WQ0037736_Sewer Extension_20150420

RECENED )ENRAM
USfE THE TAB KEY TO MOVE FR M FI<"L8��O�FIEL Application Number:
- — -- - -- — ------....._._...._.._._......... -........ --- - - - (to be completed by DWR)
1. Owner/Permittee: --��----------_---------- ---- ... .... _ _
1a. Town of Southern Pines OperationsS8ctim
o 0 3 9?3
Full Legal Name (company, murfiQfW,'MUWW1W,%A"
O 1 b. Brent Lockamy PE, Town Engineer
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials)
1c. The legal entity who will own this system is
❑ Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
0 1 d. 140 Memorial Park Court le. Southern Pines
ZMailing
Address
City
1 f.
NC
1 g 28387
Z
State
Zip Code
1 h.
910-692-1983 1 i.
1'. [e-mail]
QTelephone
Facsimile
E-mail
V
2.
Project (Facility) Information
J
2a.
The Pavilion at Morganton Park
2b. MOORE
IL
Brief Project Name (permit will refer to this name)
County Where Project is Located
Q
3.
Contact Person:
-- ......_....... _... _..... --.................................... ............... .. ..............
_............ ...... ........... _........ _... _ ...... .
Q
3a.
Shane Sanders, PE, PLS
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
910-246-0038
3c. [e-mail]
Phone Number
E-mail
1.
Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
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 [I 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))
Z
3.
Moore County
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
Q4a.
Moore County Water Pollution Control Plant 4b. NC-0037508 j
Name of WWTF WWTF Permit No.
5a.
Moore County b. 8" ® Gravity c. NC-0037508 i
LL.....
_.__........._.._.._._..._..._....___...__...---
Owner of Downstream Sewer Receiving Sewer Size ❑ Force Main Permit # of Downstream Sewer (Instruction F)
............................_.................................._........__...__..........._................................__.......:............._................................_.._.............._.................... _.............__................. ............ _................_.....- -- ---....._.----------_.._._....
Z
6.
The origin of this wastewater is (check all that a_pplyl:
H
❑ Residential Subdivision ® Retail Stores, shopping centers 1 100 /o Domestic/Commercial
❑ Apartments/Condominiums ❑ Institution % Industrial
❑ Mobile Home Park ❑ Hospital i
W
❑ School ❑ Church (Attach Description)
IL
® Restaurant ❑ Nursing Home % Other
❑ Office ❑ Other (specify):
m-_.__.._.
—____ ____ __.._ --- .—_ __.__ ._ _.._ ___ .. ___.--- ... ______.___.___._ _ _ ._____._.. _.._.__.(AttadiDescrintion)._
7.
Volume of wastewater to be allocated or permitted for this particular project: 11,160 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. l
❑ Rehabilitation or replacement of existing sewer with no new flow expected
(see 15A NCAC 02T .0303 to determine if a permit is required)
FTA 10-14 APPLICATION Page 4 of 6

LU
Z
9. Rrovide 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).
RESTAURANT FULL SERVICE: 200 SEATS X 40 GAL PER SEAT= 8,000 GPD
STORE WITH OUT FOOD: 6,513 SF X 100GAU1,000SF= 660 GPD
GENERAL BUSINESS: 100 EMPLOYEE X 25 GAL PER EMPLOYEE PER SHIFT= 2,500 GPD
TOTAL 11,160 GPD
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet) New Gravity or Additional
Force Main
8" 844 New Gravity
.............................
11_ Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
0 Pump Station Location ID:
U
Longitude:
Z
Design Flow
Q (MGD)
(self chosen - as shown on plans/map for reference)
Latitude:
.........
Operational Point Power Reliability Option
GPM @TDH 1 -permanent generator w/ATS;
2 - portable generator w/MTS
LL -----
Z Pump Station Location ID:
Longitude:
gM
IX __
W Design Flow
II (MGD)
m
Latitude:
Force Main Size Force Main Length
(self chosen - as shown on plans/map for reference)
Operational Point Power Reliability Option
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?
ElYes ® No If Yes, permit number of 2nd 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, complete and submit the Variance/Alternative Design Request (VADC 10-14) application and supporting
documents for review. Approval of the request is required prior to submittal of the Fast Track Application and
supporting documents.
FTA 10-14 APPLICATION Page 5 of

