C
a
Name and Affiliation of Someone Who Can Answer Questions About this Application
Ish_ 910-692-5616
WOODLAKE PROPERTIES, INC.
PROJECT ACCOUNT
150 WOODLAKE BLVD.
VASS, NC 28394
VASS. NORTH CAHOLI!`NA 28394
The origin of this wastewater is I
❑ P
3es1dential Subdivision
Apartments/Condominiums
❑ Mobile Home Park
❑ School
❑ Restaurant
❑ Office
ICV75
1208
/ ` / — 66-436/531
DATE_' � l � � d l/
- - -- $ qUc_� - a v
40 ca
-- ti
°W
-DOLLARS
("Vh Nr
all that apply):
❑ Car Wash
❑ Institution
❑ Hospital
❑ Church
❑ Nursing Home
❑ Other (specify):
7. Volume of wastewater to be permitted in this project: 14Aogallons per day
100 % Domestic/Commercial
% Industrial
% Other (specify):
8. If the permitted flow is zero, indicate why:
El Interceptor Line - Flow will be permitted is subsequent permits that connect to this line/
[I Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
I -PA