14..Hpye the following permitslcertifications been submitted for approval for the system or project to be served?
N
Z
O
F=
a
U
H
W
U
A
Wetland/Stream Crossings - General Permit or 401 Certification? [:]Yes ❑ No ® N/A
Sedimentation and Erosion Control Plan? ® Yes ❑ No ❑ N/A
Trout Buffer Waiver?
Stormwater?
❑ Yes ❑ No ® N/A
❑ 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/Pennittee's Certification: (Signature of Signing Official and Project Name)
1, Brent Lockamv. PE attest that this application for The Pavilion at Morganton Park 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 per violation.
la. &�, L;=:K -�// � // 5
Signing Official
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
2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, M. Shane Sanders, PE. PLS ,attest that this application for The Pavilion at Morganton Park 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 accordance with the applicable regulations, Gravity Sewer Minimum Design 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 guidance.
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
425, 000 per violation.
2a
M. Shane Sanders, PE, PLS
Professional Engineer Name
%`'"' ,
._....--
2b
... ._.-....1 1 1 ._._.._...... 1 ............ _.._ .._._.
SNS Engineering, Inc
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_ .. ..... 1 1. . . ,,
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D�9�;y9�
Engineering Firm
; QQ'D
2c.
275 South Bennett Street, Ste. A
= SEAL
Mailing Address
= ', 4 362 9
'� �i3) •�
2d.
Southern Pines
2e. NC 2f. 28387 F� '
�; !yriiNEEQ! lGQ•%
Ci ty
cP,S; ,
Q
State Zip N Np` `
2g.
910-246-0038 2h.
_ E SA ,
2i. [e-mail] 'fill , III''
Telephone Facsimile
E-mail NC PE Seal, Signature & Date
FTA 10-14 APPLICATION Page 6 of 6

a m illy r a — — --
USE THE TAB KEY TO MOVE FRil FI�LU TO EL Application Number:
(to be completed by DWR)
1. Owner/Permittee: -�
------ — —-----..._....-.._.._.._...._...._..... _ ....., _.._.. -
A
RECENED10ENRiDWR
..
ter.. ......r..
....• ff.V
Full Legal Name (company, mu5�-
_
PaYB
1 b.
Brent Lockam PE, Town En ineer
VIlft� R
fficial S
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing o-------------
1 c.
The legal entity who will own this system is:
❑ Individual ❑Federal ®Municipality ❑State/Coin❑
Private Partnership ❑ Co oration ❑ Other specify):
1d.
140 Memorial Park Court
le. Southern Pines
Mailing Address
City
;If.
NC
1g. 28387
State
Zip Code
1 h.
910-692-1983 1 i.
[e-mail]
Telephone Facsimile
.1j.
E-mail
2.
Proiect (Facility) Information:
2a.
The Pavilion at Morganton Park —__ _____ __
2b. MOORE
Brief Project Name (permit will refer to this name)
County Where Project is Located
3.
Contact Person:
3a.
Shane Sanders, PE, PLS —�
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b.
910-246-0038
3c. [e-mail]
Phone Number
E-mail
1.
Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2. Owner is ® Public (skip to Item B(3)) ❑ Private (go to Item 2(a)) I
i
2a. If private, applicant will be: 2b. If sold, facilities owned by a (must choose one
❑ RetainingOwnership
p (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)
! I —I q a1linn i mitt tlntc tnwnhnmac eat( _ en fn Itam R/2h)l
Pavilion at Motganton Park, LLC
PO Box 3340
Fort Mill, SC 29708
PAY . FOUR HUNDRED EIGHTY AND 00/100
N.C. Dept of Enviornment and Natural Resourses
TO THE 1601 Mail Service Center
ORDER Raleigh, NC 27699-1601
OF
MEMO: Sewer
Capital Bank, N.A. 001026
Tega Cay, SC 29708
DATE AMOUNT
02/27/2015 $ 480.00
❑ 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 10-14 APPLICATION Page 4 of 6

State of North Carolina
Department of Environment and Natural Resources
t ' Division of Water Resources
,�J ;K
Division of Water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-13)
Project Applicant Name: Moore County
Project Name for which flow is being requested: Pavilion at Morganton Park
More than one FTSE nary 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: Moore County Water Pollution Control Plant
b. WWTP Facility Permit #: NC 0037508
AUflows lows are in MGD
c. WWTP facility's permitted flow
10
d. Estimated obligated flow not yet tributary to the WWTP 0.4264
e. WWTP facility's actual avg. flow
4.872
f. Total flow for this specific request
0.01116
g. Total actual and obligated flows to the facility
5.30956
h. Percent of permitted flow used
53.0956%
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 / pl), Daily Flow,
Daily Flow, Obligated Available
Number) MGD MGD MGD
MGD Flow Capacity***
--*—The Firm Capacity 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.
*** 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.
Page 1 of 6
FTSE 08-13

II1. Certification Statement:
1, Randy Gould, PE, Public Works Director 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 indicates acceptance of this wastewater flow.
Official
-4:5� --el
51
Date
Page 2 of 6
FI'SE 08-13

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Proposed Sewer of .
rs 1 r Brucewood Road r — W.
r Morganton Road
Id
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S � � 275 S Bennett St, St A
N The Pavilion at Morganton Park
Southern Pines, NC 28387 W E Sewer La out
E N G I N E E R I N G P: [phone] y
Delivering efficient solutions.-. www.snsengineers.com S
3-28-15 1:9,486

• 275 S. Bennett St, Ste .A
S Southern Pines, NC 28387
Phone: [phone]
E N G I N E E R I N G www.snsengineers.com
Delivering efficient solutions... License # C-3791
Project Narrative
The site is an undeveloped 2.89 acre woodland parcel that is being developed as a 6,400 SF full
service restaurant, a 6,513 SF of store retail spaces, and 14,400 SF of General Business on the second
floor. The construction of this project will consist of sanitary sewer improvements. The total requested flow
for the project is 11,160 GPD. Once construction is completed, all Sewer lines will be owned by Town of
Southern Pines and all waste water will flow to Moore County Water Pollution Control Plant; WWTF # NC
0037508.

P '
275 S. Bennett St, Ste .A
Southern Pines, NC 28387
E N G I N E E R I N G
Delivering efficient solutions...
Phone: (910) iW 0038
www. snsengineers. com
License # C-3791
LETTER OF TRANSMITTAL
To: NCDENR
Water Qaulity Section
225 Green Street, Suite 714
Fayetteville, NC 28301
THIS TRANSMISSION INCLUDES:
Plans
Fj
Specifications
Calculations
Comments
Other: See Below
®
THESE ARE TRANSMITTED AS:
Date:
SNS Project #
Project Name:
Delivered Via:
Tracking #:
RECEIVEDA)ENR/DWR
Water Quality Regional
APR 2a, 2�c,1�5
4/17/2015 Operations Section
1412801 Fayetteville Regional once
Pavilion at Morganton Park
USPS
For Review
Re -Submittal For Your Record
® For Approval For Your Use
Qty.
Description
REV. #
2
Sewer Fast Track Application
1
Check $480
2
Flow Tracking Accpetance Form from Moore County
2
Project Narrative
2
USGS color Quad map
Remarks:
M. Shane Sanders, PE, PLS
Transmittal forNCDEN R 4-17-15.doc